Dr. Soma: Clinical Doctor and Research Oncologist

It’s not hard to see why many at Lakeside express interest in becoming doctors: It’s a fulfilling, mentally engaging, and financially stable career, at least at face value. But what’s it like actually being a doctor? Furthermore, what’s it like being a research doctor? And what is the path to becoming one?

I spoke to a family friend, Dr. Soma Subramaniam, who has experience with both clinical and research medicine, and is currently Medical Director of the Cancer Control Program at the Swedish Cancer Institute. He had many engaging answers to all of these questions!

To start, I asked Dr. Soma what led him to medicine. He pointed to “the fact that it's on a combination of the science and applying it to help people,” a sentiment often expressed at Lakeside, adding that “it's not just working indirectly to help people; [they are] having a difficult challenge in their life [and] doctors can help them.” 

Dr. Soma reminded me that it's not all roses, though, especially if a patient dies. "If you have a relationship with a patient and bond with their family, if you know them well, then you feel like you lost someone who's very close to you,” he said. It’s also possible that “[if] they have side effects from the medicines that you give, then you feel terrible that you [gave] them medicine and it doesn't work. Sometimes [there can be] complications; they pass away from disease whether it's cancer or heart disease.”

But it’s not all doom and gloom. While he did mention that cardiologists and EMTs often get burnt out due to the constant stress and higher patient casualty rates, “[in] the end of this, [there are] very few professions where you can directly make someone's life better. Where you can help cure cancer or some type of disease and give them back to normal life; that benefit far outweighs everything else.”

This leads us to our next question: once one has decided, after weighing the pros and cons, on becoming a doctor, what is the path towards that profession like? 

After completing (international) medical school, Dr. Soma had to take the STEP 1 and 2 exams, an objective way of measuring international applicants and ensuring every doctor attempting to get certified in the U.S. is up to par. He then had to apply for residency (an internship all doctors must do before becoming licensed), and he selected internal medicine as his specialty. 

The doctor pointed out to me that residency is grueling, but conditions have been improving for junior doctors. “You spend a lot of nights at the hospital; patients get sick at 2:00 p.m., and they also get sick at 2:00 a.m. [...] Someone has to be there to look after them, so it's usually the younger doctors who have to spend a lot of time in the hospital.”

While there have been some cases of exhausted medical personnel driving home and getting into car crashes, hospitals have improved conditions, creating a “locker room” where people can nap if they do not want to drive home. However, Dr. Soma is quick to add that residency is when one really wants to spend a lot of time in the hospital. Once one has completed their training, it’s up to them to make difficult decisions. It’s best to lean on people when one has the chance.

Pivoting a bit, how did Dr. Soma get into oncology research if he started out as an internal medicine doctor? He ended up doing a fellowship at the end of his residency to study cancer. He was drawn to the field by the fact that “you get an opportunity to interact with a lot of patients who are very very sick; for most people getting cancer is about the worst thing that ever happened.” Dr. Soma was excited to maximize his impact on his patients. But also, he tells me that the research is very intellectually engaging: there are so many innovations and drugs being constantly developed.

I then asked if Dr. Soma could share his research, which he described as “Detecting cancer before it’s found through a few common screening methods [...] So we're trying to figure out a blood test to look for cancer DNA. [...] That's a very challenging problem because it's hard to find small fragments of cancer DNA in the bloodstream, but with a lot of molecular biology and genomics, we're able to separate normal DNA from cancer DNA.” In Dr. Soma’s workday, he tells me that his job mainly involves explaining to patients why they might want to participate in a clinical study and advising the team behind the study to make the project more patient-friendly. 

As we wrapped up our interview, Dr. Soma finished with an encouraging statement: “We need more smart students interested in the medical field!” So, Lakesiders: after hearing from an inside perspective, what are your thoughts on becoming a medical professional?