is "oncology" the same as "radiation oncology"?

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pete.

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Hello,

Can someone shed some light for me. (I can't seem to find the search function anymore - maybe someone can help me out with this first - is it gone?)

Anyway... I'm looking for info on Oncology. In the few residency searches I've done, I can't seem to find any information on this medical specialty, unless it is one in the same as Radiation Oncology. Is this the case - do all "oncologists" actually go through a radiation oncology residency?

Also - I'd love to find a resource/link on where I might actually find some description of medical specialties - haven't been able to find one of those either.

Any information appreciated. Thanks for your time.

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Oncology is considered a Medical Specialty, generally completed after an IM residency - you'll find it listed under Fellowships as 'Heme-Onc". Radiation Oncology is a separate entity with its own residency.

I'll move this to Rotations and Residencies for you...
 
Kimberli,

Quick question...do you have to do an IM residency if you want to specialize in oncology or can you do something else, say EM or Family Med? If you don't do IM, does it look bad applying for the Onc fellowship? Thanks!
 
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Kimberli,

While we are on the topic, do you have any info on the relative competitiveness of medical vs. radiation oncology, lenght of residency, lifestyle, etc?
Thanks in advance.
 
A couple answers:

You have to do an internal medicine or pediatrics residency in order to do a hematology / oncology fellowship. That means 3 years residency plus I believe 2-3 years fellowship depending on the program for a total training time of 5-6 years. I have heard that heme/onc is a somewhat competitive fellowship but not as hard as cardiology or gastroenterology. Medical oncologists are the docs who arrange chemotherapy regimens for cancer patients and usually are the coordinator of cancer care (which may involve surgeons and radiation oncologists). Lifestyle varies but they usually make a good income (above 200K) with an OK schedule.

Radiation oncology is a separate residency (and not part of diagnostic radiology either) that is 4 years after a transitional year. There are less than 100 spots each year and the residency is as close to a 9-5 job as you can get. This makes it very competitive. From what I have heard, personal contacts and research play major roles in matching in rad onc. The job itself entails seeing referrals in clinic, arranging the radiation fields (lots of physics and computers, many academic centers have people with masters in physics doing the calculations), and overseeing the progress of the patient on radiation treatment (can have 1 week to 3 months of tx). Rad oncs also do something called brachytherapy which entails inserting catheters into a tumor and inserting radiation emitting devices. Lifestyle is usually great since you are not the primary caretaker of the patient. Again, close to 9-5. Income is as good or better than heme/onc with some making in the 500K range.

Hope this helps.
 
Wow...in my brief foray into looking up some information for you, WBC has done a great job of summarizing the two fields. First off let me say that I am by no means an expert or even very knowledgable about either of these two fields.

As WBC notes, Heme-Onc is one of the more competitive of the IM subspecialties, albeit not nearly as much so as procedural based fields like Gastro. It is generally 3 years (sometimes with an additional lab year) after 3 years of IM or Peds. The following from the AMA web site:

FREIDA Online Specialty Training Statistics Information

Hematology and Oncology (IM)

General Program Information

Academic year
2000
Number of accredited programs
116
Length of accredited training
3
Minimum number of prior years required
3
Offers graduate year 1 positions, available immediately upon medical school completion
No

Application Information

Average number of program year 1 (PY1) applications
79.7
Average number of PY1 interviews
13.7

Residents

Total number of active residents/fellows
855
Average number of residents/fellows
7.4
Average percent female
31.3%
Average percent international medical graduates
50.9%

Faculty

Average number of full-time physician faculty
17.8
Average number of part-time physician faculty
1.0
Average number of volunteer physician faculty
3.3
Average ratio of full-time physician faculty to resident/fellow
2.7

Resident Work Hours (PY1)

Average hours on duty per week
47.7
Average maximum consecutive hours on duty
16.7
Average days off duty per month

Work Environment and Compensation (PY1)

Average percent of training in hospital outpatient clinics
37.9%
Average percent of training in non-hospital ambulatory care community settings
1.2%
Average resident/fellow compensation
$40,119.9

FREIDA Online Physician Workforce Statistics Information

Hematology and Oncology (IM)

Data From Physicians as they Complete a Residency or Fellowship Program

Survey Population

Academic year
1997-1998
Survey period
1998
Response rate (interpret accordingly)
48.2%
No. of resident physicians who reported completing a GME program
94
No. of resident physicians eligible to enter the workforce (excludes those who entered another
program or fulfilled military obligation)
78

