A Fellow’s experience at WCIO

In a prior post I mentioned the WCIO Fellows’ Travel Scholarship. With the generous support of our corporate partners, 80 Fellows in their last month of training before entering the market as attending physicians attended WCIO 2012 in Chicago. There were dedicated educational sessions for trainees, including a “How-To’ evening on starting an IO practice, a private tour of the exhibit hall, and they were given autographed copies of Geschwind & Soulen’s Interventional Oncology textbook.  David Pryluck MD, a Fellow from the University of Pennsylvania and now an attending in the Mercy Health System in Philadelphia, shares his reflections on the meeting.

As a fellow in June, just days away from becoming an attending, I repeatedly found myself saying, “Now, I am really going to pay attention.” Training at the University of Pennsylvania provided me with an incredible foundation in interventional oncology. Yet I still had several lingering questions regarding treatment algorithms – most of which began with the words “why” and “when.” Why chemoembolization for this patient and radioembolization for that patient? Why could we not do the exact opposite and expect the same result? Why not drug-eluting beads? When should an interventional oncologist become involved in a patient’s care?

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Through a combination of didactics, mock tumor boards, and live case demonstrations with interactive commentaries, the WCIO faculty shared their knowledge, insight, pearls, and perspective on the future of this evolving field. Special attention was given to interventional oncology practice development and integration of the interventionalist into the treatment algorithm for a broad spectrum of malignancies. The conference curriculum seemed designed to answer my “why” and “when” questions, as well as the haunting “how” question we as fellows are often too timid to ask – “how are things done at other institutions?”

I left WCIO having learned three invaluable lessons. First, there is no single way to do anything. Nearly an entire afternoon was spent debating the role of conventional chemoembolization, bland embolization, drug-eluting beads, and radioembolization in the treatment of primary and secondary hepatic malignancies. A highlight for me was when Dr. Karen Brown (Memorial Sloan-Kettering) thanked Dr. Michael Soulen (Hospital of the University of Pennsylvania) for his lecture on conventional chemoembolization, and added that she would look for a place for that technique in her practice. As a fellow of Dr. Soulen, I found it fascinating to hear Dr. Brown advocate for bland embolization with the same conviction that Dr. Soulen would recommend chemoembolization, and Dr. Jeffrey Geschwind (Johns Hopkins Hospital) would employ drug-eluting beads. This brings me to my second lesson learned. As an attending, I do need to decide what I think is appropriate for patient care, but that decision is not made in a vacuum. As an interventional oncologist, I must “take my seat at the table” among the surgeons, medical, and radiation oncologists. I need to participate in the conversation as an equal member of the team, know each specialty’s literature as well as my own, and be prepared to speak up when interventional oncology has something to offer. This brings me to my third lesson learned – take thorough and diligent notes at the WCIO, and remember the first two lessons!

 

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