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Medical Oncology – Dr Inger Olesen

Dr Inger Olesen is a Consultant Medical Oncologist who initially studied Pharmacy. She then went on to study Medicine before completing postgraduate training in Medical Oncology. She shares some of her thoughts and experiences with MSO.

Please tell us a little about your medical background
It is amazing the combination of random one off events / decisions that change the destiny of your life !

I was randomly reading the Tertiary education section in the Sydney Morning Herald (why? I have no idea) and saw an ad for UTAS. Filled in an application for a scholarship in Science/Law – thinking that on the off chance I made the cut for interview, I’d get a chance to fly down & visit Hobart for the first time. Instead an offer arrived in the mail! Discovered in those first two years that I would be completely unsuited to becoming a lawyer (and think I was complaining to friends too much), so when I was walking past the admissions office – a friend told me to put in an application to change degrees in 3rd year – so I walked in, filled in the application form and forgot about it until the next year when a random letter arrived to say i’d been accepted into Pharmacy.

After contemplating a Pharmacy PhD investigating the optimal dose of chocolate for its’ antidepressant effect, I ended up applying for, then accepting a position in the USYD Medical program. So in April 2003, finally achieved my goal of graduating from the Great Hall of USYD and getting a picture with the gargoyles!

How did you go about deciding on medical oncology?
Enjoyed my Medical Oncology attachment at RNSH & Mater hospitals in Sydney with A/Prof Fran Boyle, but thought I should try a wide range of attachments as an intern / resident / junior registrar.. Somehow, despite ranking Oncology as a low preference repeatedly – I ended up with Radiation oncology / Chemo suite as an intern; two Medical Oncology terms as a resident; Paediatric Oncology as an SRMO; and then 6 months Haem / Onc as a junior registrar. Hence, I decided that it was probably easier to just stay!

In the end I chose my specialty according to interest and lifestyle – Medical Oncology allows you to combine research & clinical medicine and allows for a relatively flexible lifestyle.

What do you enjoy most about medical oncology?
I had enjoyed the academic side of my pharmacy degree, however felt that I would get remarkably frustrated as a hospital pharmacist & fail miserably as a community pharmacist (as the business side of things does not interest me). A career in Medical Oncology involves lots of expensive, new & complex drugs – yet a more holistic approach to medicine than many of the other other specialities. Also, as a firm believer in quality (over quantity) of life, I believe in open communication with patients & families so they can live their last days with dignity.

Many students don’t know what know what is involved with your specialty in terms of day to day work? Can you tell us what you do in a normal day? How much is spent with patients, procedures, paperwork etc?
Medical Oncology is one of the Physician specialities – and primarily involves outpatient care of patients with cancer. In terms of workload, new AMA guidelines suggest an 80:20 split between clinical & administrative work for ALL specialities – but this still rarely occurs in practice. Unfortunately a lot of administrative time is spent filling in forms to apply for “expensive” drugs either via specialised access schemes or authority paperwork to PBS.

Clinical duties would include:

  • at least 2nd daily ward rounds
  • Outpatient clinics (predominant part of each day)
  • Multidisciplinary meetings & clinics

In terms of procedures, the administration of intravenous chemotherapy is considered a “procedure” by Medicare Australia; however few other procedures are routine. In the Public setting, palliative procedures such as therapeutic pleural drainage, ascitic drainage, and lumbar puncture would generally be done by a JMO (under supervision); these may be done by a consultant in the private setting.

What are the some of the challenges associated with your specialty – how do you go about overcoming them?
The main challenge would be the fact that you have to deal with death, and the dying process on a daily basis. And being “nice” seems to be a poor prognostic factor (probably not RCT level evidence though – just anecdotal!)

What are your interests outside of medicine? Do you get time to pursue these activities?
My main hobby bushwalking. I also like taking my dog to the beach. And yes – I feel it is important to MAKE time for enjoyable activities – otherwise medicine can consume your life – and you become stressed (and boring).

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