Questions about Heme/Onc in practice (2024)

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maruchan

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  • Jan 24, 2015
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gutonc

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  • Jan 24, 2015
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maruchan said:

Hey, MSIII here deciding between radonc and heme/onc, leaning towards the latter. Would appreciate insight into any of these few questions:

- I should do heme/onc rather than rad onc if I like _______________________

Working harder than necessary, being on call and rounding on the weekends.

Honestly, if you're smart enough to pass all the rad onc boards, you should do rad onc. Good for you for thinking about this while you still have a chance to choose.

- As an attending, how often are you on call? One week out of four?
- What does being on call entail? How often do you come in on the weekends, and for what?

This will differ from group to group. Don't get hung up on it. But here are 2 real world examples. My group has 12 docs and we cover 7 different hospitals. We split our call between weeknights and weekends. It works out to 2 weeknights a month and 4or 5 weekends (Friday 5p to Monday 8a) a year.

Nights involve a few phone calls. Weekends involve rounding wherever we have inpatients. Some weekends it's a couple of hours a day, some are 7 to 7 driving between 6 different hospitals.

As a counter example, a good friend of mine joined a small group of 3 docs. They do a classic call schedule of every 3rd week but have far fewer patients and only cover 1 hospital.

- How does the above differ between academics and private practice?

Dramatically.

- What percentage of cases do you treat palliatively, as opposed to for cure?

This question pisses me off. Nobody ever asks the pulmonologist how many of their COPD patients they treat curatively, or the cardiologist how many of their CHF patients they treat curatively. News flash...everybody dies. Some do it sooner than others. As an oncologist, a lot of your patients will die, many of them from cancer. You either figure out how to deal with that or you do rheumatology.

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  • Jan 24, 2015
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Thanks!

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  • Mar 21, 2015
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gutonc said:

This question pisses me off. Nobody ever asks the pulmonologist how many of their COPD patients they treat curatively, or the cardiologist how many of their CHF patients they treat curatively. News flash...everybody dies. Some do it sooner than others. As an oncologist, a lot of your patients will die, many of them from cancer. You either figure out how to deal with that or you do rheumatology.

It shouldn't. It's a legit question. Copd and chf are chronic diseases of malfunctioning organs. Cancer is an acute disease process that can sometimes end up being managed for years after is diagnosed when it recurs/persists etc, but in the early stages and certain locally advanced stages, it can be cured.

Rad onc and surg onc have their fair share of curative cases. In fact, pretty much every surgical case is usually "definitive." In radiation oncology, we probably have a 50/50 split.

Medical oncology treatment in solid tumors is mostly palliative unless you are sensitizing with radiation or giving adjuvant/neoadjuvant with surgery and/or radiation.

Leukemia/lymphoma/germ cell tumors are the exceptions to this, generally.

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haujun

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  • Mar 21, 2015
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Good point. Also break down is not easy as black and white (cure vs palliative) as one patient can present with locally advanced tumor s/p surgery or definitive XRT for a cure and that same patient will come back one year with metastasis and the goal of care would then be palliative...Overall goal would be providing personal care to patient to improve quality of life. I have seen too many cancer that would relapse after 5 years...

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carrigallen

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I think the palliative vs. curative is a dismal simplification. No patients walk into the clinic asking for "palliative treatment only, please". Our goal is to help that patient live as long as possible. There are a lot of patients walking around with Stage 4 cancer who are in remission. Conversely, up to two-thirds of the locally advanced adjuvant or definitive cases will recur in a few years, depending on the tumor type. I think that patient outcomes usually depend on an important interaction with their socioeconomic situation, family support, and coping skills.

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  • Mar 26, 2015
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carrigallen said:

I think the palliative vs. curative is a dismal simplification. No patients walk into the clinic asking for "palliative treatment only, please". Our goal is to help that patient live as long as possible. There are a lot of patients walking around with Stage 4 cancer who are in remission. Conversely, up to two-thirds of the locally advanced adjuvant or definitive cases will recur in a few years, depending on the tumor type. I think that patient outcomes usually depend on an important interaction with their socioeconomic situation, family support, and coping skills.

