Oncologists spend their days in a mix of patient consultations, team meetings, treatment oversight, and a significant amount of documentation. A 2023 survey found that U.S. oncologists work a median of 60 hours per week, up from about 57.6 hours a decade earlier. That workload splits across direct patient care, administrative tasks, and for many, research and clinical trial work. Here’s what fills those hours.
The Three Types of Oncologists
Not all oncologists do the same work. Medical oncologists are the ones most people picture: they diagnose cancers, order and interpret tests, prescribe chemotherapy and immunotherapy, and manage patients through treatment. Surgical oncologists spend much of their day in the operating room removing tumors and performing biopsies. Radiation oncologists plan and deliver radiation therapy, a role that requires detailed knowledge of imaging anatomy and careful calibration of treatment to minimize damage to healthy tissue.
Despite these differences, all three types share core daily activities: seeing patients in clinic, collaborating with other specialists, reviewing imaging and lab results, and making complex treatment decisions. A radiation oncologist’s day looks more like a surgeon’s than an internist’s, with hands-on procedures such as implanting radioactive sources directly into tumors. A medical oncologist’s day leans more toward clinic visits, managing side effects, and adjusting drug regimens.
Morning Rounds and Tumor Board Meetings
Many oncologists start their day with a multidisciplinary tumor board, a regular meeting where surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists review individual patient cases together. These meetings have become a standard fixture in oncology over the past two decades. The goal is collaborative decision-making: the team looks at a patient’s scans, biopsy results, and overall health to agree on the best treatment plan.
Tumor boards evolved from forums where doctors presented unusual or interesting cases into working sessions for day-to-day patient management. In practice, an oncologist might present five to ten cases in a single meeting, walking colleagues through imaging findings and proposing a treatment approach. A radiologist might flag something on a scan, a surgeon might weigh in on whether a tumor is operable, and the group reaches a consensus. For complex cancers, these meetings often determine the entire course of a patient’s care.
Patient Consultations
Clinic time is the heart of the job. An oncologist’s patient load varies widely by setting, but a busy outpatient clinic can involve seeing 20 to 40 patients in a half-day session. Those visits fall into two broad categories: new patient consultations and follow-ups.
New patient appointments are the longest and most emotionally demanding. The oncologist reviews the patient’s full medical history, examines them, goes over pathology and imaging results (often pulling up scans on screen so the patient can see what’s happening), and explains the diagnosis. Then comes the hardest part: discussing prognosis and treatment options. Patients are often overwhelmed, and experienced oncologists deliver information in small, digestible pieces across multiple visits rather than front-loading everything into one conversation. Eye contact, pacing, and reading the patient’s emotional state matter enormously. Many patients don’t fully absorb details until a second or third visit.
Follow-up visits are shorter but no less important. The oncologist checks how the patient is responding to treatment, reviews new lab work or scans, adjusts medications, and assesses side effects. A key part of every follow-up is a thorough symptom check that goes beyond pain. Fatigue, nausea, sleep problems, mood changes, and appetite loss all factor into treatment decisions. At each transition point, such as switching to a new line of therapy or noticing the disease has progressed, the oncologist revisits goals of care with the patient.
Supervising Treatment
When patients receive chemotherapy or immunotherapy infusions, the oncologist doesn’t sit bedside for the full session, but they are responsible for the treatment plan and for directly supervising the clinical staff who administer it. Before each infusion cycle, the oncologist reviews the patient’s bloodwork to confirm they’re healthy enough to tolerate treatment, approves the drug regimen and dosing, and remains available in case of a reaction.
In outpatient hospital settings, chemotherapy administration requires direct physician supervision, meaning the oncologist must be physically present and immediately available in the facility. In office-based practices, the same standard applies. This means that even while seeing other patients in clinic, the oncologist is simultaneously overseeing what’s happening in the infusion center down the hall. Nurses and pharmacists handle the hands-on delivery, but the oncologist makes the clinical calls: whether to reduce a dose, delay a cycle, or switch drugs entirely based on how the patient is tolerating treatment.
Clinical Trials and Research
Many oncologists, especially those at academic medical centers, weave research into their clinical days. One of the most time-consuming research tasks is screening patients for clinical trial eligibility. This often means manually reviewing medical records to match patients against a trial’s specific criteria: tumor type, prior treatments, lab values, and other factors. It’s labor-intensive work, and patients who’ve been in a practice for years can be overlooked when new trials open unless someone is actively tracking eligibility.
Larger cancer centers employ clinical trial coordinators and financial navigators to help with this process, but the oncologist still makes the final decision about whether to offer a trial to a specific patient. For patients already enrolled in a trial, the oncologist monitors them according to the study protocol, which often involves more frequent visits, additional blood draws, and detailed documentation of side effects and outcomes.
Palliative Care Conversations
A significant and often underappreciated part of an oncologist’s daily work is managing symptoms and having difficult conversations about the end of life. Palliative care isn’t reserved for a patient’s final days. It runs parallel to active treatment, and oncologists handle much of it themselves rather than deferring to palliative care specialists.
In practice, this means asking patients at every visit about their symptoms using structured assessment tools that rate problems like pain, breathlessness, and anxiety on a scale. When a patient’s disease progresses or their physical condition declines, the oncologist raises questions that most people would rather avoid: whether the patient has a living will, who should make medical decisions if they can’t, whether they’ve thought about where they want to spend their final days. Best practice calls for introducing hospice services when a patient likely has three to six months to live, framing it as a normal part of care rather than giving up. These conversations are woven into routine follow-up visits, not saved for a single dramatic moment.
Administrative Work and After-Hours Duties
Documentation and paperwork take up a growing share of the oncologist’s day. In a 2023 survey, 68% of oncologists reported that their administrative hours had increased compared to pre-pandemic levels. This includes writing detailed notes in electronic health records after each patient visit, submitting insurance prior authorizations for expensive treatments, reviewing incoming lab and imaging results, and responding to patient messages. Much of this work spills into evenings and weekends.
On-call responsibilities add another layer. Cancer patients can develop urgent problems at any hour: fevers during chemotherapy (which can signal a life-threatening infection), uncontrolled pain, severe nausea, or new neurological symptoms that might indicate the cancer has spread to the brain. Patients and caregivers call emergency lines to report symptoms, and the on-call oncologist triages these calls, deciding whether someone needs to come to the emergency department immediately or can manage at home until morning. The volume of after-hours calls varies, but it’s a consistent reality of the job.
With 57% of oncologists reporting that their total weekly hours have increased in recent years and workloads continuing to rise, the daily rhythm is demanding. But the core of the work remains what draws most oncologists to the field: sitting across from a patient, making sense of a complicated disease, and figuring out the best path forward together.