Confirmed Employment Status Upon Program Completion

Not employed upon program completion
5.1%
Non-medical career or other plans
14.1%
Academic position
32.1%
Non-academic clinical practice in specialty
47.4%
Non-academic clinical practice in another specialty
1.3%

Work Environment for those Entering Practice in their Specialty

Working less than 30 hours per week
0.0%
Working in a group practice
70.3%
Working in a town with population less than 50,000
13.5%
Working in a different state than where GME took place
56.8%
Experienced significant difficulty finding a preferred position
13.5%
Salary equal or higher than expected
80.0%

Data From Physicians in the Workforce for 2 Years
Survey Population

Academic year
1996-1997
Survey period
1999
Response rate (interpret accordingly)
33.3%
No. of physicians who reported entering the workforce 2 years ago (includes those who fulfilled
military obligations)
57

Current Employment Status

Not employed
2.6%
Administration, non-medical career, or other plans
0.0%
Military position
5.1%
Academic position
43.6%
Non-academic clinical practice
48.7%

Work Environment for those in Academic and
Clinical Practice Positions

Average hours per week spent in patient care
46.6
Employed less than 30 hours per week
0.0%
Working in a group practice
74.3%
Working in a group/staff model HMO
7.1%
Working in a town with population less than 50,000
21.4%
Working in a federally designated underserved area
3.6%

Profile of Impact of Market Forces for those in Academic or
Clinical Practice Positions

Current salary equal or higher than expected
55.6%
Overall satisfaction with current practice arrangement: (1=very unsatisfied, 5=very satisfied)
3.6
Likelihood of changing jobs in the next 2 years: (1 = very unlikely, 5 = very likely)
2.4
Average number of job offers received
6.1
Experienced significant difficulty securing a preferred position
13.2%
Average number of positions held since completing GME (including current position)
1.3

Radiation Oncology is also fairly competitive - definitely better lifestyle (few if ever any emergencies) and pay. Not very many residency programs so it does tend to be a "who ya know" field. A colleague of a friend of mine doing Rad Onc was offered $260K right out of residency with an additional $60K "signing bonus". Not bad - she was apparently going Mercedes shopping that day! :D The same stats from AMA:

FREIDA Online Specialty Training Statistics Information

Radiation Oncology

General Program Information

Academic year
2000
Number of accredited programs
75
Length of accredited training
4
Minimum number of prior years required
1
Offers graduate year 1 positions, available immediately upon medical school completion
No

Application Information

Average number of program year 1 (PY1) applications
69.2
Average number of PY1 interviews
14.0

Residents

Total number of active residents/fellows
411
Average number of residents/fellows
5.5
Average percent female
27.3%
Average percent international medical graduates
23.6%

Faculty

Average number of full-time physician faculty
8.5
Average number of part-time physician faculty
0.4
Average number of volunteer physician faculty
1.8
Average ratio of full-time physician faculty to resident/fellow
1.6

Resident Work Hours (PY1)

Average hours on duty per week
48.8
Average maximum consecutive hours on duty
15.3
Average days off duty per month

Work Environment and Compensation (PY1)

Average percent of training in hospital outpatient clinics
72.6%
Average percent of training in non-hospital ambulatory care community settings
5.1%
Average resident/fellow compensation
$36,419.6

FREIDA Online Physician Workforce Statistics Information

Radiation Oncology

Data From Physicians as they Complete a Residency or Fellowship Program

Survey Population

Academic year
1997-1998
Survey period
1998
Response rate (interpret accordingly)
50.0%
No. of resident physicians who reported completing a GME program
68
No. of resident physicians eligible to enter the workforce (excludes those who entered another
program or fulfilled military obligation)
56

Confirmed Employment Status Upon Program Completion

Not employed upon program completion
1.8%
Non-medical career or other plans
3.6%
Academic position
21.4%
Non-academic clinical practice in specialty
71.4%
Non-academic clinical practice in another specialty
1.8%

Work Environment for those Entering Practice in their Specialty

Working less than 30 hours per week
5.3%
Working in a group practice
76.9%
Working in a town with population less than 50,000
21.1%
Working in a different state than where GME took place
75.0%
Experienced significant difficulty finding a preferred position
30.0%
Salary equal or higher than expected
75.0%

