Heme/Onc Fellowship Application Thread

[onc-guy]

Away for a couple weeks. Just got back from vacation!
I matched at University of Colorado in Denver. I thought it was a grat program and I am eager to start it July 2008.
I am also pretty glad everyone got their best choices....huge names out there!
My sincere thanks to everyone in this forum. I think we did a good job over last season and hopefully we will meet some day in the near future.
All the best.

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[Excited]

Sorry to join so late in the day. This is just to say that I think you all did a great job communicating. I am an IMG on H1 visa, applied to 30 programs, got only one interview and matched there. Just want to encourage all IMGs irrespective of visa to go for it.

 

[abefromann]

Hi,
Is there a disadvantage to doing a med onc fellowship versus heme onc? I like oncology but don't care about heme one bit. Does it make a doc less marketable, or drive down the salary, or commit him/her to an academic life? I realize this may have been posted already but I did a search and can't find it.

 

[gutonc]

Depends on who you ask. It's definitely more common to single-board in academia. If you have no desire for that kind of career, it may be worth the extra 6 mos of pain to do Heme. Having said that, there are many folks out there in private practice who are single-boarded. The overwhelming majority of hem-onc practice is onc (solid and liquid). In our town/region it seems like anything in benign heme that a medicine R2 couldn't handle gets referred to one of the hematologists @ our hospital so you can certainly have a good private practice career w/ only onc boards. As to earning potential I don't think the difference would be huge but the extra 6 mos of training (and lost earning potential) probably isn't that big of a deal either.

FWIW, I'm single boarding but planning for an academic career (ABIM research pathway, Onc only...I'd rather do a fecal disimpaction fellowship than 6 mos of benign heme).

 

[abefromann]

Thanks, brooklyneric. As an aside, do you find that enough of the patient population is put into remission for you to feel good about what you do? Also, do the attendings you work with seem happy or do they get caught up in the potentially macabre work environment? I like oncology but I'm not sure I'm emotionally equipped for it.

 

[signomi]

Then you don't want to join me on my palliative care/hospice fellowship.

I'm still ecstatic 9 days later!

 

[gutonc]

Thanks, brooklyneric. As an aside, do you find that enough of the patient population is put into remission for you to feel good about what you do? Also, do the attendings you work with seem happy or do they get caught up in the potentially macabre work environment? I like oncology but I'm not sure I'm emotionally equipped for it.

I should note (although if you look 3 posts back you'll see it already noted) that I just matched 2 weeks ago so, although I have some experience in clinical oncology, it's limited to about 14 weeks of rotations as an MS4 and a PGY1. I've yet to follow any patients from diagnosis to cure/relapse/death so maybe I'm not the right person to ask that question of.

As for the personalities of the oncologists I've worked with, the better ones are those who have a sense of humor about the things they deal with on a daily basis but are also able to handle the treatment failures w/ sensitivity and compassion while not being overburdened by it. I hope I can do that myself starting next year (or this year actually as I start my continuity clinic early).

On a side note, one thing that made a difference for me in choosing a place was the type of continuity clinic experience that was offered. Most places had "continuity" clinics where you hung out in Dr. Jones' Breast Cancer clinic 1-2x/wk for 6 months, then went to Dr. Smith's colorectal cancer clinic for 6 mos, etc., etc. In only the best and worst cases would this be continuity. I ended up going with a program that puts you in a clinic w/ your own pt panel on Day 1 and you follow them until cure/death/graduation, whichever comes first. Just something to think about in the future.

 

[docindi1]

Then you don't want to join me on my palliative care/hospice fellowship.

I'm still ecstatic 9 days later!

Signomi, Would a palliative care fellship help in getting into hemonc?. What are the positives and negatives of the fellowship? Are you going into a pain and palliative care program? Do they still consider you for a palliative care felloship if you mention your interest in med onc.?

 

[docindi1]

Hi, Could someone shed light on the benefit of doing a palliative care fellowship and how it might help getting into hemonc.
Thanks

 

[signomi]

Advantages:
Take the boards during that year and apply to onc already ABIM certified (aren't they offering it more than once a year now? May only apply if you take 2+ years off before starting onc).

Experience in acute and chronic pain management/onc emergencies/symptom management/chemo side effects/prognosis/empathy/patient & family angst.

Ability to perform at a higher level than most graduating R3s. Of course I was an attending for 2 years before this, which helped too.

