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It takes 13 to 16 years to become an oncologist, broken down into eight mandatory steps.
You need a bachelor’s degree before you can apply to medical school. You don’t need a specific major, but you do need to complete prerequisite coursework in biology, general chemistry, organic chemistry, physics, biochemistry, math, and English. Most aspiring oncologists major in a science, but the major matters far less than your GPA and the depth of your clinical exposure.
Start building your medical school application early. Shadow physicians (ideally oncologists), volunteer in cancer research labs, and look for clinical experience in hospital settings. Medical schools want to see a sustained commitment to medicine, not a last-minute sprint of extracurriculars.
A strong GPA in your prerequisite courses and a high MCAT score form the quantitative backbone of your application, but meaningful patient-facing experiences are what bring it to life.
Your MCAT score is one of the two biggest quantitative factors in medical school admissions (alongside your GPA). Competitive applicants typically score in the 515+ range, though the exact threshold depends on the schools you’re targeting.
Plan to take the MCAT after completing your core prerequisite courses, usually in the spring of your junior year. Give yourself at least three months of dedicated preparation. If your score falls short of your target range, you can retake the MCAT, but it’s better to delay and prepare thoroughly than to sit for the test underprepared.
Medical school takes four years to complete. The first two years focus on foundational sciences taught through lectures, labs, and case-based learning. The second two years shift to clinical rotations (also called clerkships), where you’ll rotate through major specialties including internal medicine, surgery, pediatrics, psychiatry, and obstetrics/gynecology.
To give yourself your best chance at admission, work with an experienced admissions consultant. Admissions consultants at Inspira Advantage help you submit a successful application the first time.
Medical schools evaluate your GPA, MCAT score, extracurricular activities, research experience, clinical experience, and fit for the school. Since the medical school admissions landscape is extremely competitive, you should aim for competitive scores and 150+ hours of research, clinical, and extracurricular experience.
During medical school, you’ll take USMLE Step 1 (typically after your second year) and USMLE Step 2 CK (usually in your fourth year). Step 1 is now pass/fail, which means Step 2 CK scores carry more weight in fellowship applications.
You can earn either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO). Both pathways lead to oncology, and the National Resident Matching Program (NRMP) match data show DO graduates matching at increasing rates. If oncology interests you, seek out clinical rotations in hematology/oncology and get involved in cancer research as early as possible.
Before you can specialize in oncology, you need to complete a three-year residency in internal medicine. Residency is where you turn from a medical student into a working physician. You’ll manage patients across a wide range of conditions, from heart failure and diabetes to acute infections and liver disease, helping you build the foundation that every oncologist relies on daily.
Strong evaluations from attending physicians, leadership roles (such as chief resident), and a track record of oncology-focused research all strengthen your fellowship application. Use your residency elective time to rotate in hematology/oncology clinics, attend tumor board conferences, and build relationships with oncology faculty who can serve as mentors and write compelling letters of recommendation.
The hematology/oncology fellowship match is highly competitive and increasingly selective. In the 2025 NRMP Medicine Specialties Match, hematology/oncology offered 809 certified positions with a 99.5% fill rate, making it one of the most sought-after internal medicine fellowships in the country. The number of fellowship programs has grown roughly 60% over the past decade, from 124 programs in 2011 to well over 200 today, but applicant demand has also increased.
According to a 2025 analysis published in Blood, the overall unmatched rate rose from 20.6% in 2014 to 25.2% in 2025, showing just how intense the competition is. Research productivity, strong Step 2 CK scores, and meaningful clinical letters of recommendation remain the most consistent differentiators for matched applicants.
A hematology/oncology fellowship lasts two to three years. During the fellowship, you’ll focus on diagnosing and treating cancers and blood disorders, developing expertise in chemotherapy, immunotherapy, targeted therapy, and clinical trial management. You’ll also pass USMLE Step 3 if you haven’t already, typically early in your fellowship year.
