The Educational Path of a Hematologist in the U.S.
Residency
After completing medical school, your first three years will generally be spent in residency. Internal medicine and pediatrics are the typical residency tracks completed prior to specializing in hematology or hematology/oncology, although you may enter hematology after completing other general residency programs as well (e.g., combined internal medicine and pediatrics or family practice). Another possible track is to do a pathology residency for approximately three years, after which you could pursue a career in hematopathology, blood banking, or transfusion/laboratory medicine. Each residency program has a unique structure, but all include elements of patient care. These programs generally do not include basic research, although they may offer brief periods of “elective” study, which, in rare cases, may be laboratory-based.
Fellowship
Fellowship is typically a three-year period in which a physician completes further training in a subspecialty. Fellows may choose to complete a fourth and/or fifth year of fellowship before seeking independent employment. Hematology-related fellowships include adult hematology, coagulation, hematology/oncology, pathology, and pediatric hematology/oncology (there are no pediatric hematology-only programs). During this time the physician is known as a fellow and can focus on a clinical or research career, but all fellows are required to gain competency in clinical research. Although the training of a fellow is more advanced than that of a resident, when treating patients, fellows are still under the supervision of an attending physician who has already completed the fellowship in the relevant subspecialty.
Post-Fellowship
After completion of the fellowship, physicians can:
- Apply for a position in academic medicine as a junior faculty member, assistant professor, instructor, or assistant/associate staff member.
- Practice their specialty in their own private practice or group practice.
- Go to work in the corporate sector (although many corporations typically require three to five years of experience beyond the fellowship).
- Seek another fellowship or employment at a government agency (such as the National Institutes of Health, Food and Drug Administration, or Centers for Disease Control).
It is likely that you will turn to a lot of sources when choosing a specialty, but one of the most important steps you can take to ensure you make the right choice is talking to someone who practices in the field you are considering. This person can provide valuable insight and could serve as your mentor should you choose to enter the field he or she is in.
Additional Resources
If you have already selected hematology as a specialty, the American Society of Hematology (ASH) has tools and resources available to support your career development, such as a career-development timeline for trainees, information about awards and funding opportunities, career advice, educational tools, and an online job bank that lists open positions in hematology. Visit the ASH Web site to access these resources and more.