The Nuts and Bolts of Getting into an Oncology Fellowship
By Bishoy Faltas, MD
November 15, 2012
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Oncology continues to be one of the most sought-after specialties. Because of a shortage of oncologists and the accelerating pace of developments in the diagnosis and treatment of cancer, oncology has become an increasingly competitive field. Accreditation Council for Graduate Medical Education (ACGME)-accredited training in oncology can be pursued in 2-year oncology-only programs or, more commonly, in 3-year combined hematology-oncology programs.
Starting this year, the application cycle for oncology fellowships began in July, when the post office of the electronic residency application service (ERAS) opened. Over subsequent months, programs review applications and invite selected applicants for interviews. Both interviewees and programs then rank each other in certified lists submitted to the National Residency Match Program. The match occurs in mid-December, and fellowships begin on the first of July.
The competitive nature of the match process makes it crucial for applicants to identify factors that would make them stand out. The main elements of fellowship application include a curriculum vitae, letters of recommendation, and a personal statement. The CV should be inclusive within reasonable limits. It is important not to neglect hobbies or areas of interest, especially those that help the applicant show consistent dedication, perseverance, and discipline. A demonstrated interest in research naturally strengthens an application but is not the most important selection factor. Publications, research projects, national presentations, and advanced degrees in research could all serve as evidence of such interest and are likely to be viewed favorably.
Letters of Recommendation
The importance of letters of recommendation from oncologists cannot be overstated. In a study examining selection factors for subspecialty training, the importance of recommendation letters was ranked by fellowship program directors only second to the importance of the fellowship interview.1 Oncologists naturally trust other oncologists because they share a unique perspective.
In general, letters of recommendation should reflect personal knowledge of the applicant and an honest evaluation of the applicant’s residency performance and suitability for fellowship training. A letter from a nationally known oncologist who marginally knows the applicant will be almost uniformly weaker than a letter from a lesser-known oncologist with intimate knowledge of the applicant’s qualifications. Applicants should always waive rights to view the letter; anything else makes applicants appear untrusting.
“Be certain that your program director has your back by reviewing the letters of recommendation before they are uploaded. I routinely reject faculty letters that are poorly composed or show no commitment to the applicant. This is part of the job description of your program director, even if you have graduated, so do not hesitate to ask” said Paul L. Bernstein, MD, former internal medicine residency Program Director at Rochester General Hospital, Rochester, New York and coauthor of a study on selection criteria for fellowships.1
According to the study, the third most important factor is the letter of recommendation from the internal medicine program director. The program director’s letter should reflect personal knowledge of the applicant as well as specific examples of his or her performance. “When writing a letter of recommendation, I usually review all of the applicant’s evaluations and include quotes about his most impressive qualities. I conclude with a detailed summative evaluation with my own assessment of the applicant’s personality, performance, and academic potential,” said Dr. Bernstein.
A well-written personal statement is an integral part of the fellowship application despite its relative unimportance compared to the CV or letters of recommendation. The key to a strong personal statement is to have a theme, a common thread that ties together the applicant’s background and formative experiences to show that she would be a “good fit” for oncology training. Applicants should be careful not to be overly influenced by personal statements of colleagues. Program directors do Google lines of text from personal statements; any plagiarism is grounds for immediate rejection and worse.
Applicants are advised to do some soul-searching before applying for a fellowship and to review aspirations and expectations with the residency program director and other mentors. Applicants should also be mindful of the different goals of different programs to which they apply. Programs typically come in three different flavors: community-based, university-based, or university-affiliated. University programs typically aspire to train academic oncologists who will become leaders in the field. Programs that aim to train physician-scientists offer both clinical and basic science research training.
“In our program, the second year of training is typically dedicated to a translational research project of the fellow’s choosing, with intensive faculty mentorship and support. Up to 18 months of training may be devoted to this project, while the fellow also continues seeing patients in a weekly continuity clinic. The fellowship applicants we favor are the ones most likely to thrive in this type of research environment ” said Ronald Scheff, MD, fellowship Program Director at the Weill Cornell Medical College hematology-oncology program.
An “away” elective at the fellowship site can offer the applicant and the program a valuable opportunity to gain first-hand knowledge of one another. It can also help the applicant obtain letters of recommendation from faculty at the program. However, an away elective can also be a double-edged sword if the applicant underperforms, so the risks and benefits of such an undertaking should be weighed carefully beforehand.
The interview is consistently ranked as the most important fellowship selection factor.1 Program directors trust their instincts and reach conclusions rapidly. The interview is also an opportunity for applicants to learn about the relative strengths and weaknesses of each program and its educational philosophy. At the end of the day, the best possible outcome of the match is producing a good fit that achieves both the applicant’s and the program’s goals. ■
Disclosure: Dr. Faltas reported no potential conflicts of interest.
1. Mikhail S, Bernstein P: Selection criteria for fellowships: Are we all on the same page? Academic Internal Medicine Insight. 5(1), 2007.