People have more respect for you once you have already completed a fellowship. Trust me, the head honchos do.

Chance to rack up awards for teaching, etc.

I'm still able to moonlight at my job as an attending in hospital medicine while doing this fellowship.

Experience with onc patient after onc patient after onc patient after.....

Chance for more research and presentations.

People love the idea of double certification in Onc and Pall Medicine

Do the fellowship at the place you want to do onc...let them see you.

98% of people love hospice docs and think they must be the best most compassionate docs ever and "I could never do your job!" (The other 2% think "hospice killed my momma!" No honey, smoking did.)

Baby boomers must die someday...cert in PCM is only going to get more valuable over time.

The Pall Med team never misses lunch. Not ever. Not no how.


Disadvantages:
1-2 more years of your life. But if you can't land an onc spot as it is now, what have you got to lose?

Death, death and more death.

Some sad and angry people.

Harder to fit in onc interviews during a fellowship (I have two months of elective and 4 weeks vacation, so it is doable).


That's what I can come up with right now. Of course I am only one week in at this point. Go to a non-malignant program if you do decide to do it. This aint your cards fellowship baby! Much much much easier.
Every place I interviewed for onc and heme-onc brought it up and thought it was a plus, and I hadn't even started yet! I got my top choice this year, so I am thrilled.

Did I mention death?

 

[docindi1]

Advantages:
Take the boards during that year and apply to onc already ABIM certified (aren't they offering it more than once a year now? May only apply if you take 2+ years off before starting onc).

Experience in acute and chronic pain management/onc emergencies/symptom management/chemo side effects/prognosis/empathy/patient & family angst.

Ability to perform at a higher level than most graduating R3s. Of course I was an attending for 2 years before this, which helped too.

People have more respect for you once you have already completed a fellowship. Trust me, the head honchos do.

Chance to rack up awards for teaching, etc.

I'm still able to moonlight at my job as an attending in hospital medicine while doing this fellowship.

Experience with onc patient after onc patient after onc patient after.....

Chance for more research and presentations.

People love the idea of double certification in Onc and Pall Medicine

Do the fellowship at the place you want to do onc...let them see you.

98% of people love hospice docs and think they must be the best most compassionate docs ever and "I could never do your job!" (The other 2% think "hospice killed my momma!" No honey, smoking did.)

Baby boomers must die someday...cert in PCM is only going to get more valuable over time.

The Pall Med team never misses lunch. Not ever. Not no how.


Disadvantages:
1-2 more years of your life. But if you can't land an onc spot as it is now, what have you got to lose?

Death, death and more death.

Some sad and angry people.

Harder to fit in onc interviews during a fellowship (I have two months of elective and 4 weeks vacation, so it is doable).


That's what I can come up with right now. Of course I am only one week in at this point. Go to a non-malignant program if you do decide to do it. This aint your cards fellowship baby! Much much much easier.
Every place I interviewed for onc and heme-onc brought it up and thought it was a plus, and I hadn't even started yet! I got my top choice this year, so I am thrilled.

Did I mention death?

Thanks Signomi, good input. Congrats again upon matching at your top choice.
Again I hope the fellowship makes a difference getting interviews as was the problem for this match.The rest of my resume will be the unchanged except for some publications this year? I might get more current letters considering hemonc being a weak aspect of my residency program, with the only attending I had known, been replaced by god knows who.
Non Malignant? Which ones? Please specify.

 

[chennai]

Hi All
I am new to this forum. I am planning to apply for Hem Onc fellowship in this yr esp in CA and texas. I have reviewed few programs both in CA& Texas. Do you guys have any idea about Baylor or UT San Antonio fellowship programs in Texas?. Input appreciated. Thanks.

 

[dennis1118]

Hey all,

Quick question to those who have applied via ERAS in the past:
I've got a pretty good application going into this upcoming match. My big possible weakness: my MSPE.

Do most programs require your MSPE via ERAS? I noticed that some programs don't (including my home program). I intend to apply all over. Any ideas as to what percentage of programs will be asking for this?

 

[gutonc]

Hey all,

Quick question to those who have applied via ERAS in the past:
I've got a pretty good application going into this upcoming match. My big possible weakness: my MSPE.

Do most programs require your MSPE via ERAS? I noticed that some programs don't (including my home program). I intend to apply all over. Any ideas as to what percentage of programs will be asking for this?

