Career In Oncology Research Articles

From Lepidoptera to uveal melanoma: Finding my career in ocular oncology.

From Lepidoptera to uveal melanoma: Finding my career in ocular oncology.

First Person: Hyman Muss, MD: Geriatric oncology pioneer continues leading efforts to help older patients with cancer.

First Person: Hyman Muss, MD: Geriatric oncology pioneer continues leading efforts to help older patients with cancer.

Cancer Education in Rwanda: Challenges and Opportunities for Undergraduate Medical Students (The EDUCAN Project)

Background: Shortage and lack of trained cancer specialists is one of the major challenges in addressing the increasing cancer burden in low and middle income countries. Inadequate undergraduate cancer education in oncology remains a major obstacle for both task shifting to general practitioners and for training of specialists. We provide the first report of cancer education in Rwanda's undergraduate program to survey how fresh graduates are prepared to provide care for cancer patients. Aim: - Identify the current status of cancer education in one of Rwanda's two medical schools; - Provide a basis for educational reforms that target improvements of cancer knowledge and management. Methods: Anonymous online survey was sent January to June 2017 to medical students in their senior clinical years (year 5 and 6). Questions related to the demographics, medical curriculum and general oncology exposure were included in the survey. Results: Of 192 eligible students, 42% (n=80) completed the survey and were analyzed. The majority were 25 to 29 years of age and 41% were female. Internal medicine was cited to provide the most exposure to cancer patients (50%) and cancer bedside teaching (55%). Close to a half (46%) have been taught oncology formally in addition to bedside teaching. A tenth (11%) of the participants felt comfortable in attending a cancer patient, and a fifth (21%) of the students felt comfortable while addressing multimodality treatment approach. The majority (99%) of the participants preferred having a formal oncology rotation. Of particular interest, 61% of the students are interested in pursuing an oncology career path. Conclusion: There is a need to modify the current oncology undergraduate curriculum to prepare future physicians for delivering cancer care in Rwanda. Raising the profile of oncology in undergraduate medical education will complement the on-going efforts to increase the country's capacity in task shifting an in training of cancer specialists.

"Hey Mom, Now I'm Officially an Oncologist".

An oncologist describes his journey toward a career in oncology in the light of his mother's simultaneous journey through a cancer diagnosis.

The Relationship Between Preresidency Peer-Reviewed Publications and Subsequent Citation-Based Scholarly Activity of United States Radiation Oncology Residents

Preresidency peer-reviewed publications (PRP) have been associated with resident choice of academic versus private practice careers in both neurosurgery and radiation oncology. The relationship between PRP and subsequent citation-based scholarly activity of radiation oncology residents has not been previously examined. A list of 2016 radiation oncology resident graduates (163 residents from 76 Accreditation Council for Graduate Medical Education-certified programs) and their PRP were compiled. The Scopus bibliometric citation database was then searched to collect Hirsch index (h-index) data for each resident, as well as manuscripts limited to first-author only and first- or second-author only for each resident. Analyses were stratified based on the absence or presence of (at least 1) PRP for each resident. The mean h-index score for all resident graduates was 4.15. Residents with at least 1 PRP had significantly higher h-index scores (5.93 vs 2.12; P < .01) than those with no PRP. PRP was also associated with significantly higher first-author only (2.84 vs 1.17; P< .01) and second-author only (3.90 vs 1.47; P < .01) scores. Radiation oncology residents with at least 1 PRP are significantly more likely than those with no PRP to have higher h-index scores, as well as higher scores when stratified by first and/or second authorship. The average radiation oncology resident graduate with at least 1 PRP has published approximately 6 manuscripts cited at least 6 times, been first or second author on nearly 4 manuscripts cited at least 4 times, and been first author on nearly 3 manuscripts cited at least 3 times. More than 30% of graduates without PRP did not publish any cited manuscripts. These results allow for potential predictive evaluation of resident productivity during the radiation oncology residency applicant process and have potential utility in predicting career choices postresidency.

