General Medicine Training

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mnf1985

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Hi folks,

I am curious to see how many of you simply enjoyed internal medicine in general, started residency uncertain of what specialty, if any, you would pursue, and later decided to do a fellowship in med onc vs those who knew in medical school that they would pursue medical oncology. I am fairly certain that I will not feel as fulfilled if I do not treat cancer patients. I have really enjoyed rotating in med-onc and participating in clinical research, but the idea of purgatory for three years of general internal medicine bums me out a little - not that I find it repulsive, but its not the end point. I was told by one specialist in a different field "its great you want to be a specialist within internal medicine, but to be a great specialist you must also be a great internist". Do you agree this holds true for med onc? Fire away.

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In a general sense, yes it's important to be a good internist to become a good oncologist. I think the reason we are supposed to go through internal medicine before Heme/Onc (or for that matter, any sub specialty) is so that we learn to look at the big picture and the patient first rather than only the disease. We learn the interplay of different sub specialties with the general medicine service. We learn how other sub specialties think and learn about the thresholds of when to call for consult help.

I always wanted to be an oncologist from early on in my life so i tried channelizing my efforts during internal medicine residency to make sure I learnt general medicine things from an oncologist's perspective.
 
I agree with the specialist in the OP and @indsha008 's points about looking at the big picture. The diseases oncologists treat and the drugs we use can affect every system and knowing that interplay is a key part of the specialty. From radiation to the chest and recognizing the risk of CAD to the immunocompromised infections patients get, I think we need to learn the IM part of things before we can do the hematology/oncology side of things. My two cents.
 
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I entered residency knowing I would apply for heme/onc and overall I still enjoyed the IM training. You are not going to need to manage patients in cardiogenic shock as an oncologist, but you may need to round on inpatients and a strong internist training will definitely be necessary. As a third year resident I am really eager to get on with it and move on to fellowship however.
 
If you like BMT, you have to be a good intensivist.

Internal medicine seems like a grueling experience, but you really do appreciate it at the end.
 
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