20 Oncology Interview Questions & Answers
Below is a list of our Oncology interview questions. Click on any interview question to view our answer advice and answer examples. You may view 5 answer examples before our paywall loads. Afterwards, you'll be asked to upgrade to view the rest of our answers.
1. It's hard to get people to quit smoking, and it's often said that 'cancer cures smoking'; what steps do you think we, as a society, can do to finally rid ourselves of this powerful carcinogen in our lives?
How to Answer
This question extends the one above about destructive behavior as pertaining to the individual, but out to society in general. As a society that has learned some painful lessons with Prohibition (alcohol) and for which there seems no clear victory coming in our 'War on Drugs,' this question is another one in which there is no correct answer. All it really wants to know is where your mind is as it pertains to the ills of society in general and how you plan to make a difference individually. Hospitals use community outreach as part of their marketing strategy, so if you include that, too, you'll seem like a good fit for them.
Written by D. Leo on April 22nd, 2021
Entry Level
"I know that one way or another, a person is going to get what he or she wants, regardless of how much you make it inconvenient, taxable, or even illegal. All I can do is attack it one patient at a time and use my knowledge to educate others in the community setting."
Written by D. Leo on April 22nd, 2021
Answer Example
"I am fully aware of how prohibition of something desirable, and more so, of something addictive, doesn't work. Besides crusading against it with each individual patient, I will also take every opportunity to address it publically with volunteer work for those who are most at risk--school children."
Written by D. Leo on April 22nd, 2021
Experienced Level
"The perceptions popularized in the media about smoking include glamor, 'coolness,' and a strange version of maturity, to those needed by cigarette companies to replace the customers who die daily from it. Such a turnover is a cruelty in that the replacements are the young. Rather than engage in a doomed battle against smoking in those who are already smoking--except for my own patients, that is--I feel I should contribute, wherever I can, to discourage initial exposure of smoking to non-smokers. I have an obligation to the community to do what I can to prevent starting at all. You don't have to do a lot of research in educating others--there's already tons of very frightening statistics that only need to be conveyed. This subject needs to use all of the tricks that propaganda uses, that is, continuous, unrelenting, and opportunistic publicising, because it's good propaganda and just that important."
Written by D. Leo on April 22nd, 2021
2. If a patient for whom you had nothing more to offer begged you to try something--anything--else, how would you respond?
How to Answer
Sometimes in medicine you just run out of answers, choices, ideas, or hope. Everything has limits, from how low a hemoglobin can get and still oxygenate tissues to end-stage victory of tumorous tissue over the healthy tissue. This question wants to know how you throw in the towel in a field in which you are expected to never give up or surrender.
Written by D. Leo on April 22nd, 2021
Entry Level
"As unpleasant as the facts are, this is a matter of my educating my patient on where he or she stands and why. Sometimes it is appropriate to accept the reality while assuring the patient you're still on the lookout for that new protocol in the literature."
Written by D. Leo on April 22nd, 2021
Answer Example
"When I first compose a protocol specifically designed for my patient, I review it thoroughly with him or her, from its hopeful beginning to the many possible ends--good and bad. By the time we get to a time of surrender, I would review it again as we did in the beginning so the timeline, in arrears, could demonstrate everything's been done that could be done. I would assure the patient I am available for any 'good' surprises that may happen and for any end-of-life plans he or she wants to implement."
Written by D. Leo on April 22nd, 2021
Experienced Answer
"As a professional who has seen this desperation many times, it is my responsibility to keep my patient anchored in reality, as disappointing as it is. By this time I would assume both patient and family were on board with this reality and how my obligations may have to shift from the temptation to fool ourselves to one dedicated to the final dignity of life well-lived."
Written by D. Leo on April 22nd, 2021
3. If an 18-year-old nulliparous woman were to ask your advice on hysterectomy and removal of her ovaries prophylactically due to a strong family history of ovarian cancer, would you arrange referral for such a surgery?
How to Answer
This question is probably jumping the gun and testing how careful you would be to avoid skipping steps on important and controversial subjects. You cannot go wrong citing protocol, if there is any; if there aren't any, you can't go wrong recruiting help from others more appropriate for such decisions, especially when the dilemma is bigger than you (which this one is).
Written by D. Leo on April 22nd, 2021
Entry Level
"I would involve her parent(s) every step of the way and involve psychological expertise as well."
