Become an Oncologist

An oncologist is a medical doctor who specializes in the treatment of cancer. There are typically three types of oncologists who work together to help treat a patient with cancer - a medical oncologist (who focuses on treating cancer with medication such as chemotherapy), a surgical oncologist (who focuses on removing cancer surgically) and a radiation oncologist (who focuses on treating cancer with various types of radiation). The American Society of Clinical Oncology (ASCO) also recognizes gynecological oncologists (who specialize in cancers of the female reproductive organs), pediatric oncologists (who specialize in treating children with cancer), and hematological oncologists (who specialize in cancers of the blood like leukemia). Becoming an oncologist will be ambitious, challenging, and arduous. But maybe more importantly being an oncologist will be rewarding, stimulating, and worthwhile.

Steps

Determining if Medicine and Oncology Are Right for You

1. Keep a career journal. Buy a brand new journal and use it only for career-related entries. Have it with you when you conduct career research. Makes notes not only about the information you locate during your research, but you personal thoughts and feelings about what you’ve found. Write down questions that arise while doing your research and work to get answers for them. Practice job interview questions and answers. Makes notes about things that went well and didn’t go well in interviews.
   • Your career journal can be as structured or carefree as you want. There are no set rules as to what it should or should not contain. Allow it to reflect your personality so you’ll feel comfortable writing in it on a regular basis.
2. Conduct research about medical careers. There are many places you can go to research different types of jobs and careers, including your guidance counsellor, a university career center, a career coaches and websites, government websites, journals and magazines, newspapers, blogs, books, and more. Start by selecting one or two of these options and investigate the details regarding a career in medicine, specifically oncology.
   • Learn about the details of what the job does, what type of work environment they have, educational requirements, potential pay ranges, and even what the future job market may look like.
   • Read the advice and opinions of people who are already medical doctors and oncologists, possibly via personal blogs or a day in the life of articles.
   • Record your findings, ideas and questions in your career journal.
3. Volunteer at a hospital, medical clinic or nursing home. All major hospitals and medical clinics will have formal volunteer programs. Contact the volunteer coordinator and determine the application process. Apply for a volunteer position. Focus on departments or organizations related to oncology.
   • Consider volunteering for a local cancer charity event, like a marathon, golf tournament, or daffodil days. Use the opportunity to speak with cancer patients and their families.
   • Consider volunteering at a camp for children with cancer. Use the opportunity not only to make the kid’s happy, but to see how the disease affects children and the potential you have to help them in the future.
   • While volunteering think about what it would be like to be in a similar environment on a regular basis. What sorts of things bother you? Can you overcome them? Do you find it emotionally difficult to deal with the patients? Use this as a learning experience to help assess if oncology is still the right career goal for you.
4. Shadow an oncologist. You will definitely have the opportunity to do something like this while in medical school, but you may want to complete a job shadow at least once before medical school to gain a better understanding of what an oncologist does on a daily basis. Some hospitals may have formal job shadowing programs, but you can also reach out personally to a department or doctor to request a job shadow.
   • The volunteer program at a hospital, or the career center at a medical school, may be able to recommend a specific oncologist to contact directly. Or they may be able to provide you with a formal process to follow to sign up.
   • Bring your career journal with you to take notes. As a job shadower, you’re there to observe, not necessarily participate. Watch what goes on and write down your questions, ideas and observations.
   • Once the doctor is finished with his/her patients, go over your questions with them. There are no bad questions.
   • Dress appropriately. If you’re in a hospital setting you’ll probably be on your feet for a long time, so make sure you’re comfortable. But also dress professionally as you want to project a respectful image to both the doctor and the patients.
   • Write about your experiences in your career journal.
   • Send the doctor you shadowed, and anyone else who helped make it happen, a thank you card afterwards. Maybe throw in a coffee gift card too - no doubt every doctor would appreciate coffee!
   • Be very respectful of the patients. Information you learn that is of a personal nature will be confidential and you should not talk about it with anyone other than the doctor your shadowing. Do not assume every patient is going to want you around, allow the doctor to introduce you and if the patient is uncomfortable, wait outside the room.
5. Develop a mentor/mentee relationship with an oncologist. A mentor is someone who is an experienced oncologist who has agreed to advise and counsel you about oncology and an oncology career. You may not be able to obtain a mentor such as this until your internship or residency as a mentee really should be pursuing the career already.
   • Formal mentoring programs do exist. If your medical school or hospital has one, definitely take advantage of it. If they don’t, actively seek out a mentor informally by becoming involved with the work of an oncologist you admire.
   • Use your career journal to make notes of your observations, ideas and questions.
6. Review your career journal regularly. Remember to look at your career journal on a regular basis. Determine if you have any outstanding questions you'd like answered - and get them answered. Write down any new thoughts and ideas that have come to mind since the last time you wrote in your journal. Keep track of any experiences you've had that are career-related, even if they aren't specifically related to medicine. Reevaluate your career goals and/or plans if you feel they've changed.

