Pediatric Heme/Onc -- Full time clinician opportunities?

[sunflower18]

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Hello,

First off, I'm not quite sure if this is the right place for this thread... Mods, feel free to move it to a more appropriate forum if so!

I'm a medical student trying to figure out my plans for future practice environment and specialty. I really think that I want to do close to 100% clinical work, with little to no time spent on research. Additionally, I am very interested in pediatric heme/onc. But I'm worried that these two career ideals are incompatible. It is my concern that pediatric heme/onc is a highly academic field, with attendings spending most of their time on research and only seeing patients one day a week or so. Is this accurate, or not? I'm still trying to figure all of this out, so more information would be greatly appreciated!!

Thanks so much!

 

[mvenus929]

My hospital runs very different from the typical academic center, but most of our attendings do have full time clinical jobs, and do research on the side (if at all). We have 7 full time heme-onc attendings here.

 

[sunflower18]

That's really helpful and good to know! I've only had exposure to one major academic center (the one associated with my med school!) and it's quite research-heavy, which I'm not sure is typical. So maybe my experience is an anomaly! Thanks 🙂

 

[Stitch]

These jobs do exist, but may be difficult to find. Also, don't mention that goal when applying. People generally want to hear that you're interested to contribute to the field. And honestly, you may find that you get interested in doing so as you become an expert. Do what you love to read about, and what you really feel like you can be good at.

 

[chemta2006]

Going into peds hem/onc fellowship here, and I hate to be a downer, but you are right that those two career ideals are going to be tough to reconcile. PHO is a very academic field, so unless you are truly magical as a clinician, you are unlikely to be doing close to 100% clinical work. If you don't bring in research money, then you will probably have to get involved with more administrative work ie. for the department or the medical school. Of course there's a spectrum of how much clinical time you'll do. Typically attendings will see patients several days a week, but not most days of the week--otherwise how will you get any work done for all of your administrative or research duties? Your major academic center sounds like a typical one; I haven't been to one like mvenus's on my fellowship interviews.

If you really don't want to do research in the future, you could consider pioneering a private practice, but the insurance/reimbursement climate is getting more chilly. Besides, it could be tough to get a solid patient base in private practice because the patients are all going to large research-oriented academic centers to get their treatments on protocols, pediatric hem/onc diseases being as rare as they are. And if you are really thinking of not doing research, please PLEASE don't say that on your application. You have to remember that the field of PHO is practically built on lab data-driven research and multi-center trials. That's where so much of the success of the field comes from; not being interested in research is like spitting on the foundation of the discipline. I may have dinged my own application just by saying I was more interested in clinical research, because most programs still expect you to earn your keep in the lab.

The upside is, you are still very early in the process and you have plenty of time to find out what really makes you passionate. Try on some research during med school and see how you really feel about it. I worked in academic hem/onc (adult side) prior to med school and went in thinking "no way I'm doing academics!" but as you can see, things turned around once I got more experience in PHO and research, and realized that I always want to be a part of what's making the field better all the time and making the most impact on patients for the future.

 

[Pedsdoc13]

I'm also going into heme/onc and I agree with previous posters- that type of job is extremely unusual. I would also echo Stitch and chemta2006, I thought that I wanted to be 100% clinical as a medical student as well. Now I have very different goals. Once you something that really interests you, you may be more excited to do research and contribute to the field.

 

[sunflower18]

Thank you both for your input!! You're right, it's early and I should be open minded. I'm glad you found a field that satisfies your passions and I hope that I am as lucky!!

 

[sunflower18]

Bumping this about a year later, since I'm having the same dilemma... I love PHO still, but really do not want to be a researcher. I'm also considering other specialties, primarily derm --> peds derm, so it would be kind of nice to know now if I should give up on PHO, since that might give me clarity as to whether to pursue derm research and such right now with gusto. I guess I'm holding back from being excited about the idea of another specialty because my heart is still in PHO.

At this point, it'd be helpful to figure out whether or not going the peds route really means that 1) I could subspecialize in what I love but have to do research most of the time which I would hate, or 2) that I'd have to do primary care or another specialty with more non-academic opportunities (like neonatology, for example).

I know there are peds subspecialists, including heme/onc docs at places like Kaiser. Is that also an anomaly, and I shouldn't consider going the fellowship route to have a small shot at a clinical job like that?

Help, I'm confused 🙁 Thanks all!