Neurology vs Oncology

[DOdoc22]

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Hey all,

I am currently a resident in a different specialty. I have decided to switch specialties because of my desire to be more involved in acute care. I am however split as to which specialty I should pursue. I am split between Oncology and Neurology.

Due to recent family health issues, I have become very interested in Oncology. I am prepared to begin from the start with IM and pursue a fellowship. I also like Neurology though as well. I am very interested in brain function and stroke.

My question (if anyone can help) is which of these specialties is better in terms of lifestyle, relationship with patients, and potential future. I already know the salary differences. I feel that either way i go, I will enjoy what I do and am very interested in both. I just need to know how my life will be beyond residency and fellowship, how busy I will be, and how much time I can spend with family. Any help would be appreciated!

 

[typhoonegator]

Neuro-oncology (ta-da!)

Reasonable hours (you would likely have to do some inpatient work, depending on your practice), exposure to clinical trials, and incredible relationships with your patients and their families. You also get the multidisciplinary flavor from working hand-in-hand with rad-onc and neurosurgery.

The biggest downside is you'd have to work at a fairly academic facility in a big city in order to get the volume to support a practice (unless you're willing to do general neurology on the side).

Neurology is a very diverse specialty, ranging from overworked adrenaline junkie neurocritical care types (like me) to movement disorders specialists who spend 90% of their time in a lab writing grants. You can make tons of money doing procedures and working your buns off in a busy clinic, or you can do considerably less.

 

[GopherBrain]

I agree; Neuro-Oncology is the way to go.

You can approach this from either:
1) Neurology residency -> Neuro-Oncology fellowship
or
2) Medicine residency -> Oncology fellowship -> Neuro-Oncology fellowship

The two pathways aren't exactly equivalent, but the implications of the two pathways depend a lot on where you go for fellowship and where you ultimately decide to work.

I'm a Neuro-Oncology fellow these days, and it is a great field.

 

[Amos]

Glad to hear neuro-onc is open to those with neuro training. Where I am at now for prelim rad-onc and neurosurg totally dominate all the onc cases.

The more options moving forward the better.

 

[DOdoc22]

How long is a neuro-oncology fellowship? I've seen 2-3 years and do they all include research?

 

[typhoonegator]

At MGH/BWH/DFCI I believe it is 2 years, with lots of research time. I do know people who have gotten jobs in neuro-onc practices after one year, however, and I also know fellows that stay for a longer time to do more research. Even if you are not particularly research-minded, however, you will still end up involved in research through the myriad clinical trials almost every one of your patients will be enrolled in.

 

[PhakeDoc]

One of my attendings only did a 1-year clinical fellowship (and thus did not do a research year which was available) in neuro-onc at Duke.

 

[BlackFrancis33]

Anybody want to discuss their fellowships or make any recommendations? I am interested in pursuing fellowship training in neuro-onc, want a 2 year fellowship with a clinical emphasis of course with plans of doing some clinical research during that time.

 

[GopherBrain]

Anybody want to discuss their fellowships or make any recommendations? I am interested in pursuing fellowship training in neuro-onc, want a 2 year fellowship with a clinical emphasis of course with plans of doing some clinical research during that time.

Fellowship choice depends on what do you want to do longterm. There are programs that think of neuro-oncology as the treatment of primary brain tumors, with a definite emphasis on gliomas. There are other places where neuro-oncologists see primary brain tumors, meningioma, metastatic disease, primary CNS lymphoma, paraneoplastic disorders, neurocutaneous disorders, spine tumors, so on and so forth...

 

[Throwaway5129]

I agree; Neuro-Oncology is the way to go.

You can approach this from either:
1) Neurology residency -> Neuro-Oncology fellowship
or
2) Medicine residency -> Oncology fellowship -> Neuro-Oncology fellowship

The two pathways aren't exactly equivalent, but the implications of the two pathways depend a lot on where you go for fellowship and where you ultimately decide to work.

I'm a Neuro-Oncology fellow these days, and it is a great field.

Can anyone specify the difference in scope/implications of these two different pathways?

 

[HemeOncHopeful19]

My understanding as an Onc fellow is that the neurology pathway ends in only seeing CNS/Brain tumors. The IM/Onc pathway leads to potentially seeing any and all cancer patients. I’ve not met many people thus far in my (admittedly short) career who willingly choose to do Neuro-Onc from the IM pathway. I feel that most of the attendings I’ve met have been Neuro trained.

Nobody has posted here yet that the actual biggest downside to Neuro-Onc is the patient outcomes in Neuro-Onc. There has also been very little innovation in the past 30-40 years (at least from the medical side) but you never know when the next Gleevec or Keytruda will happen.

Edit: I did not notice that this thread was bumped from 12 years ago but there were not any breakthroughs in those twelve years for example.

 

[Dr Meow]

My understanding as an Onc fellow is that the neurology pathway ends in only seeing CNS/Brain tumors. The IM/Onc pathway leads to potentially seeing any and all cancer patients. I’ve not met many people thus far in my (admittedly short) career who willingly choose to do Neuro-Onc from the IM pathway. I feel that most of the attendings I’ve met have been Neuro trained.

Nobody has posted here yet that the actual biggest downside to Neuro-Onc is the patient outcomes in Neuro-Onc. There has also been very little innovation in the past 30-40 years (at least from the medical side) but you never know when the next Gleevec or Keytruda will happen.

Edit: I did not notice that this thread was bumped from 12 years ago but there were not any breakthroughs in those twelve years for example.

Good point. That's sad to see no progress for so long......