Applying to an Undergraduate “Pre-Med” Program

1. Choose a pre-med undergraduate program. Most universities do not have formal pre-med programs. And in fact, medical schools, in general, do not require a specific undergraduate degree in order to apply. As harsh as it sounds, medical schools are more interested in your overall GPA and your MCAT score. Therefore, your goal in choosing an undergraduate program should be that it helps you achieve the highest GPA and MCAT scores possible.
   • Review pre-med program rankings. There are many organizations that rank colleges and universities in different ways, including what schools have the best pre-med program. While you certainly don’t need to apply to the best, if you can, you should.
   • When selecting a program consider the following: Does the program prepare me properly for the MCAT? Does the program maximize my chances of getting the best GPA possible? Does the program help me obtain another career if I don’t end up in medical school? Does the program help me in medical school? Your undergraduate program doesn’t have to be in biology, or even science. If you can get better grades by completing an undergraduate humanities degree, go for it.
   • Use the Association of American Medical College’s (AAMC) Pre-Med Coursework Worksheet to select a program that will allow you to complete all the course requirements.
2. Select an undergraduate post-secondary institution. If you’ve selected your program based on school rankings, skip this step. Once you’ve figured out what type of degree program you want to pursue, you now have to find a place to pursue it. Determine if you have any specific restrictions that limit your choices - i.e. financial, geographical, etc. Eliminate any schools do not offer the program you want, or include the restrictions you’ve identified.
   • Make a list of all the possible undergraduate schools that meet your criteria. Write down what your priorities for an undergraduate school are - for example, low cost, far away from home, also has a medical school, great pubs, etc. - and then rank them. Score each school against your priorities, then rank the schools. Select your top 20 or so schools to investigate further.
   • Obtain undergraduate admissions packages from each of your selected schools and review them.
   • Sign-up and attend local school information sessions, if they’re offered.
   • Sign-up and attend on-campus school tours and discipline-specific information sessions.
   • If possible, speak to a current or former student and ask their opinion about the school.
   • If possible, speak to a couple of current professors in your programs of interest and ask why you should attend that particular school.
   • Speak to your high school guidance or university counsellor for advice.
   • Review university/college rankings.
   • Assess each school (using your career journal) and make a final ranking.
   • Select how many schools you’re going to submit an application for. There is no real limit to how many applications you submit, except money and time. Each application comes with a fee, which is anywhere between $40 and $100. While there is no general consensus on the ideal number, the most common number is between 6 and 14.
   • If in doubt, go with your gut!
3. Submit your undergraduate admissions applications. Over 500 colleges accept something called The Common Application, which, when used, can significantly reduce the amount of time required to apply to an undergraduate program. If you are applying to one or more of the Common Application member schools, you can complete the application process on their website and will only need to complete the standard portions of the application once. For any schools who are not Common Application members, you will need to go to their admissions website to complete the application. For the purpose of an example, we’ll use Rutgers University, which does not accept the Common Application.
   • Go to the university’s undergraduate admissions website and find the location of the online application portal. Go to the online portal and register for an account.
   • Check the admissions website for application deadlines for the term you’d like to start - most commonly it would be the fall term, starting in September. The timeline will also include the date by which a decision is made and communicated to you, and the date by which you have to tell the university if you’re going to attend.
   • Take note of the required application fee, and how it is to be paid. Most universities will require the fee to be paid before they’ll even look at your application.
   • Look for an application checklist which will list all the items you’ll need to submit or do for the application. The checklist will normally include additional items like your self-reported academic record or high school transcripts and SAT/ACT scores. Make sure you have these items ready, or have already electronically submitted them to the university.
   • Review the requirements for an admissions essay, including how it needs to be submitted. Write a first draft of your essay and then have someone (like a parent or guidance counsellor) review it. Revise, edit and complete your essay.
   • Review whether your application will require a list of extracurricular activities, which would include employment, community service/volunteering, athletics, etc.
   • Review whether your application will require letters of recommendation. If required, determine how many you need, and who they have to be from (i.e. teachers, parents, employers, etc.). Select whom you’d like to have write you a letter and ask them. Remember to send them a thank you once they’ve submitted the letter! Note that in some cases letters of references must be submitted directly to the university from the referee.
   • Log into the admissions application portal and complete the application, then submit it.
4. Confirm your acceptance to an undergraduate post-secondary institution. Keep track of the decision dates that were outlined on the university’s admissions website. There may be multiple dates if the university allows for early admissions application. Most universities will provide a decision in the online admissions portal where you submitted your application, or via a specific email address that you registered for. Check the online portal (at least) after the decision deadlines to determine which schools you’ve been accepted to.
   • In general you’ll get one of three types of responses - accepted, rejected or waitlisted.
   • You are not required to confirm your acceptance before May 1st (for fall admission), so don’t make any final decisions until you’ve received responses from all your applications.
   • Once you’ve received all responses, accept the offer from the highest ranked school you determined in previous steps - unless you’ve changed your mind.
   • Acceptances are usually followed by an enrolment or registration deposit to hold your spot at the school. You should only submit an acceptance and enrolment deposit to one school.
   • After you’ve been accepted you’ll normally receive invitations to come (back) to the school for tours and events. Attending them isn’t required, but you’ll certainly view the school differently now that you know you’ll be attending!
5. Complete your undergraduate education. The most important part to remember throughout school is to ensure you’ve completed all the required prerequisite courses for your medical school application.
   • Keep track of your GPA. Consider dropping a course before the appropriate deadline (the deadline by which you can drop a course and it will not appear on your transcript) if you think you’ll end up with a bad grade.
6. Participate in non-academic activities. All medical school applications will want to know about your non-academic activities, including awards, employment, volunteer work, sports, school groups, etc. Follow the AAMC’s Timeline for Application/Admission to Medical School PDF to make sure you complete as many extracurricular activities as you can that will be helpful for medical school admission.
   • Apply for medical or science-related internships during the summer months.
   • Apply for research assistantship positions (paid or unpaid) during the summer and school terms.
7. Build relationships with your professors. All medical schools will require at least 2-3 letters of recommendation from someone who knows your abilities and skills. Letters from university professors, doctors, deans and associate deans, etc., are normally required. Volunteering in a professor’s lab, or working in a medical research centre, will make sure the professor knows you well enough to write a letter.