Written by D. Leo on April 22nd, 2021
Answer Example
"I would involve a multidisciplinary team made up of myself, her primary doctor, a social worker, a psychologist, and an ethicist. Together I would trust we could steer her correctly for such a permanent life-decision."
Written by D. Leo on April 22nd, 2021
Experienced Level
"As an Oncologist, I am ultimately the one from whom she can get a perspective on her risks if she were to do nothing. But since they are neither 0% nor 100%, I would invite her parents to take part in the discussion. Also, there is much more than her childbearing at stake here, but perhaps many children, grandchildren, family legacy, and so on. And since even high-risk genetics seldom sees malignancy begin at this age, I would recommend an agreed-upon surveillance protocol specifically for her so that we could act at the earliest opportunity if necessary."
Written by D. Leo on April 22nd, 2021
4. After a patient's adverse reaction due to a medication error, what would you do?
How to Answer
This is very similar to the question above about the misplaced lab report. However, it goes a step further by describing an incident in which a person is actually harmed. Nevertheless, your policy should be the same: own it. The repercussions from honesty are easier to withstand than surviving the fallout from dishonesty. Most hospitals or state boards require doctors to take online courses about medication errors and how to take steps in their charting protocols to lessen the possibility of their happening. Your answer, thus, should be reversal of harm, admission of fact, and prevention strategies. Also, don't be afraid to say it's never happened to you, which is always good for the interviewer to hear.
Written by D. Leo on April 22nd, 2021
Entry Level
"Patients put their trust in us as healthcare professionals, so errors, although inexcusable, are at the mercy of whatever standard of professionalism is being maintained. Such maintenance means constantly thinking about what could go wrong and double-checking every decision and order I make. When that fails, I cannot also fail in my loyalty to my patient via any type of dishonesty. Assuming I corrected any harm, I then would level with the patient and express remorse as part of my professional duties."
Written by D. Leo on April 22nd, 2021
Answer Example
"My first responsibility is to 'un-do' the harm by treating the adverse reaction, be it an allergic reaction, the wrong medication, or even an overdose. After that, I should explain to the patient what happened and what steps I felt were necessary to mitigate the harm."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Although it's never happened to me, I know what to do because we've all been trained on what to do, and I would follow hospital policy. I would treat any reaction that had been caused by the error, document the error and what steps I took to address it, and inform the patient fully on what happened, how it happened, and what implications might be there for him or her. After that, I would hope that the patient-doctor relationship could survive such an honest mistake."
Written by D. Leo on April 22nd, 2021
5. If you find a senior nurse prying into a relative's chart for some personal information that is otherwise HIPAA-protected, what steps would you take, if any?
How to Answer
Hospitals take privileged information very seriously. Violations could severely and negatively impact reputation, credentialing, and even the hospital's fiscal health (due to fines and other disciplinary measures). Your role in policing this, however, is limited. Hospitals want such indiscretions handled a certain way, and you can assure them they will be by pledging yourself to following established hospital protocol. Today, the argument of 'my word against his or -hers' no longer applies, thanks to electronic medical records which require signing in to them, establishing permanent documentation of it.
Written by D. Leo on April 22nd, 2021
Entry Level
"I would contact the hospital's legal counsel of what I witnessed and when. With documentation of signing in to the chart, it would then be up to the nurse to explain his or her actions."
Written by D. Leo on April 22nd, 2021
Answer Example
"I would notify the nursing supervisor what I saw and request he or she look into it to verify if what I suspected was correct."
Written by D. Leo on April 22nd, 2021
Experienced Level
"I would write a letter to the hospital's legal counsel and copy the nursing director and my own Chief-of-Staff what I witnessed, then step aside. It would be out of my hands at that point, as it should be."
Written by D. Leo on April 22nd, 2021
6. A lab report comes back to you after having been misplaced for over a month. What would you say to the patient and the patient's family regarding this clerical error that may have clinical implications?
How to Answer
This is a question about 'fessing up' when you should. Such mistakes can have clinical implications and even alter the course of disease or the prognosis. That being said, most patients are very good 'sports' about honest mistakes, which are going to happen when dealing with the volume today's labs navigate. As such, it's best to be honest and own any mistakes. Most checks and balances, thankfully, don't allow such mistakes to go on long enough where it makes an actual difference in the outcome, so being honest also protects you from the venom an attorney is likely to throw your way if you are caught in some type of coverup. This type of dishonesty will turn a malpractice case from bogus to legitimate, which helps no one.
