OMS-3 interested in Heme/Onc vs CCM

[Calizboosted76]

Hey everyone,

I am a 3rd year DO student who is considering applying IM with hopes to go into one of the above listed specialties. I went into medical school thinking I was going to be a surgeon and while that is still on the table, I have really enjoyed my IM rotations and am battling with foregoing my initial dreams of surgery.

My CV as it sits right now has about 3-4 leadership experiences, minimal volunteering while in medical school, 10ish publications, 10 oral presentations, and COMLEX only.

What are some things I can do (aside from making connections) to beef up my application?

I know this is very far out and I may change my mind completely however as it sits right now this is the path that I am tracking and would appreciate any guidance that this forum can supply.

Thank you!

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[Drrrrrr. Celty]

Go to the best IM residency you can. CCM is moderately competitive. PCCM is very competitive.
Hem/Onc is a niche field, but competitive. Hem/Onc loves publications and showing up that you're into it.

 

[Calizboosted76]

Go to the best IM residency you can. CCM is moderately competitive. PCCM is very competitive.
Hem/Onc is a niche field, but competitive. Hem/Onc loves publications and showing up that you're into it.

Yea alot of my publications are in different surgical fields. I will begin reaching out to Heme/Onc docs and seeing if I can get involved.

Anything in particular that I should do for PCCM to become more competitive?

 

[NewYorkDoctors]

Yea alot of my publications are in different surgical fields. I will begin reaching out to Heme/Onc docs and seeing if I can get involved.

Anything in particular that I should do for PCCM to become more competitive?

get to the best IM residency program you can. ideally if it has an in house PCCM program that will be better as you can get involved into scholarly activity more easily. it would be easier getting letters of recc from pulm rotation and MICU rotation attendings as well being able to do scholarly activity whether some case report you can make a poster abstracts into (and ideally into a case report manuscript) or tag along on some fellow projects.

as a med student I would not worry too much about tanking your resume up at the moment unless you have a specific mentor who can hook you up.

Is your avatar Pharoah Atem doing doctor cosplay? if so.... nice....

 

[Señor S]

Strongly advise going to a residency that has both fellowship programs in-house and frequently puts its own residents into those fellowships. You may need to put aside geographic preferences to do this. Target programs that have consistently taken DOs in the past. I don't know enough to say whether COMLEX only will hurt you (is it too late to take Step 2, at least)?

Getting the right type of residency is far and away the most impactful thing you can do at this stage.

 

[Calizboosted76]

get to the best IM residency program you can. ideally if it has an in house PCCM program that will be better as you can get involved into scholarly activity more easily. it would be easier getting letters of recc from pulm rotation and MICU rotation attendings as well being able to do scholarly activity whether some case report you can make a poster abstracts into (and ideally into a case report manuscript) or tag along on some fellow projects.

as a med student I would not worry too much about tanking your resume up at the moment unless you have a specific mentor who can hook you up.

Is your avatar Pharoah Atem doing doctor cosplay? if so.... nice....

I appreciate the response!

Yes it is, nice catch. Not many realize that haha.

 

[Calizboosted76]

Strongly advise going to a residency that has both fellowship programs in-house and frequently puts its own residents into those fellowships. You may need to put aside geographic preferences to do this. Target programs that have consistently taken DOs in the past. I don't know enough to say whether COMLEX only will hurt you (is it too late to take Step 2, at least)?

Getting the right type of residency is far and away the most impactful thing you can do at this stage.

Thank you for the response!

So currently the program I am rotating at for IM doesnt have in house but they have had solid matches for fellowship so far and the PD has told me to apply to their residency because they like me and want me to attend (this would be ideal because I wouldnt have to move for residency). However if it means having a better chance I will broaden my application alot wider.

From what I have seen, Comlex only will only hurt at the programs that would filter me for being a DO anyways.

 

[DrMetal]

Hey everyone,

I am a 3rd year DO student who is considering applying IM with hopes to go into one of the above listed specialties. I went into medical school thinking I was going to be a surgeon and while that is still on the table, I have really enjoyed my IM rotations and am battling with foregoing my initial dreams of surgery.

My CV as it sits right now has about 3-4 leadership experiences, minimal volunteering while in medical school, 10ish publications, 10 oral presentations, and COMLEX only.

