KAH POH (MELISSA) LOH, MBBCh BAO
Institution: Fellow, University of Rochester Medical Center
Member since: 2013
ASCO activities: Trainee Council
Hematology and oncology fellowship training requires at least 3 years to complete. For fellows who wish to single board in either hematology or oncology, a minimum of 2 years is required. A number of programs offer the option to pursue a graduate degree during fellowship. For fellows who wish to venture on this path, you should consider a number of things prior to committing to the degree.
Why pursue a graduate degree?
There are many reasons to pursue a second graduate degree during fellowship. Some fellows would like to broaden their knowledge and gain skills in a new field, but the more common reason would be to obtain skills to complement your existing clinical or research competencies and interests. For example, during my residency, I was involved in a large observational research study and self-taught data analysis using the SAS analytic software. Although the hands-on experience was useful, I realized that I was missing the fundamentals in statistics. Therefore, I sought a graduate degree to consolidate my knowledge in data analysis.
A master’s degree also adds considerable merits to your job application after completion of your fellowship.
What are the options?
There are a number of options and the choice of a degree is largely dependent on what your goals are and the institution at which you are pursuing your fellowship. Most university programs offer a variety of graduate degrees; the more common options include master’s degrees in public health, epidemiology, clinical investigation, biostatistics/medical statistics, health services, information technology, medical education, business administration, and health-care management. Most of these degrees are research-oriented. Master’s degrees in business administration or health-care management are geared toward physicians and health-care professionals who are interested in the administrative and business aspects of medicine.
A master’s degree generally takes about 1 to 2 years to complete if you are studying full-time, or 2 to 6 years if you are studying part-time. Unless you are planning to stay at the institution at which you are pursuing your degree after your fellowship training, it is better to plan to complete all the required coursework prior to your fellowship graduation. Less commonly, doctorate degrees are also offered. However, completion of a doctorate degree takes much longer and is therefore less attractive to many fellows.
If you are at a fellowship program where a graduate degree is not offered, you could consider undertaking further study at a different institution that is accessible to you geographically or through an online/distance learning program. Enrolling in such a program can be more convenient, but many of these degree programs may require periodic on-site attendance—you should be familiar with the requirements prior to enrollment. It is important to be aware that although attendance at classes may not be required, distance learning degrees often require more self-motivation and self-discipline since you are required to watch online tutorials, access course materials, and communicate with your instructors online on a set schedule. Keep in mind that, just like anything on the internet, you should verify the credibility and accreditation status of a distance learning program before you sign up.
If a master’s degree is too daunting, you could consider focusing on courses (nonmatriculated) that are of particular interest to you and will help you gain the required skills.
How much time and resources are required of you?
Graduate degrees typically require attendance at classes. Although some classes may be offered online, you are still required to spend a considerable amount of time completing coursework. Therefore, before you begin pursuing a second degree, it is important to think about what you would like to get out of it and whether it is manageable for you to complete the work in addition to performing well in your fellowship training. Discussing with your co-fellows, colleagues, or friends who have gone through the process is very helpful to gauge the time commitment and resources required of you. Making your fellowship program director aware very early on (when you are first considering pursuing a second degree) and clearly outlining the protected time and resources you need will help ensure that each piece of your education and training goes smoothly. Your mentor can also be extremely helpful in guiding you through the process.
How do you find out if a fellowship program offers a graduate degree?
If you are at a university program, the institutional and fellowship training websites will be the best sources of information on the degrees offered, course descriptions, application requirements, etc. If you are still in the process of interviewing for a fellowship program, this would be an opportune time to inquire about the possibility of acquiring a second degree from your interviewers as well as from the fellows at that institution. You may discover that no fellows in the program have ever obtained a second degree, despite the opportunity being available at the institution. From there, you should find out the potential barriers: is it because of the clinical responsibilities, a lack of support or resources, the expense of the degree, or the poor structure of the course? You may also be able to discover how this compares to fellows in other programs at the same institution.
If a large number of fellows are pursuing a degree during their training, the likelihood of you successfully doing the same is much higher.
How do you pay for a graduate degree during fellowship?
For fellows who are interested in a second degree, I find that the associated financial cost is often one of the largest barriers. The completion of a master’s degree generally costs at least $30,000, and this may add significant financial burden to fellows. This reinforces the need to involve your program director at an early stage, as the financial support available is different at various institutions. Most university programs offer reimbursement for trainees to take courses, especially those that will improve your skills. Within the department or division, there may be funding available for this purpose. Some institutions also offer a T32 award, which is a training grant funded by the National Institutes of Health that provides research support (including tuition fees) to pursue a degree.
An example of a master’s degree curriculum
I enrolled on a master’s degree in clinical investigation in the beginning of the 2nd year of my fellowship. My program requires 32 credits to graduate. For the fall semester, I took one evening class (Principles of Epidemiology) and also frontloaded all my inpatient and consult services with the permission of my program director. This gave me the flexibility to attend two classes during the spring semester (Design in Clinical Trials and Qualitative Research). For each course, I spent approximately 4 to 6 hours a week attending classes and completing assignments. In my 3rd and 4th years, I plan to take one or two courses each semester to fulfill all the requirements prior to graduation. The courses include Introduction to Data Analysis and Management, Quantitative Methods, Ethics in Professional Integrity, Advanced Biostatistics, Survey Research, and Grantsmanship. The majority of master’s degree programs, like mine, require a capstone research project in the final year. It is important to plan ahead—if you do, you may be able kill two birds with one stone by integrating the master’s thesis into your ongoing fellowship research project.
In conclusion, getting a second degree can be very useful in your career path and can also be an enjoyable challenge. Make sure you are fully prepared for the time and workload commitment and have adequate support from your institution. I know I could not be doing this without the support of my mentor, Supriya Mohile, MD, MS, and my program director, Mohamedtaki Tejani, MD. I leave you with some words of wisdom and experience that they kindly shared.
“Research training during fellowship allows candidates to translate clinical and research questions from the clinic into doable projects. Skillsets required to develop aims/hypothesis, write protocols, implement and run studies, and conduct data management and analyses are not usually provided in-depth in clinical programs, and therefore seeking out training opportunities is important. These training opportunities allow fellows to understand the lifestyle and skills necessary for a research career and allow them to identify early on if this is the appropriate career path for them.”
“I echo Melissa’s advice to discuss your plans to obtain a second degree with your fellowship program director early on. Also, be prepared for some creative scheduling of your rotations in order to fulfill program training requirements. Flexibility is a key for success here. My advice is to make the master’s coursework work for what you need in your career—focus on your own learning rather than the semester’s final letter grade.” ■
Originally published in ASCO Connection. ©American Society of Clinical Oncology. “Obtaining a Second Graduate Degree During Fellowship: Things to Consider.” ASCO Connection, September 2017. All rights reserved.