Applying to Medical School

1. Write the MCAT. The MCAT, or Medical College Admissions Test, is a standard test required by all medical schools. It is administered via the Association of American Medical Colleges (AAMC). The AAMC recommends taking the MCAT once you have completed any coursework that is relevant to the subjects on the test. However, each medical school will have its own requirements as to how old the score can be when you apply - the norm is 2-3 years old maximum.
   • The AAMC provides a timeline that can help you plan when to register for the MCAT, when to take it and when to apply to medical school.
   • The AAMC implemented a new MCAT in 2015, which replaces their previous version from 1991. If you took the MCAT before 2015, it is very important that you check the Medical school policies for accepting scores from the current and the new MCAT exams PDF. Some medical schools will only accept the 2015 version of the MCAT as of certain admissions cycles.
   • While not required, it is strongly recommended that you take some sort of prep course for writing the MCAT. The way the test is laid out, and the way in which it is timed, are very important and knowing this in advance is extremely helpful. Most prep courses also hold one or more fake exams to give you an idea of what it’ll be like in the real thing.
   • You can take the MCAT more than once, if you feel you didn’t do well the first time. However, be aware that some medical schools will actually combine the averages of the scores if the test was taken more than once (and you cannot prevent this).
2. Decide upon one or more medical schools. There are over 170 accredited medical schools in the United States. Several medical school rankings exist that help determine which schools are better than others, based on a variety of factors. There are also a number of tools found online that can help you evaluate which medical school(s) are right for you. In the end, however, selecting a medical school will be similar to when you selected an undergraduate school. You may have restrictions, such as financial, geographical, etc., that may limit which schools you can apply to.
   • Make a list of all the possible medical schools - in your career journal - that meet your criteria. Write down what your priorities for a medical school are - for example, cost, reputation, class sizes, research programs, faculty, etc. - and then rank them. Score each school against your priorities, then rank the schools.
   • Read all the information about each medical school on their websites.
   • Attend any seminars, webinars or information sessions held by the medical school. Ask questions.
   • Book a campus tour at each medical school, if possible.
   • Seek the advice of your professors, school career advisors and alumni.
   • Review the medical school rankings.
   • Assess each school (using your career journal) and make a final ranking.
   • Determine how many applications you’re going to submit. In 2014, over 170 medical schools in the U.S. received 731,595 applications, yet they only graduated 20,343 students in the same year. That’s less than a 3% admissions rate! As with undergraduate programs, there is no limit to the number of medical schools you can apply, but the fees associated with these applications are much higher ($160 for the first one plus $36 for each additional one). If you can afford it, you should try to apply to all the medical schools that interest you.
   • If in doubt, go with your gut!
3. Request letters of recommendation. Contact the people who you’d like to write your letters of recommendation and request the letters. Since you might ask one referee to send a letter to more than one school, it will probably be helpful to create a list of the medical schools and the mailing addresses for the letters and send this list to each referee. They’ll probably use the same basic letter for each school, but preparing them will take time.
   • Letters of recommendation have to mailed directly from the referee to the medical school, so don’t have your referees send the letters back to you.
4. Submit the medical school admission application. All medical school applications can be submitted via the American Medical College Application Service (AMCAS) and/or the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS). These services allow you to submit one full application and send it to as many medical schools as you want. The first application will cost $160 and each additional medical school will cost $36.

