Become An Oncology Pharmacist: 3 Ways To Learn Oncology
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Given the disruption in the pharmacy profession, the time to innovate your career path is now.
I have yet to meet a pharmacist who doesn’t think our profession is being disrupted. There is change all around us and the path between how we’ve always practiced and how we will practice in the future isn’t paved with bright lights; it’s dirt roads in the country. We need to map out our own direction, one that ideally leads us to work we find meaningful and fulfilling.
I believe oncology is the best specialty area for pharmacists now and in the future because:
Trends in FDA drug approvals show cancer therapies have been increasing over other disease areas since 2009 and the time to approval is shortening.
The number of clinical trials in cancer far exceeds other therapy areas which leads to more drug approvals.
The drugs approved are increasingly more complex both in mechanism of action, resistance, and toxicities (such as CAR T-cell and immunotherapies).
Pharmacists play a vital role in the management of patients with cancer and have many areas where we can make an impact, but we need more knowledgeable pharmacists to reach every patient undergoing treatment. There are still cancer centers in this country that treat patients without a pharmacist involved, even in product verification. We need to step up and communicate why we need to be in all the places where these patients are being treated.
There are 2 main paths into oncology: through post-graduate training and through work experience.
The Residency Path
This path includes traditional residency training and fellowship training.
I want to take some time here to talk about residency training because the divide between pharmacists with residency training and those without is growing into a chasm and it’s hurting our profession.
I believe this divide is about the perception of privilege; the idea that those who signed up for the extra work and sacrificed short-term financial gains for long-term benefits are “better” than those that took the “easy road” and who followed the short-term money train.
We want to compare ourselves to others and be the hero - the one that made the right choices. But these are false dichotomies and they cause damage.
I hear from a lot of pharmacists that want to learn oncology but think residency training is the only path. The fact that I hear this so often really gets my goat 🐐, as the saying goes. Our profession has found ourselves in an escape room of our own creation. Residency training was not meant to be the only path to oncology (or any other specialty for that matter) but a fast-track path.
I needed that fast-track because it comes with structure and support that you don’t get when you do it yourself. I am not better than others because I’m residency-trained. I just made different choices to get me to my destination earlier. And ironically, my destination has turned out to be different than I originally intended. I am incredibly grateful that I chose the residency path but there are lots of pharmacists that are smarter than me that could be a better oncology pharmacist than me - it isn’t about how you got there, it’s about what you do when you get there.
We make the best decisions we can with the information we have at the time.
If you have the ability to pursue residency training, I highly encourage it. It is a lot of work but it consistently opens doors. If you want to pursue residency after being in the workforce, ASHP has a guide for nontraditional residency candidates.
The Work Experience Path
If you’re not able to pursue residency, there are other ways to get into oncology. It takes more time, motivation, and determination but it is definitely within reach and I can point to many pharmacists I have met that are working in oncology today without residencies.
Getting an initial foot in the door can be challenging but here are some strategies to get you started. Of note, these are also important strategies for residency and fellowship-trained pharmacists too!
Build your network
You probably hear the importance of networking a lot - that’s because it’s critical. It shouldn’t feel like a chore but an opportunity. Seek out people that are working in cancer centers or other roles in oncology. LinkedIn is the best place to do this so spend time learning how to search on the platform; consider investing in the paid version to access more features.
Beyond LinkedIn, networking can occur in a lot of venues. As live events get up and running again, those offer the best opportunity to have great conversations, but you can also connect with others in RPhAlly, The Pharmacist Moms Group, The Pharmacist Women Group, and RxComedy.
It should go without saying but I’ll say it anyway, your network is not a build it and forget it kind of thing. It’s a build it and nurture it kind of thing.
You should strive to be of value to your network so they will want to be of value to you. This means you should not connect with someone on LinkedIn and ask them to help you get a job at their institution. You should offer value before you ask for anything, which is why you have to build your network before you need it. If you don’t have anything to offer, ask how you can support them or interact with their posts online by sharing and commenting.
Tell your network what you’re looking for
A great thing about having a robust network is having an army of people looking out for interesting opportunities for you. In order for them to do this, they need to know what you want! In other words, you need to be referable.
