The
nature of gynecologic oncology consists of working with women who are either
diagnosed with female cancer or suspected of a diagnosis. One of the most important things I learned with
this broad description is that the Gyn Onc surgeons are truly primary
caretakers of their cancer patients.
Aside from radiation oncology, gynecological oncology surgeons are not
just surgeons. They are diagnosticians,
surgeons, and chemotherapy caretakers.
| gyn surgery = watching a boob tube for a few hours. that's an ovary getting bovied off a ligament... |
The
training involves the Ob/Gyn 4-year residency plus a two-plus year fellowship
focusing on oncology. I only spent a
week in the exploration, but a typical academic gyn onc surgeon would operate
2-3 days a week, have 2 days a week for clinic, and an administrative day. Hours seemed very comparable to typical
general surgeons, with early mornings starting at 5 for residents and days
ending with the ending of procedures, which could vary from 5pm to 8pm on any
particular day of procedures. Many of
the surgeons seemed to like having marathon surgery days, consisting of 3 or
more surgeries one after the next. None
of this was overwhelming after just having completed my surgery rotation. In fact I enjoyed the similarity.
I
mentioned that understanding the composition of gyn onc work was one of the
most important things I learned in my week of exploration. I did not know that gyn onc spent so much
time in clinic following up with long term patients and making major treatment
plans beyond surgery. I had spent a 3-4
weeks before this exploration following surgical oncologists, and had always
enjoyed their clinic. In Surg onc,
clinic usually consisted of new patients looking for a positive or negative
diagnosis, patients ready to undergo surgical treatment decisions, patients
coming to hear their pathology results, and beyond that, long term follow-up of
already “cured” surgical patients. In
gyn onc clinic, I was distressed at the amount of bad news and difficult
decision-making advice I watched the surgeons give. These solemn encounters were oddly out of
proportion to what I had considered routine in cancer surgery work. I couldn’t help but get the impression from
this that it meant that gyn onc’s had to deal with some of the worst and most incurable
cancer seen in medicine. But I knew that
this assumption couldn’t be correct.
 |
| Da Vinci! concept kind of cool. but laparascopy in general can't ever seriously be fun unless your behind the electronic arms :) Not to mention pretty much 80% of the surgeries I saw were hysterectomies. shoo. |
It
didn’t take me long to realize that the lack of comparison to surg onc was due
to the fact that surgical oncologists have the convenience of turning away
cases that are inoperable, and thus are able to turn away situations doomed for
bad outcomes.
I
have long thought to myself that I like sick patients. But I have also thought that I like sick
patients that can and are going to get better with a physician. The typical excuse some people use when they
go into surgery comes to my mind: a desire to cure patients in a expeditious
fashion [with surgery].
I
know I want to work with cancer. This
may sound counterintuitive in the opinion of the typical person, but those who
go into cancer work dooming themselves to the struggle of dealing with failure
and death (and likely desensitizing themselves to death in the meantime)…. are
the medical oncologists. I want to go
into a field of oncology that has been shown to be capable of truly curing
cancer patients. Surgeons may not cure
all, but the rate of disappointment is statistically much better than those who
have to depend on chemotherapy.
After
getting my peak into gyn onc, I do wonder if I still may like regular OB/GYN. But I am running out of time to decide, and
after my experiences in my surgery rotation and my enjoyment of my cancer
research, I like the path I’ve already started trailing down. Cancer surgery!