1. • AMCAS and AACOMAS each provide a complete instruction manual for applicants [1]

[2] that can be downloaded in PDF form from their website. Download, print (if you want) and review the manual in detail before attempting your application.

1. • The AAMC also recommends that you obtain a personal copy of all your post-secondary school transcripts so you have them to reference while completing the application.
   • Register for an account on the AMCAS website.
   • Log into the website, when ready, and enter all the information requested while following the instruction manual.
   • Submit the application online, when completed, and pay all the associated application fees.
   • Check your AMCAS and/or AACOMAS account(s) regularly to check the status of each application and submit any additional information that is requested.
2. Prepare for and attend the medical school interview(s). Some, but not all, medical schools will require an interview as part of the admissions process. Some interviews may be conducted on the phone or via the internet, but many are done in person.
   • Book your travel to/from each medical school.
   • For each medical school for which an interview is requested, print out and complete the Mission & Interview Question Worksheet from the AAMC website.
   • For each medical school for which an interview is requested, review their website and read any information they have posted regarding the interview.
   • Review your career journal and determine if you have any outstanding questions you wanted to ask during the interview.
3. Confirm your medical school acceptance. Review the admissions websites for each medical to which you have applied and check the timeline for when you can expect an admission offer and the deadline for when you have to accept the offer. If you’ve been accepted to more than one medical school, check how you ranked the schools and accept the school that you ranked highest - unless you’ve changed your mind.
4. Complete your medical school education. In general medical school will take 4 years to complete, and those 4 years are very structured. Your first year, and possibly some or all of your second year, will include mainly coursework. Your second and/or third years will include actual clinical experience where you’ll rotate among most of the major medical disciplines. Your third and/or your last year will be spent on a project that will include additional clinical experience, but this time in a specific discipline of your interest.
   • Your scholarly project is where you can focus on oncology as a specialty, and be assigned to one or more oncologists as an advisor or mentor.

Applying for an Oncology Residency

1. Choose an oncology sub-specialty. There are three main types of oncologists - medical, radiation and surgical. In addition, there are also oncologists who specialize in gynecology, pediatrics and hematology. Based on your experiences in medical school, select which type of oncology you’d like to focus on - this will help narrow down residency options.
2. Choose one or more residency programs. By this point in your medical education, you’ll have met a lot of medical doctors, specialists, and professors, not to mention fellow students. All of these are sources for ideas on where to do a residency. Do some additional research online and determine what your priorities are for a residency - then compare those priorities to the programs offered. Select more than one program to which to apply.
   • There are many things to consider regarding a residency, including: the stability of the program (does it have a future?), what type of support you get in the program, how flexible is the program schedule, what is the reputation of the institution, does it provide you with the possibility of advancement after it done, location, and more.
3. Submit residency applications. Review all the prerequisites and requirements of the application and ensure you have them all in order. Write a draft of your personal statement, walk away for at least 24 hours and come back and revise it. Ask someone (professor, doctor, fellow student) to review your statement for you and provide feedback. Update and finalize your CV. Submit your applications via the method indicated for each program.
   • Many residency programs use the National Resident Matching Program (NRMP) which helps potential residents and residency programs find each other.
   • Many residency programs also use the Electronic Residency Application Service (ERAS) as a centralized method to receive applications and documentation from applicants.
4. Attend the residency interviews. Just like medical school, every residency program will want to interview you before offering your admission to their program. At this level it is likely you’ll need to attend the interview in person, but some programs may help pay the cost of travel.
5. Accept a residency offer. Your residency offers (or matches in this case) will come through the ERAS system where you submitted your application. All residency matches are released on Match Day which is the third Friday of March each year. Due to how the system works, you should receive only one offer - based on how your ranked each programs, and how each program ranked you. You are required to accept that offer, which means you have to be very care how many programs you select, and how you rank them.
6. Complete your residency program. The experiences you gain in your residency program are vital to your career as an oncologist. Don't hesitate to ask questions if you have any. Use your residency to enlarge your professional network and learn about potential fellowships and full-time jobs.

