Guideposts for quests in the realm of oncology careers

Oncology is a small world in Canada, but the practice each individual undertakes is unique. During the 3 years 2012– 2014, 29 physicians per year, on average, wrote the Royal College of Physicians and Surgeons of Canada’s Medical Oncology subspecialty examination, and 21 per year, on average, wrote the Radiation Oncology examination¹. The path that each of those new graduates will take in their career will differ widely based on their chosen scope of practice (community vs. academic), tumour sites (breast vs. lung), and academic interests (teaching vs. research), among other variables. Furthermore, oncologists are, as individuals, unique, and our personal aspirations, goals, and interests—as well as the challenges we face—will vary greatly.

In the article by Jacobs and colleagues² in this issue of Current Oncology, 5 practical considerations for the first 5 years of practice are discussed. Those considerations—responsibility, productivity, mentoring, dealing with criticism effectively, and self-care—are well chosen. They are broad enough to apply to the diversity of individual practices and lives, but each is approached pragmatically with solid and specific “pearls of wisdom.”

For many of us who have already gone through the first few years of practice, the article highlights themes that carry an element of “If only I had known ...,” but should also serve as a good reminder, for all us, to “make time in [our schedules] for self-reflection and self-awareness.”

Jacobs et al. provide ample examples that highlight their chosen practical considerations of responsibility, productivity, mentoring, and dealing with criticism effectively. Perhaps an equally important consideration is how to deal with self-criticism or self-doubt. When treatment recommendations fall into “grey areas” or “uncharted territories,” self-doubt is the marker of a caring and responsible oncologist. Learning to more definitively own decisions made and to have more confidence comes with time and experience, but that little voice whispering “What if” at 02h00 has to be expected and recognized as normal. The “informal” tumour board of mentors and peers becomes invaluable in such situations; having reassurance that the decision-making process in others mirrors your own can make all the difference and can help to promote a good night’s sleep.

Jacobs et al. also reflect on the topic of self-care—perhaps one of the most important practical considerations. It is a topic of universal relevance regardless of one’s place in a career trajectory. Indeed, we should all take a look at our long-term personal goals, especially with a view to recognizing those that cannot be postponed.

New graduates are usually young, less than 40 years of age, and at that point in their personal lives they may be starting or adding to a young family. During the next decade, family focuses will shift—perhaps as care for aging parents becomes a priority. Beyond family, other life experiences that are important have to be actively prioritized. Whether it means training for a triathlon, climbing Mount Kilimanjaro, or taking a trip with your teenagers before they leave home for university, it is always important to take time to reflect on personal choices, making sure that the demands of professional life are not doing one’s personal life a disservice that could later lead to regret.

We thank Jacobs et al. for their invaluable words of wisdom in this edition of Current Oncology. Their practical considerations should be heeded not only by those who are just embarking on their initial 5 years of practice, but perhaps also by many who have long passed that milestone. Indeed, the guideposts set forth by Jacobs et al. will undoubtedly help each reader find his or her own way in the quest through the realm of oncology careers.

CONFLICT OF INTEREST DISCLOSURES

We have read and understood Current Oncology’s policy on disclosing conflicts of interest, and we declare that we have none.