Oncologist Job Description

An oncologist is the physician who takes charge of a cancer once it has a name. A surgeon or a gastroenterologist may find the tumor and a pathologist may read the biopsy, but the oncologist decides what happens next, writes the treatment orders and stays with the patient through every scan that follows. The federal occupational system has no code of its own for the work: the 2018 Standard Occupational Classification lists oncologist as an example under Physicians, All Other.

The word covers three distinct specialties. Medical oncologists treat cancer with drugs: cytotoxic chemotherapy, immune checkpoint inhibitors, targeted agents, antibody-drug conjugates and hormone therapy. Radiation oncologists design and supervise radiation courses delivered on linear accelerators and through brachytherapy. Surgical oncologists remove tumors and sample lymph nodes. This page focuses on the medical oncologist, who may also train as a combined hematologist-oncologist and treat leukemia, lymphoma and myeloma.

A new-patient visit starts with the chart. The oncologist pulls the pathology report, the CT or PET images, the tumor markers and any genomic panel, then sets the stage using the AJCC TNM system. Stage and biology drive the plan. A lung adenocarcinoma with an EGFR mutation calls for a different first drug than one with high PD-L1 expression and no driver alteration, and a hormone receptor-positive breast cancer follows a different track from a triple-negative one. Reading a next-generation sequencing report, separating actionable variants from noise, is part of the job.

Treatment runs through the infusion center. The oncologist signs each chemotherapy order, checks counts and organ function before every cycle, and adjusts or holds doses when toxicity appears. Oncology pharmacists verify the orders and oncology nurses give the drugs, but the clinical calls stay with the physician: whether a fever means neutropenic sepsis, whether new shortness of breath is pneumonitis from immunotherapy, whether a rising marker means the regimen has failed. The oncologist checks each plan against published guidelines such as the NCCN Guidelines.

Cancer care is a team sport, and the tumor board is where the team meets. Surgeons, radiation oncologists, radiologists and pathologists review cases together and agree on order: chemotherapy before surgery or after, radiation alone or with a sensitizing drug. The medical oncologist then carries that plan back to the patient.

Much of the hardest work is talk. Oncologists explain prognosis in plain numbers, ask what a patient values, and say when further treatment is more likely to harm than help. They bring in palliative care early, enroll eligible patients in clinical trials, and, for those who finish treatment, write survivorship plans that hand long-term follow-up back to primary care.

Becoming an oncologist is a long, structured path with few shortcuts. As a rough guide, a medical oncologist spends four years in medical school, three years in internal medicine residency and two to three years in fellowship, before practicing independently.

Medical school and licensing. The path starts with an MD or DO degree. MD students take the USMLE series, owned by the Federation of State Medical Boards and the National Board of Medical Examiners; DO students take COMLEX-USA from the National Board of Osteopathic Medical Examiners. A full, unrestricted license comes from the medical board of each state where the physician practices, and prescribing controlled substances for cancer pain requires a registration with the Drug Enforcement Administration.

Residency. Medical oncologists first finish an internal medicine residency and become board certified in Internal Medicine through the American Board of Internal Medicine (ABIM). Residents who want oncology seek out heavy inpatient oncology rotations, research projects and mentors who can write strong fellowship letters.

Fellowship and board certification. The fellowship is either medical oncology alone or combined hematology and medical oncology. ABIM awards Medical Oncology and Hematology as separate subspecialty certifications, and combined fellows can sit for both. ABIM certification must then be kept current under the board's ongoing requirements.

Other routes into cancer care. Each related specialty has its own training and board:

• Radiation oncology: a dedicated residency and certification from the American Board of Radiology.
• Surgical oncology: general surgery residency, then fellowship and Complex General Surgical Oncology certification from the American Board of Surgery.
• Gynecologic oncology: obstetrics and gynecology residency, then subspecialty certification from the American Board of Obstetrics and Gynecology.
• Pediatric oncology: pediatrics residency, then Pediatric Hematology-Oncology certification from the American Board of Pediatrics.

Skills that matter on the job.