10/10 places I applied to wanted it. Some places obviously don't and some people (FMGs in particular) don't have one and programs recognize this and will find a way to get around it.

 

[MNOnc]

I was told by a few programs, BID in particular, that the MSPE was necessary for the application.

 

[happybob]

just want to congratulate everyone who matched this year again! heard recently from a heme-onc fellow (who was told by heme-onc attendings involved with the fellowship application) that it was extremely difficult to get a heme-onc spot during this past match. supposedly the number of applicants tripled last year due to the ERAS/Match effect, but this year the number went up even further. A lot of programs were getting 300-400 applicants. this resulted in the highest number ever of applicants who couldn't get a spot.

not sure if anyone else has heard something similar from heme-onc program directors. but based on what i know, 6 people from my residency program applied to heme-onc last year, and 5 out of 6 matched. this year again 5-6 people applied, and only one person matched. also heard from a friend at a decent residency program on the east coast that a lot of people in her program didn't match in heme-onc this year.

no idea why heme-onc is all of sudden becoming more popular now despite chemo reimbursement getting lower and lower.

 

[ITP123]

I agree happyboy. This year was very competitive as I spoke with several prestigous attendings at famous NYC institutions who told me that many places had applicants almost qualified to start as attendings! Certain programs would not even take someone with stellar recommendations without publications or SIGNIFICANT research. It is not an insult to anyone who did not match by any means. In a process where 400-600 applications and let's say 50-90 interviews are supposed to narrow down to 4-12 spots it is no wonder how easy it is not to match and still be an oustanding doctor. Its a numbers game and location game. If you willing to move all over the country people match, but even that its not guaranteed. Your comments are dead on.

itp123

 

[ITP123]

I forgot to answer your question why is heme/onc so popular. Its simple really; ALL MEDICAL SPECIALTIES or atleast the more lucrative (GI, cards, Heme/onc are top 3 salary positions) because medical school debt is rising and no one wants to bother with the countless hours of reimbursement rejections, phone calls and colds/work physicals that internists do. Internists are outsanding doctors( most of them) but the field is not as sexy as the specialty fields. And besids heme/onc is the most interesting field without question! WE have tons of molecular and targeted and gene based therapies on the horizon!

itp123

 

[carrigallen]

no one wants to bother with the countless hours of reimbursement rejections, phone calls.....that internists do

Hmmm I think onc, as with most medical specialities, has its fair share of paperwork and phone calls. I agree with all your reasons listed, except for perhaps that one.

 

[interestedinonc]

hello everyone!

does anyone have a list of programs they consider "more clinically oriented?"
Doesn't have to be a big name program- I'll probably be looking all over the US- so any location would be really helpful- thanks

 

[gutonc]

hello everyone!

does anyone have a list of programs they consider "more clinically oriented?"
Doesn't have to be a big name program- I'll probably be looking all over the US- so any location would be really helpful- thanks

Pretty much any community program or university based program that you've never heard of until you looked in ERAS (my med school alma mater fits the latter category) will be a good place for more clinically oriented training. Most of the big names are more research oriented, many of them somewhat to the detriment of clinical training. I've mentioned this before and this will cement my blacklisting there but, although they swear up and down that they would never stoop so low as to train someone who - heaven forefend - would want to be a community/private practice oncologist, NYU probably has the best overall clinical training you can imagine. 1 year of heme (most to all of it benign) and one year of onc then a 3rd research year. Most other academic places will want at least 1 1/2 yrs of lab time from you. Sorry I don't have more specific info for you.

 

[king of scut]

from the interview trail 2 years ago - i think scripps green in san diego had one of the best clinical training programs - they said 80-90% of their pt load was outpatient, even doing outpt bmt . other strong, lesser known programs that were clinically oriented- george washington (it seemed like they made you a junior partner when you came on) and U maryland, but a lot of UM's clinical training comes in the form of their active BMT program.
i think the generalization that the big academic programs focus on research is correct. by clinical training i am assuming you mean bread and butter clinical oncology, 'cause if you want clinical trial training, come to the NCI - protocol, protocol, protocol

 

[mshheaddoc]

I've opened part 2 of this thread for the 2007-2008 cycle discussion here We close threads once they reach 1000 posts. I tried to keep everything from this cycle together.