The Growing Pain of Becoming an Oncologist

The Growing Pain of Becoming an Oncologist

Physician Wellness

Jul 18, 2018

Dr. Samah NassereddineBy Samah Nassereddine, MD

If I had to re-decide on my subspecialty, I would choose again hematology/oncology. I am passionate about the sciences behind tumorigenesis and all the amazing progress in this field. The privilege of being an oncologist is an honor and a great responsibility that brings me deep satisfaction and teaches me the virtue of humility. As I finished my first year of fellowship in hematology/oncology, I realize how much this year has changed me. I experienced growing pains; the challenges that affect the growth of a physician are not limited to a curriculum but are also about emotional growth. There are no guidelines to tell us how to cope with that. 

In our field of work, we witness rebirth and joy but also sorrow and sadness. During a 12-hour shift, we are constantly exposed to the fears, anxiety, and pain of patients. We are breaking bad news—although it's out of our control, it seems that we are the ones announcing that someone's life is about to change and their dreams put on hold. In this 12-hour work shift, where we see mostly the dark side of life, the sickness and the fear of death, some oncologists become desensitized, others grow to cope with their emotions, others suppress them, but no one is told what the best way is to channel these emotions. 

Our egos as physicians prevent us from talking about all these things—we think we are smart enough to know how to adjust. We are always in a rush to see the next patient, to write our notes, to prepare for a journal club, and to work on our presentations. We do not take time to reflect on how sad we feel sometimes, how exhausted we are, and how anxious we have become. 

I want to continue to do what I am doing; I want to continue to provide the best care I can. I want to hold patients’ hands and tell them, "We will go through this together." I want to be able to teach medical students the art of being a great doctor. I truly believe that in order to be the best we can, we need to be more mindful of our wellbeing. 

I do my part. I exercise and I meditate. I "rush" to make time for my yoga practice. But I don't think this is enough.

We need a cultural change. The system needs to acknowledge that the job of a provider, and in particular that of an oncologist, is very demanding, emotionally and physically exhausting. The system needs to implement wellness program that provide mental health support for physicians. I encourage all the programs to start integrating wellness programs in their practice and to change the work environment to be more welcoming and relaxed. We are in a need for a healthier health care system that brings better satisfaction to both patients and providers. 

Dr. Nassereddine is a post-doctoral hematology/oncology fellow at the George Washington University Hospital and the George Washington Cancer Center. She has a special interest in malignant hematology. Follow her on Twitter @SamahNd.


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Stephen B. Strum, MD, FACP

Aug, 27 2018 10:56 PM

Dear Dr. Nassereddine, 

A fine commentary.  I am a 75 year old hemonc doc, still practicing this very special subspecialty of internal medicine.  You have insights that many "seasoned" oncologists have not touched on.  You have idealism and passion that is so important to the being/essence of a fine physician.  What I have found over the years is that real physicians are characterized by the "C's": 

The "C's": competent, caring, collaborative, conscientious, collegial, cost-effective, considerate, cooperative, concerned, compassionate, compulsive.   

I hope your generation of physicians does far better regarding many of these characteristics.  Sooner or later, we or our loved ones become patients.  The way we have made our collective bed is how we will "sleep" in it.  I fear for what may lie ahead for the patients of the future, and even for those that are patients currently.  Be the change you wish to see in the world. -- Gandhi 


samah Nassereddine,

Sep, 10 2018 8:38 PM

Thank you Dr Strum for your well thought out comment. The "C"s are essentials to every physician.

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