Oncology vs. Radiation Oncology

[Mesinan]

Hey guys, just posting in here because you guys would know more than hSDN and pre-med.

What exactly is the difference in oncology and radiation oncology?
Also, what are the different residency lengths?



thanks

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[ComradeDoktor]

The two have little in common, besides the fact that you see people with cancer in both. A medical oncologist is someone who finished a 3-year internal medicine residency followed by a three year fellowship in hematology/oncology. They are the primary doctors of patients who have cancer. They prescribe chemotherapy and other drug treatments like endocrine therapies, manage the side-effects of those drugs, and act as the long-term care providers of cancer patients. They are also board-certified in hematology, allowing them to treat patients' benign blood disorders like sickle-cell anemia and hemophilias.

Radiation oncologists complete a four-year residency in radiation oncology. They do exactly what it sounds like they do: they zap tumors with radiation. They don't prescribe chemo and they don't really care for patients long-term. Their primary concern is how to best irradiate the tumors and how to deal with the immediate side-effects of the radiation. They do, however, have a great lifestyle and some of the coolest gadgets in medicine.

If a patient has cancer, they are under the care of a medical oncologist. They may or may not need the services of a radiation oncologist depending on their condition.

 

[Pons Asinorum]

lol at a highschooler posting a question easily answerable by the google being answered (surprisingly well) by a premed. All in the allo forum. Somebody crossed the streams.

 

[Didierdrogba]

lol at a highschooler posting a question easily answerable by the google being answered (surprisingly well) by a premed. All in the allo forum. Somebody crossed the streams.

midlevel creep?

 

[Pons Asinorum]

midlevel creep?

I lol'd. Hard.

 

[534455]

lol at a highschooler posting a question easily answerable by the google being answered (surprisingly well) by a premed. All in the allo forum. Somebody crossed the streams.

Well written PONS. My thoughts exactly.
The Pre-Med answered fairly well to the highschooler. He/she did forget one major tier: Surgical Oncology.

Oncology is driven by three drivers:

Medical Oncologist
Radiation Oncologist
Surgical Oncologist

All are oncologists. The Med Oncologist prescribes the Chemo but so much more as well: runs the clinical trials, determines the staging of the cancer, diagnosis as to whether the cancer is benign, neo-adjuvant, adjuvant, metastatic, palliation, etc.

The Rad Onc administers the radiation but also much more. Lots of neat toys in a Rad Onc Center. Check them out. Visit one. Pretty futuristic stuff.

The Surgical Oncologist works with the Med Oncologist once the Med Oncologist finds the tumor, and the Surg Oncologist takes out what they can, then informs the Med Oncologist what was removed, clean margins, what was solid, what was not, and what other surrounding areas needed to be sacrificed (breast lump vs breast mastectomy). After surgery and radiation, it's back to the Med Oncologist to determine whether chemo should be administered which often is, enrolled in a clinical study or just administer palliative tx. the Med Onc has the really cool job b/c they are part of the last stage of life. Dying is part of life. While some would feel it is depressing field, I disagree. It is a great career when you think about being there for patients for their last stage in life.

Oncology is a very profitable field, and each division makes a different amount based on their modality of tx. The Med Onc makes money for diagnosis, office visits, quality of life issues, instruction, plus the actual administration of chemo and other meds via IV in their office. The medication is profitable to the Med Onc to the toon of: 6% plus ASP (Average Sales Price) based on CMS tables as to the chemo prescribed. Meaning, the Med Oncologist is at an advantage to prescribe branded chemo products (non-generic) b/c they are the pricier ones. So, if a patient needs chemo, the Med Onc MIGHT be motivated to Rx a branded chemo instead of a generic b/c they will make 6% plus ASP on that drug from the distributor. If the drug chosen is generic, then the Med Onc makes peanuts.

The surgical oncologist only gets paid when she/he yanks something out.
The Rad Onc gets paid when she/he administers Radiation.

Notice how the Med Onc calls the shots. It's up to the Rad Onc and Surg Onc to grovel, nay, network w/ their local Med Oncs for referrals. No ticket = no laundry

I see it all the time and I love this part of medicine.

"show me the money"
Tom Cruise in "Jerry Maguire"

 

[evilbooyaa]

The two have little in common, besides the fact that you see people with cancer in both. A medical oncologist is someone who finished a 3-year internal medicine residency followed by a three year fellowship in hematology/oncology. They are the primary doctors of patients who have cancer. They prescribe chemotherapy and other drug treatments like endocrine therapies, manage the side-effects of those drugs, and act as the long-term care providers of cancer patients. They are also board-certified in hematology, allowing them to treat patients' benign blood disorders like sickle-cell anemia and hemophilias.

