Transplant vs Oncology

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FutureDrDanielle

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Hello everyone. I'm Danielle, and am in college, looking ahead to MS. I'm currently waffling between Transplant Surgery and Surgical Oncology. What are the pros and cons of each? Does one have easier residency slots to come by? Is it possible, or even advisable, to combine them?
 
FutureDrDanielle said:
Hello everyone. I'm Danielle, and am in college, looking ahead to MS. I'm currently waffling between Transplant Surgery and Surgical Oncology. What are the pros and cons of each? Does one have easier residency slots to come by? Is it possible, or even advisable, to combine them?
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Agreed, with above. Both of these are surgical sub-specialties requiring fellowships. Neither is a stand alone residency. One would do a general surgery residency first. You’re a long way off from there.
 
FutureDrDanielle said:
Hello everyone. I'm Danielle, and am in college, looking ahead to MS. I'm currently waffling between Transplant Surgery and Surgical Oncology. What are the pros and cons of each? Does one have easier residency slots to come by? Is it possible, or even advisable, to combine them?
Click to expand...
While we generally discourage such early specialization (since most change their minds not only about super speciality, but speciality once in med school), but for funsies (others should feel free to chime in):

1)Pros and Cons

a) Transplant Surgery
- its cool
- you may find the immunology interesting
- is there anything else?
Cons are legend: unpredictable lifestyle, early burnout, patient population can be "difficult" (ie, drug abusers, alcoholics), probably have to do general surgery as well

b) Surg Onc
- you may find the genetics behind cancer interesting
- surgeries are usually elective
- easier to specialize and be "the melanoma guy", "the foregut guy" etc
Cons: surgeries can be long, patients can be sick, harder to do in community, very academic

2) Transplant has been reputed to take any warm body. The fellowship match is not terribly competitive.

Because Surg Onc is very academic, it generally requires a couple of years in the lab to be competitive. As noted above, these are still general surgery subspecialties, so fellowships done after 5-7 years of general surgery. They are not stand alone residencies.

Combining two separate fields is a pre-meds dream, a la, "I wanna be a neuropsychodermatopulmonologists who operates on children. You either pick one speciality and do it well or spend your lifetime in training, have trouble finding your niche and doing both average or below average.
 
Winged Scapula said:
While we generally discourage such early specialization (since most change their minds not only about super speciality, but speciality once in med school), but for funsies (others should feel free to chime in):

1)Pros and Cons

a) Transplant Surgery
- its cool
- you may find the immunology interesting
- is there anything else?
Cons are legend: unpredictable lifestyle, early burnout, patient population can be "difficult" (ie, drug abusers, alcoholics), probably have to do general surgery as well

b) Surg Onc
- you may find the genetics behind cancer interesting
- surgeries are usually elective
- easier to specialize and be "the melanoma guy", "the foregut guy" etc
Cons: surgeries can be long, patients can be sick, harder to do in community, very academic

2) Transplant has been reputed to take any warm body. The fellowship match is not terribly competitive.

Because Surg Onc is very academic, it generally requires a couple of years in the lab to be competitive. As noted above, these are still general surgery subspecialties, so fellowships done after 5-7 years of general surgery. They are not stand alone residencies.

Combining two separate fields is a pre-meds dream, a la, "I wanna be a neuropsychodermatopulmonologists who operates on children. You either pick one speciality and do it well or spend your lifetime in training, have trouble finding your niche and doing both average or below average.
Click to expand...
Just to add to the general conversation, not so much for the OP yet...

For me some of the cons listed for transplant are pros in my book. I love the patient population and find it the most rewarding specialty, but that's just me. Also, love having the opportunity to continue doing general surgery. Additional pro is that your practice is already built for you from day 1 in the form of the transplant wait list. And another pro is the field is relatively 'young' with many exciting new developments and changes ongoing both in the medical/surgical care, and policy surrounding it. Additional con...and the reason I didn't choose transplant...job options are quite limited compared to other gen surg subspecialties. People argue this will change with xenotransplantation if that truly takes off, but still unclear.

Anyway, not sure why I'm defending transplant so much this morning. Vascular is clearly the best.
 
