Heme Onc question

[kronickm]

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I am a long way from fellowships but I have a question.

I currently work in a blood bank/apheresis center. I have a lot of experience with Heme Onc patients (TTP, Leukemics in blast crisis, SCD and many others) and I really like working with them (I think the fact that they are very vulnerable makes it very fulfilling to work with them). My questions are as such.

1. How many of you Heme Oncs went the pathology route and how many went the internal medicine route.

2. How much of your time is spent at the bench looking into a microscope and how much is spent with patients.

All of the physicians I work with are transfusion medicine docs so I don't really get to interact all that much with pure heme oncs.


3. Do most heme oncs go into academic medicine or private practive/community medicine. Is it somehow looked down upon if you do not want to be an academic heme onc?

 

[frenchymmd]

hi, i have no help for you. I just wanted to say thanks for posting the question. I'm curious about heme Onc too.

Hopefully others will respond

 

[gutonc]

I am a long way from fellowships but I have a question.

1. How many of you Heme Oncs went the pathology route and how many went the internal medicine route.

If you want to do hem/onc, you go the medicine route. If you want to do blood banking or heme-path, you go the path route. There are some hospitals (academic) where pathologists do some (US-guided or unguided) biopsies and the bone marrows. Other places, the radiologists do those biopsies and onc folks do the marrows.

2. How much of your time is spent at the bench looking into a microscope and how much is spent with patients.

I'm a resident, matched into onc but not started it yet. I have yet to see a microscope outside of the onc fellows office. None of the attendings I've worked with (University, VA or at Kaiser) spend any time looking in a microscope unless it's with the pathologists.

3. Do most heme oncs go into academic medicine or private practive/community medicine. Is it somehow looked down upon if you do not want to be an academic heme onc?

The short answer to all of your questions here is "yes." Clearly, there are more community oncologists out there than academics. And the vast majority of people are trained in academic fellowships (community fellowships are more common on the east coast and upper midwest, virtually unknown out west). Academic centers will swear up and down that all they do is train academic oncologists and they don't know how people get out in the community. The honest ones will then tell you that 25-75% of their grads go into private practice depending on the program and the year (I interviewed at NW, MSKCC and UCSF among others this year and their rate of grads going to private practice last year was ~50%). There's not much they can really do to keep you from doing one route or the other once you're done. Plenty of people go back and forth too although it's much easier to go from academics to private practice than the other way around (but I know people who have done it).

Hopefully this answers some of your questions.

 

[kronickm]

Academic centers will swear up and down that all they do is train academic oncologists and they don't know how people get out in the community.

This is what I have heard and is why I asked the question. Thanks for the responses

 

[texashemonc]

1. How many of you Heme Oncs went the pathology route and how many went the internal medicine route.

I've never heard of private practice hem/oncs going the pathology route. Everyone I know goes through 3 years of internal medicine residency followed by 3 years of hem/onc fellowship.


2. How much of your time is spent at the bench looking into a microscope and how much is spent with patients.

In private practice, I spend very little time looking into microscope other than looking at CBC smears for new patients either in hospital or office with heme related problems- anemia, thrombocytopenia, leukopenia. So majority of time is with patients.

All of the physicians I work with are transfusion medicine docs so I don't really get to interact all that much with pure heme oncs.


3. Do most heme oncs go into academic medicine or private practive/community medicine. Is it somehow looked down upon if you do not want to be an academic heme onc?

It depends on lifestyle choices- in my fellowship, I could easily worked at big name centers but I'm not a researcher or academician at heart so I chose private practice. Even though there may be a "snob" factor felt by the academicians, I don't really care as I'm too busy taking care of patients!

Now in private practice, many hem/oncs do look down on colleagues who have only done med.oncology fellowship and no heme. So do the 3 years and get properly trained!

 

[Benzo4every1]

the fellowship program at my program is weak on heme and very strong on oncology, even though you will have to be boarded in both after you get out.

 

[crys20]

I'ma med student and not too sure on what the lifestyle of a fellow is like - particularly in heme/onc. Can anyone comment?