What are some things I can do (aside from making connections) to beef up my application?

I know this is very far out and I may change my mind completely however as it sits right now this is the path that I am tracking and would appreciate any guidance that this forum can supply.

Thank you!

Heme/Onc and CCM can be worlds apart (sure end-stage Onc leads to CCM, but that case is no longer Onc). Explore both, but understand their differences.

 

[Calizboosted76]

Heme/Onc and CCM can be worlds apart (sure end-stage Onc leads to CCM, but that case is no longer Onc). Explore both, but understand their differences.

Oh no, I am very aware of both. These are just my interests as of now. I like the acuity and how intricate the ICU is (and like procedures so far) but I also found that I like heme/onc as well.

But yes I am 100% taking into consideration how different they are.

 

[HemeOncHopeful19]

I’ve said it before and I’ll say it again.

“If you can’t decide between Heme/Onc and ICU, then Bone Marrow Transplant is for you.”

-Sun Tzu, The Art of War

 

[aafisahar]

I’ve said it before and I’ll say it again.

“If you can’t decide between Heme/Onc and ICU, then Bone Marrow Transplant is for you.”

-Sun Tzu, The Art of War

Don't forgot the corollary

"heart failure is the worst of both worlds"

 

[HemeOncHopeful19]

Don't forgot the corollary

"heart failure is the worst of both worlds"

Yeah I think that one was So-crates

 

[CCM-MD]

Thank you for the response!

So currently the program I am rotating at for IM doesnt have in house but they have had solid matches for fellowship so far and the PD has told me to apply to their residency because they like me and want me to attend (this would be ideal because I wouldnt have to move for residency). However if it means having a better chance I will broaden my application alot wider.

From what I have seen, Comlex only will only hurt at the programs that would filter me for being a DO anyways.

I don't agree with that and recommend taking Step 2 CK and shooting for a good score. MD programs willing to take a DO will definitely look at those with a strong Step 2CK score more favorably than those who haven't taken it at all. It is hard to compare Comlex and USMLE scores. Only thing you can do right now to maximize your chances for a fellowship position, is to get into the best IM residency.

 

[CCM-MD]

As already mentioned in this thread, going to a program without an in house fellowship in the subspecialty you are interested in will make it substantially more difficult to match that particular subspecialty. This is especially true for competitive fellowships like the ones you are interested in.

 

[Calizboosted76]

I don't agree with that and recommend taking Step 2 CK and shooting for a good score. MD programs willing to take a DO will definitely look at those with a strong Step 2CK score more favorably than those who haven't taken it at all. It is hard to compare Comlex and USMLE scores. Only thing you can do right now to maximize your chances for a fellowship position, is to get into the best IM residency.

As already mentioned in this thread, going to a program without an in house fellowship in the subspecialty you are interested in will make it substantially more difficult to match that particular subspecialty. This is especially true for competitive fellowships like the ones you are interested in.

Thank you for the information! I will definitely take this into consideration. The residency where I have connections and they have asked me to rotate at they have matched residents into PCCM, Cards, and heme/onc. Will this play any role in opening doors for me?

 

[Calizboosted76]

Go to an academic residency program with in-house fellowships. Oncology conferences don't accept case reports (Cardio/GI/PCCM conferences do). If you end up in a community program where no one knows how to do an IRB and options are only case reports, you'll have trouble having onc conference presentable research needed to match heme-onc

Thank you for the info!

What would be some academic programs in Florida?

Miami, UF, FSU?

 

[HemeOncHopeful19]

Thank you for the info!

What would be some academic programs in Florida?

Miami, UF, FSU?

You can find lists of all fellowship programs ERAS 2024 Participating Specialties & Programs and it is broken down by state

 

[CCM-MD]

Thank you for the information! I will definitely take this into consideration. The residency where I have connections and they have asked me to rotate at they have matched residents into PCCM, Cards, and heme/onc. Will this play any role in opening doors for me?

Having a track record is nice but not as good as having in-house fellowships. Your goal should ideally be a university based IM program or a community based one with in-house fellowship programs, AND a track record. You have a good amount of research already, I think if you are able to swing a good CK score and apply widely enough, you should be able to get one of those.