Written by D. Leo on April 22nd, 2021
Entry Level
"I would have to inform the patient and then face the music. I would hope the patient-physician relationship that has been grown would allow us to assess together whether it will make a difference. Hopefully, it won't; but if it theoretically could, I would explain to the patient the steps I would implement to mitigate any harm from the mistake."
Written by D. Leo on April 22nd, 2021
Answer Example
"Even if it's not directly my fault, if I ordered the test, it's my responsibility to follow up on it. My policy is to inform the patient as soon as I discover the problem and then offer a perspective on whether the mistake will even affect the outcome."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Hiding something like this is never acceptable. Of course I would inform the patient and hope we, together, could address its implications, if in fact there were any. I would also do a thorough review of how this mistake happened. It could have been someone's simple negligence or ineptness--perhaps even my own--or it may have been some perfect storm of otherwise legitimate policies that lined up to create this unintended clerical accident. Either way, it would become my responsibility to identify the cause and then take steps to prevent it from recurring."
Written by D. Leo on April 22nd, 2021
7. Your cancer patient has as favorable diagnosis, but asks you to sign an advanced care directive that disallows aggressive resuscitative measures; how do you counsel her not to give up that easily?
How to Answer
This is a question that wants you to declare, in no uncertain terms, that you know better. And you do. So don't be afraid to say it. 'Above all, do no harm' means that, among the obvious ways you can harm your patient, you also pledge to not allow your patient to harm herself out of ignorance. You have a role as an educator and an obligation to put her on the same page, clinically and ethically. It's all part of care as much as surgery, chemotherapy, and radiation.
Written by D. Leo on April 22nd, 2021
Entry Level
"Since I am a specialist in Oncology and the patient is not, it is my responsibility to illustrate how what I know refutes what she thinks she knows, because that really is the situation here. My role as a teacher is crucial here to correct her misconceptions and allow be to practice at my best."
Written by D. Leo on April 22nd, 2021
Answer Example
"It is my duty to inform my patient that her life is worth aggressive resuscitative measures, especially when they are likely to be successful. Hers is obviously a matter of an incomplete understanding of the prognosis, which is favorable."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Patients have certain rights, but deciding on a course that is just based on ignorance is not one of them. I would include her family in my frank discussion about how her case is completely salvageable toward a complete and normal life and make sure I can document their understanding. If she still refuses certain things that are indicated and, frankly, excellent ideas, I would get an informed consent on what is being given up, but still pledge to step in wherever I can if needed or a change in her mind occurs. I would make sure she understood how such a plan may close certain windows of opportunity toward that complete and normal life."
Written by D. Leo on April 22nd, 2021
8. Your terminal patient has cognitive dysfunction from a closed head injury, and if his family pleads with you to keep him unaware of his terminal prognosis because of how he won't be able to deal with it, would you?
How to Answer
This is a question centering on a patient's right to know. Keeping germane information of one's illness from him or her is deceit by omission. The issue gets cloudy, however, if a patient is not completely oriented. You should base your answers according to ethics and legality.
Written by D. Leo on April 22nd, 2021
Entry Level
"I would only withhold information if the patient were not able to process it appropriately due to cognitive impairment and when such a situation would interfere with my care. The family may be right in predicting an ugly reaction, but if the patient's right to know doesn't interfere with my care, I owe the information to my patient."
Written by D. Leo on April 22nd, 2021
Answer Example
"If my patient is oriented to person, place, and time--the three cardinal perceptions--I owe it to him or her to be completely honest; by 'completely' I mean fully, without holding anything back."
Written by D. Leo on April 22nd, 2021
Experienced Level
"If my patient can understand the objective significance to the diagnosis, it's my duty to inform him or her, as a member of the 'partnership' we've established for care in the patient-physician relationship. Anything less is dishonest. Unless the patient had an Advanced Directive forbidding such bad news, and that is doubtful, I need to use my own judgement in when, how, and to what extent I keep my patient informed, tempered with what ability there is for him or her to fully understand."
Written by D. Leo on April 22nd, 2021
9. Do you have coverage for your patients for when you are vacationing or for when you get sick?
How to Answer
Continuity of care is important enough to be included in a hospital's rules and regulations. Your answer should be yes, as if it were assumed. Luckily, most Oncologists easily can arrange for such coverage from other Oncologists due to an absence of the usual competitive drives seen in other specialties. This partly is due to the scarcity of Oncologists compared to the general population and the rising of life expectancy.
