Oct 27, 2022
Charles R. Thomas, MD, FASTRO, FASCO, is a professor and chief of radiation oncology at Dartmouth Geisel School of Medicine and Dartmouth Cancer Center, where he joined the faculty in fall 2021. Previously, he served as a professor and chair of the Department of Radiation Medicine at Knight Cancer Institute, Oregon Health & Science University (OHSU) School of Medicine and OHSU Health Care. He recently served as a mentor for ASCO’s Oncology Summer Internship program and on the faculty of the 2022 ASCO Annual Meeting. (Disclosure.)
How did you initially choose your current career path? Were there any unexpected detours along the way?
CT: In June 1986, during the last rotation of my intern year in the internal medicine residency program at Baylor University in Houston, TX, I decided that oncology was the specialty for me. I would sneak across the street to attend seminars, conferences, etc., at MD Anderson Cancer Center whenever I had a spare moment. After finishing medical oncology fellowship at Rush University in Chicago and starting as a medical oncology attending at the University of Washington (UW) in Seattle, I began to learn more about radiation oncology. The main oncology clinic at UW Medical Center was a shared area with medical oncology, radiation oncology, and hematology. For the first time, I was able to closely observe exactly what radiation oncologists do. I then learned about a few highly productive academic radiation oncologists who had prior training in medical oncology (including Drs. Mack Roach, Andrew T. Turrisi III, Theodore S. Lawrence, Timothy J. Kinsella, and C. Norman Coleman) and decided that I could add value by gaining additional training in radiation oncology. I eventually became triple-board certified (internal medicine, medical oncology, and radiation oncology). My focus on clinical trials and multidisciplinary care was launched and has been maintained ever since.
Describe your typical workday or work week.
CT: My wife, Muriel, and I typically drive into downtown Hanover through the picturesque campus of Dartmouth College and get a light breakfast before I’m dropped off at the Dartmouth-Hitchcock Medical Center in nearby Lebanon, NH.
Typically, I’m involved in direct patient care (predominately thoracic oncology cases) at least two days per week, and the remainder is divided between mentoring/career development of others, research, editorial duties for JAMA Oncology, and administrative duties (both intra- and extramurally).
In order to minimize disruptions to my faculty, I have begun serving as the Doctor-of-the-Day (alternately, Officer-of-the-Day) for three days of the week. It allows me to understand the clinic flow and allows the faculty to stay focused on their planned tasks.
I usually leave work, similar to my tenure at OHSU, between 7 PM and 8 PM. As things quiet down after hours, I have more time to think and be proactive as opposed to the varying reactive demands of the core workday.
What does your work as chair of radiation oncology entail?
CT: Actually, Dartmouth’s Radiation Oncology Program is finally evolving into full departmental status over the next year or so. This has been long overdue.
As physician-in-chief of the Radiation Oncology Program, I have oversight over the clinical, education, patient care, and research programs. It is critical that these are strategically aligned with the missions of multiple stakeholders such as the Dartmouth-Hitchcock Medical Center, the Dartmouth (formerly Norris Cotton) Cancer Center, and the Geisel School of Medicine, as well as maintaining and building strategic interface with programs within the broader Dartmouth community and beyond.
What does your work as associate director of Diversity, Equity, and Inclusion (DEI) entail?
CT: To begin with, I would not have come to Dartmouth unless I was allowed to lead the Radiation Oncology Program. Having said that, I absolutely refuse to allow myself or other folks serving in the DEI roles across cancer centers and academic medical centers to be a “check box.” As such, I weave DEIIBJ (diversity, equity, inclusion, intentionality, belonging, and justice) into normative processes each and every day.
Intentionality cannot be over-emphasized. For instance, our team was intentional in being able to recruit a pair of highly talented women physician investigators to join the Dartmouth Radiation Oncology family. We now are beginning to develop long overdue gender parity and equity.
Furthermore, since I have oversight over a critical financial engine within the larger clinical enterprise (I am referring to the clinical radiation oncology program), there is a diminished capacity to be viewed by others as one-dimensional and/or an afterthought—the aforementioned “check box.” The faculty and staff of the Dartmouth Radiation Oncology program strive to walk the talk regarding DEIIBJ in everything we do, full stop.
If you have to pick one aspect, what part of your job is your favorite? What part is the most challenging or frustrating?
CT: Being involved in mentorship, sponsorship, and overall career development for a broad spectrum of learners and faculty is most rewarding. Our book, Career Development in Academic Radiation Oncology, contains multiple pearls of wisdom that can help a myriad of investigators across the oncology spectrum (regardless of specialty, quite frankly) navigate academic medicine.
The most challenging, though arguably one of the most important to me as a leader, is to hold the line on protected administrative and research time commitments for my faculty. I absolutely refuse to allow faculty to be denied a fair opportunity to mature and thrive in the scholarly/academic mission. Some faculty have been conditioned to expect that protected time is a false promise. I worked to change the culture at OHSU and our Dartmouth team is embracing a renewed focus on not sacrificing the research mission. A recent roll-out of a mini-sabbatical program is just one program that we’ve begun. More to come in this space.
What do you wish you had known before you chose your career path?
CT: I do regret not getting an MPH or a Master’s in Clinical Investigation concurrently during my medical school training. It would have certainly accelerated my learning curve as a clinical research investigator and trialist.
Why would you recommend your career setting to someone starting out in oncology?
CT: Clinical oncology is a big-league specialty and needs folks who have a thirst to ask questions and formulate testable hypotheses to ultimately improve patient care. Radiation oncology, in particular, is a vibrant and critical component in the care of patients with cancer.
What kind of person thrives in these professional environments?
CT: Individual virtues needed to thrive: curiosity, discipline, optimism. Support-team virtues needed to thrive: supportive family, including my spouse of 37 years, Muriel Thomas.
Can you share a personal experience that shaped your professional journey and led you to where you are today?
CT: There’s a mentee of mine, Dr. Clifton Dave Fuller, now a highly successful clinical investigator at MD Anderson Cancer Center’s Radiation Oncology Program, who was and has been very instrumental. He’s surpassed any accomplishments that I have achieved, far and away. That is a good thing. Dr. Fuller has showed me how valuable sustained mentoring and reverse mentoring can be.