Finding Your First Oncology Job: 10 Things You Should Know

Narjust Duma, MD

After completing medical school, surviving residency, and finally getting to study your disease of choice during fellowship, your program coordinator sends you an email titled, “Job opportunities.” Minutes after I received that email, anxiety started building up. Is it time to start looking for my first faculty job? How does this work? Where do I start?

Those questions followed me for days. Then I heard some of my co-fellows had already found their first jobs and were close to signing their contracts. And my anxiety turned into fear. A lack of knowledge, and an excess of coffee, just added fuel to the fire.

I am writing this article to share some of my experiences while looking for my first faculty position in medical oncology. This information is not unique to hematology-medical oncology and may be helpful to fellows from other specialties.

1 Say Goodbye to The Match

Starting with the medical school application, medical students live by a time line and an organized system. One perfect example of this is The Match: The application opens in July, you complete an application, the interviews go on for a few months, you create a ranking list, and at the end you receive an email with your new destination.

Finding your first job is quite different. A few job openings can be found on society websites, such as the American Society of Clinical Oncology or the American Society of Hematology, or career sites, but the most common style is word of mouth—and there is no official posting for many jobs. You can work with recruiters, and if you’re interested in working with the pharmaceutical industry, each company has a medical liaison that works with your institution developing and opening clinical trials. Ask your mentor or program director for the liasion's contact information and email them about your interest and curriculum vitae (CV).

2 Private Practice Versus Academia Versus Industry

Oncology practice has evolved over the years, and it no longer involves only the options described above; you can also pursue a career in government or with a consulting firm, among other options. All of them have their pros and cons, from salary to research time to the opportunity to wear jeans on Friday. It’s important that you define what type of environment best fits your professional and personal goals before you start looking for that first job.

3 CV and Cover Letter

It’s time to put all your accomplishments in writing again. You can follow your institution’s template, or whichever template you feel most comfortable using, but do not forget to write everything down: posters, local oral presentations, that time you taught a course in the medical school, and any award, however small or big, you received during your training. The people doing the hiring won’t know what you've done unless you tell them.

In my case, English is not my first or even second language, so I had a few people review my CV and cover letter for grammar and to make sure I didn’t accidently drop a Spanish word here or there.

The cover letter is more specific to the job and institution to which you are applying. Try to explain why you think this role and this place would be a good fit for you and how you can help the institution achieve its goals.

4 Reaching Out

There are several ways of contacting potential employers: emailing the contact person listed in the job posting, cold emailing the division chair or disease-specific chair to see what positions might be available, asking your mentor to make inquiries for you, and contacting a recruiter who can help you establish those connections. In addition, you can connect with future employers at conferences and career fairs.

In my case, I emailed many people, many times, and had a decent success rate. The times when jobseekers were told “Do not contact program directors” are over; it’s your duty to seek an answer.

5 Phone Interview

Before your visit is scheduled, your potential employer will contact you for a brief screening interview, a 10- to 15-minute conversation about your interests and what they are looking for. Research the person you'll be speaking with ahead of time and try to reduce interruptions. In the case of video interviews, wear business causal.

6 The In-Person Interview (first and second looks)

Congratulations! They want to bring you in for face-to-face meetings. This time around, your potential employer will cover the cost of your travel, such as airfare and hotel. Work closely with your fellowship program coordinator to plan time away and coverage if needed. Remember, we are still fellows.

The interview will vary depending on the type of practice you decide to pursue, but general concepts will apply. You will likely have a dinner with some people from the institution the night prior, and the following day you will meet with key people (eg, division chair, future colleagues, etc).

What to wear? For the interview day, full business attire is appropriate, so get that interview suit out of the closet! For the dinner prior, and perhaps after the interview, business causal is fine.

In academia, a second look is almost mandatory. The goal of this second visit is to see if the institution and city are a good fit for you. Second looks are a great opportunity to meet with future mentors and tour the city; in most cases, you can bring your partner/spouse for a real estate tour. On this visit, you’ll discuss salary and benefits, and you can meet with human resources to discuss vacation time, sick leave, and other benefits.

7 The Job Talk

In many settings, you will be asked to give a “job talk,” or a summary of your research. Many people recommended against discussing a review topic, such as immunotherapy in lung cancer or CAR T-cell therapy in lymphoma, because you want to demonstrate that you are capable of starting and completing a project, and no one will know more about your research topic than you (hopefully).

The talk should last about 45 minutes. Avoid delivering excessive amounts of text in your PowerPoint, credit all your collaborators, and try to focus on only a few topics. Finally, tell a story that the attendees can follow.

8 Contract Negotiations

You’ve been offered a job. Congratulations! This is a huge moment, so let yourself enjoy your success. That said, you still have work to do.

Remember, everything is negotiable. Consider their first offer to be a draft, and do not be afraid to ask for what you want—the worst they can say is no. You can negotiate clinical versus research time, salary, bonuses, conference attendance, participation on boards, access to support staff, in-patient time, and more.

Ask your mentors, friends, and co-fellows what they have negotiated. As someone once told me, “Nothing is off limits.”

9 Legal Advice

This applies more for private practice where you negotiate partnerships. Many of my co-fellows had an attorney review their contract. A legal professional can help you navigate the noncompete agreement and other legal language that can be difficult to understand.

10 Your First Job Is Not Your Last Job

We all want to find the “perfect” faculty job with the plenty of clinical time, available start-up funds, and amazing coworkers. In reality, that perfect job may not exist. Understand the difference between your must-haves and your nice-to-haves, decide where you’re willing to compromise, and pick the job that best fits your personal and professional goals.

Additionally, your first job is just that, your first job. Important names in oncology have changed institutions and you can, too. Your goals and needs will likely change over time and more opportunities will come.

One final recommendation: Be honest and be you. You want to be hired for who you are and not for who you pretend to be.

Good luck!