October 7, 2025
Written By
Michael Minh Le
Subscribe to the Premed Catalyst Newsletter
You know you want to help people fight cancer. You’re willing to put in the work. But you’re not sure of the path. How do you become an oncologist? What are the steps? How long does it take? And what kind of life are you signing up for?
This guide breaks it all down. You’ll get the full timeline from college to fellowship, understand what oncologists really do, what skills you’ll need, what the lifestyle looks like, and how to know if this specialty is truly right for you.
But none of it matters if you can’t get into medical school. Most premeds just don’t know what it takes to get accepted, and their path to oncology stops before they even really start. That’s why, at Premed Catalyst, we created the resource we wish we had as premeds. You’ll get free access to 8 real AMCAS applications that earned acceptances to some of the top medical schools in the country. Use this access to reverse engineer what works.
Get your free resource here.
Oncology is one of the most complex, emotionally charged, and scientifically intense specialties in medicine. These are the physicians who diagnose, treat, and even work to prevent cancer.
Oncologists aren’t just treatment experts. They’re detectives, strategists, and lifelong students of a constantly evolving field. They use imaging, lab tests, and biopsies to diagnose cancer. Then they develop tailored treatment plans that might include medication, surgery, radiation, or all of the above.
But they don’t stop there. Oncologists are also on the front lines of cancer prevention. They screen high-risk patients, educate communities, and sometimes even identify genetic mutations before a single tumor ever forms.
Cancer isn’t one disease, and there’s no one-size-fits-all approach to treating it. That’s why oncology is divided into specialized roles. Some oncologists work at the cellular level, others in the operating room, and some sit behind computer screens mapping out radiation plans.
Here’s more about the main types of oncologists:
Think of them as the chemists and immunologists of cancer care. These doctors prescribe chemotherapy, immunotherapy, hormone therapy, and precision-targeted drugs to attack cancer cells systemically. They often follow a patient throughout their entire journey, from diagnosis through remission or palliative care.
Medical oncologists are the quarterbacks of cancer treatment, coordinating care across specialties and helping patients navigate both the science and the emotion of the disease.
These are the doctors who use a scalpel to save lives. They perform biopsies to confirm diagnoses and surgically remove tumors when it’s possible and safe.
But let’s be real: this isn’t just surgery. It’s life-and-death decision-making under pressure. How much tissue can be removed? Is the cancer operable? What are the risks of waiting versus acting now?
Surgical oncologists walk that razor’s edge every day.
These doctors kill cancer with radiation. They use precisely targeted beams to destroy tumor cells while sparing as much healthy tissue as possible. It’s technical, mathematical, and absolutely unforgiving. One mistake? You burn something you didn’t mean to. No room for sloppy work here.
Cancer can attack anywhere in the body, which is why oncology includes a wide range of subspecialties:
14+ years. Zero shortcuts.
Read that again.
Becoming an oncologist is not for the faint of heart. It's a relentless, high-stakes path that demands brains, stamina, and an unshakable “why.” From college to fellowship, you're looking at a decade-plus of grinding.
Here’s exactly how to become an oncologist.
Your undergraduate major doesn’t matter. Your prerequisites do. You’ll need biology, general and organic chemistry, physics, and math. Most premeds go the biology route, but as long as you hit the requirements, any major is fair game.
This is your launchpad. GPA is mission-critical, so take it seriously. Schools will look for a consistent upward trend and academic rigor. Aim for research experience early, join premed clubs with intention, and start crafting your “why” story now. It’ll shape every part of your application later.
Before you even apply, you’ll face the MCAT. Expect 7.5 hours of mental warfare. Strategy wins here. Don’t just grind blindly. Retakes are possible, but let’s be honest: you want to crush it on the first try.
But med school admissions? They’re not just about numbers. Sure, GPA and MCAT scores matter, but they’re just the start. What really gets you in is a story. A cohesive, well-supported narrative that ties together your academics, clinical exposure, community work, and research.
Here’s what you’ll need:
At this point, you’re in, but that only means the real work begins.
Somewhere in this chaos, you’ll also need to pass the USMLE Step 1 and Step 2 (or COMLEX for DOs). These exams are brutal, and they matter.
Time to choose your foundation. Oncology is not a direct residency. You’ll first match into internal medicine, surgery, pediatrics, or another base specialty. This is where you sharpen your clinical instincts.
The match process (ERAS + NRMP) is highly competitive. You’ll need to apply broadly, crush your interviews, and rank programs wisely.
What makes you stand out?
This step sets the tone for your entire career, so you need to get it right.
This is where you finally specialize. Oncology fellowships are highly competitive, with limited spots and high expectations.
Whether you go into medical, radiation, or surgical oncology, you’ll train in high-stakes patient care, clinical trials, and advanced treatments like immunotherapy and precision medicine.
Want to stand out? Get research published, find mentors early, and build a network that vouches for your skill and your character.
