Heme onc vs rad onc--lifestyle and practice

[rad_onculous]

I posted this in the allo forum but realized this is probably a better place.

I am choosing between rad onc and heme onc. I have done rotations in both, and have found in many ways they were more similar than different so I am having a hard time deciding between the two. Both have a similar clinical approach (i.e. see the patient, review imaging/studies, determine if they are a candidate for your therapy, and then follow for side effects and response). I would say that I enjoyed hearing about med onc research more and the med oncs seem to have had more flexible long-term careers (changing area of clinical focus over time), so based on subject matter med onc might have a slight advantage, but I have heard rad onc has a better lifestyle hours-wise.

What are the comparative lifestyles of these two fields as attendings? It was really impossible to tell the specifics while on rotation since I did not know what the attendings did when I was not with them, and I was with different attendings every few days. It was also not easy to ask them what the lifestyle is like without looking lazy. I could not tell what the hours of each are. I got the sense that med onc attendings had to come in more in the evening or overnight to admit patients for complications of their cancer or therapy, and that the med oncs had to do 2-3 weeks of inpatient service time per year, which was really busy. Also, most of the med oncs at my institution work 5 days per week but I met some rad oncs that work 3-4 days and are home for one or two days per week (all of these rad oncs had small children, like I hope to have, and physician spouses).

Any insight into med onc vs rad onc call/lifestyle?

---

Members don't see this ad.

 

[stems]

I posted this in the allo forum but realized this is probably a better place.

I am choosing between rad onc and heme onc. I have done rotations in both, and have found in many ways they were more similar than different so I am having a hard time deciding between the two. Both have a similar clinical approach (i.e. see the patient, review imaging/studies, determine if they are a candidate for your therapy, and then follow for side effects and response). I would say that I enjoyed hearing about med onc research more and the med oncs seem to have had more flexible long-term careers (changing area of clinical focus over time), so based on subject matter med onc might have a slight advantage, but I have heard rad onc has a better lifestyle hours-wise.

What are the comparative lifestyles of these two fields as attendings? It was really impossible to tell the specifics while on rotation since I did not know what the attendings did when I was not with them, and I was with different attendings every few days. It was also not easy to ask them what the lifestyle is like without looking lazy. I could not tell what the hours of each are. I got the sense that med onc attendings had to come in more in the evening or overnight to admit patients for complications of their cancer or therapy, and that the med oncs had to do 2-3 weeks of inpatient service time per year, which was really busy. Also, most of the med oncs at my institution work 5 days per week but I met some rad oncs that work 3-4 days and are home for one or two days per week (all of these rad oncs had small children, like I hope to have, and physician spouses).

Any insight into med onc vs rad onc call/lifestyle?

In terms of a lifestyle radonc has more flexibility in terms of limiting the number of hours. I disagree with you in that radonc is very flexible (if not more so than medonc) in terms of career path. A good barometer of lifestyle is the difficulty of getting into the field. Radonc is much more difficult to break into than medonc. As a resident I have never had to leave home after 6pm to see a patient on weekdays (and I'm almost done with residency). There is no overnight call for radonc and all call is home call. But the best part of radonc is all the awesome technology we get to play with

 

[rad_onculous]

In terms of a lifestyle radonc has more flexibility in terms of limiting the number of hours. I disagree with you in that radonc is very flexible (if not more so than medonc) in terms of career path. A good barometer of lifestyle is the difficulty of getting into the field. Radonc is much more difficult to break into than medonc. As a resident I have never had to leave home after 6pm to see a patient on weekdays (and I'm almost done with residency). There is no overnight call for radonc and all call is home call. But the best part of radonc is all the awesome technology we get to play with

Thank you for the specifics here! I know rad onc is tougher to get into than IM and then med onc, but there could be other factors there (e.g. more pay as rad onc which I do not care about and you do not have to go through IM, which some do not like but I again do not mind).

Do you (or anyone else) know what the hours of a med onc are like? How much do you have to come back on a night or weekend as a med onc?

I do like the technology of rad onc but felt that med onc has their own version of "technology" (chemotherapeutics). I found both intellectually exciting and satisfying, which is why the differences in treatment modality don't help me choose between the two.

 

[142348]

Thank you for the specifics here! I know rad onc is tougher to get into than IM and then med onc, but there could be other factors there (e.g. more pay as rad onc which I do not care about and you do not have to go through IM, which some do not like but I again do not mind).

Do you (or anyone else) know what the hours of a med onc are like? How much do you have to come back on a night or weekend as a med onc?

I do like the technology of rad onc but felt that med onc has their own version of "technology" (chemotherapeutics). I found both intellectually exciting and satisfying, which is why the differences in treatment modality don't help me choose between the two.

It depends highly on practice type:

Academics-

For both rad onc and med onc, there aren't as many attendings in on nights and weekends, the exception in my experience being med oncs who focus on pecs, or acute leukemias/transplant. If you are at an academic center with residents you more often than not have residents to cover for you. in terms of work week hours, it depends on what track- clinician, clinician scientists, or basic science but on average they are usually pretty good for both in terms of clinic hours which you make up for in terms of research hours, admin, time, etc.

Private-

Depends on free standing vs. hospital based but in general rad onc is pretty good. You need OPPS coverage so it depends on how busy you are but most practices that means 730-8 AM start and 4-5 finish though if you are busy you run longer, not so much shorter. Tumor boards may be early a few days so that means a bit earlier. In terms of nights/weekends, home call and very rarely called in.

Med Onc much more variable depending on rounding on admissions, tumor boards, call. My med oncs can have long weekends in terms of admissions, management and more night activity.

 

[radiaterMike]

Quality of life is horrible for both if you are not happy with your career choice. I would make an effort to find out which field excites and motivates you most.

 

[Winged Scapula]

Merging with thread in Allo as the OP is a current medical student and it will draw more users there.