Careers in BMT

[mnf1985]

Hi Guys,

I am a med student interested in Oncology, although I am unsure which form this will take (e.g. Hem-Onc, Rad-Onc, Surg). I have done some rotating in BMT and enjoyed it - there was only one other thread posted several years back on BMT so I was hoping to expand on this discussion.

For one, I noticed that (obviously), patients on the transplant service are often extremely ill - not only this, but that my mentor, along with one other physician, were essentially the only attendings covering approximately 30 patients (although they had mid-level provider help out the wazoo). Is this pretty typical for BMT service? Moreover, despite being an ultra-specialist, he was essentially in charge of every aspect of their medical care - anything from adjusting a PPI to anti-anxiety meds to heavy duty immunosuppressants. I was extremely impressed with his attention to detail and general medical knowledge beyond the specific treatment of hematologic malignancy. Again, is this typical, or is this perhaps the style of one individual? Thanks!

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[gutonc]

For a large number of oncology patients, once cancer winds up on their problem list, the PCP checks out for anything other than the meds they'd already prescribed. In the case of BMT patients, the PCPs will close their practice and move out of state before handling any issues. So, yeah, that's pretty typical.

 

[mnf1985]

Thanks Gutonc - I've heard differing things regarding training for BMT - is it becoming increasingly necessary to do additional BMT fellowship training to attain a position in an academic center, or is Hem/Onc at a BMT heavy place sufficient?

 

[gutonc]

I don't hire (or want to be) transplanters so I can't rightly say.

 

[RustBeltOnc]

I agree with gutonc re PCPs and advanced cancer patients.

A transplant fellowship isn't absolutely necessary to become a transplant attending. But consider these scenarios:

1) fellowship at a program that doesn't have transplant (they send you to nearby university for transplant rotation, etc)
2) decide late in fellowship you want to do transplant and they make you do extra training (reasonable, I think)
3) want another year before the tenure clock officially starts.
4) in community practice, decide you want to be transplant/leukemia attending

 

[gutonc]

Agree with RustBeltOnc - If you go to a transplant heavy fellowship and go in saying you want to do transplant, you won't need to do a 4th year. Interestingly, one of the fellows from my program a few years behind me actually transferred as a 3rd year fellow to do the transplant fellowship at MDACC. He won't have to do a 4th year if he doesn't want to (but will probably get roped into it anyway since that's the way programs like that tend to roll).

On a completely unrelated note, despite the hole it left in the call schedule, nobody was sad to see him go.