Obtaining a Medical License and Certification

1. Register for and complete the United States Medical Licensing Examination (USMLE). The USMLE is a three-step examination that tests potential doctor’s on their skills in medicine and patient care. Medical licenses are granted by each state, not nationally, but each state requires the USMLE as a requirement to licensing.
   • Use the Licensing Examination Services portal of the National Board of Medical Examiners to register for Steps 1 or 2 of the examination.
   • Step 1 and Step 2 CK exams cost $590 each, Step 2 CK costs $1250, Step 3 costs $815..
   • Step 1 is normally taken after your second year of medical school, while Step 2 is normally taken after your fourth year of medical school. Step 3 is taken while you’re completing your residency.
   • The process to apply for Step 3 of the examination differs between states, but you can use the Federation of State Medical Boards online portal to register and pay for the Step 3 exam.
2. Obtain your medical license in the state where you will be practicing. Each state has its own medical board which controls licensing of doctors, therefore each state has slightly different requirements for obtaining a license. Find the medical board’s website for the state where you will be practicing and review the licensing procedure.
   • We will use the state of Colorado as our example for obtaining your medical license.
   • The state of Colorado requires that you have malpractice insurance in the state ‘’’before’’’ you apply for your license. Obtain malpractice insurance if you do not already have it, or determine if you meet one of the exception requirements.
   • The state of Colorado requires that each applicant meet the following qualifications: proof of graduation from medical school, passage of USMLE or other national exam, completion of postgraduate education (i.e. residency) and reference letters from places where you have previously practiced.
   • Twenty-three states use the Federation of State Medical Boards’ Uniform Application for potential licensees. The Uniform Application is essentially a centralized, online application portal for submitting license requirements. The nice thing about the Uniform Application is that once you’ve completed one application it can be sent to any of the states that participate in the program.
3. Complete an oncology fellowship. Medical oncologists must complete a three-year residency in internal medicine and then complete a two-year fellowship in medical oncology. Surgical oncologists must complete a five-year residency in general surgery and then complete a two-year fellowship in surgical oncology. Radiation oncologists complete a five-year radiation oncology program (residency) but do not need to complete a fellowship.
4. Become board certified in your oncology specialty or subspecialty - optional. Board certification is not a requirement to practice medicine or oncology. However, board certification will most likely increase your reputation and job potential.
   • Medical oncology is certified by the American Board of Internal Medicine (ABIM).
   • Radiation oncology is certified by either the The American Board of Radiology or The American Board of Physician Specialties.
   • Surgical oncology is certified by the The American Board of Medical Specialties.
5. Apply for and obtain a full-time job as an oncologist. During your residency and/or fellowship you would have developed an extensive professional network. Use your network to determine if there are any oncologist positions available in your favoured locations. Search for oncology positions on your own using any and all resources available to you.
   • The Journal of Clinical Oncology, as an example, has an online Oncology Career Centre with oncology-related positions available in the United States, and around the world. Each posting will provide you with instructions on how to apply to that specific position.
   • The Society of Surgical Oncology, as another example, has a career website that specialized in surgical oncologist positions available in the United States. Each posting will provide instructions on how to apply to that specific position.
   • Remember that if you apply to and accept a position in a state other than where you're licensed, you will need to obtain a license to practice medicine in that state before you can begin practicing.
   • Take advantage of the career centers and advisors available at your medical school to help you find oncology positions. Use their help to update your CV, craft cover letters and personal statements, and practice for interviews.

Tips

• To become a medical doctor in the United States you can obtain either a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.). There are 33 schools in the U.S. that offer a D.O. degree. Most things are exactly the same between both program except the admissions system (AACOMAS for the D.O.), the licensing exam (COMLEX for the D.O.), and the requirement of additional training in the musculoskeletal system and Osteopathic Manipulative Treatment (OMT) for the D.O. program.

Warnings

• The process for applying to a joint B.S./M.D. or B.S./D.O. program or a joint M.D./PhD or D.O./PhD program will be different from what is explained in this article.

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