Subspecialty Careers: Highlights about Careers in Internal Medicine: Medical Oncology
The Discipline
The word oncology is derived from the Greek word ongkos, meaning “a bulk or mass,” which later was changed to mean “a tumor.” Medical oncology is the subspecialty which involves the diagnosis and management of benign and malignant neoplasms. Oncologists typically identify individuals at risk for malignancy and counsel them regarding risk reduction and screening, investigate clinical symptoms and syndromes suggestive of underlying malignancy, identify and treat neoplasms with a potential for cure, and undertake the care of patients with solid and hematologic tumors to prolong life and/or palliate symptoms.
Procedures
Important procedural skills for the oncologist include bone marrow aspiration and biopsy and, for some oncologists, fine needle aspiration of the thyroid and breast. In addition, the oncologist is an expert in interpreting bone marrow cytogenetics and immunophenotyping, cytology and pathology, estrogen and progesterone receptor assays, and serological molecular markers for tumors.
Training
Medical oncology fellowship training requires two years of accredited training beyond general internal medicine residency. Of the two years, a minimum of 12 months must include clinical training in the diagnosis and management of a broad spectrum of tumors. In addition, a minimum of one half-day per week must be spent in a continuity outpatient clinic for the entire two-year curriculum.
Dual certification in hematology and medical oncology requires three years of full-time combined fellowship training which must include: (a) a minimum of 18 months of full-time clinical training with patient care responsibility; (b) a minimum of 12 months in the diagnosis and management of a broad spectrum of neoplastic diseases including hematological malignancies; and (c) a minimum of six months of training in the diagnosis and management of a broad spectrum of non-neoplastic hematological disorders. During the entire three years the trainee must attend at least one outpatient clinic for a minimum of one half-day per week and be responsible for providing continuous care to a defined cohort of patients being managed for neoplastic and hematological disorders.
Certification
The American Board of Internal Medicine, ABIM, offers certification in medical oncology, and hematology and oncology.
Training Positions
As of August 2005, there were 125 ACGME-accredited training programs that offered 1,164 combined fellowship training positions in hematology/oncology. There were also 18 ACGME-accredited training programs in medical oncology with 160 active training positions. 42% of the trainees were female, and 54% were United States medical school graduates.
Practice
Approximately 50% of the graduates from combined training programs enter clinical practice in hematology and oncology in the United States, and 42% enter academic medicine. Approximately 35% of the graduates who receive only medical oncology fellowship training enter clinical practice in the United States, and 49% enter academic medicine.
Major Professional Societies
American Society of Clinical Oncology
1900 Duke Street, Suite 200
Alexandria, VA 22314
(703) 299-0150
asco@asco.org
Major Publications
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