What is memorable about you? What is memorable about what you’re looking for? People need to remember who you are when they come across an opportunity that matches. If you don’t know what you’re looking for, start getting very clear now by asking yourself:
What do you want to do more of?
What do you want to do less of?
What are you naturally good at - what do people come to you for help with?
Do you want to be a big fish in a little sea or a little fish in a big sea (meaning what size institution or company do you want to be at)?
How risk averse are you?
Are you willing to relocate?
Consider these 2 examples of pharmacists:
Pharmacist A:
“I am frustrated with my current job and am looking for anything new where I can use my clinical skills. I just want to do something different.”
Pharmacist B:
“I am looking for opportunities in facilities that treat patients with cancer, preferably a smaller institution where I can get to know my patients and colleagues and not feel like a cog in a wheel. I’d like to stay within 40 miles of my current city. I am skilled at organization and writing procedures and would like a role where I can improve processes. I don’t have oncology experience yet but I am motivated to learn and am willing to put in the hard work, starting at the bottom if necessary. In fact, I’ve started self-learning solid tumors and am excited to put it to use.”
I have a very clear picture in my head about the type of role that pharmacist B is looking for but I won’t remember anything about pharmacist A. If your network is paying attention (and most of us are), they hear about opportunities on a regular basis (LinkedIn posts, job boards, list serves, networking sites, conversations). You don’t need people to be actively looking for roles for you (although that would be pretty awesome), they just need to know what you’re looking for so when they hear of a role that meets some or all of your criteria they will remember you and can quickly share it with you. The reason this is effective is because we all like helping people but we don’t have a lot of bandwidth to do it. Make it easy on your network and you will increase your chances that they share what they come across.
So, your tasks:
Summarize what you want - make it as specific as possible, it needs to be memorable.
Share it with your network on a regular basis in an organic way - do no pepper them with unsolicited LinkedIn messages or post about your job search every day. Find ways to weave it into conversation.
Locate the centers near you that treat patients with cancer
This seems intuitive but there are probably facilities near you that you are not aware of. A lot of smaller centers are non-specific infusion centers that treat cancer along with other conditions (iron deficiency, neurological disorders, etc).
Here are a few places to look:
The Commission on Cancer (CoC) is a group of professional organizations that promotes improved outcomes in cancer care through accreditation standards. They accredit more than 1500 cancer centers in the US. They have a searchable database of these centers on their website (scroll to bottom of page).
The National Infusion Center Association has an infusion center locator that lets you search by specialty area, location, and other factors.
The Association of Community Cancer Centers (ACCC) lists their cancer program members by state on their website.
Patientresource.com also has a list of cancer centers that is searchable by state.
Once you find your local centers, do some research on them. Search for employees and their business page (if they have one) on LinkedIn. Find their website and their career page. Look for events they host that you could attend to meet people. If you are not able to relocate, you can be hyper-focused on these centers. Even if they don’t have openings now, change is inevitable so the closer you are paying attention, the increased likelihood you’ll know when something opens.
Volunteer
Participating in local cancer events can introduce you to people and help you learn more about your cancer community. Every year there are many events that support cancer research and patients such as Velosano in Ohio, Pan-Mass Challenge in Massachusetts, Light The Night events from the Leukemia & Lymphoma Society, Pancreatic Cancer Action Network events, and so many others.
If you currently work at a facility that treats patients with cancer, offer to cross-train
Due to the perceived (and real) complexity of cancers and their treatments, many pharmacists shy away from working in these areas. Because of this, some centers, particularly smaller ones, struggle to find staff willing to cross-train to help fill coverage gaps. Make it very clear to your boss that you are willing to take on this challenge - be the solution to a problem they have.
A sure-fire way to get ahead is to identify pain points and offer solutions to fix them.
Keep an open door to recruiters
The majority of our careers are not in active job search mode, hopefully, which is probably why many of us ignore messages from recruiters on a regular basis. My standard response to these messages is to say that I’m not looking for new opportunities currently but that I would love to be considered in the future.