 

[Calizboosted76]

Having a track record is nice but not as good as having in-house fellowships. Your goal should ideally be a university based IM program or a community based one with in-house fellowship programs, AND a track record. You have a good amount of research already, I think if you are able to swing a good CK score and apply widely enough, you should be able to get one of those.

Okay awesome. I appreciate the advice.

So just to clarify, UF has in house fellowships but FSU doesnt have in house. So it would be best to apply to UF and Miami and not FSU

 

[Señor S]

Okay awesome. I appreciate the advice.

So just to clarify, UF has in house fellowships but FSU doesnt have in house. So it would be best to apply to UF and Miami and not FSU

I would apply to all 3, plus any other program in Florida that has both fellowships (both academic and community), all university programs in the Southeast (minus the obvious longshots), plus some outside the Southeast and some community program back-ups. 50 programs applied to would be a good number.

 

[Calizboosted76]

I would apply to all 3, plus any other program in Florida that has both fellowships (both academic and community), all university programs in the Southeast (minus the obvious longshots), plus some outside the Southeast and some community program back-ups. 50 programs applied to would be a good number.

Awesome! Thank you for all the help!

 

[Calizboosted76]

Another question,

Should I be doing more research in those fields I am now interested in? A lot of my research is surgical focus and I dont want to come off as I am applying to IM as a backup to GS. The PD that I have became close with told me to just explain it in my personal statement and cover letter.

 

[diesel2202]

Another question,

Should I be doing more research in those fields I am now interested in? A lot of my research is surgical focus and I dont want to come off as I am applying to IM as a backup to GS. The PD that I have became close with told me to just explain it in my personal statement and cover letter.

You can explain it in your PS. People change their career course and that's understandable. If you can find an interesting project to get involved with now then that's great. Otherwise, just look for opportunities once you start residency.

 

[Calizboosted76]

You can explain it in your PS. People change their career course and that's understandable. If you can find an interesting project to get involved with now then that's great. Otherwise, just look for opportunities once you start residency.

Awesome, thank you!

 

[Calizboosted76]

I'm not familiar with them sorry. As long as they have all the fellowships, go for it

Some community residency programs with IMGs have good fellowship match rates but keep in mind many IMGs have done a lot of research before residency (vs typical US MD/DO grads)

I also wouldn't worry about the field of research at your level. Anything is a + for ERAS purposes

How much is a lot of research would you say?

 

[Calizboosted76]

This is gonna vary based on who you ask. I'm a heme-onc applicant

ASH and ASCO are the major conferences. The more abstracts you get accepted to them the better (and neither accept case reports)

Only 2 out of the 10 were case reports. Would you mind Dming me non-specifics of your CV?

 

[The kitchen sink]

Oh no, I am very aware of both. These are just my interests as of now. I like the acuity and how intricate the ICU is (and like procedures so far) but I also found that I like heme/onc as well.

But yes I am 100% taking into consideration how different they are.

Full disclosure, the ‘intricacies of the ICU’ become old pretty fast. Lots of stuff can become algorithmic.

The manipulation of physiology to counter pathophysiology is what remains fascinating. The rest of the politics of living in a hospital do not. Just be completely aware of what you are getting into. That is why you should 100% do a subspeciality + CCM (PCCM being the most common combo)

Heme/Onc is heavily tailored to outpatient, great income potential, research and pharma opportunities to transition into as well. Some busy inpatient services as well, but nice part is you can turf your sick patients to CCM.

 

[Calizboosted76]

Full disclosure, the ‘intricacies of the ICU’ become old pretty fast. Lots of stuff can become algorithmic.

The manipulation of physiology to counter pathophysiology is what remains fascinating. The rest of the politics of living in a hospital do not. Just be completely aware of what you are getting into. That is why you should 100% do a subspeciality + CCM (PCCM being the most common combo)

Heme/Onc is heavily tailored to outpatient, great income potential, research and pharma opportunities to transition into as well. Some busy inpatient services as well, but nice part is you can turf your sick patients to CCM.

The further I go through rotations the more I find that I enjoy almost everything except being in a primary care clinic 100% of the time. I wish there was just a crystal ball that gave me the answers as to what specialty to focus my sites on.

