Oncology (Hem/Onc) Residency Pathways

[katiajanah]

From my knowledge, if one would like to go into Oncology or Hem/Onc, one would first apply for an Internal Medicine residency, then later apply for an Oncology sub-specialty training.

Is that always the training pathway, or are there "Oncology residency program" that you can apply for right out of medical school, where you do a few years of Internal Medicine, then do your years of Oncology, the whole time knowing that you are set to do Oncology? Or does everyone who wants to do some sort of internal medicine subspecialty have to apply for these after their internal medicine years?

I guess I am wondering about the structure of the Internal Medicine programs, how much variation there is between institutions, and how internal medicine subspecialty training works. Any information about this would be appreciated!

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[Donald Juan]

Heme/onc or medical oncologists are the ones who typically manage patients chemotherapy or other medications, and might act as a primary coordinator for radiation and surgical treatments. As far as I know, all programs require the 3 years of IM plus a fellowship (2 or 3 more years, depending on if you want heme/onc or just medical onc). I don't think their are any guaranteed tracks or combined programs. You can apply for the fellowship during your IM residency so that you start immediately following residency, or sometime after residency if you wanted to go practice as a general internist or hospitalist for some time. Heme/onc is usually considered a fairly competitive specialty as far as the IM subspecialties go, so getting into the best residency possible and working hard throughout would be key.

In addition to heme/onc doctors, there are radiation oncologists who specialize in the use of radiation to treat cancer. They have their own residency that is 5 years total. There is also a surgical oncologist, and this pathway is 5-7 years of general surgery followed by a 2 year fellowship.

Keep in mind many specialties work with cancer patients. For example, a urologist would likely be the primary provider of both medical or surgical treatments for a patient with urogenital malignancies, or a dermatologist would provide most treatment modalities of a dermatological cancer. Don't think that because you are interested in cancer you are tied down to just heme/onc.

 

[eteshoe]

What you described is medical oncology.

There's radiation oncology which tends to have a transitional or prelim year + rad/onc residency (5 yrs total)

There's surgical oncology which tends to be a general surgery residency + some surgical oncology sub-specialty fellowship (7 yrs total)

If you are a pre-med, you got plenty of time before you have to worry about the different clinical paths of oncology

 

[WilliamofOckham]

Yes - it is possible to do an ABIM pathway, in which (if accepted) one does two years of IM and then 4-4.5 years of Heme/Onc fellowship + research. But these are intended for MD/PhD types, and the expectation is that the applicant will stay academic beyond training.

I'm not sure precisely how competitive these tracks are, as the applicants are very self-selecting. To be a viable candidate, you will have to distinguish yourself in research during medical school.

 

[Lord_Vader]

Heme/onc or medical oncologists are the ones who typically manage patients chemotherapy or other medications, and might act as a primary coordinator for radiation and surgical treatments. As far as I know, all programs require the 3 years of IM plus a fellowship (2 or 3 more years, depending on if you want heme/onc or just medical onc). I don't think their are any guaranteed tracks or combined programs. You can apply for the fellowship during your IM residency so that you start immediately following residency, or sometime after residency if you wanted to go practice as a general internist or hospitalist for some time. Heme/onc is usually considered a fairly competitive specialty as far as the IM subspecialties go, so getting into the best residency possible and working hard throughout would be key.

In addition to heme/onc doctors, there are radiation oncologists who specialize in the use of radiation to treat cancer. They have their own residency that is 5 years total. There is also a surgical oncologist, and this pathway is 5-7 years of general surgery followed by a 2 year fellowship.

Keep in mind many specialties work with cancer patients. For example, a urologist would likely be the primary provider of both medical or surgical treatments for a patient with urogenital malignancies, or a dermatologist would provide most treatment modalities of a dermatological cancer. Don't think that because you are interested in cancer you are tied down to just heme/onc.

Sorry to hijack this thread but what type of cancers do hem/oncs most commonly treat? I know they treat the bloodborne malignancies as well as breast, colon and lung cancer. But what about rarer malignances like brain tumors? Or something like osteosarcoma or Wilm's tumor for that matter (as opposed to an orthopod managing the treatment)? Basically I'm trying to figure out whether they deal with the same handful of cancers throughout their careers or whether it's a broad variety of disease they treat.

 

[QuizzicalApe]

Sorry to hijack this thread but what type of cancers do hem/oncs most commonly treat? I know they treat the bloodborne malignancies as well as breast, colon and lung cancer. But what about rarer malignances like brain tumors? Or something like osteosarcoma or Wilm's tumor for that matter (as opposed to an orthopod managing the treatment)? Basically I'm trying to figure out whether they deal with the same handful of cancers throughout their careers or whether it's a broad variety of disease they treat.

In an academic setting, a heme/onc physician is more likely to be single-boarded (just heme or just onc) and relatively hyper-specialized within that single scope of practice. This could be as specific as just breast cancer, just leukemia or it could be broader like "GI malignancies". In a more community sort of setting, you are more likely to be generalist and maintain a double board certification and see a little bit of everything just because there generally isn't the same vast patient population there to support hyper-specialists. What you're comfortable managing and how far you're willing to run with it depend on your level of comfort from training and the resources available to you when it comes to the really rare stuff, or things that require very careful specialized inpatient management. Some stuff, like acute leukemias, are going to be shuffled to a major center because there are limits to what can be done at Uncle Joe's Back-Country Hospital What's For Humans.

 

[Crayola227]

Sorry to hijack this thread but what type of cancers do hem/oncs most commonly treat? I know they treat the bloodborne malignancies as well as breast, colon and lung cancer. But what about rarer malignances like brain tumors? Or something like osteosarcoma or Wilm's tumor for that matter (as opposed to an orthopod managing the treatment)? Basically I'm trying to figure out whether they deal with the same handful of cancers throughout their careers or whether it's a broad variety of disease they treat.

every field has its bread and butter and its zebras

 

[WilliamofOckham]

Sorry to hijack this thread but what type of cancers do hem/oncs most commonly treat? I know they treat the bloodborne malignancies as well as breast, colon and lung cancer. But what about rarer malignances like brain tumors? Or something like osteosarcoma or Wilm's tumor for that matter (as opposed to an orthopod managing the treatment)? Basically I'm trying to figure out whether they deal with the same handful of cancers throughout their careers or whether it's a broad variety of disease they treat.

There are the "top" five or six malignancies that a medical oncologist would treat (breast, lung, pancreatic, prostate, colon, ovarian, etc.), but when I was on my one-month Heme/Onc rotation in med school, I saw several patients with brain tumors. Now, the hospital-affiliated H/O group's attendings did prefer to focus on specific areas (GI, breast, and so on), but it's certainly possible to stay abreast of medical treatment modalities in all the areas of oncology... it's just more demanding.

 

[WedgeDawg]

Moving to pre-allo as OP is a premed