Apr 27, 2020
Cecilia Monge Bonilla, MD, MPH, FACP, is an assistant research physician in the Gastrointestinal Malignancies Division, Thoracic and Gastrointestinal Malignancies Branch, of the U.S. National Cancer Institute (NCI), National Institutes of Health (NIH). She is a member of the ASCO Trainee Council. Follow her on Twitter @CeciliaMonge4.
How did you initially choose your current career path? Were there any unexpected detours along the way?
CMB: I had a 10-year detour as an internal medicine attending and clinical researcher before deciding to do a fellowship in oncology.
All the exciting new discoveries in cancer research motivated me to specialize further. While practicing internal medicine, I was watching the progress that was being made in oncology from afar—I found it amazing how the overall survival of some types of cancers had changed dramatically over the last years. I remember thinking that medical history was being written in oncology, and I decided that I wanted to be part of the efforts to move the needle forward and improve the prognosis in these deadly diseases.
I can’t point to one specific experience that shaped my journey, other than deciding to apply to an oncology fellowship even though I was already 10 years out from residency. As a senior fellow, I spent my research time with the developmental therapeutics group. After completing a fellowship in oncology at NCI, I was very interested in the opportunity to do clinical research with the Gastrointestinal Malignancies Division because of the exciting protocols underway.
I suppose my message is that it is never too late to further specialize if you find a field which captivates you enough.
Describe your typical workday.
CMB: Being part of the NCI, one of the twenty-seven institutes or centers at the NIH, is a unique experience. The day starts with rounds, most of our inpatients are receiving the first doses of a study protocol therapeutic intervention or are admitted because of adverse events that need to be managed in-house. I staff fellows and see patients in the outpatient clinic two days a week; most of our patients, who are enrolled on our studies, have experienced disease progression after receiving standard-of-care therapies or do not have further treatment options for their disease.
We have weekly team meetings for clinical management, translational research from the lab (led by Dr. Tim F. Greten) to the clinic, branch division meetings, and seminars. I also attend tumor board, where our challenging cases are discussed by a multispecialty team resulting in a very interesting academic activity. I sit on various committees and dedicate a part of my week to that as well as attending journal club. There are amazing lectures and grand rounds with world-renowned speakers on a weekly basis at NCI, as well as multiple opportunities to learn and grow professionally.
If you have to pick one aspect, what part of your job is your favorite? What part is the most challenging or frustrating?
CMB: The favorite part of my job is relaying good news to the patients who take part in and are treated on our studies. Patients often come to NCI as their last hope, if they are not eligible for a protocol or their disease progresses on a study; having to face the reality that there may not be other treatment options can be somewhat frustrating.
Coming up with creative, novel, and feasible ideas for new research study protocols is a great challenge to have… but it is a big challenge!
What do you wish you had known before you chose your career path?
CMB: While training at NCI, I was able to work with assistant research physicians during my fellowship and became familiar with their clinical and research activities and the characteristics of their career path. I wish I had known I was going to be lucky enough to end up working at NCI—the uncertainty of the future during fellowship is a reality. It turns out that through focus, hard work, persistence, and resilience, things mostly turn out for the best in the end.
Why would you recommend this career to someone starting out in oncology?
CMB: In oncology, most well-trained and brilliant physicians dedicate themselves to delivering standard of care, which is of utmost importance. However, if you have an interest in focusing on translational or clinical research, NCI is a great place to build your career as an investigator. There are many opportunities to grow as a researcher and I have found an extremely supportive academic environment. I find the bench-to-clinical research collaboration, working hand in hand with the labs, to be a very enriching interaction.
What kind of person thrives in this professional environment?
CMB: Resilience, creativity and scientific curiosity are the best words to describe a person who may enjoy working at NCI.