Radiation oncologists complete a four-year residency in radiation oncology. They do exactly what it sounds like they do: they zap tumors with radiation. They don't prescribe chemo and they don't really care for patients long-term. Their primary concern is how to best irradiate the tumors and how to deal with the immediate side-effects of the radiation. They do, however, have a great lifestyle and some of the coolest gadgets in medicine.

If a patient has cancer, they are under the care of a medical oncologist. They may or may not need the services of a radiation oncologist depending on their condition.

Pretty close on the difference. One thing I'll say is that Rad Onc is a 5 (1 year of prelim/transitional + 4 years of true Rad Onc training) residency.

Med Oncs alone don't become the primary provider for cancer patients. Sometimes Surg-Oncs will do that as well, especially for cancers that don't require chemo (like early stage stuff).

Now one thing that hasn't been mentioned is the Gyn-Onc. I originally thought this was just a surg-onc that did gyn cancer surgeries only. However, I was incorrect. Gyn-Oncs deal with only gyn cancers, but they can do chemo like a med onc, as well as being the primary provider for that patient long-term. The only thing that Gyn-Oncs can't do for gyn cancers is radiation, for which they have to refer to a Rad Onc.

 

[qxrt]

Well written PONS. My thoughts exactly.
The Pre-Med answered fairly well to the highschooler. He/she did forget one major tier: Surgical Oncology.

Oncology is driven by three drivers:

Medical Oncologist
Radiation Oncologist
Surgical Oncologist

All are oncologists. The Med Oncologist prescribes the Chemo but so much more as well: runs the clinical trials, determines the staging of the cancer, diagnosis as to whether the cancer is benign, neo-adjuvant, adjuvant, metastatic, palliation, etc.

The Rad Onc administers the radiation but also much more. Lots of neat toys in a Rad Onc Center. Check them out. Visit one. Pretty futuristic stuff.

The Surgical Oncologist works with the Med Oncologist once the Med Oncologist finds the tumor, and the Surg Oncologist takes out what they can, then informs the Med Oncologist what was removed, clean margins, what was solid, what was not, and what other surrounding areas needed to be sacrificed (breast lump vs breast mastectomy). After surgery and radiation, it's back to the Med Oncologist to determine whether chemo should be administered which often is, enrolled in a clinical study or just administer palliative tx. the Med Onc has the really cool job b/c they are part of the last stage of life. Dying is part of life. While some would feel it is depressing field, I disagree. It is a great career when you think about being there for patients for their last stage in life.

Oncology is a very profitable field, and each division makes a different amount based on their modality of tx. The Med Onc makes money for diagnosis, office visits, quality of life issues, instruction, plus the actual administration of chemo and other meds via IV in their office. The medication is profitable to the Med Onc to the toon of: 6% plus ASP (Average Sales Price) based on CMS tables as to the chemo prescribed. Meaning, the Med Oncologist is at an advantage to prescribe branded chemo products (non-generic) b/c they are the pricier ones. So, if a patient needs chemo, the Med Onc MIGHT be motivated to Rx a branded chemo instead of a generic b/c they will make 6% plus ASP on that drug from the distributor. If the drug chosen is generic, then the Med Onc makes peanuts.

The surgical oncologist only gets paid when she/he yanks something out.
The Rad Onc gets paid when she/he administers Radiation.

Notice how the Med Onc calls the shots. It's up to the Rad Onc and Surg Onc to grovel, nay, network w/ their local Med Oncs for referrals. No ticket = no laundry

I see it all the time and I love this part of medicine.

"show me the money"
Tom Cruise in "Jerry Maguire"

You forgot about Interventional Oncology.

 

[HatWobble]

FWIW, there are three other specialties that are integral to cancer care as well, but aren't considered "oncologists":

1. Pathology -- Does a lot of important work in tumor classification and staging
2. Radiologist - Uses imaging to visualize the tumor
3. Family Physician - Manages the long-term care of the pt and his/her other medical conditions

Those three, plus the heme/onc, rad onc, and surg onc MDs are the six that have usually presented the cases at the tumor board conferences I've been to.

 

[HatWobble]

...

 

[calvnandhobbs68]

Notice how the Med Onc calls the shots. It's up to the Rad Onc and Surg Onc to grovel, nay, network w/ their local Med Oncs for referrals. No ticket = no laundry

I see it all the time and I love this part of medicine.

"show me the money"
Tom Cruise in "Jerry Maguire"

Eh this kind depends on what field you're working in.

For instance, Otolaryngology is the primary for a lot of the head and neck tumors. Lots of times people with a suspected H/N tumor get referred to the Oto first, they biopsy, grade and stage and decide whether they need to go to Med Onc first or not. They'll usually send someone over for a consult before the surgery so Med Onc knows whats coming but then just do the surgery and follow up with chemoradiation later.