Data From Physicians in the Workforce for 2 Years
Survey Population

Academic year
1996-1997
Survey period
1999
Response rate (interpret accordingly)
43.9%
No. of physicians who reported entering the workforce 2 years ago (includes those who fulfilled
military obligations)
54

Current Employment Status

Not employed
0.0%
Administration, non-medical career, or other plans
0.0%
Military position
0.0%
Academic position
22.0%
Non-academic clinical practice
78.0%

Work Environment for those in Academic and
Clinical Practice Positions

Average hours per week spent in patient care
49.5
Employed less than 30 hours per week
4.0%
Working in a group practice
87.0%
Working in a group/staff model HMO
9.8%
Working in a town with population less than 50,000
11.9%
Working in a federally designated underserved area
5.0%

Profile of Impact of Market Forces for those in Academic or
Clinical Practice Positions

Current salary equal or higher than expected
62.0%
Overall satisfaction with current practice arrangement: (1=very unsatisfied, 5=very satisfied)
3.6
Likelihood of changing jobs in the next 2 years: (1 = very unlikely, 5 = very likely)
2.5
Average number of job offers received
3.4
Experienced significant difficulty securing a preferred position
30.0%
Average number of positions held since completing GME (including current position)
1.4
 
Med-onc & Rad-onc have traditionally been VERY lucrative fields with some med-onc's making up to $1,000,000/yr or more in the 1980's. Like everyone, they have taken their lumps & were just recently targeted by the feds for heavily reduced reimbursements for outpatient chemotx. infusion. As it was explained to me, they make most of their money from the mark-up of chemotherapy drugs with little of their income from procedures or inpatient medicine & they would have been KILLED by the bill which was passed after the government balked at the 2-10X markup that was being passed along by the oncologists on the drugs. After a lot of lobbying, they succesfully bought a stay of execution, but the real possibility of massive pay cuts is looming for the field the way it has traditionally been structured.

Rad-onc has also taken hits apparently from their hey-day but it still is a field with low #'s of providers and stable hours.

BTW Kimberli, @ least once during your residency you will have to have someone emergently radiated for acute Superior Vena Cava syndrome from a mediastinal tumor mass so I would read up on it. I've had three people with it myself(you also will get something asked about it on your inservice exam @ some point. Hope you did good on your this year incidentally!)
 
•••quote:•••Originally posted by droliver:

BTW Kimberli, @ least once during your residency you will have to have someone emergently radiated for acute Superior Vena Cava syndrome from a mediastinal tumor mass so I would read up on it. I've had three people with it myself(you also will get something asked about it on your inservice exam @ some point. Hope you did good on your this year incidentally!)•••••Thanks for the information, RIO. I admit I hadn't thought about the example you gave, although it still stands to reason that emergencies in Rad Onc are few.

I have no idea how I did on the ABSITE (we will apparently get our scores discussed during our quarterly evaluation) although rumor has it that I DIDN'T get the worst score here (despite my fears). I'm sure my score was pretty bad - I'd forgotten most of my basic science and didn't study near enough. <img border="0" title="" alt="[Eek!]" src="eek.gif" />
 
Holy Crap!

Thank you all for exceeding my expectations for replies. This has been very helpful.

...btw - what did happen to the 'search' function on SDN??
 
•••quote:•••Originally posted by pete.:
•Holy Crap!

Thank you all for exceeding my expectations for replies. This has been very helpful.

...btw - what did happen to the 'search' function on SDN??•••••Search function has been temporarily disabled for SDN improvements :)

Hopefully when things are running much faster and smoother the search button will reappear :)
 
If one wanted to get into med onc, would they focus on this during the 3 years of Internal Medicine, or does the resident cycle through all subspecialities of medicine?
 
Internal medicine residents rotate through general medicine and all of the subspecialties during their 3 years. Although it depends on the program, some have several months of elective choice in 2nd and 3rd year when they can choose to do more months of a specialty (such as heme/onc). Generally this only adds up to 4-5 months of electives.

On another note, doing research in a field is a great way to not only increase your exposure to it but will also expose you to the oncologists so you can get good letters and connections in the field. This will be beneficial during the fellowhips application process. It can be difficult to do research in residency but may be worthwhile (there are usually some easy months in medicine residencies).
 
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