Choosing a career in oncology: results of a nationwide cross-sectional study

BackgroundLittle information is currently available concerning young medical students desire to pursue a career in oncology, or their career expectations.MethodsThis project is a cross-sectional epidemiological study. A voluntary and anonymous questionnaire was distributed to all young oncologists studying in France between the 2nd of October 2013 and the 23rd of February 2014.ResultsThe overall response rate was 75.6%. A total of 505 young oncologists completed the questionnaire. The main determining factors in the decision to practice oncology were the cross-sectional nature of the field (70.8%), the depth and variety of human relations (56.3%) and the multi-disciplinary field of work (50.2%). Most residents would like to complete a rotation outside of their assigned region (59.2%) or abroad (70.2%) in order to acquire additional expertise (67.7%). In addition, most interns would like to undertake a fellowship involving care, teaching and research in order to hone their skills (85.7%) and forge a career in public hospitals (46.4%). Career prospects mainly involve salaried positions in public hospitals. Many young oncologists are concerned about their professional future, due to the shortage of openings (40.8%), the workload (52.8%) and the lack of work-life balance (33.4%).ConclusionsThis investigation provides a comprehensive profile of the reasons young oncologists chose to pursue a career in oncology, and their career prospects.

A Survey of Medical Oncology Training in Australian Medical Schools: Pilot Study.

BackgroundOncology is a rapidly evolving field with continuous advancements in the diagnosis and treatment of cancer. Therefore, it is important that medical students are provided with the knowledge and experience required to care for oncology patients and enable them to diagnose and manage toxicities of novel therapeutic agents.ObjectiveThis study was performed to understand the medical students’ perspective of the oncology education provided in universities across Australia and identify areas of education that could potentially be modified or improved to ultimately attract more students to a career in oncology.MethodsThis pilot cross-sectional study consisted of an 18-question survey that was submitted online to medical students in their final year and interns rotating to the Tamworth Hospital.ResultsThe survey was completed by 94 fifth-year medical students and interns. Oncology was taught both theoretically and clinically for 68% (63/93) of participants, and 48% (44/92) had an exclusive oncology rotation. Both theoretical and clinical oncology assessments were conducted for only 21% (19/92) of participants. Overall, 42% (38/91) of participants were satisfied with their oncology education, and 78% (40/51) were dissatisfied with the number of oncology teaching hours. The importance of a career in oncology was rated as low by 46% (41/90) of participants.ConclusionsThis pilot study indicates that there are potential areas to improve oncology teaching in Australian universities. The majority of surveyed students were dissatisfied with the number of teaching hours they receive in oncology. More global assessment of students and/or interns from other Australian institutes may yield further useful information.

Why choose a career in clinical oncology?

Sally Appleyard and Samantha Cox explain what clinical oncology involves and consider why trainees might want to choose to specialise in this evolving branch of medicine

YI 01.03 Community versus Academic Oncology

YI 01.03 Community versus Academic Oncology

Early Career Outcomes for Radiation Oncologists Interested in Global Health: A Survey of Recent Graduates from ARRO, ACRO, and CARO

