PGY-2 Radiation Oncology – Columbia University – McMaster University – University of Toronto
Hi! My name is Amir and I’m a PGY-2 Radiation Oncology resident at the University of Toronto. I am a Torontonian and devoted Leafs fan. I obtained my BA at Columbia University studying Biology and Music (I considered a career as a violinist at one point), an MSc at the University of Toronto researching sarcoma genomics, and an MD at McMaster University.
Why I chose Radiation Oncology
I had developed an academic interest in Oncology through senior year coursework and research in graduate school. However, learning about cancer care through the experiences of those close to me translated my academic interest into an aspiration to be an Oncologist. Early in medical school, I considered different avenues to pursue a career in Oncology, and very quickly found Radiation Oncology to be the best fit and most fulfilling. Imagine having the chance to provide cure and meaningful pain and symptom relief to your patients, locally treat cancer from head-to-toe in adults and children, and work with arguably the most interdisciplinary teams in all of medicine to leverage cutting-edge technology and care for patients in the most challenging time of their lives!
What does a typical day of clinical duties involve?
What kinds of rotations are required in your program?
Our PGY-1 year begins with two introductory months on-service, consisting of clinics, lectures, and calls backed-up by senior residents. The remainder of the year consists of off-service rotations in Otolaryngology (Head and Neck Surgery), Surgical Oncology, Medical Oncology, Internal Medicine, Oncology-specific urgent care, Radiology, and Palliative Care.
We remain connected to Radiation Oncology during PGY-1 by doing Radiation Oncology call on some of our off-service rotations, as well as an academic block during which we complete a national Radiobiology course. We are exclusively on-service starting from PGY-2, doing rotations in different disease sites (e.g. breast, lung, central nervous system) which are 1-3 months long each. The Royal College requires completing one research project during our residency, but we are encouraged to make the most of all the research activity that is around us and explore it as much as we’d like.
Which of your personality characteristics are particularly helpful in your field?
I would say I’ve drawn most on my communication skills when working with patients, inter-disciplinary colleagues, and staff. There is a lot of information and emotion to process in Oncology patient care, so being a good listener, validating, and distilling issues into the most important, accessible, relevant items goes a long way. Analytical personalities are also commonly found in Radiation Oncology, as each case requires balancing many patient, disease, treatment/technical, and logistical considerations.
What are the best aspects of your residency?
The best aspects of Radiation Oncology are the unique and deep relationships you get to build with patients and their families. I enjoy the diversity in a given week, transitioning from direct patient care in a busy clinic to treatment planning in a quiet area, from bedside rounding on call to multidisciplinary and QA rounds. I enjoy the innovative atmosphere at both cancer centres I work at and the opportunity to see new technologies evolve and be used to improve patient outcomes. I love the highly collaborative nature with different medical specialties, with our allied health colleagues, and with our colleagues in physics and dosimetry. I appreciate the predictability in our hours and that our clinical workflow is not physically taxing.
What are the most challenging aspects of your current role?
There are academic challenges and there are emotional challenges. The breadth and depth of clinical and technical knowledge we need to acquire in our training can be daunting, but putting in daily, incremental work and having a growth mindset helps to celebrate each step and be patient through training. The conversations we have with patients run the spectrum from breaking bad news to bedside conversations about dying with patients and their loved ones, which are never easy, but instill a deep gratitude and sense of purpose.
What is one question you’re often asked about your decision to pursue a non-clinical career?
It’s actually a triad of questions: “What is Radiation Oncology?” “Do you see patients?” “Is it different from Radiology?”.
I think these questions speak to how unique our specialty is, as there really is no other direct comparable among specialties. It also speaks to the need for our specialty to evangelize itself, share our interesting world with more med students and welcome them into our departments and clinical activities. Please come and spend time with your local Radiation Oncology department!
Can you describe the transition from clerkship to residency?
It was a steep learning curve! I remember the craziness of my first call shift well. Just as it started, I had a page about a seizing patient on the ward, a recent transfer-back from ICU with hypertensive urgency, and a few consults, all within a few hours! It definitely took a few months to become comfortable. I was lucky to have very supportive senior residents who were always happy to answer questions and provide guidance.
There is a lot of information and emotion to process in Oncology patient care, so being a good listener, validating, and distilling issues into the most important, accessible, relevant items goes a long way.”
What are your fellow residents like and how do you interact with each other?
I am lucky to go through this journey with a kind, supportive, funny, hard-working, and extremely bright group of co-residents. These qualities are found in most Radiation Oncology residents, and the added advantage in Toronto is that there are four residents per year (in contrast to 1-2 in other programs), so I have had excellent peer support thus far. We work one-on-one with our staff, so we don’t work together in-clinic, but we hang out in our resident area/room while contouring, working on research, studying, and outside of work.
What are your academic interests?
I have been actively engaged in a number of clinical research projects thus far, which helped me to build my Radiation Oncology knowledge base during my primarily off-service PGY-1 year. I enjoy medical education activities and will be involved in teaching activities in the coming year, as well as medical education research.
I worked with the Resident Doctors of Canada (RDoC) Competency-Based Medical Education (CBME) project team, helping to develop a “Top Ten List” of tips for navigating Competence-by-Design (CBD), and look forward to future work with RDoC in the coming years.
What is your work-life balance like, and how do you achieve this?
Work-life balance is certainly compatible with Radiation Oncology residency training. I stay in touch with my family and close friends daily, which is perhaps the most important contributor to my wellness. I enjoy listening to music so I make time for this on a regular basis. I am an avid Leafs fan and try to watch a full Leafs game every week, while closely following the league online every day. I’m a cinephile and enjoy watching and analyzing movies with friends. I plan out and request my vacation time early in the year so I have points of the year to look forward to.