Hi, I'm a second year resident interested in Surg onc among other specialties. I want to get a sense of what surgical oncologists are doing at other people's institutions and what direction people think this specialty is headed. Surgeons are continuing to specialize in certain types of procedures, I find at my institution most of the colon cancers are being done by colorectal, pancreatic cancers by HPB, breast cancers by breast, thyroid by endocrine/ENT. All these fellowships do indirectly give exposure to non-surgical treatment of these cancers, and the surgeons with the best outcomes are those from the anatomically oriented specialties(at my institution). There may be these complex tumor cases that are fit for surg onc, but they are rare. I'm also not at the most academic place.
The surgical oncologists we do have: one does some cases that don't really fit a mold, melanoma/sarcoma cases, gastrectomies/esophagectomies(what he does most frequently), another does again some oddball cases and here and there the occasional colon, liver, gastrectomy, esophagectomy, whipple or adrenal. They also have less volume overall then the other specialties despite their breadth of surgical offerings.
Clearly its a specialty lending itself to academics, their fellowship requires experience with all the different types of oncology therapy and in a big center they're probably doing more of the stuff with peritoneal chemo but overall, it seems like they are doing a broad range of cases without really mastering any of them unless their practice is built towards focusing on a certain one. Nowadays with a 2-3 year fellowship including research and time with medical/radiation oncology it seems hard to imagine mastering many of these cases if one didn't come close in residency, and if their mentors dont have high volume. Gastrectomies and melanoma/sarcoma seem to be the main operations/areas they end up controlling and mastering, but maybe that's just what I'm seeing.
A bigger question then is what will really be the role for these types of surgeons with the continuing trend, the random complex tumor case requiring peritoneal chemo or enbloc radical resection with other random cases and time supervising the lab? Or should they too focus on a certain type of cancer/procedure.
What are other people's experiences with this department and thoughts on the utility of such a fellowship?
The surgical oncologists we do have: one does some cases that don't really fit a mold, melanoma/sarcoma cases, gastrectomies/esophagectomies(what he does most frequently), another does again some oddball cases and here and there the occasional colon, liver, gastrectomy, esophagectomy, whipple or adrenal. They also have less volume overall then the other specialties despite their breadth of surgical offerings.
Clearly its a specialty lending itself to academics, their fellowship requires experience with all the different types of oncology therapy and in a big center they're probably doing more of the stuff with peritoneal chemo but overall, it seems like they are doing a broad range of cases without really mastering any of them unless their practice is built towards focusing on a certain one. Nowadays with a 2-3 year fellowship including research and time with medical/radiation oncology it seems hard to imagine mastering many of these cases if one didn't come close in residency, and if their mentors dont have high volume. Gastrectomies and melanoma/sarcoma seem to be the main operations/areas they end up controlling and mastering, but maybe that's just what I'm seeing.
A bigger question then is what will really be the role for these types of surgeons with the continuing trend, the random complex tumor case requiring peritoneal chemo or enbloc radical resection with other random cases and time supervising the lab? Or should they too focus on a certain type of cancer/procedure.
What are other people's experiences with this department and thoughts on the utility of such a fellowship?