 

[Winged Scapula]

Well written PONS. My thoughts exactly.
The Pre-Med answered fairly well to the highschooler. He/she did forget one major tier: Surgical Oncology.

Oncology is driven by three drivers:

Medical Oncologist
Radiation Oncologist
Surgical Oncologist

All are oncologists. The Med Oncologist prescribes the Chemo but so much more as well: runs the clinical trials, determines the staging of the cancer, diagnosis as to whether the cancer is benign, neo-adjuvant, adjuvant, metastatic, palliation, etc.

The Rad Onc administers the radiation but also much more. Lots of neat toys in a Rad Onc Center. Check them out. Visit one. Pretty futuristic stuff.

The Surgical Oncologist works with the Med Oncologist once the Med Oncologist finds the tumor, and the Surg Oncologist takes out what they can, then informs the Med Oncologist what was removed, clean margins, what was solid, what was not, and what other surrounding areas needed to be sacrificed (breast lump vs breast mastectomy). After surgery and radiation, it's back to the Med Oncologist to determine whether chemo should be administered which often is, enrolled in a clinical study or just administer palliative tx. the Med Onc has the really cool job b/c they are part of the last stage of life. Dying is part of life. While some would feel it is depressing field, I disagree. It is a great career when you think about being there for patients for their last stage in life.

Oncology is a very profitable field, and each division makes a different amount based on their modality of tx. The Med Onc makes money for diagnosis, office visits, quality of life issues, instruction, plus the actual administration of chemo and other meds via IV in their office. The medication is profitable to the Med Onc to the toon of: 6% plus ASP (Average Sales Price) based on CMS tables as to the chemo prescribed. Meaning, the Med Oncologist is at an advantage to prescribe branded chemo products (non-generic) b/c they are the pricier ones. So, if a patient needs chemo, the Med Onc MIGHT be motivated to Rx a branded chemo instead of a generic b/c they will make 6% plus ASP on that drug from the distributor. If the drug chosen is generic, then the Med Onc makes peanuts.

The surgical oncologist only gets paid when she/he yanks something out.
The Rad Onc gets paid when she/he administers Radiation.

Notice how the Med Onc calls the shots. It's up to the Rad Onc and Surg Onc to grovel, nay, network w/ their local Med Oncs for referrals. No ticket = no laundry

I see it all the time and I love this part of medicine.

"show me the money"
Tom Cruise in "Jerry Maguire"

Seriously?

Did a medical oncologist pay you to post this highly inaccurate (and borderline insulting) assessment?

Eh this kind depends on what field you're working in.

For instance, Otolaryngology is the primary for a lot of the head and neck tumors. Lots of times people with a suspected H/N tumor get referred to the Oto first, they biopsy, grade and stage and decide whether they need to go to Med Onc first or not. They'll usually send someone over for a consult before the surgery so Med Onc knows whats coming but then just do the surgery and follow up with chemoradiation later.

This is what is *more* common.

The PCP refers the patient with a mass/other symptom/abnormal imaging to the surgeon for evaluation.

We perform the biopsy.

We make the diagnosis.

We then refer the patient (when appropriate) to medical and radiation oncologists. Surgeons absolutely do not grovel for business from the medical oncologists. Its quite the opposite really and its the reason why this year (and every other year) Santa has brought me gift certificates for spa weekends, a cashmere blanket, tickets to pro sport games, etc. The medical and radiation oncologists want MY business. Hospitals and oncology groups recognize that the surgeons are the source of the referrals and where the referrals go, so goes the money. Not a month goes by without one of the large oncology (rad or med) groups approaches us about joining them; they want to drive all of our business their way.

I then order the PET scans and any other pre- adjuvant therapy imaging, do any relevant genetic counseling, run the test and review the results with the patient. Every other surgeon I know who does oncologic work does the same.

I don't just get paid when "<I> cut". I get paid for all consults, office visits, biopsies, surgeries, placement of radiation catheters and medi-ports, etc. I also enroll the patient in one of several clinical trials where I'm a co-investigator (when appropriate).

The reality is that it is a multidisciplinary team where everyone has a role to play to treat cancer. Stating that one specialty is more important is way off base and insulting to everyone involved.

 

[calvnandhobbs68]

I don't just get paid when "<I> cut". I get paid for all consults, office visits, biopsies, surgeries, placement of radiation catheters and medi-ports, etc. I also enroll the patient in one of several clinical trials where I'm a co-investigator (when appropriate).

The reality is that it is a multidisciplinary team where everyone has a role to play to treat cancer. Stating that one specialty is more important is way off base and insulting to everyone involved.

Yeah it's like this guy has never heard of surgery clinic visits before.

 

[jerseytrash]

Seriously?