Written by D. Leo on April 22nd, 2021
Entry Level
"Being new to this hospital, I will volunteer to serve on hospital committees for the purpose of meeting my colleagues, one or some of which I can ask about a coverage arrangement."
Written by D. Leo on April 22nd, 2021
Answer Example
"If I am my patient's doctor, it means I am responsible for his or her care, even I were to arrange for coverage from someone else."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Oncology is a specialty that has very well organized continuing educational platforms, such as tumor boards or multispecialty treatment teams for our cancer patients. This means getting to know most of the Oncologists in the area, and so it won't be a problem for me to have coverage arrangements when needed."
Written by D. Leo on April 22nd, 2021
10. How would you answer a patient who indicated he wanted self-assisted suicide instead of a lengthy, pain-filled period of final days?
How to Answer
Your specialty is one that tries to sidestep death, but the jump out of the way isn't easy and it's never guaranteed. It makes even a rational man consider the tradeoffs in just accepting death and, to that end, even consider a 'designer' death that is easier than the alternative. You need not have a position on this subject, but siding with your patient and his or her rights may give you a way to please both sides of the issue.
Written by D. Leo on April 22nd, 2021
Entry Level
"Spiritually, ethically, and morally I cannot take someone's life. However, the caveat of 'do no harm' means not allowing pain to dominate one's final days or moments. Those belong to him or her and loved ones--it's a special time that should not be wasted because of being consumed with pain. I can comfort a patient by whatever means becomes necessary. Although I cannot take life, I also cannot allow harm, which is what pain is, especially when it's being there or not makes no difference in the expected outcome."
Written by D. Leo on April 22nd, 2021
Answer Example
"I morally feel no one is qualified to actively take a life. However, I would pledge to my patient a dedication to his or her comfort, even if it meant pain management that was fraught with the risk of side effects that brought on the inevitable sooner, such as with respiratory depression."
Written by D. Leo on April 22nd, 2021
Experienced Level
"We all will die. It is inevitable. However, if the inevitable were to come sooner by a few minutes or hours because I was treating something else, like intractable pain, my patient has a right to that relief. If he or she wanted death to come sooner by months or years, however, then that is nothing less than suicide. There is a big difference between experiencing a side effect of pain relief and committing euthanasia, even if it results in the same thing. I want my patient to have the right to the former, but I am not doing my best in being an Oncologist by embracing the latter."
Written by D. Leo on April 22nd, 2021
11. What made you want to choose Oncology as a vocation?
How to Answer
This is such a predictable question as to be a cliche. Nevertheless, you can count on it being asked. What's different in a setting involving an Oncologist is that it's not just a question of why you wanted to be a doctor (that is the cliche), but why choose a specialty in which you're sure to see a lot of people die. You have to express something positive about a specialty that often fails to cure its patients, and that is difficult to do. As such, you best place of refuge is probably that you want to help people any way you can, even when the odds of success are very low. Don't be afraid to wax philosophical, because after all you're answering a question that centers on a patient's very existentialism.
Written by D. Leo on April 22nd, 2021
Entry Level
"I've always been interested in biochemistry and the body's interaction with it, hopefully at the expense of the malignant tissue. As such, it is a scientific specialty, with new possibilities all the time. I hope cancer will be eradicated in my lifetime , and I want to be a part of that when it happens."
Written by D. Leo on April 22nd, 2021
Answer Example
"As a person who became a doctor for wanting to help others, I felt that helping the most vulnerable and endangered--even when tainted with a poor prognosis--would be the most fulfilling for me."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Why oncology? It's tempting to just say, 'Someone's got to do it.' The truth is that the reverence for life is directly proportional to the dangers to it, and you can't get any more dangerous than cancer. In striving and struggling to keep life going--in partnership with a patient--with a hope of eliminating the disease altogether, I find it a very powerful reverence for life and very beautiful. This is the beauty I see in my field and makes its price for admission worth it."
Written by D. Leo on April 22nd, 2021
12. Are you opposed to using new protocols you find in the literature before they become accepted as "evidence-based" medicine?
How to Answer
This question is similar to the one above that asks if you would venture out of the bell curve of evidence-based medicine. However, more than that, it is asking if you feel you have a 'pass' to 'try anything' with a patient who has cancer, since it is a diagnosis with mortality and survival rates that can be statistically cited. It asks if you can follow your 'art of medicine' beyond that of evidence-based protocols, regardless of your patient's prognosis, when you see something that seems more promising in the literature. This question is also a sneaky way of asking if you recognize difference levels of evidence.
