Becoming an oncologist requires 2-3 years of fellowship training through the American Board of Internal Medicine (ABIM), American Board of Surgery (ABS), or the American Board of Obstetrics and Gynecology (ABOG) following 4 years of medical school and 4 years of residency. We break it down step-by-step for you below.
The medical field is an expansive and increasingly complicated network of specialties and sub-specialties, each with their own unique training and certification requirements. The Career Series is here to help medical students navigate the road from medical student to practicing physician.
From Medical School to Practice: How To Become an Oncologist
Timeline Overview
Step 1: Medical School
Medical school is a 4-year program consisting of 2 years of basic clinical sciences followed by 2 years of clinical rotations.
Years 1 and 2
While patient contact is somewhat limited during the first 2 years of medical school, most universities have resources for students to connect with departments they are interested in through research or shadowing opportunities. Students that think they may be interested in becoming an oncologist can begin connecting with oncologists at their university to learn more about the field.
Following their second year, students will take the first of 3 “Step” exams required for US medical licensing (Step 1).
Years 3 and 4
During the third and fourth years of medical school, students complete their clinical rotations. Each rotation lasts between 4-6 weeks with the “core” clinical rotations generally including internal medicine, surgery, obstetrics and gynecology, pediatrics, family medicine, psychiatry, neurology, and radiology.
Following their third year, students will take the second of 3 “Step” exams required for US medical licensing (Step 2).
Once the core rotations are complete, usually by the beginning of year 4, students can take a number of elective rotations in departments of their choice. Students interested becoming an oncologist can take an elective rotation in oncology at their university hospital or at another teaching hospital within the US (with their medical school’s approval). This is a great opportunity for students to learn more about hospitals where they are considering applying for a residency position, and to network with other physicians there.
In the fourth and final year of medical school students will also begin their applications to residency programs through the online centralized application system “ERAS”. Students interested in oncology can apply to residency programs in internal medicine, obstetrics and gynecology, or surgery. After completing these residencies, they can then apply to fellowships focused on general oncology, gynecologic oncology, or surgical oncology respectively.
Alternatively, students interested in radiation oncology apply to radiation oncology residency programs and the prerequisite “preliminary” / “transitional” year programs on ERAS at the same time.
Step 2: Residency
Internal medicine, obstetrics and gynecology (ob/gyn), and surgery are the only specialties that allow for future sub-specialization in oncology. So an oncologist will generally begin their career with a 3-5 year residency in one of these departments. Internal medicine, surgery, and even ob/gyn are very generalized fields, so residents will usually get a well-rounded experience of these areas of medicine before fellowship training to focus on an oncologic subspecialty.
Residents will take the third of 3 “Step” exams required for US medical licensing following their first year of residency (Step 3). In the final year of residency, those interested in an oncology subspecialty can begin applying for fellowships.
After completing their residency programs, physicians must then take the board exam for their respective specialty (through the American Board of Internal Medicine, American Board of Obstetrics and Gynecology, or the American Board of Surgery). Most subspecialty fellowship programs require their physicians to have passed this board exam before beginning their fellowship training.
Radiation oncology is a little different, and physicians can begin radiation oncology residency training immediately following a 1-year “preliminary” or “transitional” program. The “preliminary” / “transitional” year is a year of more general clinical experience rotating through a variety of departments, but mostly internal medicine. The subsequent radiation oncology residency program is four years of radiation oncology experience.
These are usually completed at different hospitals, but can be completed together in certain “combined” programs. These physicians will take the third of 3 “Step” exams required for US medical licensing following their 1-year preliminary / training program (Step 3). And upon completion of their Radiation Oncology residency program, they must also take the certifying board exam through the American Board of Radiology.
Step 3: Fellowship (Medical, Surgical, and Gynecologic Oncology Only)
Sub-specializing in medical, surgical, and gynecologic oncology requires a 2-3 year fellowship program after initial residency training and board certification. This fellowship training generally consists of clinical and research experience in a broad range of oncologic diseases within the specialty.
Upon completing fellowship training, these physicians will take a second board exam to attain board certification in their oncology subspecialty. This is in addition to their first board exam taken after residency to attain board certification in their general specialty.
Once achieving board certification, physicians can apply to positions as a practicing oncologist in their specialty at any US hospital or clinic.
Final Thoughts
The road to become an oncologist is long and clinical training is not easy. But the field is full of opportunities, and the work is incredibly rewarding. Medical or pre-medical students interested in oncology should connect with local physicians in their specialty of interest to learn more about the day-to-day responsibilities, career outlook, and lifestyle that come with a career in oncology.