If they are unfamiliar with what I’m looking for, I will explain that too (the more clear the better). Ask them if they have a job posting you can share with your network. Remember, these are the people with the pulse on hiring and they get paid when they place someone so if they don’t have something for you, try and help them find someone that is a good fit - that’s an example of bringing value.
Join oncology-focused organizations
There are more than 100 oncology organizations across the world so there is likely to be one that interests you! Here is a list to get you started.
Once you decide which one(s) would be best suited to where you are today and where you want to go, determine opportunities to get involved. Organizations are always looking for volunteers to do a variety of roles so start digging in. Not only will you learn what the organization is working on but you’ll meet others interested in oncology.
Although some organizations restrict their membership access (such as COG and NCODA), the majority don’t mandate you are working in oncology. For example, HOPA’s full members are “pharmacy clinicians, educators, and researchers who are involved in or who support hematology/oncology pharmacy practice”.
Analyze job postings for how the requirements are described
Use this information to direct what skills you should work on obtaining and how to describe your current skills to better align with what is being sought in the market. Think of specific examples in your work that exemplify those skills. How have you demonstrated critical thinking skills? How have you used communication skills to defuse potential conflict? How have you managed a particular project to its successful completion? If you see these or other requirements in job postings and you haven’t done them yet, seek out opportunities where you can. If there are not opportunities to do so with your employer, find other ways such as professional organization involvement.
Get an outside opinion
Another tool at your disposal is access to coaches. Why would you invest money in a coach? Because they have knowledge and experience you don’t have - same reason you go to the doctor instead of relying on Google (you do this, right?!).
I heard a great piece of advice a while ago that continues to resonate with me - “staff your liabilities”. This means identifying what you’re not good at and finding someone else to bridge that gap. It’s near impossible to see the forest of your career through the trees of day to day work so hiring someone else to be an objective party holds its weight in gold.
For some reason, pharmacists are not very keen on spending their own money on professional development. I’m not really sure where this comes from. Perhaps we have PTSD from student loans but in my opinion that’s why we should be doubling down on our career. We have already invested so much time and money, now is the time to put all that to the highest use possible.
How to learn oncology
A big barrier to working in oncology is getting the foundational knowledge. The amount and complexity of oncology information scares a lot of people. This reminds me of Warren Buffett’s quote:
Be fearful when others are greedy and greedy when others are fearful.
He was talking about investing but I think it applies here too. When other pharmacists are fearful of oncology, you should be greedy! Step up and start learning and reap the future rewards.
So how and where do you get started learning?
If you pursue residency or fellowship training, your course is mapped out for you from day 1. If you’re on the work experience path, you are in DIY land. Keep in mind, we all had to start somewhere and we all have to continue to learn. The double-edged sword with oncology is that it’s rapidly changing so we all have to keep up with the new drugs and treatment regimens that are constantly changing.
Spend some time developing a strategy and setting realistic expectations. There is an endless amount of information available and it will quickly become overwhelming without a plan. How best do you learn? How much time will you commit every week? How will you resolve questions? How will you track progress?
All the information you need is available online thanks to the world wide web (okay, there is a lot of information behind paywalls but there is so much for free you won’t notice for a while). But that’s a blessing and a curse. Where do you start and how do you prevent yourself from falling down 20 rabbit holes before you even get to treatment options?
Rabbit holes have always been my kryptonite. I find so many aspects of medicine fascinating that I’ll detour for hours reading something that is not relevant to the task at hand. This is why residency was the best path for me; I needed the “pencils down” structure of a finite amount of time on a particular rotation or project.
How will you stay on task?
When it comes to learning oncology (and other areas), there are 3 paths: DIY (do it yourself), curated content, and facilitated learning.
DIY (aka drinking from a fire hose)
As I said, everything you need is available online for no or minimal cost. The price you pay is in sweat equity finding and organizing all the content in a way that you can learn. Here are some resources to get you started but it is certainly not a complete list.
The National Cancer Institute (NCI) has so much information I don’t even know where to begin! Take some time looking around, it will be a great resource now and in the future.
