Outpatient oncology clinic
Clinic 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.
Prepare every patient the night before
- Diagnosis, stage and biomarkers.
- Current treatment: regimen, line of therapy, cycle and day, date of the last dose.
- Last imaging, and when restaging is due.
- Today’s labs compared with the regimen’s treatment parameters (counts, creatinine, liver tests).
- Pending results, referrals and the open questions from the last note.
The new patient visit
- Build the full oncologic history. Read the pathology report yourself, not just the summary.
- Confirm stage and what staging is still missing.
- Ask about family history. Many patients qualify for germline genetic testing.
- Assess performance status, comorbidities, social support, transportation and work.
- Ask what the patient knows and what matters most to them.
- Present to your attending before the patient hears a treatment plan.
The treatment visit
- Ask about the toxicities that matter for that regimen: neuropathy, diarrhea, rash, mouth sores, fatigue, appetite, weight.
- Grade the toxicities. Grading drives dose holds and reductions.
- Check the labs against the regimen’s parameters. If they don’t meet them, the plan is usually to hold, delay or reduce. Ask your attending.
- For oral cancer drugs, ask about adherence, missed doses and new medications that could interact.
- Leave with a clear plan: treat, hold, dose reduce or restage, and when the next visit and scan are.
Surveillance and survivorship visits
- Know the surveillance schedule for the cancer type: which scans and labs, and how often.
- Ask about late effects of treatment: cardiac, neuropathy, fatigue, fertility, mood, return to work.
- Recurrence fear is common. Ask about it directly.
Communication in clinic
- Ask, tell, ask: find out what the patient knows, share information in small pieces, then check understanding.
- Never share scan results the patient has not heard yet without agreeing on the plan with your attending first.
- Sit down. Silence after bad news is okay.
The work behind the visit
- Coordinate with the infusion nurses and pharmacist. They catch things.
- Learn how prior authorizations and peer-to-peer reviews work. It’s a big part of real practice.
- Write notes the next clinician can use: the timeline at the top, the plan clearly stated.