Community or academic
Before 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 area of expertise, teaching, research? The answer shapes which fellowships fit you best.
Community oncologist
- You want to be a busy clinician, seeing patients most days of the week.
- You enjoy a diverse population and a broad mix of disease: benign hematology, malignant hematology and every kind of solid tumor.
- You want frequent consults and new patients, and to make an impact through the number of people you care for.
- You want to keep everything you learned in fellowship and stay current across all of hem/onc.
- Compensation is often higher.
If this sounds like you, community oncology is a great fit.
Academic hematologist or oncologist
- You see yourself focused on one disease: only lung cancer, only breast, sickle cell disease, myeloma, malignant hematology or transplant.
- You see patients once or twice a week.
- Most of your time goes to writing papers, running trials, reviewing guidelines, giving talks and traveling to meetings.
- Your goal is to move the field forward.
If this sounds like you, an academic career is what you are looking for.
Most careers are not purely one or the other. Many academic oncologists are clinician educators with busy clinics, and many community practices run clinical trials. You can also change course later. Still, knowing your leaning now helps you choose where to train.
How that shapes your program list
- Aiming for academics? Apply to large university programs built to train academic physicians: protected research time, strong mentors in your disease of interest, research training grants and a track record of graduates who land academic jobs.
- Aiming for community practice? Both academic and community programs can train you very well. Community programs are sometimes even busier clinically and show you exactly what community oncology looks like day to day.
- Ask every program where their recent graduates went, how much clinic time fellows have and how research time is structured.
Training beyond fellowship
Some careers add a year or more after hem/onc. Availability varies by institution.
- Blood and marrow transplant and cellular therapy, including CAR T.
- Hospice and palliative medicine.
- Benign or classical hematology, including hemostasis and thrombosis tracks.
- Geriatric oncology.
- Advanced research training, such as an extra research year, a master’s in clinical investigation or a research training grant.
- Focused areas like cancer genetics, cardio-oncology and survivorship.
Where to start exploring
- FREIDA, the AMA database of residency and fellowship programs.
- NRMP for Match rules and the Medical Specialties Matching Program.
- ASCO and ASH trainee resources and career pages.
- ASTCT for transplant and cellular therapy careers.
- Program websites and, most of all, conversations with current fellows.