The Hemonc wiki page is a free resource of interventions, regimens, and general information for hematology and oncology.
Research To Practice has a lot of content separated by tumor type including video, audio, and slides.
Clinical Care Options offers a variety of content from video, slides, podcasts, and a section called Clinical Thought where a clinician describes their perspective on a particular topic. Of note, they have an international audience so you might find content in languages other than English.
Cancer Therapy Advisor is a free resource whose mission is to provide practice-focused clinical and drug information that is reflective of current and emerging principles of care that will help inform oncology decisions. There is a lot of content on their site but I have found the treatment regimens to be the most useful.
The Merck Manual is great for background information.
NCODA has created clinical guidance documents called PQIs (Positive Quality Interventions) that range from adverse effect management to drug class overviews and many topics in between.
National guidelines from NCCN (National Comprehensive Cancer Network), ASCO (American Society of Clinical Oncology), MASCC (Multinational Association of Supportive Care in Cancer), ESMO (European Society of Medical Oncology), ASTCT (American Society of Transplantation and Cellular Therapy), SITC (Society for Immunotherapy of Cancer), and COG (Children’s Oncology Group).
Curated Content
The DIY approach is often overwhelming so another path is to find content that has passed through a filter of some kind; content that has already been curated and packaged for you. This content is still DIY in the sense that you have to read/watch/listen to it, comprehend it, and apply it. These programs are not free since you’re paying for someone to filter the noise for you.
Enjoy Learning Oncology: The Basics is my online self-study basics program that is ~3 hours of video lessons with downloadable slides, an oncology pocket guide, and a chemotherapy verification checklist.
HOPA Core Competency Certificate Program is an online self-study program for pharmacists new to oncology. It has 12 modules on a variety of high level topics (order evaluation, effective patient education, medication procurement, value based frameworks, etc) and they can be purchased as a package or as individual modules.
HOPA BCOP Preparatory Course has 6 sections with multiple lessons in each ranging from disease-specific content to pharmacology to practice management. They also offer other on-demand education, which includes annual BCOP self study releases.
ACCP and ASHP collaborate on an oncology preparatory review and recertification course. The intended audience is pharmacists preparing for the BCOP exam and “those seeking a general review and refresher on disease states and therapeutics”. In my opinion, this content is very difficult for a novice in oncology and I do not recommend it as a starting point.
The Canadian Association of Pharmacy in Oncology (CAPhO) has several resources on their website, including an oncology basics course, for purchase or part of their membership.
Facilitated Learning
The last path to learning oncology is the least common. Facilitated learning means having access to an expert to answer your questions.
The biggest challenge with learning oncology is putting all the information in context. Consider if you are learning about multiple myeloma. You’ve learned about the difference between transplant-eligible and ineligible but are now stuck in how to decide among the multiple category 1 recommendations for primary therapy in transplant-ineligible patients. Which regimen is best? When would you use IV vs SQ daratumumab? What is low-dose dexamethasone and why don’t all the regimens use it?
If you are currently working in oncology, you could discuss these questions with your pharmacy colleagues but you may not have a knowledgeable resource. There is a lot of value in discussing patient case examples to bring out the nuances of cancer care. You learn oncology through clinical pearls gleaned from these discussions. This is where personalized support can help.
I offer this kind of support in the ELO program. The ELO Certificate and ELO Collaborative tiers includes weekly curated content, study questions, a community of your co-learners, and case study walkthroughs/Q&A sessions with oncology pharmacy experts (live and asynchronous). This is a guided program that leads you through the content, removes barriers, and brings the accountability of a group cohort. If you need support and structure to learn oncology, this can help you achieve your goals.
Yes, oncology is challenging, but remember, pharmacists are skilled self-learners. We can learn anything and do anything with the right support.
You can do hard things!
About The Author
Kelley is a board-certified oncology pharmacist that strongly believes oncology is the best specialty for pharmacists and that anyone can learn it. She founded the ELO (Enjoy Learning Oncology) Program, the only private member network exclusively for oncology pharmacists. Want to get instruction and personalized support to take your oncology knowledge and career to the next level?