Did a medical oncologist pay you to post this highly inaccurate (and borderline insulting) assessment?



This is what is *more* common.

The PCP refers the patient with a mass/other symptom/abnormal imaging to the surgeon for evaluation.

We perform the biopsy.

We make the diagnosis.

We then refer the patient (when appropriate) to medical and radiation oncologists. Surgeons absolutely do not grovel for business from the medical oncologists. Its quite the opposite really and its the reason why this year (and every other year) Santa has brought me gift certificates for spa weekends, a cashmere blanket, tickets to pro sport games, etc. The medical and radiation oncologists want MY business. Hospitals and oncology groups recognize that the surgeons are the source of the referrals and where the referrals go, so goes the money. Not a month goes by without one of the large oncology (rad or med) groups approaches us about joining them; they want to drive all of our business their way.

I then order the PET scans and any other pre- adjuvant therapy imaging, do any relevant genetic counseling, run the test and review the results with the patient. Every other surgeon I know who does oncologic work does the same.

I don't just get paid when "<I> cut". I get paid for all consults, office visits, biopsies, surgeries, placement of radiation catheters and medi-ports, etc. I also enroll the patient in one of several clinical trials where I'm a co-investigator (when appropriate).

The reality is that it is a multidisciplinary team where everyone has a role to play to treat cancer. Stating that one specialty is more important is way off base and insulting to everyone involved.

Well said - onc is a great field b/c it's cutting edge stuff and because it really requires the expertise of MANY different doctors - whether it's med onc, rad onc, or surg onc. interventional onc is a pretty specific field as far as I remember, so I can't really comment on it.

 

[534455]

Seriously? Did a medical oncologist pay you to post this highly inaccurate (and borderline insulting) assessment?

If you can't win with facts you insult your opponent to get some personal attention.

As I have stated in another post on SDN.....

And if it even whiffs of a personal attack, they are telling us alot more about themselves than they think they are about their intended audience.


Personal Attacks are so sophomoric. I don't even know why I have engaged this guy/gay, other than to remind them not to stoop to their level

Santa has brought me gift certificates for spa weekends, a cashmere blanket, tickets to pro sport games, etc. The medical and radiation oncologists want MY business. .

Santa?

In addition to engaging ad hominem attacks, you have provided us more information about yourself:

You accept bribes.
How terribly foolish yet highly instructive.

Please tell SDN followers (and the US Congress) more details on your scam of how you, as a Surgical Attending, further accept bribes. At least you had the stupidity to publicly state what the US Congress is trying to eliminate, that is physicians getting bribed for services. Bravo!

so kiddies, take note what NOT to do in the future:

1. Accept bribes in return for business
2. Publicly state it if you do.

 

[qxrt]

 

[JP2740]

 

[Noegrus]

I wouldn't attack her, if I were you.

 

[calvnandhobbs68]

If you can't win with facts you insult your opponent to get some personal attention.

As I have stated in another post on SDN.....

And if it even whiffs of a personal attack, they are telling us alot more about themselves than they think they are about their intended audience.


Personal Attacks are so sophomoric. I don't even know why I have engaged this guy/gay, other than to remind them not to stoop to their level



Santa?

In addition to engaging ad hominem attacks, you have provided us more information about yourself:

You accept bribes.
How terribly foolish yet highly instructive.

Please tell SDN followers (and the US Congress) more details on your scam of how you, as a Surgical Attending, further accept bribes. At least you had the stupidity to publicly state what the US Congress is trying to eliminate, that is physicians getting bribed for services. Bravo!

so kiddies, take note what NOT to do in the future:

1. Accept bribes in return for business
2. Publicly state it if you do.

Uh what?

Where was the personal attack again? Where she asked you if a medical oncologist paid you to write that? And then backed up her statement with a whole couple paragraphs showing you how oncology works in the real world? And then you responded by making an entire post about bribes? Who is making the personal attacks again? Plus, weren't you the dude who talked about surgeons "groveling" to med-onc? Seriously?

I know you think you're old and experienced man but no matter how old you are, you're a first year medical student. I think an attending has a little more of an idea how, you know, actual medical practices work.

 

[as1212559]

If you can't win with facts you insult your opponent to get some personal attention.

As I have stated in another post on SDN.....

And if it even whiffs of a personal attack, they are telling us alot more about themselves than they think they are about their intended audience.


Personal Attacks are so sophomoric. I don't even know why I have engaged this guy/gay, other than to remind them not to stoop to their level



Santa?

In addition to engaging ad hominem attacks, you have provided us more information about yourself:

You accept bribes.
How terribly foolish yet highly instructive.