 

[Drrrrrr. Celty]

The further I go through rotations the more I find that I enjoy almost everything except being in a primary care clinic 100% of the time. I wish there was just a crystal ball that gave me the answers as to what specialty to focus my sites on.

what have you enjoyed so far?
what havent you enjoyed so far?
what would you like in your life to make you feel fulfilled and happy?

 

[Calizboosted76]

what have you enjoyed so far?
what havent you enjoyed so far?
what would you like in your life to make you feel fulfilled and happy?

So far I have really enjoyed: Rushing to a patients room that was crashing (might have just been the adrenaline), Being in the OR (really enjoyed the emergent cases however I liked the quicker cases such as lumpectomy, hysterectomy, SCC removal), Rounding (I enjoyed being in the hospital, it felt calming).

So far I have not enjoyed: Outpatient primary care clinic (it was very slow. Only saw roughly 3-4 patients a day, and that was with the resident.) I didnt love the primary care aspect of refilling medications and doing wellness visits. I could deal with it if it was worked into a focuses specialty like H/O or Cards, but as a specialty on its own I dont think I could do PC.)

So to be happy in my life: I want a few things. I would like to have a decent earning potential so that way I could take care of my spouse and child but also support my parent. I want a specialty that can be inpatient but also have clinic on the side where I could do outpatient procedures if I wanted. I would like to do procedures or surgeries inpatient. I like the thought of having knowledge about everything but also wouldnt mind being specialized. I do have a family as stated above and I would like to be a present parent as well and will sacrifice anything for my child.


So the best practice set up that I have seen thus far and have really enjoyed has been my current rotation. The Physician has clinic Monday, Wednesday, Thursday. On Thursday he does procedures in his clinic. On Tuesday and Friday he does surgeries. He also rounds daily on patients that are admitted. I also dont mind being called in for emergent cases.

I know that I cant have everything and that to make what I want to have career wise work that I will have to sacrifice as well as be very very busy. I am okay with that.

 

[Drrrrrr. Celty]

How much is enough. An actual number helps. Is 200k enough? Then any field is fine. If 400k is enough then you're much more constricted.
How much work is too much. How much call is too much?
Can you do a surgery residency? I don't mean this pejoratively. Just that 20% of Surgery residents don't finish. And a lot probably regret finishing.

Primary care resident clinic is honestly not representative of medicine. But yes, there's something beautiful about a highly scheduled, predictable office without interruptions.

I personally find hospital consults or admissions somewhat jarring because of their irregularity. You can have a day where you are given 10-12 consults and you've got to cancel evening plans. You have days where you have 0 and you go home at 1.

 

[Calizboosted76]

How much is enough. An actual number helps. Is 200k enough? Then any field is fine. If 400k is enough then you're much more constricted.
How much work is too much. How much call is too much?
Can you do a surgery residency? I don't mean this pejoratively. Just that 20% of Surgery residents don't finish. And a lot probably regret finishing.

Primary care resident clinic is honestly not representative of medicine. But yes, there's something beautiful about a highly scheduled, predictable office without interruptions.

I personally find hospital consults or admissions somewhat jarring because of their irregularity. You can have a day where you are given 10-12 consults and you've got to cancel evening plans. You have days where you have 0 and you go home at 1.

I would say net pay of $300k would be enough.

Honestly I am kind of a workaholic so I am okay with 7 on 7 off then clinic days on my off week.

I would say call every 2-3 days would be too much call.

As far as finishing a surgical residency, I believe I could do it but I’m not ignorant enough to say “Oh yea definitely” without actually having rotated with a GS residency.

I did my inpatient medicine rotation as well and enjoyed hospitalist medicine, I just think the pay is low and there wasn’t enough procedures for me.

This has been a real issue I am dealing with because here soon I have to choose what to devote to.

 

[Drrrrrr. Celty]

I would say net pay of $300k would be enough.

Honestly I am kind of a workaholic so I am okay with 7 on 7 off then clinic days on my off week.

I would say call every 2-3 days would be too much call.

As far as finishing a surgical residency, I believe I could do it but I’m not ignorant enough to say “Oh yea definitely” without actually having rotated with a GS residency.

I did my inpatient medicine rotation as well and enjoyed hospitalist medicine, I just think the pay is low and there wasn’t enough procedures for me.

