How will an 18-month clinical/18-month research heme-onc fellowship impact job prospects

[coolbrite11]

I'm considering a hematology-oncology fellowship program that offers 18 months of clinical training followed by 18 months of research. I'm trying to understand how this structure might affect my job prospects, as I'm considering two potential career paths:

1. Academic position with 80% clinical and 20% research focus
2. Private practice or community-based practice

Some oncologists I've spoken to claim that an 18/18 program won't adequately prepare me for community practice. However, seeing more fellowships moving towards this model makes me question this assertion. I'm particularly interested in how potential employers in community settings view this training structure.To be clear, I'm not asking about the impact of program prestige on private practice opportunities, as I understand that generally has little effect. Instead, I'm specifically concerned about the clinical training duration.Questions:

1. For those in academic settings: How valuable is the extended research time for clinician-educator positions with an 80% clinical focus?
2. For those in private/community practice: Do you consider the 18/18 split as adequate clinical training compared to all-clinical programs? If not, what specific skills or experiences do you feel might be lacking?

---

Members don't see this ad.

 

[HemeOncHopeful19]

Most employed jobs you are going to be interviewing with a nurse manager that has climbed the ladder for 20 years.

They won’t know or care about details of your training as long as you will see X number of patients Y number of days and don’t cause problems.

For PP I probably wouldn’t care about your research but if you like a particular disease type AND our group didn’t already have multiple people doing that disease type AND you wanted to bring trials to the group then it would probably be a plus. I don’t think it would be held against you for PP IMO unless you’re applying to a true sweatshop but it’s on you to learn how to take care of all different types of Onc patients and if you can’t then you might not have a good time.

 

[Ubba]

Even if you do 18 months of research, my understanding is that ACGME regulations universally require at least a half-day of continuity clinic a week. You're not going to be able to just hang out in sweatpants and t-shirts for a year and a half. lf the dynamic is similar in 3 years to how it is now, your prospects will be robust regardless of where you do your training.

 

[gutonc]

When I was interviewing, 18/18 was the standard and the few programs that were 24/12 (at least in top/mid-tier programs) were atypical. Has the environment shifted to 24/12 across the board except for research heavy programs now?

But to answer the question, nobody will care. By the time you get into your last 6-12 months of training, you know what you're going to be doing and any half decent program will let you shift your focus accordingly if necessary.

 

[ShuperNewbie]

Agreed 18/18 is pretty standard. That said, even during your research time you'll have a continuity clinic (I would... presume? Unless something dramatic has changed in the short time I've been out) and you can generally do as much or as little as you want with that continuity time.

 

[gutonc]

Agreed 18/18 is pretty standard. That said, even during your research time you'll have a continuity clinic (I would... presume? Unless something dramatic has changed in the short time I've been out) and you can generally do as much or as little as you want with that continuity time.

I was a Research Pathway fellow and even I had a full clinic day a week during my last year (1.5 during my 2nd year).

 

[TexasMed22]

If you're at a big fancy academic program, but you don't enjoy research, could you just scale back the research during those 18 months and do more (ie 3 days) clinic a week?

 

[MD46]

We had 3 paths after 18 months in:

1. Bench research with the PhD Doc who had grants etc, where you would be expected to publish and go to AACR etc but still have 1 full day clinic or two, half day clinics a week. Less inpatient burden as well.

2. Clinical research with an attending who was PI on various clinical trials and would be expected to again publish something but 2 full clinics a week and more inpatient. Expected to goto ASH ASCO etc

3. Full clinical track: almost 5 days of clinic rotating with different attendings in clinic. Inpatient and BMT coverage along with consult coverage. This is where you would see most volume. Still expect to do some research per ACGME requirements and a Quality improvement project of sorts.

 

[ONC2023]

It’s great you’re thinking about this proactively to keep your job options open. I’m at the tail end of my job search, and no employer asked me about the details of my training program schedule. All of them, however, cared about whether I felt ok doing general heme-onc or had some limitations, and that’s determined not by 18/18 vs 24/12 but rather by whether the program allows you to go to a general clinic or has sufficient time to allow you to rotate in a lot of sub specialist clinics.

In a program like mine, subspecialization is not only encouraged but basically impossible to avoid because the clinics are so finely divided (eg, there’s no leukemia clinic, there’s a CLL vs AML Vs MDS clinic; there’s no GI clinic, there’s gastric vs pancreas vs colon, etc).

 

[HemOncCheng]

It’s great you’re thinking about this proactively to keep your job options open. I’m at the tail end of my job search, and no employer asked me about the details of my training program schedule. All of them, however, cared about whether I felt ok doing general heme-onc or had some limitations, and that’s determined not by 18/18 vs 24/12 but rather by whether the program allows you to go to a general clinic or has sufficient time to allow you to rotate in a lot of sub specialist clinics.

In a program like mine, subspecialization is not only encouraged but basically impossible to avoid because the clinics are so finely divided (eg, there’s no leukemia clinic, there’s a CLL vs AML Vs MDS clinic; there’s no GI clinic, there’s gastric vs pancreas vs colon, etc).

haha, mine is similar, but GI is all together though