ABIM fast track with Radiation Oncology?

[OhBoyRadOnc]

I matched for a PGY2 radiation oncology spot starting July 2016 and am now completing my preliminary year. The problem is I love it! I know that a "fast track" is available with ABIM for hem/onc etc in which you are able to take the IM boards after only 2y of IM training - but I believe this is limited only to IM subspecialties. Does anyone know if it would be possible to do this for radiation oncology? IE - do 2 years of IM and then 4 years of rad onc? I'm guessing not but if I could be IM board certified after two years I would love to stay for an extra year and do that. Of course, I'm guessing my rad onc program wouldn't grant me a year deferral. The reason why I am interested in doing this are 1) to get more medicine training, 2) to be able to work as a hospitalist should finding a job be impossible/difficult. If it would require 3 years (ie 2 more years of training) I'm not as interested at this point. I still am excited about rad onc training, don't get me wrong. Any input would be helpful!

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[ramsesthenice]

I don't think this will work and I don't think you should. I am very glad to hear that you love your intern year. I had a killer intern year but I liked mine more than most people on this site just like you did. However, there are multiple problems.

First, the ABIM will never let anyone sit for boards after only 2 years of training. The heme/onc fast trackers only do 2 years of official medicine but then have at least two more clinical years during their fellowship which are inpatient based care. You don't do enough medicine during your time in rad onc to justify getting enough additional experience to sit for boards.

Second, as you eluded to, your rad onc program matched you to a specific year. Its not as easy as simply asking please let me come a year later.

Last, don't worry so much about the job market now. I know this site makes it sound like the sky is falling but that is largely over blown. It is very true that compared to other specialties it is a very tight market. If you absolutely need to be in a very particular location and its a desirable one then yes, that could certainly be a problem and if you love medicine so much you might want to see if you could find a way to just finish a medicine residency. That wouldn't be that easy though because if your current medicine program offered you a spot to continue on I think that would count as a match violation since you already have a categorical spot in rad onc elsewhere, but I could be wrong. HOWEVER, If you have some flexibility in where you can be then don't worry about that yet. The big majority of graduates each year find good jobs. You matched into rad onc for a reason. Which field do you think would make you happier in your daily life? That should be what you are asking yourself now.

 

[napoleondynamite]

Focus on what you love and do it well. If you love IM, while I think you'd be nuts, consider bailing on radonc and focus on IM. If that doesn't feel right, then abandon the crazy notion of doing both..it really is not necessary. You will find a job. If hell freezes and you don't, locums radonc is a waaay better stop gap than working as a hospitalist. I did that myself, not because I didn't have a job, but because I considered it paid vacation for my family and I to travel to cool spots and do locums.

Even if you do the extra year of IM, you will still forget all of it. A comparison would be to try to think about how much of your undergraduate study you now can call upon..probably not much. After 4 years of intense radonc study, you will lose the IM knowledge and you will almost certainly lose the desire to do IM as well.

Again, I'd go with your heart on what you love and stick to that..but I see no compelling reason to torture yourself with both. I see it as a mistake worth hundreds of thousands of dollars and precious mortal minutes that could be spent doing something much more fun than an IM year later in life. Think of it this way - if you could spend a year doing something, anything you love, would it really be another year of IM training? I understand the appeal from your vantage point of having a backup plan and leaving additional doors open, but agree with Ramses 100% that the sky is not falling..don't over think this. A year of your life is not an insignificant additional sacrifice to put on the alter of medicine..

 

[FreeRT]

There are many rad-oncs who did full IM residencies and even got boarded in IM. (Even some famous rad-oncs who were also former med-oncs) I did 3 years of IM, and although I wouldn't want to do it again, I'm glad I've got a strong clinical background in my rad-onc practice. Many of my colleagues in residency were IM trained before doing rad-onc, and we used that to our advantage by moonlighting on weekends at the VA or other hospitals to make extra money and keep our clinical skills sharp (sometimes, we would even see some of our rad-onc patients getting admitted). I had to pretty much do 2 residencies, as there are no formal IM-RadOnc combined programs currently (although there are some IM-Diagnostic Rad programs). The IM background has opened a lot of leadership opportunities in the hospital where I practice that wouldn't normally be considered for a pure rad-onc.

 

[Gfunk6]

Whatever ancillary benefits there are of doing an IM residency before RO residency, I sincerely believe it is not worth the extra two years of effort, heartache, and pain. Doubly so for a PhD (unless you plan to do research with it).