After completing your fellowship, you’ll sit for the American Board of Internal Medicine (ABIM) certification exam in Medical Oncology. The exam covers the full spectrum of cancer types, treatment modalities, supportive care, and cancer prevention. Passing the ABIM exam earns you board certification, which is a credential that hospitals, employers, and patients expect.
Board certification requires maintenance through the ABIM’s Maintenance of Certification (MOC) program, which includes ongoing learning activities and periodic reassessment. Oncology evolves rapidly, so continuous learning isn’t just a requirement; it’s a professional necessity.
Every state requires its own medical license. You’ll need to submit documentation of your education, training, and USMLE scores to the state medical board where you plan to practice. Some states have additional requirements or reciprocity agreements, so start the paperwork early, especially if you’re planning to practice in multiple states.
Once you’re licensed and board-certified, you’re ready to practice as an attending oncologist. Your options include academic medical centers, community cancer centers, large health systems, private practice groups, and hospital-employed positions. The setting you choose will shape your day-to-day work, your earning potential, and your quality of life.
Oncology itself branches into several distinct disciplines. Medical oncologists prescribe chemotherapy, immunotherapy, hormone therapy, and targeted drugs. Surgical oncologists remove tumors and perform cancer-related surgical procedures, requiring a general surgery residency rather than internal medicine. Radiation oncologists treat cancer with precisely targeted radiation beams, completing a separate radiation oncology residency after medical school.
Within hematology/oncology, you can further subspecialize in areas like:
Some oncologists pursue additional fellowship training in bone marrow transplant and cellular therapy or in specific tumor types. Your subspecialty focus often develops organically during fellowship based on mentorship, research interests, and clinical experience.
Oncology ranks among the highest-compensated internal medicine subspecialties. The average oncologist earns $290,463 per year in the United States. The 25th percentile oncologists earn $143,000, and the 75th percentile earn $400,000.
Many practicing oncologists (especially those with established patient panels, in-house infusion centers, or clinical trial revenue) earn well above these posted figures. Fifteen states pay above the national average, with Washington, D.C., and New York topping the list.
Where and how you practice drives compensation more than almost any other factor. Community oncologists in private practice or single-specialty groups typically out-earn their academic counterparts, often by a wide margin.
Academic medical centers offer lower base salaries but provide access to clinical trials, research funding, protected research time, and institutional prestige that many oncologists value.
The BLS projects 3% employment growth for physicians and surgeons overall from 2024 to 2034, with about 23,600 annual openings across all specialties. But oncology-specific demand far outpaces general physician growth.
It takes 13 to 16 years to become an oncologist. This comprises four years of undergraduate education, four years of medical school, three years of internal medicine residency, and two years of hematology/oncology fellowship.
Here is a breakdown of the timeline:
Yes, both MD and DO graduates match into hematology/oncology fellowships. The 2025 NRMP data show DO graduates matching at a 78% rate across the medicine specialties.
Medical oncologists treat cancer with systemic therapies. Surgical oncologists physically remove tumors and cancerous tissue through surgery. Radiation oncologists use precisely targeted radiation beams to destroy cancer cells. Each path requires a different residency: internal medicine for medical oncology, general surgery for surgical oncology, and radiation oncology (a stand-alone residency after medical school) for radiation oncology.
The hematology/oncology fellowship match is very competitive. The 2025 match filled 99.5% of 809 available positions, according to NRMP data. Research publications, strong clinical letters, and competitive Step 2 CK scores give you the best chance of matching.
The major branches include medical oncology (systemic therapy), surgical oncology (tumor removal), and radiation oncology (radiation therapy). Within medical oncology, you can further focus on specific disease sites: breast oncology, thoracic/lung oncology, GI oncology, genitourinary oncology, neuro-oncology, and gynecologic oncology. Hematologic oncology covers blood cancers like leukemia, lymphoma, and myeloma. Pediatric oncology requires a separate pediatric residency and fellowship.
Reviewed by:
Orthopaedic Surgery Resident Physician, Lewis Katz School of Medicine at Temple University
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