Advice for Onc Rotations as fresh Intern?

[EEtoPre-Med]

Hello everyone!

I just got my schedule for intern year and it appears I’ll have Onc inpatient as my second month and Onc Clinic as my 3rd month. I’m excited to get some early exposure to the field but also nervous that I will be still a brand new intern (possibly making a few mistakes). Any advice for performing well on the rotation? I also think it would be a good opportunity to meet research mentors but I know that starting research so early in intern year may be difficult as I want to focus on being the best intern possible. Thoughts on how to approach those conversations?
Thanks!

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[CatFactorial]

Inpatient
-Unlikely to meet mentors on this service, attendings are on for a week or two and are more than likely wishing they were back in clinic and/or lab
-Majority of patients will be symptom control related to their therapy or disease. Nausea, pain control, constipation
-Neutropenic fever
-Immunotherapy related adverse events (worth learning)
-You will be calling lots of consults, so this is a good rotation to get decent at this
-YMMV as far as acuity on inpatient onc. Mostly symptom control and stable, can have the occasional patient who is circling the drain and needs hospice hands

Clinic
-More likely to meet mentors if there are particular attendings or clinics you would like to see. Talk to your program/chief about it in advance to get placed where you may want to be
-Pretty variable based on attendings. Again may want to ask your chiefs who are the good ones. Ideally you would be placed in a clinic with minimal note writing and focusing more on your learning.
-Also, if you're looking for broad exposure to onc, I would recommend lung/breast/GU/GI clinics over sarcomas/CUP/zebras. For heme same idea, you'd be better off in a broad-based malignant heme clinic (lymphoma, myeloma, maybe some leukemia) as opposed to a phase 1 person for high risk AMLs

 

[HemeOncHopeful19]

I agree with everything said above which is better than I could’ve written.

I wouldn’t stress about impressing in month 2/3 of intern year, just focus on being an intern and enjoy getting to work around a subspecialty you’re interested in. People will know you’re new and should be understanding as long as you show an interest, read about your patients and work hard.

Honestly in my experience we tend to remember if someone says they want to do Heme/Onc and it’s not like GI/Cards where you might need to suck up to fit in.

 

[gutonc]

Inpatient: Really depends on how the onc wards are setup. We didn't have residents on ours because it was basically just a chemo service and there was 0 learning on it after about day 3. Residents were on onc consults which runs the gamut from working up potential new cancer diagnoses to managing SEs of treatment and disease.

Outpatient: Definitely agree with finding out who the good mentors are and sticking with the "Big 4" in terms of clinics (breast, lung, GU, GI) to get the best exposure. Sure, sarcoma and Phase 1 seem cool, but they're way too niche to give you good exposure and training as an intern (or even a senior resident). And head/neck and CNS get pretty dull fast since there's only so many ways to say "cisplatin" and "temodar".

Pay attention to NCCN guidelines for workup and treatment, but then don't get too hung up on them when your attending heads out to left field on a patient. Knowing the guidelines will help your knowledge base, and impress attendings. Arguing with your attending because she's not following the guidelines (as you understand them) is a good way to get a crappy evaluation.

 

[ecogfive]

I agree with everything said above which is better than I could’ve written.

I wouldn’t stress about impressing in month 2/3 of intern year, just focus on being an intern and enjoy getting to work around a subspecialty you’re interested in. People will know you’re new and should be understanding as long as you show an interest, read about your patients and work hard.

Honestly in my experience we tend to remember if someone says they want to do Heme/Onc and it’s not like GI/Cards where you might need to suck up to fit in.

Thirding.

OP, I had inpatient onc my first month of intern year. To be honest, I thought it was fantastic; at my program, H/O has a reputation for being overwhelming and stressful, but being a new intern is so overwhelming and stressful in itself that I was really no worse off, lol. I was transparent about my ignorance and just tried to absorb as much information as possible. I think it was the right way to go. No one expected me to know ANYTHING about chemo (etc). Saying "Hey, I like this stuff and I'll do my best to learn" carried me a long way.