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The Internal Medicine Department is the largest department at KHCC. Our oncologists and specialists are at the core of medical care for adult patients. Even when patients do not require chemotherapy, the Internal Medicine Department works alongside other specialists to formulate a treatment plan. We believe in not just specialization, but also in sub-specialization so our oncologists have unique experiences in their specific fields. We stay up-to-date on the most recent advances in cancer treatment by appraising peer-reviewed studies from leading journals, as well as attending international conferences for the latest in medical advances. This combination of knowledge, experience and dedication make our department a leader in advancing cancer care in Jordan and the region.
Research activities are highly recognized and encouraged by the Department of Internal Medicine and our staff is continuously involved in academic and clinical research. The Department of Internal Medicine provides a comprehensive program of services to patients with all types of cancer. These services include up-to-date therapies for solid tumors, hematological malignancies, as well as bone marrow and stem cell transplantation. Patients receive care in state-of-the-art inpatient and outpatient facilities by coordinated teams of physicians, nurses, social workers, pharmacists, psychiatrists and psychologists.
Cases are usually presented to the multidisciplinary clinic, where decisions are made according to evidence–based medicine. There are several multidisciplinary clinics where patients are seen by consultants from varying medical specialties (medical oncologists, surgeons and radiation therapists). Clinics have been established for lung, GI, sarcomas, GU, head and neck, CNS, and gynecological malignancies.
The Internal Medicine Department treats between 2,000-3,000 new cases per year, with the number of patient visits exceeding 40,000 visits (according to 2006 data).
The Department of Internal Medicine provides a broad range of services for patients at the King Hussein Cancer Center. In addition to its inpatient unit, the Department provides intensive care for the whole Center.
Outpatient clinic services are offered in more than fifty weekly medical oncology and other supportive specialties. An endoscopy suite and full pulmonary function lab serve the entire Center, utilizing the latest technology and equipment. Additionally, the department is actively involved in all multidisciplinary programs and services.
- Clinics operated by the Internal Medicine Department:
a) Medical oncology clinics: 25 clinics per week
b) Non-medical oncology clinics: 25 clinics per week
c) Multidisciplinary clinics: 9 clinics per week
- Inpatient beds: 50 beds in addition to 12 ICU beds (these will increase once the new KHCC expansion is completed in 2013)
- Number of patients treated annually: 11,000 +
- New Cases: per year: 3,000 +
- Inpatient admissions to internal medicine: 2,000 +
- Number of chemotherapy patients/year: about 2,000
- Average number of chemotherapy patients per month: 845
- Average number of procedures performed in procedure clinic: 460
Education & Training Activities
The Department of Internal Medicine participates in various educational activities designed to teach and refresh the knowledge of its medical staff. The department proudly offers residency and fellowship programs to new graduates in pursuit of careers in cancer care. Graduates of the prestigious program have enjoyed positions that include staff appointments at KHCC among others.
In an effort to keep our consults up-to-date on the latest in cancer care and treatment, physicians and clinical staff routinely participate in medical conferences both nationally and internationally. Our medical team also attends hospital and local grand rounds, lectures, tumor boards, and journal clubs.
The Internal Medicine (IM) residency program involves 23 residents who rotate within all sub-specialties. They have daily morning discussions of cases with consultants. The program provides the opportunity for the residents to learn how to perform some procedures such as bone marrow biopsies, paracentesis, insertion of in-dwelling catheters, insertion of central lines, endotracheal intubation…etc.
Our residents participate in the in-training examination that is annually conducted in the United States of America for accredited IM programs. We are proud that the score of our residents is among the highest 95th percentile and the highest achieved score has belonged to one our residents for 2 consecutive years.
The IM residency program provides a suitable environment for newly graduated doctors who are planning to get 2 years transient training and who need adequate time to prepare for for the United States Medical Licensing Examination (USMLE) before going to the US for their post-graduate studies.
It is worth mentioning that KHCC’s IM residency program also accommodates university residents to do clinical attachment and training.
The fellowship program in medical oncology is supervised by the Chairman of the IM Department & the Director of the Fellowship Program. It currently involves 11 fellows and 1 – 2 new board-certified physicians are accepted into the Fellowship Program annually. The duration of the program is 3 years. Fellows are subjected to an intense and comprehensive oncology training curriculum and they deal with almost all types of cancers. This is due to the fact that KHCC is the only comprehensive cancer center in Jordan.
Our fellows sit for the oncology board examination of the Jordan Medical Council. The pass-rate is 100% and they also sit for the in-training oncology examination of the United States.
The KHCC-IM department provides great job opportunities for newly graduated oncologists and helps them to excel in their profession.
Dr. Hikmat Abdel-Razeq – Chairman
Dr. Alaa Addasi
Dr. Salah Abbasi
Dr. Mohammed Dowairi
Dr. Ghadeer Abdeen
Dr. Lina Marei
Dr. Rim Turfa
Dr. Sameer Yaser Abdullah
Dr. Yasser Yamin
Dr. Hazem Abulelah
Dr. Faisal Al Badainah
Dr. Rula Ammarin
Dr. Samer Salah
Dr. Ihab Shehadeh
Dr. Mohammed Zaher Mokhaimer
Dr. Feras Hawari
Dr. Taghreed Al Najjar
Dr. Enas Younis