To describe the job-seeking experience of recently graduated North American radiation oncologists with a prior interest in global health. The authors distributed an online survey to PGY-5 residents and recent graduates (2010-2016) affiliated with the American Society for Radiation Oncology (ARRO), Canadian Association of Radiation Oncology (CARO), and American College of Radiation Oncology (ACRO) who either served on a global health subcommittee or won a resident society scholarship to rotate abroad in a resource-limited setting. Respondents were queried about global health activities while in training, interest in integrating global health into their career, job placement outcomes, and barriers to integrating global health into their first job placement after residency. Survey responses were compiled using Qualtrics. Of 54 contactable physicians, 22 responses (41%) were received. Seventeen (77%) were affiliated with ARRO, five (23%) with CARO, and two (9%) were affiliated with ARRO & ACRO. Of these 22, with some in multiple categories, fourteen (64%) entered residency with the goal of incorporating global health into their career. Twelve (55%) completed a rotation in a resource-limited setting during residency, twelve (55%) completed research activities related to global health, and eight (36%) received grant funding for global health related projects during residency. Seventeen (77%) sought to continue global health activities when they entered clinical practice. Nine (53%) desired to incorporate global health activities into their academic career and eight (47%) planned to continue global health activities on their own time. Of the respondents who desired to incorporate global health into their career and responded about their success (n=13), success was judged as completely unsuccessful (n=5, 28%), somewhat unsuccessful (n=1, 6%), somewhat successful (n=3, 17%), and very successful (n=4, 22%). Barriers encountered during the job search were lack of protected academic time (n=10, 45%), lack of research funding (n=9, 41%), lack of time for international travel (n=9, 41%), lack of opportunity (n=7, 32%), lack of interest of chair/hiring partner (n=7, 32%), lack of knowledge of how to pursue global health interest (n=7, 32%), and lack of mentorship (n=6, 27%). For the seven respondents who listed factors associated with a successful integration of global health into their career, the most common factor listed was chairperson/departmental support (n=3, 43%). Early career outcomes for radiation oncologists interested in global health appear mixed for integrating global health into their initial job with numerous barriers encountered. Chairperson support is a potentially very important factor for careers in global radiation oncology. This survey can serve as a baseline for future analyses for global radiation oncology career outcomes.

The Evolving Landscape of Systemic Therapy for Well-Differentiated Neuroendocrine Tumors of the Lung

James Yao*, MD, is professor and chairman of gastrointestinal medical oncology at the MD Anderson Cancer Center (TX, USA). He is the chair emeritus of the North American Neuroendocrine Tumor Society (NANETS). He has numerous awards including the American Society of Clinical Oncology Career Development Award 2003, and the Carcinoid Cancer Foundation Research Award 2006, MD Anderson Distinguished Alumni Award 2009, Irwin H. Krakoff Excellence in Clinical Research Award 2011, and The Murray Brennan Distinguished Lecturer, Memorial Sloan-Kettering Cancer Center, 2012. In 1995, Dr. Yao received his doctorate of medicine at Baylor College of Medicine (TX, USA). His credentials include board of certification in internal medicine (ABIM) in 1999 and board of certification in medical oncology (ABIM) in 2003. Dr. Yao has special interests in neuroendocrine tumors and gastric cancer and has authored over 100 manuscripts including practice-changing articles in New England Journal of Medicine and The Lancet. He has also been a principal investigator in numerous investigator initiated and multicenter clinical studies. He led the development of everolimus in neuroendocrine tumors from first patient treated through FDA approval for pancreatic neuroendocrine tumors in 2011 and lung and gastrointestinal neuroendocrine tumors in 2016.

Radiation oncology residency selection: A postgraduate evaluation of factor importance and survey of variables associated with job securement

BackgroundMedical students often choose to pursue a career in radiation oncology with limited meaningful exposure to the field. We previously identified factors that were most influential to an applicant’s rank list order. Here, we sought to assess if residency graduates had differing views regarding those factors. We also polled recent graduates’ attitudes of the current job market. Methods and materialsAn anonymous, internet-based survey was developed and distributed to graduates of radiation oncology residencies from 2003 through 2006 and 2012 through 2015 to assess the importance of factors with regard to residency selection, training, and job securement and attitudes toward the job market within the United States. ResultsResponses were received from 198 of 848 (23%) of those invited to participate. The respondents were divided into 2 cohorts for analysis, an “early” cohort (2001-2009) and a “contemporary” cohort (2010-2016). Respondents recalled “quality of clinical training,” “perceived happiness of residents,” and “sense of community among faculty and residents” as the 3 most important factors influencing the rank list. Postresidency, the most valued factors of the residency experience were “quality of clinical training,” “geographic location,” and “faculty mentorship.” Factors that were assigned the greatest differential value in hindsight to influence the rank list included “faculty mentorship,” “willingness of faculty to call employer,” and “quality of alumni base.” Sixty-four percent of respondents reported the job market to be difficult or very difficult. This perception was more common among contemporary graduates (P < .05). Sixty percent of respondents reported “far too many” or “somewhat too many” residency positions for the actual job needs in the United States. ConclusionAfter training, residency graduates place higher value on factors in residency that can directly improve job procurement. This finding is more common among more recent graduates, potentially a result of the perception of a tightening job market with too many radiation oncologists in training.

