We all have to balance competing demands on our time. But as an academic oncologist, I have to keep a foot in 2 worlds, research and clinical, while still keeping my balance.
Working as a medical oncologist in an academic setting challenges doctors to have a foot in 2 worlds: the first world revolves around scientific advancement, and the second around patient care. Each realm has inherent opportunities, rewards, and difficulties that we encounter every day. In this brief snapshot of my experiences, I will try to describe a day that illustrates the balance between these worlds, which is essential to achieve a balanced career in academic oncology.
Of course, each academic medical center has its own culture, demands, and spectrum of job types. Some academic physicians have a much more lab-based research practice; others focus on a strictly clinical research practice. My description reflects my own experiences in what might be a typical workday for a clinical trial researcher in gastrointestinal oncology.
Each week, I spend 2 days with an entirely clinical schedule. On these days, I see patients in the clinic and administer chemotherapy. I also have at least 1 day each week for entirely academic work. On this academic day, I dedicate my time to research protocols; student, resident, and fellow mentorship; and administrative duties. On other days, I have a mixed schedule with both clinical and research responsibilities. In this article, I will describe a typical Tuesday, which is the best example of a mixed clinical and academic day on my schedule.Tuesday 7–8 a.m.Multidisciplinary colon conference
Our GI oncology group works closely with a variety of other disciplines, and we are lucky to have collaborators in surgery, radiation oncology, gastroenterology, and radiology who share a common vision for patient care and research. We meet weekly to review challenging cases at a colorectal surgical conference. Since this conference is run by our surgical colleagues, we have an early start (but coffee is readily available)! The surgeons review new patient consults and challenging cases. Representatives from each of the participating disciplines have an opportunity to weigh in with their expertise and feedback. This conference is not only a place to collect fascinating cases, it is also a chance to learn the styles and personalities of the other physicians from other departments. Outside of this in-person conference, I may only interact with them over the phone. During conference, we also discuss open research trials, update the group on how shared patients are doing, or vet ideas about possible proposals for new research studies. Getting a “buy-in” for study participation from the providers who have the first contact with patients (in GI, that is usually the gastroenterologists and surgeons) will lead to more fruitful studies and faster subject accrual.8 am–1 p.m.Hepatobiliary-pancreas clinic/conference
After meeting with the colorectal surgeons, we share clinic space and time with our hepatobiliary surgical colleagues. Like the colorectal conference, this multidisciplinary clinic provides us with an opportunity to see patients as close to the time of diagnosis as possible. In this half-day clinic, we see up to 7 patients. Pancreaticobiliary malignancies often need neoadjuvant/adjuvant therapy, which requires delicate timing and effective collaboration between medical oncologists, radiation oncologists, and surgeons. This collaboration is both clinically and academically rewarding. Patients like to be able to have a “one-stop shop” to see multiple health care providers, and the close collaboration across specialties maximizes our patients’ potential for the best clinical outcome. In addition to the clinical benefits, this multispecialty coordination allows for direct research collaboration among 3 different sets of research disciplines, since each subspecialty has its own multi-institution research group. We are an Eastern Cooperative Oncology Group (ECOG), Radiation Therapy Oncology Group (RTOG), and American College of Surgeons Oncology Group (ACOSOG) site. Furthermore, having other clinical and research experts from other departments working closely together and reviewing common literature helps keep all of us at the top of our games. At the conclusion of clinic, the most complicated cases are often also reviewed with our colleagues from radiology and pathology, which allows them to offer their insights as well.1–2 p.m.GI Research Group meeting