oncology fellowship

[titan]

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I have preliminary interests in going into medical oncology. As I understand it you must first do your residency in IM and then do a fellowship in oncology. Am I right in my assumption? If so, is this type of fellowship competitive? Anyone who is experienced in the residency/fellowship requirements of oncologists (preferably all types) and the competiveness of each please tell me what you know. Thanks!

 

[Voxel]

The road to medical oncology is usually through a 3 year internal medicine residency followed by a 3 year hematology/oncology fellowship. That means 6 years of residency training after 4 years of medical school.

It is competitive but not as competitive as cardiology and GI. Competitiveness is also a function of what internal medicine program you were able to match into, how you did there, your letters of recommendation, who you know, and any research you have done while in an internal medicine residency. There are other factors such as location and reputation. Some of the less known in the heme/onc circles, geographically less desirable programs will be less competitive. (obviously).

The last thing you should know is that it is not as popular because you constantly deal with dying patients.

Heme/Onc may seem glorious as a med/pre-med student, but be prepared to deal with terminally ill patients on a daily basis. Try it, before you buy it.

 

[Academic Radiation Oncologist]

Best programs:

Memorial Sloan Kettering, NY
MD Anderson, Texas
Dana-Farber, Harvard
Duke, NC
Yale, CT
U of Minnesota, MN
UCSF, CA
John Hopkins, MD
NCI, MD
U of Wisconsin, WI
U of Washington, WA
Mayo Clinic, MN
Stanford, CA
Princess Margaret Hospital, Toronto, ON 😛

 

[Gregory Gulick]

I too have an interest in hematology/oncology, and from my research I have found that it is hardly competitive at all. I based this on the fact that, according to the AMA, over 50% of the current fellows in training are from medical schools outside the United States. While this is by no means a direct indicator of how competitive a program is, it may very well be suggestive of the competition. If, for example, you look at surgery (very competitive), only 12% of their spots are held by international medical school graduates.

In addition, Isserson's book on residencies gives it one star out of five, where five stars is a very hard residency/fellowship to land.

So it is safe to say that if you are intersted in being an oncologist, you can pretty much plan on doing so. It is a great field. I enjoy working with the population -- the only downside is that when you do new consults in a hospital, your patients are never happy to see you.

Best of luck.

G.

 

[Voxel]

I agree that it may not be as competitive as GI or cardiology, but if he wants to go to a top program, it will be competitive. Try getting a fellowship at Sloan-Kettering or MD-Anderson, you better be top notch. I'm sure you are happy to get a consult and your patients are not. I think we all know why it is not as competitive as cardiology or GI, even though the compensation is similiar.

Iserson's book is outdated in terms of competitiveness. Just look at radiology.

 

[MS05']

Does anyone know of any joint programs where for example you would do a three year IM or peds residency then at the same institution do the three 3 year Hem/Onc fellowship? I know they do this for some surgical residencies..ie do PGY1 in gen. surgery then do the next 6 in your specialty, just wondered if it works the same way for Hem/Onc...thanks.

 

[Voxel]

Yes, they do combined "research" residencies in IM plus their subspecialties. These are usually available at top academic medical centers. A friend from med school is applying to these programs as well as regular IM programs. However, you had better show some real commitment to research. Either MD/PhD or some significant bench research during medical school. Usually you do 2 years of IM+ 3yrs research in the fellowship area+ 2yrs of clinical fellowship. Atleast 7 years from what I hear and you take call during your research years at some places. You should probably look on an internal medicine residency website for the exact details and contact programs directly.

If all you want is to practice clinical medicine, I am not sure this is worth it.

 

[MS05']

Voxel, thanks for the info. I guess what I'm really looking for is something like a program where you do 2 years of IM (or peds) then do 2 or 3 of hem/onc. I don't think I want to do the research, if I did I'd probably take a year or two off and head to the NIH (bet that looks good on a residency application). Anyway, anyone know of any combined programs like the above?