Please tell SDN followers (and the US Congress) more details on your scam of how you, as a Surgical Attending, further accept bribes. At least you had the stupidity to publicly state what the US Congress is trying to eliminate, that is physicians getting bribed for services. Bravo!

so kiddies, take note what NOT to do in the future:

1. Accept bribes in return for business
2. Publicly state it if you do.

 

[xrevision]

Neurosurgeon takes out the brain tumors, ENT takes out head and neck tumors, Surg Onc/Plastics help take care of breast tumors, surg onc takes care of gut tumors, ortho takes care of bone tumors, gyn onc takes care of gyn tumors, urology takes care of prostate tumors, interventional onc/radiology offers treatments like TACE, and ablations, etc etc.

 

[Winged Scapula]

If you can't win with facts you insult your opponent to get some personal attention.

As I have stated in another post on SDN.....

And if it even whiffs of a personal attack, they are telling us alot more about themselves than they think they are about their intended audience.


Personal Attacks are so sophomoric. I don't even know why I have engaged this guy/gay, other than to remind them not to stoop to their level

I see no indication where I attacked you. As a matter of fact, I simply responded to your insulting post (insulting to surgeons, medical and radiation oncologists) with a query about your motivation. I never personally attacked you nor have I any desire to do so.

Santa?

In addition to engaging ad hominem attacks, you have provided us more information about yourself:

You accept bribes.
How terribly foolish yet highly instructive.

Please tell SDN followers (and the US Congress) more details on your scam of how you, as a Surgical Attending, further accept bribes. At least you had the stupidity to publicly state what the US Congress is trying to eliminate, that is physicians getting bribed for services. Bravo!

so kiddies, take note what NOT to do in the future:

1. Accept bribes in return for business
2. Publicly state it if you do.

Seriously?

You claimed that surgeons "grovel" for business from medical oncologists. I am simply demonstrating to you that in fact they come to me for my business. A bribe implies that I asked for the gifts and that they impact my medical decision making. They do not. As a matter of fact, the medical oncologists and radiation oncologists who send those unsolicited gifts every year, do so because I find them wonderful caring colleagues who are deserving of the referrals I send their way. I do not refer them patients for any other reason and frankly most of the gifts are shared with my office staff.

If anything, the reps and my office will tell you that I refuse lunches brought to the office and don't allow them to wine and dine me when I don't/won't use the product.

I suggest that the next time you claim "personal attacks" you look in the mirror.

 

[Kaustikos]

^ Those are the moments I wish I could rep people on this forum.

 

[as1212559]

^ Those are the moments I wish I could rep people on this forum.

this. 5 star thrad.

 

[Pons Asinorum]

Stole my gif you ****er!

Dis definitely gon b gud...

 

[rocketbooster]

I see no indication where I attacked you. As a matter of fact, I simply responded to your insulting post (insulting to surgeons, medical and radiation oncologists) with a query about your motivation. I never personally attacked you nor have I any desire to do so.



Seriously?

You claimed that surgeons "grovel" for business from medical oncologists. I am simply demonstrating to you that in fact they come to me for my business. A bribe implies that I asked for the gifts and that they impact my medical decision making. They do not. As a matter of fact, the medical oncologists and radiation oncologists who send those unsolicited gifts every year, do so because I find them wonderful caring colleagues who are deserving of the referrals I send their way. I do not refer them patients for any other reason and frankly most of the gifts are shared with my office staff.

If anything, the reps and my office will tell you that I refuse lunches brought to the office and don't allow them to wine and dine me when I don't/won't use the product.

I suggest that the next time you claim "personal attacks" you look in the mirror.

I see where you're coming from Winged Scapula but you also seem ultra sensitive about comments made about surgeons. I recall making a comment about gen surg in the recent past and then you instantly gave me an infarction for "intent to flame" when all I was doing was telling about my gen surg experience.

In the context of this thread, you actually started more of the ad homs and, if you were not a mod, would already have an infarction against you by another Winged Scapula-esque mod.

Anyways, carry on. I agree with Winged Scapula on this one.

 

[calvnandhobbs68]

I see where you're coming from Winged Scapula but you also seem ultra sensitive about comments made about surgeons. I recall making a comment about gen surg in the recent past and then you instantly gave me an infarction for "intent to flame" when all I was doing was telling about my gen surg experience.

In the context of this thread, you actually started more of the ad homs and, if you were not a mod, would already have an infarction against you by another Winged Scapula-esque mod.

Anyways, carry on. I agree with Winged Scapula on this one.

Do people around here even know what "ad hominem" means? Saying something that could possibly be conceived as insulting is not an ad hominem.

If she said "You are old so your argument is invalid" that's an ad hominem. Asking sarcastically if he's been paid by a medical oncologist to write a post because he said ridiculous things like surgeons "grovel" for business from med onc and do basically nothing except chop out tumors is not an ad hominem.

