Subspecialty Careers: Highlights about Careers in Internal Medicine: Medical Oncology
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.
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.
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.
The American Board of Internal Medicine, ABIM, offers certification in medical oncology, and hematology and oncology.
For the 2010-2011 academic year, there are 14 ACGME-accredited training programs in Medical Oncology with 99 active positions. Forty-two percent of the trainees are female and 41% are U.S. medical graduates. There are also 131 programs with 1,412 active fellowship positions in hematology and oncology. Forty-four percent of the trainees were female and 54% were U.S. graduates.
Major Professional Societies
American Society of Clinical Oncology
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