Agree that there can be a spectrum, but upfront, you kinda have an idea of which way you are trying to go. You are going to try and cure those locally-advanced non metastatic patients upfront, and then obviously it becomes palliative if/when they recur or met out.

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Questions about Heme/Onc in practice (2024)

FAQs

How competitive is heme onc? ›

Hematology-oncology fellowships are highly competitive. To become an attractive candidate, it can be helpful for you to: Participate in research in your field.

What is the difference between a medical oncologist and a heme oncologist? ›

Oncology (on-KOL-uh-jee) is the medical specialty that studies and treats cancer. Hematology-oncology (often called hem-onc) is the study, diagnosis, treatment, and prevention of blood diseases and cancer.

What is a heme oncologist? ›

Hematology oncology combines two fields of medicine: hematology, which is the study of the blood, and oncology, the study and treatment of cancer. Hematologic oncologists are trained in the diagnosis, treatment and prevention of blood cancers and blood-related disorders.

What is the acceptance rate for heme oncology? ›

Statistics on the Hematology-Oncology Match

In 2022, hematology-oncology had a total of 3,669 applicants and 663 spots. This equates to 5.5 applicants per position. Of the 1,267 U.S. MD seniors who applied, 148 did not match.

How much does a heme onc doctor make in the US? ›

Hematology Oncology Physician Salary. $129,000 is the 25th percentile. Salaries below this are outliers. $250,000 is the 75th percentile.

Why choose hematology oncology? ›

Hematology is deeply rewarding work, with the opportunity to help patients with life- threatening illnesses through both hands-on patient care and practice-changing research. Advances in the field of hematology have increased hematologists' ability to cure patients or help them achieve greater quality of life.

Why do hematology and oncology go together? ›

Oncologists diagnose and treat all kinds of cancer. Hematologists focus on problems with your blood and parts of your body that help produce blood. That said, there's a natural overlap between hematology and oncology, as many types of cancer start in blood cells in your bone marrow and lymphatic system.

How hard is the OCN exam? ›

How hard is the OCN exam? The OCN exam is a complicated exam to pass, but if you study well beforehand, passing on your first attempt is more than possible.

How much does the OCN exam cost? ›

The cost to take the OCN exam is $300 for ONS/APHON members and $420 for non-members.

How long is OCN certification good for? ›

ONCC certifications are valid for four years. Three renewal options are available for most credentials - Option 1 is most popular. You must have a current, active, unencumbered RN license and meet the requirements for the specific renewal option.

Why is heme so important? ›

Heme is an essential molecule for living aerobic organisms and is involved in a remarkable array of diverse biological processes. In the cardiovascular system, heme plays a major role in gas exchange, mitochondrial energy production, antioxidant defense, and signal transduction.

What are the most common heme cancers? ›

Common types of hematologic cancer are lymphoma, myeloma, and leukemia.

What is the main function of the heme? ›

The heme attached with the hemoglobin molecule or myoglobin is known as the heme group, while the separate heme is known as the heme molecule. The heme group helps in the transport of oxygen in the body. Heme molecule also helps in respiration, detoxification of drugs, and other different biological functions.

How hard is it to match hematology and oncology? ›

The percentage of applicants matched in their top 3 programs increased from 53.4% in 2009 to 57.4% in 2022 (range: 50-62%). Conclusions: The hematology and oncology fellowship match is highly competitive with outcomes more favorable to US-allopathic graduates than non-US allopathic graduates.

What is the match rate for heme onc? ›

This figure included 3,892 graduates of MD medical schools, 1,093 graduates of DO medical schools, 935 U.S. citizen international medical graduates, and 1,715 non-U.S. citizen international medical graduates. With regard to hematology and oncology, 703 applicants matched out of a pool of 923, or 76.2%.

Is it hard to match into radiation oncology? ›

Is Radiation Oncology IMG Friendly? Radiation Oncology is moderately IMG-friendly, with an overall 58% match rate and 11% of spots filled by IMGs in the 2022 Match. In 2022, 12 US IMGs and 24 non-US IMGs applied to Radiation Oncology; 8 US IMGs and 13 non-US IMGs matched.

How many people apply to the Heme Onc fellowship? ›

Over 400 applicants apply annually.

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