• Pharmacology depth: mechanisms, dose modifications, drug interactions and the toxicity profile of every regimen on the formulary.
• Molecular literacy: reading genomic panels and liquid biopsy reports, and knowing which findings change treatment.
• Procedures for hematology-oncology: bone marrow aspiration and biopsy, and lumbar puncture for intrathecal therapy.
• Communication: delivering bad news, running family meetings and documenting goals of care.
• Trial fluency: understanding eligibility criteria, consent requirements and adverse event grading under the Common Terminology Criteria for Adverse Events.

Choosing a practice setting. Fellows choose between an academic cancer center, where clinical time is shared with research and teaching and physicians can focus on one disease site, and community oncology, where a single physician may treat many tumor types in one clinic session. Hospital-employed roles sit between the two. Fellows aiming at academic jobs should publish during training and present at national meetings; those heading into community practice benefit from learning infusion center operations, prior authorization and payer contracting before their first job.

BLS does not project oncology on its own. It groups oncologists with all physicians and surgeons and expects about 22,100 openings a year on average across that whole occupation over the 2025 to 2035 decade. BLS says many of those openings are expected to come from the need to replace workers who move to other occupations or leave the labor force. For the specialty itself, a current count comes from the American Society of Clinical Oncology.

ASCO's workforce analysis, published in JCO Oncology Practice on October 7, 2025, tabulated hematologists and medical oncologists billing Medicare. Their number rose from 12,267 in 2014 to 14,547 in 2024. Over the same period, the count per 100,000 people aged 55 and older fell from 15.9 to 14.9. The authors used that age group because it is where 80% of new cancers are diagnosed. The analysis also identified counties where 25% or more of oncologists are in late-career phases.

A Medicare oncology payment model. The Enhancing Oncology Model from the Centers for Medicare & Medicaid Services is a nationwide voluntary payment model in which oncology practices take on accountability, including downside risk, for quality and total spending during six-month episodes of care for Medicare patients receiving systemic treatment for seven cancer types. The model began on July 1, 2023, added a second cohort on July 1, 2025, and both cohorts end on June 30, 2030. Participating practices receive Monthly Enhanced Oncology Services payments and must carry out eight core redesign activities, among them 24/7 access to a clinician with access to the electronic health record and patient navigation.

Pay by setting. Because oncologists sit inside Physicians, All Other, BLS industry data describes that whole occupation, not oncology. With that caveat, the May 2025 median for the occupation was $311,390 in offices of physicians and $122,260 in general medical and surgical hospitals. BLS does not report what drives the gap or whether it holds for oncologists.

AI use among fellows. A multicenter survey in JCO Oncology Practice, published May 31, 2026, drew responses from 118 hematology-oncology fellows at 18 of 30 invited US programs. In that group, 74% reported using AI tools, only 8% said they had received formal AI training, and 82% wanted it. AI-assisted documentation was the most frequent clinical use, reported by 51%. Fellows used large language models most commonly to clarify concepts and summarize literature. Respondents came mainly from academic centers, so the results describe trainees at teaching programs rather than the community workforce.

Dear Dr. Whitaker,

I am writing to apply for the medical oncology position at Riverbend Cancer Institute. I complete my hematology and medical oncology fellowship at Lakeshore University Medical Center in June, and I am looking for a community-based practice where I can treat a broad mix of solid tumors and stay close to the patients I care for.

During fellowship I ran a continuity clinic focused on thoracic and gastrointestinal cancers. I built a habit of reading every genomic report line by line before the visit, and twice that habit turned up a targetable fusion that the summary page had not highlighted. Both patients started targeted therapy instead of chemotherapy, and I presented one of those cases at our regional tumor board.

I also spent a year as the fellow representative on our infusion center safety committee. Working with the oncology pharmacists, I helped redesign the order set for weekly regimens so that dose holds for low counts were flagged before patients were already in the chair. The change cut down on same-day order corrections and gave our nurses fewer surprises.

Clinical trials matter to me, and I noticed that Riverbend participates in several cooperative group studies. I served as sub-investigator on two trials during fellowship and know the work involved in screening, consent and adverse event reporting. I would welcome the chance to help grow enrollment among patients who would otherwise travel hours for a trial.

Most of all, I value the conversations that come with this specialty. I trained with our palliative care team for a month and learned to ask patients what a good week looks like for them before I talk about the next line of therapy.

I would be glad to visit Riverbend and meet the team. Thank you for your time and consideration.

Sincerely, Dr. Priya Raman