This has been a real issue I am dealing with because here soon I have to choose what to devote to.

300k net is a lot. It's basically ~450k gross.

uhh some people do that. Most hospitalist jobs aren't 1 week on 1 week off. Most firms don't have true nocturnist gigs and rotate folks. So you'll do more like 16-18 shifts a month with 2 nights a lot of time unless you have a pure day job which will pay less.
That being said Clinic on days off means you have to handle the inbasket while doing inpatient. That is a lot of work and stress. You don't want to be admitting pts and being asked to refill lisinopril at 5pm on a friday.

It sounds like you should do EM.

 

[Calizboosted76]

300k net is a lot. It's basically ~450k gross.

uhh some people do that. Most hospitalist jobs aren't 1 week on 1 week off. Most firms don't have true nocturnist gigs and rotate folks. So you'll do more like 16-18 shifts a month with 2 nights a lot of time unless you have a pure day job which will pay less.
That being said Clinic on days off means you have to handle the inbasket while doing inpatient. That is a lot of work and stress. You don't want to be admitting pts and being asked to refill lisinopril at 5pm on a friday.

It sounds like you should do EM.

Yea I am not totally sure that I will enjoy EM. I scribed for a long time and while I enjoyed the ED I dont want that to be my every day. I have a few electives scheduled and I am hoping that I just fall in love with one of them and I get stuck on a specialty.

So far I have interventional cards, PCCM, and another H/O scheduled.

 

[gutonc]

Yea I am not totally sure that I will enjoy EM. I scribed for a long time and while I enjoyed the ED I dont want that to be my every day. I have a few electives scheduled and I am hoping that I just fall in love with one of them and I get stuck on a specialty.

So far I have interventional cards, PCCM, and another H/O scheduled.

Aside from the money aspect, Hem/Onc fills literally none of your criteria except in highly specialized situations, almost all of them in academia (which then ruins the money criterion).

It's almost universally outpatient.
Almost no procedures (most of us only do bone marrow biopsies, and many hem/oncs don't even do them anymore if IR is available).
No emergent anything...at least that you can do anything about.
When you've got a full clinic schedule, rounding on inpatients sucks...and doesn't pay well.

So to be happy in my life: I want a few things. I would like to have a decent earning potential so that way I could take care of my spouse and child but also support my parent. I want a specialty that can be inpatient but also have clinic on the side where I could do outpatient procedures if I wanted. I would like to do procedures or surgeries inpatient. I like the thought of having knowledge about everything but also wouldnt mind being specialized. I do have a family as stated above and I would like to be a present parent as well and will sacrifice anything for my child.

This^

So the best practice set up that I have seen thus far and have really enjoyed has been my current rotation. The Physician has clinic Monday, Wednesday, Thursday. On Thursday he does procedures in his clinic. On Tuesday and Friday he does surgeries. He also rounds daily on patients that are admitted. I also dont mind being called in for emergent cases.

I know that I cant have everything and that to make what I want to have career wise work that I will have to sacrifice as well as be very very busy. I am okay with that.

Honestly I am kind of a workaholic so I am okay with 7 on 7 off then clinic days on my off week.

...and these^^^ are not compatible with each other.

You're going to have to decide if you want to work your a** off, or if you want to be able to spend time with your family. And if you're going to work that hard, you shouldn't do it for less than twice the money you're talking about.

I would say call every 2-3 days would be too much call.

2-3 days a month is too much IMO. But that's just me.

 

[The kitchen sink]

The further I go through rotations the more I find that I enjoy almost everything except being in a primary care clinic 100% of the time. I wish there was just a crystal ball that gave me the answers as to what specialty to focus my sites on.

Procedural specialities reimburse well, hence high salaries. You can’t go wrong with cards, GI, or heme/onc in general.

So far I have really enjoyed: Rushing to a patients room that was crashing (might have just been the adrenaline), Being in the OR (really enjoyed the emergent cases however I liked the quicker cases such as lumpectomy, hysterectomy, SCC removal), Rounding (I enjoyed being in the hospital, it felt calming).

So far I have not enjoyed: Outpatient primary care clinic (it was very slow. Only saw roughly 3-4 patients a day, and that was with the resident.) I didnt love the primary care aspect of refilling medications and doing wellness visits. I could deal with it if it was worked into a focuses specialty like H/O or Cards, but as a specialty on its own I dont think I could do PC.)

