Subspecializing in Thoracic/Lung medical oncology, non academic setting: feasible/possible?

[EatMorChikungunya]

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Hi all. I'm currently in Heme Onc fellowship at a low tier community program.

When I finish I'd like to subspecialize in a field of onc, and lung in particular interests me the most. Don't really want to do general, and not particularly interested in research/academic settings.

1) Would it be possible to subspecialize and only see thoracic/lung clinically, in non academic setting? Whether that be private practice/hospital employed/hybrid etc.
2) What would the typical salary be for this type of position?
3) Advisable to pursue a 1 year thoracic oncology fellowship to gain more knowledge? My training to be honest is sub par at best.
4) Does anyone know of particular groups in the Denver, CO area that would offer this type of setup? That's where my husband is and I'd like to end up there.

Thank you for any and all advice!

 

[HemeOncHopeful19]

ONLY see lung? Probably not

BUT you might could find a group where you could carve out a niche as the “guy that likes to see lung and is willing to hit up the thoracic tumor boards” and end up slanted toward a thoracic heavy clinic while still seeing a bit of everything.

 

[gutonc]

Hi all. I'm currently in Heme Onc fellowship at a low tier community program.

When I finish I'd like to subspecialize in a field of onc, and lung in particular interests me the most. Don't really want to do general, and not particularly interested in research/academic settings.

1) Would it be possible to subspecialize and only see thoracic/lung clinically, in non academic setting? Whether that be private practice/hospital employed/hybrid etc.

Maybe. If you were to work in one of the large academ-ish groups out there, you might be able to find such a position. But many of these are going to also want some (at least clinical) research output from you. More likely to be the "prefers lung" person who also sees all the head/neck, thyroid and upper GI or CNS cancers.

2) What would the typical salary be for this type of position?

Too variable to answer this question. $1-1,000,000 roughly.

3) Advisable to pursue a 1 year thoracic oncology fellowship to gain more knowledge? My training to be honest is sub par at best.

Waste of time.

 

[MifflinDunder]

Following this for the future. I may do something similar but GU.

 

[CatFactorial]

Following this for the future. I may do something similar but GU.

Malignant hematology/transplant/cell therapy FTFY

 

[MifflinDunder]

Malignant hematology/transplant/cell therapy FTFY

Honestly, I don’t want be on call that much or entertain job offers with the same base salaries as hospitalists. I already spoke to recruiters and I know the latter is more common in the heme world. I guess more importantly and maybe it’s just my training, solid tumor literally make more sense to me than heme does.

 

[HemeOncHopeful19]

Malignant hematology/transplant/cell therapy FTFY

 

[MifflinDunder]

 

[gutonc]

Following this for the future. I may do something similar but GU.

As long as you can convince your local urologists to send you every hormone sensitive prostate cancer they see, this is more do-able. But in the community, many of them are not interested in giving up that revenue stream.

 

[JoeDilly]

As long as you can convince your local urologists to send you every hormone sensitive prostate cancer they see, this is more do-able. But in the community, many of them are not interested in giving up that revenue stream.

The "oh this patient's prostate cancer is finally progressing through ADT +/- ARPi and now my cash cow actually requires me to think and do medicine and care" community urology dump is my absolute favorite referral. Characteristics usually include:

- Patient never offered triple therapy
- Patient with no idea they've had metastatic disease for years
- Bicalutamide started/stopped on multiple occasions throughout course, seemingly at random
- Cross-sectional imaging repeated for PSA increase of 0.00001 or PSADT <800 yrs
- Progress note comprised of a list of every PSA ever checked and literally no other information

Always a treat.

 

[flowers]

Hi all. I'm currently in Heme Onc fellowship at a low tier community program.

When I finish I'd like to subspecialize in a field of onc, and lung in particular interests me the most. Don't really want to do general, and not particularly interested in research/academic settings.

1) Would it be possible to subspecialize and only see thoracic/lung clinically, in non academic setting? Whether that be private practice/hospital employed/hybrid etc.
2) What would the typical salary be for this type of position?
3) Advisable to pursue a 1 year thoracic oncology fellowship to gain more knowledge? My training to be honest is sub par at best.
4) Does anyone know of particular groups in the Denver, CO area that would offer this type of setup? That's where my husband is and I'd like to end up there.

Thank you for any and all advice!

1) You'll likely see everything on call and then hand over some cases to partners who do breast/heme/GU. I think if you do lung plus something else you could have a nice practice in lots of settings.
2) The less flexibility you have the lower the salary. If you are both geographically constrained and site constrained you will make less than if you are a geographic and site agnostic free agent.
3) No, would not advise more training. Just like in medical school the best training is to read about your patients. Except now you can listen to podcasts/watch webinars etc. If you have EPIC you can use the "lookalike" feature for rare diagnoses and reach out to others. For example, if you have a patient with Necrobiotic Xanthogranuloma. You can use EPIC to find an academician who has treated a similar patient recently. EPIC gives you their contact info, so you can reach out and ask.
4) No knowledge of Denver groups. Can you husband follow you or is Denver a non-negotiable? Your marriage and family is vital so finding what your must haves vs your wants will be important.

Good luck!