Training in hem/onc
For residents
Getting started
Give yourself time to decideSome residents walk in on day one knowing they want oncology. That’s great. Many don’t, and that’s fine too. Spend time on the wards, in clinic and on…The timelineInternal medicine residency is three years, and you apply to fellowship at the very start of PGY3. Programs read your application in July of PGY3, so…ElectivesTake every heme/onc rotation and elective your program allows. These months are where faculty get to know you, and they write your letters.
Rotation prep
Hematology consultsBenign hematology consults are detective work. The answer is usually in the trend, the smear and the medication list. Your job is to gather those three…Oncology consultsInpatient oncology consults usually fall into four buckets: a new suspected cancer, a patient on treatment who is now sick, an oncologic emergency, and…BMT and transplant serviceTransplant has its own language and its own calendar. Learn the vocabulary on day one and present every patient by their transplant day.Outpatient oncology clinicClinic is where most oncology happens. The difference between a resident who slows clinic down and one who speeds it up is preparation the night before.Presenting an oncology patientCancer history is a timeline. When you present a patient who has received any treatment for a malignancy, you need every date and every step. “I don’t…Know your drugs, not your trialsAs an internal medicine resident, you are not expected to know a single clinical trial. Not one. That’s the fellow’s job. If you are working on a research…
Research and meetings
Research worth your timeResidency is short. Choose projects that can realistically become an abstract and then a paper before you apply.The abstract calendarMost big oncology meetings follow the same rhythm every year. Plan projects backward from the deadline, not forward from the idea. Each ring runs from the…Working a conferencePresenting your abstract is one goal. The main reason you go is to meet people. Connect, connect and connect.
Career
Community or academicBefore you build a program list, ask yourself where you see yourself in ten years. What matters most to you: compensation, a busy clinical life, a narrow…A week in the lifeTwo sample weeks, to make the difference concrete. Every practice is different, so treat these as illustrations, then ask the oncologists you work with…The applicationOncology is a long career. The habits you build now, including sleep, boundaries and people outside medicine, matter as much as your CV.
For fellows
Fellowship years
Making the most of fellowshipFellowship goes fast. The clinical year feels endless while you are in it, and then suddenly you are signing a contract. The fellows who come out ahead…Research in fellowshipAlmost every fellowship includes research time. What you do with it matters most if you want an academic job, but every fellow benefits from finishing at…
Career paths
Academic, community or something elseAs a resident you picked a fellowship. Now you pick a job, and the choices are wider than the two words academic and community suggest. Start with what…Building an academic careerAn academic job is a contract to do three things: see patients, teach and produce scholarship. How those three are weighted, and who pays for each…Thriving in community oncologyMost cancer patients in the United States are treated in the community. A community oncologist is the specialist for a whole region: breast cancer at 9, a…Generalist or specialistSeparate from academic versus community is a second choice: how broad do you want your practice to be?
The job search
The job search timelineJobs are usually filled months before graduation, and the paperwork after you sign takes longer than most fellows expect. Work backward from your start date.Reading a job offerThe salary is the first number you see and rarely the most important part of the contract. Read every section, ask questions and get the answers in writing.Questions for job interviewsYou are interviewing them as much as they are interviewing you. The best information comes from the oncologists who work there now, and from the ones who…Your first year as an attendingNo one checks your plans anymore. That is the freedom and the weight of the first year. A few habits make it much easier.