Dr Nick Zdenkowski is a final-year medical oncology advanced trainee at the Calvary Mater Newcastle, NSW
Why did you specialise in medical oncology?
I realised how much medical oncology had to offer both as a career and to the increasing number of cancer patients. I could see that the knowledge base in oncology was increasing faster than in other specialties, and I wanted to be part of that. It was an opportunity to be involved in basic and translational research, and to contribute to improving cancer treatment and services.
What do you enjoy most about the training program?
I applied for an advanced trainee job at the Mater in Newcastle because it has a large academic oncology unit in a town with a great lifestyle. There is an active clinical trials unit, and the diagnostic and treatment services are on par with most capital city oncology units.
The constantly changing landscape of investigations and treatments keeps your mind engaged and instils hope. It is rewarding to communicate with patients about complex scenarios, particularly demystifying the cancer journey for them. When you share the highs and lows, you develop a close clinical relationship with patients and their families. The variation in patient presentations is endless and is not limited to a single organ system.
What are the main obstacles/challenges?
It can be difficult, if not impossible, to keep up with the evolving understanding of oncology, and there is a tendency to subspecialise to maintain currency. It is important to use strategies to avoid burnout. In the current health economic climate, it can be difficult to aim for excellence in any specialty, but in this era of high-cost drugs, it is a particular challenge in oncology.
What advice do you have for young doctors interested in medical oncology?
Medical oncology is an engaging and stimulating specialty, with a variety of career options, in research, private and public work, and academic and clinical roles. Patients on the oncology ward tend to have complications of treatment or of advanced cancer but these patients are in the minority. Most patients are ambulant and relatively well. It is not all doom and gloom — often you can be the bearer of good news, or at least able to share a joke with your patients.
What do you plan to do when you finish your advanced training?
Next year I will be the clinical research fellow with the Australia and New Zealand Breast Cancer Trials Group in Newcastle. Beyond that, I intend to work in an academic centre and remain involved with clinical research and teaching while maintaining a clinical focus.
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