Domestic Job Shortage or Job Maldistribution? A Geographic Analysis of the Current Radiation Oncology Job Market

To examine whether permanent radiation oncologist (RO) employment opportunities vary based on geography. A database of full-time RO jobs was created by use of American Society for Radiation Oncology (ASTRO) Career Center website posts between March 28, 2016, and March 31, 2017. Jobs were first classified by region based on US Census Bureau data. Jobs were further categorized as academic or nonacademic depending on the employer. The prevalence of job openings per 10 million population was calculated to account for regional population differences. The χ2 test was implemented to compare position type across regions. The number and locations of graduating RO during our study period was calculated using National Resident Matching Program data. The χ2 goodness-of-fit test was then used to compare a set of observed proportions of jobs with a corresponding set of hypothesized proportions of jobs based on the proportions of graduates per region. A total of 211 unique jobs were recorded. The highest and lowest percentages of jobs were seen in the South (31.8%) and Northeast (18.5%), respectively. Of the total jobs, 82 (38.9%) were academic; the South had the highest percentage of overall academic jobs (35.4%), while the West had the lowest (14.6%). Regionally, the Northeast had the highest percentage of academic jobs (56.4%), while the West had the lowest (26.7%). A statistically significant difference was noted between regional academic and nonacademic job availability (P=.021). After we accounted for unit population, the Midwest had the highest number of total jobs per 10 million (9.0) while the South had the lowest (5.9). A significant difference was also observed in the proportion of RO graduates versus actual jobs per region (P=.003), with a surplus of trainees seen in the Northeast. This study presents a quantitative analysis of the RO job market. We found a disproportionately small number of opportunities compared with graduates trained in the Northeast, as well as a significant regional imbalance of academic versus nonacademic jobs. Long-term monitoring is required to confirm these results.

Factors Influencing Hematology Career Choice in Hematology and Oncology Fellows at a Major Academic Institution

INTRODUCTION/BACKGROUNDThe majority of graduating fellows from hematology/oncology subspecialty training programs in the U.S. pursue careers in medical oncology or in non-academic fields. A workforce shortage of physicians specializing in hematology has been predicted for the next decade. Large-scale surveys have identified a number of factors responsible for this trend, including financial considerations, educational debt, work-life balance, and fellowship exposure. Qualitative studies in other subspecialty fields have yielded unique insights into specific factors motivating career decisions, but no such study has been conducted in hematology. We performed a qualitative study to identify factors influencing trainees' perceptions of careers in hematology.METHODSSenior or graduating fellows in the hematology/oncology training program at Yale School of Medicine were invited to participate in this study. Semi-structured interviews lasting between 30 and 90 minutes were conducted. Recordings were transcribed and analyzed using the framework method.RESULTSEight trainees participated in the study, five in their senior year of training, three shortly after graduation. Five were female. Three held dual M.D. and Ph.D. degrees. Most were planning on an academic career or a career with an academic affiliation; two were specifically pursuing careers in benign or malignant hematology. Trainees' career decisions and perceptions of hematology revolved around five major themes: serendipity, mentorship, clinical exposure and teaching, intellectual interest, and lifestyle factors. Most trainees identified seminal, career-defining experiences prior to medical school but were not influenced by medical school classroom experiences and were not differentiated at the start of fellowship with respect to a hematology- or oncology-oriented career. By the end of their first year of fellowship, almost all had decided to pursue careers in solid tumor oncology owing to clinical exposure and research opportunities. Mentorship was identified as the single most important determinant, with mentorship opportunities tending to occur "randomly" or by "happenstance," and with oncology having "more" "available mentors" who played a "huge role" in the career-decision process. Trainees characterized hematology as having a less desirable work/life balance than oncology, and trainees' experiences on the inpatient hematology services caused some of them to feel "burned out." Despite this, fellows commonly perceived hematology to be more "interesting" and "challenging" than oncology, with "much more complex" disease pathology. Financial considerations were of importance to only a minority of trainees.CONCLUSIONSMentorship and research opportunities are the major factors guiding career decisions among hematology/oncology fellows. An increase in structured mentorship opportunities in hematology may lead to greater trainee recruitment. Trainees view hematology as an intellectually engaging field although lifestyle factors render it less desirable than oncology. DisclosuresPodoltsev:Incyte: Consultancy, Honoraria; Ariad: Consultancy, Honoraria.