Written by D. Leo on April 22nd, 2021
Entry Level
"I wouldn't use any protocols that weren't sanctioned by my professional organization or the American Board of Oncology. Following such a straightforward strategy means there are also established protocols for when these don't work, based on evidence."
Written by D. Leo on April 22nd, 2021
Answer Example
"Until my therapeutic plan fails, I feel obligated to follow the established protocols. After a failure of therapy, I would seek out the protocols already established, vetted, and used for recalcitrant cases."
Written by D. Leo on April 22nd, 2021
Experienced Level
"A peer-reviewed journal that introduces a different therapy would have to pass muster as Level 4 or Level 5 according the established levels of evidence used in research. Therefore, I wouldn't consider using anything that hadn't been sutdied further using meta-analysis. But if such a protocol were to quaify according to those criteria, I would have no problem implementing them after any standard protocol had failed."
Written by D. Leo on April 22nd, 2021
13. How far would you go in giving opiates to a patient with end-stage cancer? Would you go as far as giving enough to shorten his or her life if that's what it took to give relief?
How to Answer
Don't be fooled by this question. It isn't about the opiate 'crisis' of overdose deaths or narcotic diversion. Also, it's not about euthanasia. It's about the patient and what's best for him or her. Think of opiates as any other medication, with a perspective on its side effects or adverse effects as it applies, individually, to your patient. Also, you need to include in your answer an appreciation for Advanced Directives (AD).
Written by D. Leo on April 22nd, 2021
Entry Level
"I would make sure my patient had advanced care directives to follow, including pain management and end-of-life care. Such a document would include the risks vs benefits of the different directions things could go."
Written by D. Leo on April 22nd, 2021
Answer Example
"At the appropriate time I would have a frank discussion with my patient for end-of-life care, which would include prolongation of life vs quality of life. Whatever I do with opiates, should they be needed, will have been discussed beforehand."
Written by D. Leo on April 22nd, 2021
Experienced Level
"By this time our discussions regarding end-of-life care would have been made, including their philosophical implications. I would make sure that my patient understood that end-of-life care includes not a 'quantity' of life but a 'quality' of life, including the use of anything that I will give, even if it were to shorten his or her life. I feel everyone deserves merciful comfort during the last days of disease that is unarguably terminal, however it affects the timeline."
Written by D. Leo on April 22nd, 2021
14. How might you react if you, as an Oncologist, were given a diagnosis of cancer?
How to Answer
You deal with people who get life-threatening diagnoses all the time. This question isn't designed to see if you would react according to some appropriate standard, because there is no quintessentially appropriate way to react to this. You know this from your own patients. Therefore, this question is really designed just to see how you react to provocative and very personal scenarios. You really can answer it any way you want, because there is no perfect answer, and there are as many answers as there are people. However, you should include in it your empathy with others who have to deal with terrible diagnoses.
Written by D. Leo on April 22nd, 2021
Entry Level
"My reaction will change with each patient to whom I give similar news. Identifying with my patients empathetically makes each of their reactions seem right each time."
Written by D. Leo on April 22nd, 2021
Answer Example
"Frankly, I don't know how I would react. I know from my own patients that it's such a critical abstraction that it's impossible to answer unless I were to personally identify with it actually happening."
Written by D. Leo on April 22nd, 2021
Experienced Level
"I am well aware of the phases patients experience, especially given the possibility of mortality. I know I have no special protection from the denial, anger, bargaining and, finally, acceptance that I've seen many times. I just hope my insight into these phases would help me navigate them more quickly and appropriately without unnecessarily distressing my loved ones."
Written by D. Leo on April 22nd, 2021
15. If you thought family members were taking advantage of a terminal patient financially, would you intervene?
How to Answer
One of the most common types of elder abuse is financial, but this just underscores how people who can take advantage of others usually pick the most vulnerable. Similarly, terminal disease will involve patients who are confused, fatalistic, or who feel helpless. If aware of what's going on, the last thing such a patient wants is confrontation with 'loved ones' to add unnecessary drama to his or her final days. Regardless of whether the patient cares or not, financial abuse of anyone is ethically wrong and illegal, and you have a responsibility to act on it like on any abuse.