Thanks everyone for the feedback! I'm DEFINITELY putting the cart before the horse, but wanted to feel prepared. I already knew I'd be doing a Gen Surgery residency 1st, but wanted to know if 1 field was more competitive for fellowships. It sounds like "transplant oncology" isn't a thing? (Not that I REALLY thought it was) someone above alluded to kids having ideas like that in their heads.
 
BTW: why I thought "transplant oncology" would be a thing: doing transplants on patients whose organ was compromised by cancer.
 
FutureDrDanielle said:
BTW: why I thought "transplant oncology" would be a thing: doing transplants on patients whose organ was compromised by cancer.
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Indications are limited. Off the top of my head are liver transplants for hepatocellular carcinoma and cholangiocarcinoma (very selective). It's more the domain of transplant surgery than surg onc.
 
FutureDrDanielle said:
BTW: why I thought "transplant oncology" would be a thing: doing transplants on patients whose organ was compromised by cancer.
Click to expand...
As noted above, indications are limited as malignancies are often systemic diseases. There are very few in which surgical management is the sole treatment (excluding those such as renal cell where adjuvant therapy isn't very effective). Removing a malignant organ and transplanting it with a donor organ ignores the systemic nature of cancer.
 
Before you decide on transplant surgery read “When Death Becomes Life” by Joshua Mezrich. It will either convince you or dissuade you entirely.
 
FutureDrDanielle said:
BTW: why I thought "transplant oncology" would be a thing: doing transplants on patients whose organ was compromised by cancer.
Click to expand...

You should pioneer transplanting cancer from one patient to another. Would there be a point to it? Probably not, but it would really get your name out there.
 
Med Ed said:
You should pioneer transplanting cancer from one patient to another. Would there be a point to it? Probably not, but it would really get your name out there.
Click to expand...
Fun fact: there are actually examples of both intraspecies cancer transmission (dogs, Tasmanian devils, Syrian hamsters, some bivalves, and immunocompromised patients accidentally receiving cancerous organ transplants) and interspecies cancer transmission (I know of one case where an HIV patient died of a tumor that had tapeworm [H. nana] origins). All of these are transmission via a clonal non-viral vector.
 
MemeLord said:
Fun fact: there are actually examples of both intraspecies cancer transmission (dogs, Tasmanian devils, Syrian hamsters, some bivalves, and immunocompromised patients accidentally receiving cancerous organ transplants) and interspecies cancer transmission (I know of one case where an HIV patient died of a tumor that had tapeworm [H. nana] origins). All of these are transmission via a clonal non-viral vector.
Click to expand...

Huh? Died of a tumor that had tapeworm origins?

This makes no sense to me. Do you have the article?
 
bump

For OP- I would say there is a lot of oncology in transplant. HCC is an interesting disease and the management is complex. Transplant surgeons do a lot of transplants for HCC (often a third of center volume) as well as resections.

In addition to HCC, indications for transplant include selected cases of hepatoblastoma (Peds), unresectable Cholangiocarcinoma, and Metastatic neuroendocrine to the liver. Sweden transplants for metastatic colon cancer to the liver.

Other oncology-related diseases and patient problems include PTLD/lymphoma from Immunosuppression, recurrent cancer after transplant (treatment and modulation of immunosuppression), and cancer in the donor (how cancer hx impacts offer acceptance as well as unexpected findings at time of procurement).

Depending on your practice setting, transplant surgeons may do HPB surgery for their hospital.
 
FutureDrDanielle said:
Hello everyone. I'm Danielle, and am in college, looking ahead to MS. I'm currently waffling between Transplant Surgery and Surgical Oncology. What are the pros and cons of each? Does one have easier residency slots to come by? Is it possible, or even advisable, to combine them?
Click to expand...
Hi! First, go enjoy college. It's a time in your life that you'll never get back. Do something fun!

Don't try to pick one specialty now. You're not in medical school yet. Everyone I know who went to med school thought they wanted to do one specialty, but changed their mind after rotations. Be open minded and keep your options open.

That said, I do know a transplant surgeon. Sometimes he has crazy hours (as can be expected), but he does a ton of research. He spends a lot of time doing research.
 
Oh, I definitely hope to make the most of college! Glad Transplant and a Oncology are SOMEWHAT blendable.
 
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