Impact of a 2-Week Oncology Placement on Medical Students' Perception of Cancer.

Statistics show that more than one in two people born after 1960 in the UK will develop cancer during their lifetime. However, a 2013 study found that only 36% of UK medical schools offer dedicated clinical teaching in oncology. The aim of this study was to assess the views of medical students on five domains of oncology before and after their first clinical placement, to assess the impact, and to obtain students' views on the oncology curriculum. A 28-item questionnaire was developed to compare responses before and after the students' first 2-week clinical placement, and impact was measured as a positive or negative deviation from a baseline response. Students were asked about their career intentions and to evaluate their received teaching. Thirty-six (80%) students responded to the questionnaire. The largest areas of change were identified in students' confidence in breaking bad news, recognising red flag symptoms, and awareness of the complications of cancer management. Following their placement, 19 students said they would consider a career in oncology, 14 said they would not, and 2 were undecided. Students stated that Maggie's Centre, a patient support facility, was the most useful learning experience. The evidence demonstrates that all students should experience oncology in a variety of settings to aid their learning. Student feedback and perception can help to guide and shape medical teaching.

What is the impact of a career in gynecologic oncology on personal life?

What is the impact of a career in gynecologic oncology on personal life?

Oncology and medical education-past, present and future.

Oncologists should contribute to the undergraduate curriculum whenever they can, and should teach communication skills, acute oncology, prescribing, and other transferable skills. Newly qualified doctors will care for many patients with cancer in their first years of work, and all doctors need to know when an urgent oncology referral is required and to be aware of the pace of change in oncology. Oncologists should involve their patients in teaching whenever it is appropriate. We should aim to inspire junior doctors to consider a career in oncology. The oncology education community should adopt new teaching methods, for example simulation, mock MDTs and student led clinics. CPD provided by honorable organisations, including online learning, is becoming more important for oncologists to keep up to date.

The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents

The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. The new curriculum represents 56hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since the publication of previous recommended curricula, and to provide practical training modules in clinical radiation oncology physics and treatment planning. The PCCSC is committed to keeping the curriculum current and consistent with the ABR examination blueprint.

Barriers to a Career Focus in Cancer Prevention: A Report and Initial Recommendations From the American Society of Clinical Oncology Cancer Prevention Workforce Pipeline Work Group.