 

[Winged Scapula]

I see where you're coming from Winged Scapula but you also seem ultra sensitive about comments made about surgeons.

You are correct in that I have had a difficult week, professionally and personally, and am a bit cranky because of it. So while I do not regret my responses in this thread (or the other where a pre-med was lecturing me on how surgeons practice), my tone was borne out of the heat of the moment and I apologize for that. I should have "taken a moment" before posting my response (although the content would have been the same).

I recall making a comment about gen surg in the recent past and then you instantly gave me an infarction for "intent to flame" when all I was doing was telling about my gen surg experience.

We don't typically comment on infractions publicly but since you brought it up, the difference is that you came into the Surgery forums and posted an inflammatory response. This is a violation of the Terms of Service. It was added years ago at the behest of the members of the EM forum who objected to the many threads there blasting them and their specialty. This is why the Anesthesia forum is allowed to have a thread which says <basically> "Surgeons suck" but they can't come into the Surgery forum and start such a thread.

Therefore, while you may have seen comments such as " The only ppl I know who like surgery and choose to do gen surg are the ones who didn't have high enough Step 1 scores to get into a subspecialty" as just expressing your experience, I'm sure you can see how it can be interpreted as insulting and inflammatory and why you were handed the infraction.

In the context of this thread, you actually started more of the ad homs and, if you were not a mod, would already have an infarction against you by another Winged Scapula-esque mod.

I beg to differ on 2 points: 1) I have not violated the TOS; being an arse is unfortunately not a TOS violation, even when exhibited by an SDN staff member; 2) as noted above, I have committed no ad hominem attacks against the user in question (who actually has posted a thread elsewhere essentially calling me out - a TOS violation - and attacking me and my ethics).

 

[pathstudent]

Working with many oncologists, I think I can say a lot of the fun is out of the field.

As one oncologist put it, "the pathologist tells you what it is, the radiologist tells you where it is, the nurse gives the drugs, and the insurance companies treat guidelines like mandates so they won't reimburse if you don't follow the guidelines. Basically all I do is sign orders"

 

[rocketbooster]

You are correct in that I have had a difficult week, professionally and personally, and am a bit cranky because of it. So while I do not regret my responses in this thread (or the other where a pre-med was lecturing me on how surgeons practice), my tone was borne out of the heat of the moment and I apologize for that. I should have "taken a moment" before posting my response (although the content would have been the same).



We don't typically comment on infractions publicly but since you brought it up, the difference is that you came into the Surgery forums and posted an inflammatory response. This is a violation of the Terms of Service. It was added years ago at the behest of the members of the EM forum who objected to the many threads there blasting them and their specialty. This is why the Anesthesia forum is allowed to have a thread which says <basically> "Surgeons suck" but they can't come into the Surgery forum and start such a thread.

Therefore, while you may have seen comments such as " The only ppl I know who like surgery and choose to do gen surg are the ones who didn't have high enough Step 1 scores to get into a subspecialty" as just expressing your experience, I'm sure you can see how it can be interpreted as insulting and inflammatory and why you were handed the infraction.



I beg to differ on 2 points: 1) I have not violated the TOS; being an arse is unfortunately not a TOS violation, even when exhibited by an SDN staff member; 2) as noted above, I have committed no ad hominem attacks against the user in question (who actually has posted a thread elsewhere essentially calling me out - a TOS violation - and attacking me and my ethics).

Yes and I still stand by what I said. That's how exactly how it is at my school. So yes that's my experience. But my program isn't a great gen surg program either. Half of the residents are DOs. I'm sure top programs are different.

Anyways, apology accepted and I agree with your stance on onc.

 

[Winged Scapula]

Yes and I still stand by what I said. That's how exactly how it is at my school. So yes that's my experience. But my program isn't a great gen surg program either. Half of the residents are DOs. I'm sure top programs are different.

The issue isn't that you can't complain about your program or surgery; its just the forum has to be appropriate. The place to do it would have been in the Clinical Rotations forum, IMHO. But water under the bridge, right?

 

[rocketbooster]

The issue isn't that you can't complain about your program or surgery; its just the forum has to be appropriate. The place to do it would have been in the Clinical Rotations forum, IMHO. But water under the bridge, right?

 

[tantacles]

This thread was so helpful until you started fighting. That being said, I'd like to quote the two most useful posts in the hope that we all learn something.

The two have little in common, besides the fact that you see people with cancer in both. A medical oncologist is someone who finished a 3-year internal medicine residency followed by a three year fellowship in hematology/oncology. They are the primary doctors of patients who have cancer. They prescribe chemotherapy and other drug treatments like endocrine therapies, manage the side-effects of those drugs, and act as the long-term care providers of cancer patients. They are also board-certified in hematology, allowing them to treat patients' benign blood disorders like sickle-cell anemia and hemophilias.

