How I Became a General Oncologist and Training Program Director

Nov 07, 2019

Nishin Bhadkamkar, MD, joined the Department of General Oncology at The University of Texas MD Anderson Cancer Center in 2011 and was promoted to associate professor in 2017. He recently assumed the role of associate program director (medical oncology) for the Hematology/Oncology Fellowship Program, prior to which he served as the director of education for the Hematology/Oncology Fellowship Program for 3 years. Dr. Bhadkamkar is the chair-elect of ASCO’s Oncology Training Programs Committee and a member of the Clinical Practice Guidelines Committee.

How did you initially choose your current career path? Were there any unexpected detours along the way?

NB: My current career path was certainly not master-planned. During the majority of my fellowship at MD Anderson, I was focused on becoming a clinical investigator in gastrointestinal malignancies. However, in the course of my job search, I engaged in a great deal of self-reflection and ultimately realized that my skillset was much better suited to the educational arena. I was finally honest with myself and determined that I would be much more fulfilled with education as my academic calling card. I’m so thankful that I came to this realization when I did (rather than 5 or 10 years later).

Describe your typical work day.

NB: I work with our hematology/oncology fellows 3 days per week in a general oncology clinic. My educational and clinical efforts are therefore highly integrated. The other 2 days of the week are mostly devoted to fellowship program initiatives (strategic planning, educational projects, etc.), with clinical research and institutional committees accounting for the remainder of my time. I enjoy the diverse activities that constitute my job and appreciate the fact that no 2 days are exactly alike.

If you have to pick one aspect, what part of your job is your favorite? What part is the most challenging or frustrating?

NB: My favorite parts of the job are taking care of patients in the clinic/hospital and contributing to the professional development of our fellows. It’s a tie between those two things, which are equally rewarding in different ways. As a general oncologist and educator, the most challenging aspect of the job is keeping informed about new therapeutic developments across a broad spectrum of oncologic subspecialties and then determining how best to convey this information to our fellows.

The most frustrating part of the job is dealing with financial obstacles to patient care. When an effective treatment option can’t be offered on account of a financial coverage issue, it’s very disappointing. As a health care system, we have to do better.

What do you wish you had known before you chose your career path?

NB: There are too many things to cover, but I will mention a few!

First, I wish I had better understood the approach to determining one’s optimal career track in oncology. The first and most important step is to be honest with yourself and identify your source of passion. What will fuel you and sustain you over the course of a decades-long career? Passion leads to productivity; it’s never the other way around.

Second, I wish I had realized that there are many pathways to success in academia. As a fellow at MD Anderson, I knew that I wanted to pursue an academic career. However, I proceeded under the naïve assumption that I only had two choices: physician-scientist and clinical investigator. Since laboratory science was far out of my comfort zone, the clinical investigator track was the only feasible option in my mind. As I mentioned above, the job search provided a great deal of clarity and opened my eyes to possibilities that I had never considered. In retrospect, it all seems so obvious!

Third, career paths are not linear. If I knew then what I know now, I would have approached my fellowship very differently. That being said, I don’t regret the way my fellowship unfolded because that journey was essential to my career destination. The time spent searching for one’s passion is always time well spent, even if it ultimately involves some detours.

Why would you recommend this career to someone starting out in oncology?

NB: The opportunity to play an integral role in the education and professional development of trainees is truly a privilege. I’m constantly motivated and inspired by their enthusiasm for learning. The landscape of oncology is rapidly changing as we better understand the molecular underpinnings of malignancy, and this creates unique challenges for educators. Amidst the explosion of data, how do we utilize innovative educational tools to effectively convey new information to trainees? How do we facilitate their self-directed learning, which will be so critical to future success? As an educator, one can make a tremendous impact and leave an enduring legacy that can’t be measured by traditional metrics.

What kind of person thrives in this professional environment?

NB: Dedicated, industrious, empathic people with excellent interpersonal skills will thrive in academic practice, as they would in any work environment. With respect to the educator phenotype in particular, patience and humility are also essential traits. We must be able to put ourselves in the learners’ shoes and understand their potential challenges in connecting the dots. We must be able to deconstruct complex concepts to make them more easily digestible. Each trainee will have a unique learning trajectory that reflects their prior knowledge and experiences, and our educational approaches must bear that in mind.

As educators, we must also consistently model the learning traits that we hope to foster in trainees. These include self-awareness to recognize one’s limitations, diligence to identify and fill knowledge gaps, and a willingness to learn from others irrespective of hierarchy.

Can you share a personal experience that shaped your professional journey and led you to where you are today?

NB: After my freshman year of college, I was very fortunate to participate in a summer research program at MD Anderson. I was assigned to work with two junior surgeons who also happened to be brothers. I shadowed them in the clinic and operating room and also collected data for a retrospective project on sarcomatoid renal cell carcinoma. They were extraordinary mentors who truly made me feel like part of the team. Their exceptional support and encouragement made the program a transformative experience, and I emerged from that summer with the conviction that a career taking care of patients with cancer could be very fulfilling and rewarding for me.

Twenty-one years later, both of my mentors still work at MD Anderson; Dr. Louis Pisters is a professor in the Department of Urology and Dr. Peter Pisters is the president of the institution. I guess things turned out well for all of us!

When I see them now, I feel a deep sense of gratitude because their mentorship was truly a gift. If that summer experience had not gone so well, I sincerely doubt that I would be navigating this particular career path. They have clearly demonstrated the enduring impact of great mentorship, and I continue to aspire to their example as I mentor trainees.

 

“How I Became” is a series about the numerous and varied career paths in oncology. In each issue, a member will discuss their career journey and give an insider’s view of their profession. Email ascoconnection@asco.org to tell us what career paths you’d like to see covered, or to contribute to this series.


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