Written by D. Leo on April 22nd, 2021
Entry Level
"To me, this is no different, legally, than sexual abuse of a child. Therefore, it is reportable, and I have the legal obligation to do just that."
Written by D. Leo on April 22nd, 2021
Answer Example
"My duties are to my patient, even if I see things that are unethical or illegal outside of my specialty. As such, I have the obligation to take all of the appropriate steps to stop the abuse and to address those who are doing it."
Written by D. Leo on April 22nd, 2021
Experienced Level
"The first thing I would do is assess the awareness of my patient. It may be that he or she approves of whatever financial scenarios are at work here. However, if I felt the patient were being misled or that there was confusion due to cognitive impairment from illness, I would contact the hospital's legal counsel to set into motion the appropriate protocols to address this, ethically, morally, and even legally."
Written by D. Leo on April 22nd, 2021
16. Patients with life-threatening conditions often change their attitudes to life, hopefully for the better. However, if you discovered destructive lifestyle changes, how would you get involved?
How to Answer
The pithy adage, 'Cancer cures smoking,' means to say that bad habits continue until the psychodynamics of appreciating one's mortality give the added strength needed to re-appraise lifestyles for adjustments. This is a procrastination of least resistance, and there always seems to be time in the future to stop bad habits. However, when the time of danger becomes 'the present,' there are many reasons persons continue--even accelerate--their self-destructive habits, and the interviewer wants to know you consider the mindset of a person facing mortality as different from others.
Written by D. Leo on April 22nd, 2021
Entry Level
"Destructive lifestyles are more destructive to those with already endangered lives than persons without disease. The behavior that made them sick can only make them sicker when it catches up with them. Treatment of cancer, when complicated by counterintuitive behavior, requires a team approach which can be addressed at a 'tumor board' meeting of all of the patient's other caregivers. This will help give me the direction I need to address what's going on in the patient's mind."
Written by D. Leo on April 22nd, 2021
Answer Example
"The concept of mortality is existential, and usually the first realization of a person's future death is life-changing. If this were to cause someone to go off kilter and jeopardize my therapeutic plan with behavior that was counterproductive, I would involve the assistance of psychological services in tandem with my own therapeutic strategies, simply, because whatever they're doing is based on a different disease."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Such behavior is bigger than just Oncology. Therefore, I would enlist the help of an appropriate counselor--social worker, psychologist, or psychiatrist--with an additional safeguard: I would make sure it included family therapy, because often the most objective opinions about the patient's behavior come from loved ones; it also provides encouragement to do the right thing from persons the patient may actually listen to."
Written by D. Leo on April 22nd, 2021
17. Many patients with life-threatening conditions find comfort in religion; how would you counsel a patient who feels therapy can be adjusted because of faith in God (Allah, etc.)?
How to Answer
This is similar to the other question in which a patient refuses chemotherapy, and like that, it's not your basic non-compliance situation. But unlike that question, you have the reason for the patient's refusal, which gives you a starting point to begin your discussion. As an educator, that discussion could very well end up a negotiation, so you should ask if a representative of his or her faith could be there when you discuss the situation. This is no different than a Jehovah's Witness refusing blood products in a hemorrhagic life-and-death crisis.
Written by D. Leo on April 22nd, 2021
Entry Level
"In this country, everyone has a right to refuse treatment. If this were to be the decision of an adult of legal age and it were confirmed by his or her church or church leaders, all I can do is offer to be available for the natural progression of the disease."
Written by D. Leo on April 22nd, 2021
Answer Example
"If the patient were to use a faith-based argument to refuse treatment, I would want a higher authority (for the patient) in that faith than the patient him- or herself. I would ask that his church leader take part in our discussions."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Adults have the right to make decisions about their bodies. However, one pitfall of religion is that adults sometimes keep devotion to religion at a childhood level. This means that perhaps they are not making medical decisions as an adult when based on religious tenets of a child. I would ask that such a refusal be agreed upon by loved ones, spouse, other family, and church representatives. Including them may introduce some sobering facts for the patient to consider, since they have a lot at stake with the final decisions. I would make sure everyone in this 'team' understood the gravity of the disease, the treatment, the lack of treatment, and the outocome."
Written by D. Leo on April 22nd, 2021
18. Do you feel you can abandon evidence-based medicine and pursue the 'art' of medicine, especially in a patient with a high risk of mortality?