Radiation oncologists complete a four-year residency in radiation oncology. They do exactly what it sounds like they do: they zap tumors with radiation. They don't prescribe chemo and they don't really care for patients long-term. Their primary concern is how to best irradiate the tumors and how to deal with the immediate side-effects of the radiation. They do, however, have a great lifestyle and some of the coolest gadgets in medicine.

If a patient has cancer, they are under the care of a medical oncologist. They may or may not need the services of a radiation oncologist depending on their condition.

Well written PONS. My thoughts exactly.
The Pre-Med answered fairly well to the highschooler. He/she did forget one major tier: Surgical Oncology.

Oncology is driven by three drivers:

Medical Oncologist
Radiation Oncologist
Surgical Oncologist

All are oncologists. The Med Oncologist prescribes the Chemo but so much more as well: runs the clinical trials, determines the staging of the cancer, diagnosis as to whether the cancer is benign, neo-adjuvant, adjuvant, metastatic, palliation, etc.

The Rad Onc administers the radiation but also much more. Lots of neat toys in a Rad Onc Center. Check them out. Visit one. Pretty futuristic stuff.

The Surgical Oncologist works with the Med Oncologist once the Med Oncologist finds the tumor, and the Surg Oncologist takes out what they can, then informs the Med Oncologist what was removed, clean margins, what was solid, what was not, and what other surrounding areas needed to be sacrificed (breast lump vs breast mastectomy). After surgery and radiation, it's back to the Med Oncologist to determine whether chemo should be administered which often is, enrolled in a clinical study or just administer palliative tx. the Med Onc has the really cool job b/c they are part of the last stage of life. Dying is part of life. While some would feel it is depressing field, I disagree. It is a great career when you think about being there for patients for their last stage in life.

I took out the parts that everyone was arguing about and that seemed sort of attacky. Anyone want to add to this post in a nice way?

 

[calvnandhobbs68]

Dude helpful to who? Pre-meds? It shouldn't even be in this forum to begin with. Medical students tend to know the difference between med-onc, rad-onc and surgery.

 

[Kaustikos]

Dude helpful to who? Pre-meds? It shouldn't even be in this forum to begin with. Medical students tend to know the difference between med-onc, rad-onc and surgery.

But seriously - what does "oncology" mean?

 

[Pons Asinorum]

But seriously - what does "oncology" mean?

Study of fluid dynamics as caused by soluble protein concentration, amirite?

 

[rocketbooster]

This thread was so helpful until you started fighting. That being said, I'd like to quote the two most useful posts in the hope that we all learn something.





I took out the parts that everyone was arguing about and that seemed sort of attacky. Anyone want to add to this post in a nice way?

You're a stupid premed who doesn't know how to use google. The "attacking" part was the only good part of the thread. Jk, the good part was learning how to correctly ad hom like the one I just used.

 

[Kaustikos]

And this is how you know you're in med school:

You laugh at this

Study of fluid dynamics as caused by soluble protein concentration, amirite?

 

[45408]

Well written PONS. My thoughts exactly.
The Pre-Med answered fairly well to the highschooler. He/she did forget one major tier: Surgical Oncology.

Oncology is driven by three drivers:

Medical Oncologist
Radiation Oncologist
Surgical Oncologist

All are oncologists. The Med Oncologist prescribes the Chemo but so much more as well: runs the clinical trials, determines the staging of the cancer, diagnosis as to whether the cancer is benign, neo-adjuvant, adjuvant, metastatic, palliation, etc.

The Rad Onc administers the radiation but also much more. Lots of neat toys in a Rad Onc Center. Check them out. Visit one. Pretty futuristic stuff.

The Surgical Oncologist works with the Med Oncologist once the Med Oncologist finds the tumor, and the Surg Oncologist takes out what they can, then informs the Med Oncologist what was removed, clean margins, what was solid, what was not, and what other surrounding areas needed to be sacrificed (breast lump vs breast mastectomy). After surgery and radiation, it's back to the Med Oncologist to determine whether chemo should be administered which often is, enrolled in a clinical study or just administer palliative tx. the Med Onc has the really cool job b/c they are part of the last stage of life. Dying is part of life. While some would feel it is depressing field, I disagree. It is a great career when you think about being there for patients for their last stage in life.

Oncology is a very profitable field, and each division makes a different amount based on their modality of tx. The Med Onc makes money for diagnosis, office visits, quality of life issues, instruction, plus the actual administration of chemo and other meds via IV in their office. The medication is profitable to the Med Onc to the toon of: 6% plus ASP (Average Sales Price) based on CMS tables as to the chemo prescribed. Meaning, the Med Oncologist is at an advantage to prescribe branded chemo products (non-generic) b/c they are the pricier ones. So, if a patient needs chemo, the Med Onc MIGHT be motivated to Rx a branded chemo instead of a generic b/c they will make 6% plus ASP on that drug from the distributor. If the drug chosen is generic, then the Med Onc makes peanuts.

