What I Have Learned Since Fellowship: Tips for Professional Success and Happiness

Lawrence B. Afrin, MD | June 20, 2011

I have just finished my 15th year on faculty and my 13th year directing the hematology/oncology fellowship program at the Medical University of South Carolina. Although none of what I have learned along the way is truly novel, I hope that a few observations born of experience in my professional life will help you achieve success and happiness in yours.

Board Exams

Take ’em, Take ’em Early, and Keep On Taking ’em Until You Pass ’em



Take whatever boards you are eligible for as early as possible. A board exam covers the specialty’s full breadth, yet odds are good that once in practice you will quickly come to focus in some subset of the specialty. Do not be surprised if you quickly lose much of your knowledge, skills, and currency in any area in which you do not regularly practice. So take your exams at the earliest opportunity. For those training in combined hematology/oncology, do not wait to take the hematology exam until the year after taking the oncology exam. And if you feel you need extra study time, ask for it (ideally when negotiating your employment arrangements). Your employer wants you to obtain and maintain certification for all boards for which you are eligible, so a wise employer should grant you a reasonable amount of study time if you think you need it.

Experience Always Trumps Reading, but if Reading Is All You Can Do…



Unless you are convinced your knowledge in a particular area is deficient, do not bother studying much for your first attempt at the boards, with 1 exception: hematology/ oncology fellows should not forget that gynecologic oncology is on the oncology boards. In many adult medical oncology and hematology/oncology programs there is little opportunity to attend didactics in—let alone practice— gynecologic oncology, so this area of the boards can hurt you if you have not even read in this area. Remember that board questions are written carefully, and it has been my consistent observation across multiple exams that if you have seen a case of X within the last year or so, you will quickly know the right answer. Conversely, if you have never seen a case of X, you may be able to narrow it down to a couple of choices, but mere preparatory reading likely will not help you any more than a coin fl ip would. So if you fail an exam, actively seek opportunities to practice (and read) more in the areas in which you were deficient. (You will always learn far more from practice with reading than reading without practice.) Then take that exam again as soon as possible.

"The best advice I can give you is to know yourself and then do what makes you happy."

Do Not Waste a Year of Your Life



If you are in a combined adult hematology/oncology program and facing the prospect of not 1 but 2 (expensive) exams, just suck it up and take them both until you pass them both. It is silly to have spent an unrecoverable year of your life in exchange for a modest fellow’s salary and the right to take the hematology boards—and then end up not getting certified in hematology. (At that rate, you would have been far better off doing just 2 years of oncology training and going right out into practice.) So take ’em both until you pass ’em both. It makes an important statement to yourself, your colleagues, your institution, and, most importantly, your patients. And if you flunk the hematology boards on your first attempt but then are so focused on your oncology practice that you realize you need to take a hematology review course prior to retaking the hematology boards, then by all means take a hematology review course.

Your Next Board Exam Is Sooner Than You Think



Maintenance of certification (MoC) processes are far from perfect, but they are the best methods we have for assuring those around us of our continuing competency. You should keep abreast of the seemingly ever-changing MoC requirements and develop a plan to meet the requirements starting at the earliest possible point. Your practice and perhaps other work will quickly grow to consume your professional life, so if you have not developed and followed your MoC plan, you will find it needlessly challenging and anxiety-provoking to rush at the end to finish everything that must be done before you can once again sit for the boards.

Career Direction

Don’t Worry, Be Happy




View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Advances in™ Targeted Therapies: The Emerging Role of PI3K Inhibitors in the Treatment of Hematologic MalignanciesNov 16, 20171.5
Community Practice Connections™: The Emergence of CAR-T Cell Therapy for Hematologic Malignancies: Moving From Bench to BedsideDec 29, 20171.5
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