rad onc vs peds onc

[19347]

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This question has been asked before, and I've read those threads, but my question is a bit different. I really enjoy working with cancer patients so I'm looking at both radiation oncology and medical (pediatric) oncology. I like what I've seen so far in radiation oncology and feel like I've got a pretty good feel for what the field entails. I do enjoy working with adults, but I feel like I'll always have a pull towards working with sick kids, so I'm looking at pediatric oncology as well. Although I certainly see benefits of rad onc (salary and lifestyle of course, but also technology, some procedures, a lot of variety, avoidance of a pediatric residency, great patient interactions and follow up), I have a few reservations. One, peds rad onc seems really limited, true? Again, I'm not looking to just treat kids but I would like to be able to. Also, I do enjoy 'medicine' and in truth I'm not sure how I feel about studying the hard science of radiation and physics and forgetting a lot of medicine. that being said, much of pediatric medicine I don't like anyway, it's only the more critical care/sick kid stuff that I enjoy. So yeah, I'm a little unsettled with this but I'm wondering if anyone in here had any serious interest in pediatric oncology or if anyone has any strong thoughts about the availability to work with kids in rad onc.
Thanks.

 

[Gfunk6]

Pediatric Radiation Oncology is done by-and-large in academic medical centers. I don't have hard numbers, but I would conservatively estimate > 90% of Rad Oncs who practice Pediatric Rad Onc are in academic centers. The reasons for this include: pediatric cancers are relatively rare, most pediatric treatments are performed on protocol, and pediatric oncology requires strong multi-disciplinary cooperation (including things like social workers and pediatric anesthesiologists).

Since a sizable chunk of Pediatric Rad Onc tends to be CNS-oriented (medulloblastoma, ATRT, brainstem GBMs), many Pediatric Rad Oncs perform a combination of Peds and Adult CNS.

On the one hand Pediatric Oncologists have to perform a lot of 'general medicine,' while Pediatric Rad Oncs don't participating much in 'critical care.' In the end, you should rotate in both fields and decide what is the best fit for you.

 

[MedStud!]

Pediatric Oncology likely would have been my second choice... mostly because for many pediatric malignancies the cure rate can be pretty good. It would be pretty rewarding to save kids lives. I like that in Radiation Oncology we are often offering a cure to our patients, rather than just trying to extend their life with chemo. So both fields have that going for them.

The things that cemented Rad Onc over Med or Peds Onc for me:

1) I really, really dislike hematology. It was my absolute least favorite subject in medical school. I could never see myself treating sickle cell the rest of my life. On the other hand my favorite subject is CNS which is mostly treated with radiation; and you sometimes get to treat kids as well (as the other poster mentioned). We have a faculty member at our institution who treats many pediatric patients... but that is a very specific niche.

2) I'm not sure I could handle the parents day in and day out. You really have to be able to treat the kids AND their parents.

I do like medicine... but not to the extent that it really affected my decision. But I can say without a doubt that the pediatric oncologists were some of the most impressive doctors I have seen. So if you think you will miss the medicine part then you should give Peds Onc serious consideration.

If you haven't yet... do the rotation and see what it is like. If you can't see yourself doing that day in and day out; then its not right for you. Same for Rad Onc. My decision was cemented once I did my Peds Onc rotation. I have tremendous respect for them, but it is not for me.