COMMENTARY

If You Like Science and a Challenge, Consider Oncology

Alok A. Khorana, MD

Disclosures

July 02, 2013

The Specialty of Medical Oncology

Why oncology? It's a question that I am often asked -- by trainees, by other physicians, sometimes even by patients or their families. Implicit in this question is the pervasive belief that cancer medicine is a "difficult" specialty. I would like to address this perception and dispel some of the myths about the treatment of cancer.

Oncology as used here refers primarily to medical oncology, which is a subspecialty of internal medicine. A fellowship in medical oncology typically lasts for 2 or 3 years following a 3-year residency in internal medicine. The 2- or 3-year term is determined by whether you are subspecializing in hematology and oncology (3 years) or oncology alone (2 years). Hematology encompasses benign diseases such as anemia and thromboembolism, as well as a greater emphasis on malignant hematologic disorders and stem cell transplant. Surgical and radiation oncology are separate subspecialties, although many of the issues are applicable across the board to the treatment of patients with cancer. And although my discussion centers broadly on medical oncology, it is quite common (particularly in academic medical centers) for oncologists to subspecialize. The most obvious split is hematology (benign or malignant) and oncology (basically solid tumors), but multiple other areas of focus can be pursued. My own practice and research, for instance, focus on gastrointestinal cancers; similarly, other oncologists focus solely on lung, genitourinary, leukemia, or transplant patients.

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