Once fellowship is done, you’re almost there, but not quite. You’ll need to get board-certified, which is typically through the American Board of Internal Medicine, the American Board of Surgery, or your specialty board.
Each state also has its own licensing process (and red tape). You’ll need to renew and stay up to date through Continuing Medical Education (CME). Oncology changes fast. You can’t afford to fall behind.
Not everyone is built for this. Oncology demands more than medical knowledge. It takes grit, focus, and emotional range that most people never develop.
If you want to step into this field, these four skills aren’t optional. They’re the baseline.
Emotional Resilience
You will look someone in the eye and tell them they have cancer. You will do it again and again. You’ll do it for young parents, grandparents, and teenagers. Some days, you’ll deliver hope. Other days, the worst news of their life.
You can’t flinch. Your ability to stay grounded under emotional weight is what makes you the doctor they need.
Analytical Thinking
Every tumor tells a story. Location, size, cell type, genetic profile, spread. Each detail is a clue. Your job is to piece them together into a treatment plan that gives the patient their best shot. Oncology is medicine meets detective work. You have to think critically, constantly.
Communication
This isn’t just about talking. It’s about connecting with patients, families, nurses, surgeons, and pharmacists. Your words carry weight. Explaining complex treatments in plain English can make or break a patient’s ability to follow through. And when emotions are high, clarity saves lives.
Precision Under Pressure
There’s no “almost” in oncology. Radiation, surgery, chemo dosing, even a mistyped chart note, matters. You will make life-altering decisions in high-stakes moments. The margin for error? It doesn’t exist. You have to be sharp, steady, and unshakable.
Most oncologists earn between $300K and $450K a year, depending on subspecialty, practice setting, and location.
Academic oncologists may earn less. Private practice or high-demand subspecialties like surgical or radiation oncology can earn more. The compensation reflects the intensity of the work and the stakes involved.
But here’s the truth: the reward is high, but so is the risk of burnout.
You’ll be managing chronic disease, delivering devastating news, and walking families through the hardest moments of their lives. Emotionally, it’s heavy. Intellectually, it never stops.
Work-life balance? It’s possible, but only if you build it intentionally. That means setting clear boundaries, protecting your time, and saying no when you need to. Discipline is non-negotiable. The oncologists who last in this field aren’t just brilliant. They’re structured, self-aware, and fiercely protective of their mental health.
Let’s not pretend this career is all white coats and miracle recoveries. Oncology is one of the most rewarding fields in medicine, but it’s also one of the hardest. You need to know what you’re signing up for.
Emotional Weight
You will lose patients. No matter how skilled you are, some battles aren’t winnable. And when that happens, it hurts, especially when you’ve walked the entire journey with them and their families. If you don’t process that grief, it builds up fast.
Long Training Timeline
Around 14 years of school, residency, and fellowship. You’ll be in your 30s before you’re fully practicing. Friends will be buying houses, starting families, and traveling, and you’ll still be on call or grinding through board prep.
Burnout Is Real
Constant decision-making, end-of-life conversations, and administrative overload take a toll. Oncology has some of the highest burnout rates in medicine. If you don’t set limits early, this career will eat into your health, relationships, and sense of purpose.
The Pressure to Be Perfect
Mistakes aren’t just inconvenient in this profession. They’re irreversible. A wrong dosage, a delayed diagnosis, a missed mutation can change or end a life. That kind of pressure isn’t for everyone.
If you're going into oncology for prestige or money, you won’t last. But if you're called to it, and you're willing to do the work, there's nothing more meaningful.
This isn’t a career to choose lightly. Before you go all in on becoming an oncologist, ask yourself these questions:
Can you emotionally compartmentalize without shutting down?
You’ll hear the words “stage four” more times than you can count. You’ll celebrate remissions and grieve losses, sometimes in the same day. You need to stay present for your patients without carrying their pain like it’s your own.
Are you willing to train longer than almost any other specialty?
Four years of college. Four years of med school. Three to five years of residency. Two to three more in fellowship. If you want fast results, this isn’t it. Oncology is a marathon with no shortcuts, and the finish line is just the starting line of your real work.
Do you need your work to mean something bigger than a paycheck?
This job will test your stamina, your empathy, and your sense of self. But for the right person, it’s worth it. Every hard conversation, every late night, and every breakthrough means something. Because in oncology, you’re not just treating cancer. You’re helping people fight for their lives.
You know the mission. You’re ready for the long road. But none of it happens if you don’t make it past the first gate: getting into medical school.
That’s where most premeds get stuck. Not because they didn’t care or work hard, but because they didn’t know what a real, successful application looks like.
That’s why we built the resource we wish we had. Free access to 8 real AMCAS applications. These aren’t hypothetical examples, but actual submissions that earned acceptances to top-tier medical schools.
See what worked. Reverse engineer your strategy.
Get the free resource here.