How to Answer
Evidence-based medicine is Gaussian in its distribution, and the further away from the mean the patients wander, the more art you will need to put into your practice. Although there may be a point at which you may choose an 'outlier' of therapy on that bell curve and say, 'What harm can it do?' (especially for a terminal patient), you still have a responsibility to the science. This sentiment is part of the professionalism the interviewer wants to see.
Written by D. Leo on April 22nd, 2021
Entry Level
"The flowsheets of therapy are very well delineated in my specialty. There are very few situations where I would have to totally 'wing it.' Nevertheless, I would not refuse any reasonable quirk in the treatment plan if a patient were to ask and if it wouldn't alter the final course of the disease or interfere with the accepted treatment."
Written by D. Leo on April 22nd, 2021
Answer Example
"I practice according to the guidelines of my specialty, and when these blur in complicated cases, I feel I am free to adjust on-the-fly, as long as I can document a solid rationale to my decisions and an appreciation of the risks vs benefits."
Written by D. Leo on April 22nd, 2021
Experienced Level
"I think the most famous existential crisis in Oncology is when a patient asks to be put on some new treatment still in trials, after it's been deemed his mortality is inevitable. There is a reason for studies to be randomized, double-blinded, etc., and it's to advance the science. If he or she were in such a study, I would be unwavering in following the rules. If he or she were not in the study, I would offer to write a letter to the institution and it's Investigational Review Board for a special provision for this patient, with the understanding that his or her response to therapy could not be part of the study. If they denied the request, there's nothing more I could do in this respect."
Written by D. Leo on April 22nd, 2021
19. If you had a patient who was newly diagnosed with cancer but refuses chemotherapy for whatever reason, how would you counsel him or her?
How to Answer
This is so much more than just non-compliance. It goes against common sense. There are many reasons a patient would spurn appropriate therapy, especially to save his or her life--fear of the treatment, denial of disease, fear of wasting valuable quality time when the prognosis is poor already. Whatever the reason, this questions tests your ability to relate with your patient as his or her educator, counselor, and confidant, over and beyond just 'doctor.'
Written by D. Leo on April 22nd, 2021
Entry Level
"I would make sure the patient were making an informed decision and, if so, I would respect it. But I would also make sure that the window of opportunity, which can close very rapidly with malignancy, was very clear to him or her--that optimism, now, can turn into pessimism, later, in a time-sensitive progression."
Written by D. Leo on April 22nd, 2021
Answer Example
"I would do my best to identify the exact reason for refusing treatment when the alternative is death. I would assure him or her that I understand some reasons make sense, but I would educate him on the things he or she could expect, both with or without treatment. Choices have repercussions, and those should be spelled out."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Besides the education into the risks vs benefits of chemotherapy and/or radiation, I would remind the patient that any important decision, made unilaterally, may be unfair to loved ones. Because of the special relationship with them, he or she owes them their input and letting them take part in the decision."
Written by D. Leo on April 22nd, 2021
20. More than any other type of specialty, there frequently is death occurring in your work; what is your strategy for avoiding psychological distress?
How to Answer
This is a concern that has risen to prominence in all specialties due to the COVID-19 pandemic. But Oncology has always had the high mortality, and a question about burnout is fair territory. You want to come off as objective, but empathetic; fatalistic but optimistic. These are difficult dichotomies to verbalize successfully, especially to someone for whom death is a rarity in his or her life. There is a lot of science going on in your specialty, so use that in your answer.
Written by D. Leo on April 22nd, 2021
Entry Level
"Yes, I have to admit that when a patient loses the fight against cancer, it is distressing. But being professional, I do what is expected--to stay on track for the next challenge. It is that continued diligence which gets me through."
Written by D. Leo on April 22nd, 2021
Answer Example
"I didn't become an Oncologist because I thought I could cure everyone; I became one to try my best to cure one person at a time. As the science advances, I am hopeful the odds will be improving and want to be the one to do that. That keeps me on-task and on-message."
Written by D. Leo on April 22nd, 2021
Experienced Level
"Any doctor will tell you that you're not just treating a patient, but a whole group of loved ones, too. So when a patient dies, something in each family dies as well. You would think this would amplify the grief--with more involved--but it actually helps me process the grief, because just as I partnered with the patient and family before, that partnership also helps share the grief. Even though the patient may be dead, there is something alive about him or her in the family, and I'm right there with them. "
Written by D. Leo on April 22nd, 2021