 

[Goofy]

Originally posted by Voxel:
•I agree that it may not be as competitive as GI or cardiology, but if he wants to go to a top program, it will be competitive. Try getting a fellowship at Sloan-Kettering or MD-Anderson, you better be top notch. I'm sure you are happy to get a consult and your patients are not. I think we all know why it is not as competitive as cardiology or GI, even though the compensation is similiar.

Iserson's book is outdated in terms of competitiveness. Just look at radiology.•••


I agree with Voxel about the iserson book. The information is outdated and outmoded. In medicine, this is usually the case if it is older than a year when it comes to residencies and fellowships as trends change very quickly.

I also agree that Heme/Onc is less competitive than GI and Cardiology. That doesn't make it non-competitive though. GI and Cards are arguably the hardest fields in all of medicine to enter when you consider the sheer number of applicants per spot. Heme/Onc is a very competitive field, even in smaller programs. Compensation, lifestyle, procedures, and increasing ability to offer a cure are reasons why interest in this evolving specialty have made it very very competitive. Don't be fooled by using GI and Cardiology, the toughest fields to enter, as a meter.

Another poster cited FMG's in the field. This is a very poor meter as well. What might be said of IM residencies isn't necessarily the case with fellowship. There are a large number of FMG's in cardiology for example. Take a look at the amsa web site. FMG's get into fellowships for a number of reasons. For example there are a number of FMG only medicine programs. Those programs are going to take a certain number of their own residents into fellowship spots regardless of where they went to medical school. There are many other reasons why FMG's get fellowship spots, including that many of em are just as good and even better than some AMG.

Having said that. If you are prepared to work hard, you can get these fellowships.

 

[droliver]

FYI: medical oncology is facing a HUGE drop in salary realted to decr. reimbursement for chemotherapy infusions by the feds.

 

[titan]

Thanks for all of your input! This is the area of medicine I have been most exposed to, and gained the most experience with. Although very preliminary, I have developed quite an interest in medical oncology. Salary isn't very important to me, but practicing medicine is. I just want to choose the field that best suits me and my strengths while maximizing my potential as a physician. Thanks again for your replies, and I welcome any further input!

 

[Voxel]

MS05' Taking a year off and doing research at the NIH/NCI during medical school will look impressive on your CV even if you are going for clinical heme/onc. You will probably be more attractive to top academic centers (if you have similiar numbers as other applicants) when applying for IM. Especially if you followed up on that research at during IM residency, you would be attractive to top heme/onc fellowships which are all academic and love research. These things show a serious committment to the field.

 

[AJM]

Originally posted by MS05':
•Does anyone know of any joint programs where for example you would do a three year IM or peds residency then at the same institution do the three 3 year Hem/Onc fellowship? I know they do this for some surgical residencies..ie do PGY1 in gen. surgery then do the next 6 in your specialty, just wondered if it works the same way for Hem/Onc...thanks.•••

Well, there aren't really any formalized combined programs of the type I think you're looking for. What does exist at many academic internal medicine programs is a program that Voxel already referred to -- the Clinical Investigator Pathway. This pathway is commonly known as "Fast Tracking", even though it doesn't save any time, and often costs more time. Although there are some variations on specifics, what it typically involves is doing 2 years of medicine residency (1 year internship + 1 year residency) rather than 3 years. During what would be your 3rd year, you become a "research fellow" for 1 or more years. The trick is, you still have to spend another 3 years as a heme/onc fellow. This program is great if you are interested in research and academic medicine, but not so good if you just want to do clinical practice. In addition, it's not even guaranteed you can do a Fast Track in the first place. You apply for it during your internship, and many programs have limits on the number of residents that can do this pathway.

Now there is a kind of "informal" joint program, in that if you go to a residency program that has a fellowship program in your area of interest, chances are that the fellowship program there would accept you as a fellow. How easy that is to do depends greatly on the program as well as on the specialty. When you end up applying to residency programs, you can ask the residents at programs you're applying to about how it works where they are at.

Hope this helps!