Why should you study abroad?

Naoto T. Ueno, MD, PhD, FACP
Professor of Medicine
Executive Director of the Morgan Welch Inflammatory
Breast Cancer Program and Clinic
Chief, Section of Translational Breast Cancer Research
Department of Breast Medical Oncology
The University of Texas MD Anderson Cancer Center.

When?
MedicalSchool

FellowshipResidency

Research

Staff

US Residency

Staff

US
Fellowship/Res
earch

Research

Staff

Good Reasons● Love America● Clinical Training● Research Training– Clinical– Translational– Basic– Epidemiology– Others

Very Good Reasons● Exposure to different idea
● Exposure to different logic● Exposure to different cultures● Friends● Mentors● Networking● Research infrastructure● Clinical infrastructure

Not the Greatest Reasons● Educational purpose● Prestige● Clinical skill advantage● Impact factor

When to return?
MedicalSchoolFellowshipResidency

Research

Staff

US Residency

Staff

US
Fellowship/Research

Research

Staff

Financial● Salary– Postdoctoral Fellowship– Clinical Residency/Fellowship– Faculty● No salary– Saving– Grant– Award– Home institution

Who do you want to be?
● Personal Vision● Personal Mission● Personal GoalsSome Thoughts● Clinical Practice– General vs Specialized– Academic vs non-academic– Yes or no● Research– Yes or no● Community Outreach– Yes or noCareer Development● Private practice● Academic– Clinical practitioner– Clinical investigator– Physician scientist– Basic scientist● Industry– Pharma– Diagnostic companies● Government: NCI, FDA, etc.

Role of Academic
Oncologists● Provide high-quality of patient care
– Establishment of standard of care
– Innovative research opportunities– Implementation of multidisciplinary care
● Produce high-quality evidence or ideas– Innovative research– Innovative clinical trials

Hematology/Oncology Curriculum
1-18 M:• Mandated clinical rotations for 12-18 M• Continuity clinic 1 ½ per week

19-36 M:
Individualized (tailored) training tracks:• Physician Scientist: Predominantly laboratory-based research• Clinician Investigator:
 Drug development and clinical trial design
 Epidemiology, genetics, outcomes research, prevention
 Masters of Science in patient-based biological research• Community-Based Practice: Electives in neuro-oncology, radiation oncology,
community oncology (satellite clinics)

American Society of ClinicalOncology and Fellowship Training• ASCO has no OFFICIAL role in fellowship training• ASCO supports educational initiatives● In-training examination for 2nd and 3rd-year fellows, 2007
● Career planning workshops● Fellows lounge

Annual Meeting● Communications/breaking bad news

• ASCO supports research● Young investigator awards: $50,000 for 1 year
● Grant-writing workshops● Travel awards to present original researchOncology is Changing!
1960s-1970s

1980s-1990s●Cell cycle kinetics●Expansion of cytotoxic agents●Alkylator therapy●Colony-stimulating factors●High-dose chemotherapy●Begin multidisciplinary care

2000-Present●Molecular therapy●Routine multidisciplinary care

●Immunotherapy●Personalized cancer therapy

Training Must Change!

The Oncologist of the 21st Century● Multidisciplinary team member or teamleader● Maximize efficacy, minimize toxicity, andrespect organ preservation (personalizedmedicine)● Develop robust communication skills &leadership● Biology- and patient oriented clinician

Tips for Studying Abroad● What is your vision?
● Is your vision aligned with your host/mentor?

● Pick the right mentors.
● Well defined goals based on mission andvision● Communication and leadership skills● The real challenge after your return to Japan.

Acknowledgment
Robert A. Wolff, MD
Professor of Medicine
Clinical and Educational Affairs
Division of Cancer Medicine

Facebook: Naoto Ueno
Twitter: @TeamOncology