So to be happy in my life: I want a few things. I would like to have a decent earning potential so that way I could take care of my spouse and child but also support my parent. I want a specialty that can be inpatient but also have clinic on the side where I could do outpatient procedures if I wanted. I would like to do procedures or surgeries inpatient. I like the thought of having knowledge about everything but also wouldnt mind being specialized. I do have a family as stated above and I would like to be a present parent as well and will sacrifice anything for my child.


So the best practice set up that I have seen thus far and have really enjoyed has been my current rotation. The Physician has clinic Monday, Wednesday, Thursday. On Thursday he does procedures in his clinic. On Tuesday and Friday he does surgeries. He also rounds daily on patients that are admitted. I also dont mind being called in for emergent cases.

I know that I cant have everything and that to make what I want to have career wise work that I will have to sacrifice as well as be very very busy. I am okay with that.

wait how are you getting OR experience and primary clinic clinic experience at the same time? Are we in med student phase rn?

 

[Calizboosted76]

Aside from the money aspect, Hem/Onc fills literally none of your criteria except in highly specialized situations, almost all of them in academia (which then ruins the money criterion).

It's almost universally outpatient.
Almost no procedures (most of us only do bone marrow biopsies, and many hem/oncs don't even do them anymore if IR is available).
No emergent anything...at least that you can do anything about.
When you've got a full clinic schedule, rounding on inpatients sucks...and doesn't pay well.


This^


...and these^^^ are not compatible with each other.

You're going to have to decide if you want to work your a** off, or if you want to be able to spend time with your family. And if you're going to work that hard, you shouldn't do it for less than twice the money you're talking about.

2-3 days a month is too much IMO. But that's just me.

Yea I have a lot to figure out. I know for sure that I want to be a present part of my child's life. However I know neurosurgeons that are active parents so I think that aspect is what you make it.

I am trying to not focus so much on the emergent stuff that I like because I know when I age I may not enjoy then what I do now. I want to set myself up for a fulfilling career. I feel like while H/O may not be the emergent criteria that I like now, it will be fulfilling to me due to personal reasons. I also can deal with death so that side of things will also be okay to me.

 

[Calizboosted76]

Procedural specialities reimburse well, hence high salaries. You can’t go wrong with cards, GI, or heme/onc in general.

wait how are you getting OR experience and primary clinic clinic experience at the same time? Are we in med student phase rn?

Yes the title said OMS-3. I am going through rotations currently and trying to hone in on what I enjoy most because I have to pick a specialty soon to focus my application on.

Edit: I re-read this and it sounded rude but it was not intended to be that way at all.

 

[Calizboosted76]

Aside from the money aspect, Hem/Onc fills literally none of your criteria except in highly specialized situations, almost all of them in academia (which then ruins the money criterion).

It's almost universally outpatient.
Almost no procedures (most of us only do bone marrow biopsies, and many hem/oncs don't even do them anymore if IR is available).
No emergent anything...at least that you can do anything about.
When you've got a full clinic schedule, rounding on inpatients sucks...and doesn't pay well.


This^


...and these^^^ are not compatible with each other.

You're going to have to decide if you want to work your a** off, or if you want to be able to spend time with your family. And if you're going to work that hard, you shouldn't do it for less than twice the money you're talking about.

2-3 days a month is too much IMO. But that's just me.

To add, I enjoyed my outpatient H/O experiences so far. It is very fulfilling being able to be there for the patient population.

 

[rokshana]

I would say net pay of $300k would be enough.

Honestly I am kind of a workaholic so I am okay with 7 on 7 off then clinic days on my off week.

I would say call every 2-3 days would be too much call.

As far as finishing a surgical residency, I believe I could do it but I’m not ignorant enough to say “Oh yea definitely” without actually having rotated with a GS residency.

I did my inpatient medicine rotation as well and enjoyed hospitalist medicine, I just think the pay is low and there wasn’t enough procedures for me.

This has been a real issue I am dealing with because here soon I have to choose what to devote to.

Net pay of $300k… you will have to make closer to $ 450-500k for that.

 

[aafisahar]

Cardiology fills most of those, especially interventional or heart failure.