To assist in determining barriers to an oncology career incorporating cancer prevention, the American Society of Clinical Oncology (ASCO) Cancer Prevention Workforce Pipeline Work Group sponsored surveys of training program directors and oncology fellows. Separate surveys with parallel questions were administered to training program directors at their fall 2013 retreat and to oncology fellows as part of their February 2014 in-training examination survey. Forty-seven (67%) of 70 training directors and 1,306 (80%) of 1,634 oncology fellows taking the in-training examination survey answered questions. Training directors estimated that ≤ 10% of fellows starting an academic career or entering private practice would have a career focus in cancer prevention. Only 15% of fellows indicated they would likely be interested in cancer prevention as a career focus, although only 12% thought prevention was unimportant relative to treatment. Top fellow-listed barriers to an academic career were difficulty in obtaining funding and lower compensation. Additional barriers to an academic career with a prevention focus included unclear career model, lack of clinical mentors, lack of clinical training opportunities, and concerns about reimbursement. Reluctance to incorporate cancer prevention into an oncology career seems to stem from lack of mentors and exposure during training, unclear career path, and uncertainty regarding reimbursement. Suggested approaches to begin to remedy this problem include: 1) more ASCO-led and other prevention educational resources for fellows, training directors, and practicing oncologists; 2) an increase in funded training and clinical research opportunities, including reintroduction of the R25T award; 3) an increase in the prevention content of accrediting examinations for clinical oncologists; and 4) interaction with policymakers to broaden the scope and depth of reimbursement for prevention counseling and intervention services.

Faculty of Radiation Oncology 2014 workforce census.

IntroductionThis paper reports the key findings of the Faculty of Radiation Oncology 2014 workforce census and compares the results with earlier surveys.MethodsThe census was conducted in mid‐2014 with distribution to all radiation oncologists, educational affiliates and trainees listed on the college database. There were six email reminders and responses were anonymous. The overall response rate was 76.1%.ResultsThe age range of fellows was 32–96 (mean = 49 years, median = 47 years). The majority of the radiation oncologists were male (n = 263, 63%). The minority of radiation oncologists were of Asian descent (n = 43, 13.4%). Radiation oncologists graduated from medical school on average 23 years ago (median = 22 years). A minority of fellows (n = 66, 20%) held another postgraduate qualification. Most radiation oncologists worked, on average, at two practices (median = 2, range 1–7). Practising radiation oncologists worked predominantly in the public sector (n = 131, 49%), but many worked in both the public and private sectors (n = 94, 37%), and a minority worked in the private sector only (n = 38, 14%). The largest proportion of the workforce was from New South Wales accounting for 29% of radiation oncologists. Radiation oncologists worked an average of 43 h/week (median = 43 h, range 6–80). Radiation oncologists who worked in the private sector worked less hours than their public sector or public/private sector colleagues. (38.3 vs. 42.9 vs. 44.3 h, P = 0.042). Victorians worked the fewest average hours per week at 38 h and West Australians the most at 46 h/week. Radiation oncologists averaged 48 min for each new case, 17 min per follow up and 11 min for a treatment review. Radiation oncologists averaged 246 new patients per year (median = 250, range = 20–600) with men (average = 268), Western Australians (average = 354) and those in private practice seeing more (average = 275). Most radiation oncologists considered themselves as specialists (n = 151, 60%), but nearly all those from South Australia were generalists (n = 15, 94%) as were three‐quarters of those from private practice. A minority of radiation oncologist respondents (10%) intended to retire within 5 years with a further 16% within 10 years.There was a stabilisation of trainee numbers in Australia and New Zealand with no increase compared with 2010 (142 in 2014 vs. 143 in 2010). The most common age bracket for trainees remained 31–35 years. One‐third of trainees were of Asian descent and nearly half held other degrees. The majority of trainees were satisfied with their career, but 30% were not entirely satisfied. Nearly half of trainee respondents would have reconsidered their choice of specialty had they known about the possible oversupply in the workforce with 12.4% undecided about continuing their career in radiation oncology. There were still 16% of trainees with no protected time during the working week, and a further 21% with only 1 h. Only one trainee respondent preferred to work in private practice, and job availability remained a concern for 89% of respondents.ConclusionsThe radiation oncologist workforce numbers have increased at a much slower rate, and unemployment remained low. Many parameters remained similar to the 2010 survey. However, there has been a decrease in the average number of new patients seen per year, working hours and also a slight decrease in the time spent per new patient. The trainee numbers have stabilised, but job availability remained a concern. A significant proportion of trainees were not satisfied with their career.