title: Inpatient Hematology-Oncology Rotation Is Associated With a Decreased Interest in Pursuing an Oncology Career Among Internal Medicine Residents.
abstract: OBJECTIVE
  The demand for hematologists and oncologists is not being met. We hypothesized that an inpatient hematology-oncology ward rotation would increase residents' interest. Potential reasons mitigating interest were explored and included differences in physician distress, empathy, resilience, and patient death experiences.
  
  
  METHODS
  Agreement with the statement "I am interested in pursuing a career/fellowship in hematology and oncology" was rated by residents before and after a hematology-oncology rotation, with 0 = not true at all, 1 = rarely true, 2 = sometimes true, 3 = often true, and 4 = true nearly all the time. House staff rotating on a hematology-oncology service from November 2013 to October 2014 also received questionnaires before and after their rotations containing the Connors-Davidson Resilience Scale, the Impact of Events Scale-Revised, the Interpersonal Reactivity Index, demographic information, and number of dying patients cared for and if a sense of meaning was derived from that experience.
  
  
  RESULTS
  Fifty-six residents completed both before- and after-rotation questionnaires (response rate, 58%). The mean interest score was 1.43 initially and decreased to 1.24 after the rotation (P = .301). Female residents' mean score was 1.13 initially and dropped to 0.81 after the rotation (P = .04). Male residents' mean score was 1.71 initially and 1.81 after the rotation (P = .65). Decreased hematology-oncology interest correlated with decreased empathy; male interest decrease correlated with decreased resilience.
  
  
  CONCLUSIONS
  An inpatient hematology-oncology ward rotation does not lead to increased interest and, for some residents, may lead to decreased interest in the field. Encouraging outpatient hematology-oncology rotations and the cultivation of resilience, empathy, and meaning regarding death experiences may increase resident interest.
authors.affiliation: Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; and Memorial Sloan-Kettering Cancer Center, New York, NY daniel.mcfarland@mountsinai.org.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: McFarland
authors.affiliation: Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; and Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Jimmie
authors.initials: J
authors.lastname: Holland
authors.affiliation: Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; and Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Randall F
authors.initials: RF
authors.lastname: Holcombe
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D003643:Death; D004645:Empathy; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006405:Hematology / Q000193:education; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008495:Medical Oncology / Q000193:education; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires