Training and practice activities of hematology and medical oncology diplomates

Diplomates of the American Board of Internal Medicine in hematology or medical oncology were surveyed about the content and setting of their practices, adequacy of training for professional activities, and preferences for certification. The response rate was 60% (N = 2516). Approximately 20% of cases seen by diplomates in hematology involve nonhematopoietic neoplasms, and 10% of cases managed by oncologists concern hematologic disorders. Diplomates were satisfied with training in areas corresponding to their own field(s) of certification, except for immune and/or acquired immunodeficiency syndrome-related and nonneoplastic leukocyte disorders. Training deficits most frequently recalled were office management skills and psychosocial/communication skills. Nearly half of the respondents preferred to maintain separate certificates. Data indicate that the two fields are distinct. However, the overlap in practice brings into question the adequacy of training for diplomates who manage problems outside of their field of certification and suggests that some degree of cross-fertilization in all training would be beneficial.