The surgical oncologist only gets paid when she/he yanks something out.
The Rad Onc gets paid when she/he administers Radiation.

Notice how the Med Onc calls the shots. It's up to the Rad Onc and Surg Onc to grovel, nay, network w/ their local Med Oncs for referrals. No ticket = no laundry

I see it all the time and I love this part of medicine.

"show me the money"
Tom Cruise in "Jerry Maguire"

If you can't win with facts you insult your opponent to get some personal attention.

As I have stated in another post on SDN.....

And if it even whiffs of a personal attack, they are telling us alot more about themselves than they think they are about their intended audience.


Personal Attacks are so sophomoric. I don't even know why I have engaged this guy/gay, other than to remind them not to stoop to their level



Santa?

In addition to engaging ad hominem attacks, you have provided us more information about yourself:

You accept bribes.
How terribly foolish yet highly instructive.

Please tell SDN followers (and the US Congress) more details on your scam of how you, as a Surgical Attending, further accept bribes. At least you had the stupidity to publicly state what the US Congress is trying to eliminate, that is physicians getting bribed for services. Bravo!

so kiddies, take note what NOT to do in the future:

1. Accept bribes in return for business
2. Publicly state it if you do.

It's better to be thought a fool than to open your mouth and remove all doubt. Those were some ridiculously foolish comments to make.


For everyone else, surgical oncology is a relatively small field, and most cancer patients who see a surgeon will see a general or colorectal surgeon (outside of H&N, neuro, ortho, uro or gyn malignancies) instead of a surgical oncologist.

 

[matchb0x]

Yes and I still stand by what I said. That's how exactly how it is at my school. So yes that's my experience. But my program isn't a great gen surg program either. Half of the residents are DOs. I'm sure top programs are different.

Anyways, apology accepted and I agree with your stance on onc.

Nice "dick"-like jab at DOs while you're at it, you really know how to make friends dontcha?

 

[evilbooyaa]

Nice "dick"-like jab at DOs while you're at it, you really know how to make friends dontcha?

It's unfortunate, but percentage DOs and IMGs is absolutely a way to determine the competitiveness of the program. Whether that will changes after 2015 is something that is yet to be determined.

 

[MegMurry]

Dude helpful to who? Pre-meds? It shouldn't even be in this forum to begin with. Medical students tend to know the difference between med-onc, rad-onc and surgery.

They tend to, but sometimes don't. I learned this when I had to explain to a fellow classmate what the difference between bench and clinical research was in addition to the difference between radonc, rads and medonc a few weeks ago.

Internally, I half-facepalmed, half-felt guilty for wanting to facepalm.

It's unfortunate, but percentage DOs and IMGs is absolutely a way to determine the competitiveness of the program. Whether that will changes after 2015 is something that is yet to be determined.

Here's where I show my ignorance. What's happening in 2015?

 

[alpinism]

Here's where I show my ignorance. What's happening in 2015?

Basically ACGME & AOA are moving towards a single match system.

Here ya go:

http://forums.studentdoctor.net/showthread.php?t=959475

 

[Pons Asinorum]

Basically ACGME & AOA are moving towards a single match system.

Here ya go:

http://forums.studentdoctor.net/showthread.php?t=959475

Very much still a proposal. Seems like the DO's think this is a bit of wishful thinking and that the AOA/COCA won't go along with it, even in the newer threads. We'll see I guess.

Edit: sorry not trying to threadjack. Carry on!

 

[HeyNumber2]

If you can't win with facts you insult your opponent to get some personal attention.

As I have stated in another post on SDN.....

And if it even whiffs of a personal attack, they are telling us alot more about themselves than they think they are about their intended audience.


Personal Attacks are so sophomoric. I don't even know why I have engaged this guy/gay, other than to remind them not to stoop to their level



Santa?

In addition to engaging ad hominem attacks, you have provided us more information about yourself:

You accept bribes.
How terribly foolish yet highly instructive.

Please tell SDN followers (and the US Congress) more details on your scam of how you, as a Surgical Attending, further accept bribes. At least you had the stupidity to publicly state what the US Congress is trying to eliminate, that is physicians getting bribed for services. Bravo!

so kiddies, take note what NOT to do in the future:

1. Accept bribes in return for business
2. Publicly state it if you do.

Roadlesstraveled being condescending again, what a surprise. I seriously hope you don't start to give us nontrads a bad name. Show some humility, you're just a med student, even if you are "older" than a lot of attendings.

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