Objectives Approximately 50% of deaths occur in acute hospitals, and doctors-in-training (DITs) regularly encounter death in many forms and settings. Despite this frequent exposure to death and dying, DITs often feel unprepared and unsupported, leading to significant distress. This study is the first performed to date in Ireland to assess the training and support provided to DITs at Cork University Hospital in managing death and dying and explore the impact of these experiences on their spiritual well-being. Methods A 27-question electronic survey was completed by 130 DITs, gathering information on their training, confidence in managing end-of-life care (EoLC), perceptions of available support and spiritual impacts of death and dying. Results 67% of DITs felt inadequately trained in death and dying, with nearly half lacking confidence in discussing EoLC with patients or families. Additionally, 69% reported inadequate support or debriefing after patient deaths. Most respondents indicated that patient deaths had a personal impact; however, on average, respondents had a moderate sense of spiritual well-being. Conclusions This study highlights the need for improved training and support for DITs in managing death and dying, which could enhance both their overall well-being and the quality of patient care. Further research will expand the survey to other hospitals nationwide.

Non-small-cell lung cancer (NSCLC) accounts for 80%–85% of all lung cancer cases, being the leading cause of cancer-related mortality worldwide. Historically, outcomes for patients with resectable disease have trailed those with other solid organ malignancies. Advances in treatment strategies, particularly in immunotherapy (IO), have revolutionised the landscape of lung cancer care. In resectable NSCLC (rNSCLC), including stage III disease, the integration of immunotherapy is increasingly being explored for its potential to reduce recurrences and improve survival outcomes. Several landmark clinical trials have resulted in regulatory approvals, and the rapid adoption of immunotherapy in the neoadjuvant, perioperative and adjuvant settings. This review will comprehensively examine the evolving role of immunotherapy in rNSCLC, with a focus on trial evidence, mechanisms of action, biomarkers and challenges in clinical implementation. We also discuss its implications for multimodal therapy across neoadjuvant, perioperative and adjuvant settings while highlighting potential future directions and identifying unanswered questions.

High-quality end-of-life care (EoLC) is a critical yet often underemphasised component of oncology care. Several shortcomings in the delivery of EoLC for oncology patients in our centre during the COVID-19 pandemic were identified in our initial 2021 audit. In 2022, we introduced a care of dying patients proforma, an EoLC quality checklist, targeted education and training for staff, and an expanded end-of-life (EoL) committee. This re-audit aimed to review how these changes impacted on the care received by patients in a tertiary cancer centre. A second retrospective re-audit of patients who died between 11 July 2022 and 30 April 2023 was performed to assess quality of EoLC using the Oxford Quality indicators. A total of 72 deaths occurred over the audit period. Quality of EoLC improved significantly when compared to the initial audit (χ² (3, n = 138) = 9.75, p = 0.021). Exploration of patients’ wishes was documented in 48.8% and referral to pastoral care was documented in 68.3%, from 24.2% and 10.6%, respectively. The proportion of patients receiving poor EoLC reduced from 21.2% to 8.3%. Our study demonstrates the benefits of simple interventions, the importance of re-audit, and the role of ongoing interdisciplinary commitment to improving EoLC for our patients.