LAUSR

e23009 Background: Systematic reviews show that second opinion consultations in Oncology are frequent (1 – 35%) and differ from initial recommendations by up to 50% (BMJ Open 2021;11:e044033). This study evaluates the variability of second opinions of Oncology Fellows in a Virtual Observational Standard Clinical Examination (V-OSCE 2021) (J Clin Oncol 39, 2021, suppl 15; abstr 11005). Methods: One of the stations of the V-OSCE 2021 included a simulated patient’s relative requesting a second opinion. The patient was a 62-year-old male with advanced lung adenocarcinoma (Mts in lymph nodes, bone and liver) PDL1 3%. All other markers (EGFR, ALK, ROS1 and Her2) were negative. The tumor progressed at first line with standard chemoimmunotherapy (Carboplatin + Pemetrexed + Pembrolizumab). At the time of consultation, the patient had PS2, depression, hepatic progression without evidence of CNS lesions and all laboratory results were normal. Docetaxel had been recommended as a second line of treatment. The case was sent to each Fellow before the examination, and the evaluation consisted of ten standardized prognostic and therapeutic questions. Results: A total of 16 Oncology Fellows were evaluated. Sex Female/Male (11/5) Age: Mean 33 years (r= 30-35). We analyzed the answers to ten standardized questions (Table). Conclusions: A) The Oncology Fellows agreed on only two out of ten answers to the standardized questions (incurability and mental health referral); and in the remaining eight, disagreement is evident. B) Within the first seven questions, all Fellows differed among themselves in at least one answer. C) These findings coincide with our daily practice: It is highly likely that if a patient gets a second opinion, they will get divergent and even contradictory answers about their case. D) Are these findings a product of differing knowledge or physicians’ noises and biases? Further research could address how medical education and professional development can help with reflecting upon these issues.[Table: see text]