Single boarded medical oncology in US practice option

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icecoo

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Hi, I'm a Canada trained medical oncologist. Came down to US for fellowship and stayed to practice in academic setting treating melanoma until 1.5 years ago when I had to take a break from practice to be a caretaker for family and worked on oncology clinical trial design (non-clinical) during the gap. I'm resuming practice as a volunteer clinical faculty at the same university doing some inpatient heme/onc ward work soon. I'm wondering what are the options to return to practice considering I'm single-boarded in medical oncology, having only practiced in academic setting specialized in treating a rare cancer, and also have a gap to address.

I'm going to see if the place I previously practice is hiring first. But otherwise, are there locum works in melanoma/solid tumor oncology only to bridge the gap? Can I work in the community being only trained in med onc? Thank you for any advice that you may have!
 
Hey - I can speak a bit to this.

I am med onc boarded only, and I’m only comfortable with solid tumor - and within solid tumor, I’m only comfortable with some solid tumors.

I found a community job with only minimal trouble last year. However, I was very geographically flexible, which helped a lot.

Being melanoma only is a bit more restrictive than I was - if you’re willing to see a few more solid tumor types, it might open up quite a few more positions.
 
Hey - I can speak a bit to this.

I am med onc boarded only, and I’m only comfortable with solid tumor - and within solid tumor, I’m only comfortable with some solid tumors.

I found a community job with only minimal trouble last year. However, I was very geographically flexible, which helped a lot.

Being melanoma only is a bit more restrictive than I was - if you’re willing to see a few more solid tumor types, it might open up quite a few more positions.
How do you take call?
 
The single board thing is mostly irrelevant. I'm single boarded (onc) and have been practicing in the community my entire career. For the first 12 years I was in an academ-ish setting that allowed me to mostly focus on a few organ systems (GI, thoracic, breast, melanoma) but I still saw whatever came my way when the other person who saw most of that (GU, heme, brain, HN) wasn't available. 2 years ago I moved to a rural CAH position where I'm solo practice and the only non-locums oncologist within a large catchment area (60 miles in one direction, 120-200 miles in every other direction to the next nearest hem/onc). I see literally everything including a large amount of classical heme. So that part is "easy". Just a lot of self-directed learning.

You have to address both a practice gap and a knowledge gap if you're going to practice in any setting, especially a more generalist one.

There are definitely melanoma-only, or melanoma mostly jobs out there in large community based groups (primarily hospital employed), but you don't necessarily have to limit yourself to that with some work upfront.
 
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  • Yes, you can work in some community settings with being Med Onc only. While melanoma is specialized, I think you could position yourself as having relevant experience for a variety of solid tumors. You have broad familiarity with immunotherapy, cytotoxics and targeted therapy and managing the toxicities of those therapies. I see oncology as moving away from "primary site" to "primary driver mutation" treatment planning and delivery.
  • The longer the gap, the harder it will be to get credentialed, so I'd take a job in clinical oncology sooner rather than later. Our hospital requires a re-entry pan with a supervising physician if there is a lapse in clinical practice. There will always be a re-entry plan needed if it has been >2 years. Different hospitals may have different requirements. Volunteering or locums is ok, but a paid full-time job will be better. The VA comes to mind as having some lower barriers to entry (ie accept any state license). After you have worked somewhere full-time for a year, the gap won't impact your credentialing so you'd be free to move around.
 
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