Healthcare

How to Become an Oncologist (Cancer Treatment) in Ontario: Salary, Training, and Career Outlook

by Occupations.ca Team
11 min read

Have you ever imagined being the doctor who stands with patients and families on one of the toughest days of their lives—and then helps guide them through treatment, options, and hope? If you feel called to combine science, compassion, and teamwork, a career as an Oncologist (Cancer Treatment) in Ontario may be right for you.

Job Description

Oncologists are specialist physicians who diagnose and treat cancer. In Ontario, you can pursue three main clinical routes:

  • Medical Oncologist: focuses on drug-based treatments such as chemotherapy, immunotherapy, targeted therapies, and hormone therapy.
  • Radiation Oncologist: uses radiation therapy to treat cancer, working closely with radiation therapists and medical physicists.
  • Surgical Oncologist: performs cancer-related surgeries (often after completing general Surgery) and works alongside medical and radiation oncologists as part of a multidisciplinary team.

You typically work in large regional cancer centres and Teaching hospitals, coordinate care with nurses, pharmacists, social workers, and palliative care teams, and engage in ongoing research and clinical trials to improve cancer outcomes.

Daily work activities

As an oncologist in Ontario, your day might include:

  • Seeing new referrals to diagnose and stage cancer.
  • Running follow-up clinics to monitor response to treatment.
  • Discussing treatment plans with patients and families.
  • Leading or joining multidisciplinary tumour boards to plan care.
  • Reviewing imaging, pathology reports, and genetic testing results.
  • Supervising residents, medical students, and fellows.
  • Participating in research and clinical trials.
  • Coordinating supportive care, including pain Management, Nutrition, and psychosocial services.
  • Providing inpatient consultations and managing complications from treatment.
  • Documenting care, preparing treatment orders, and ensuring safe Delivery of therapy.

Main tasks

  • Evaluate symptoms and order tests (bloodwork, imaging, biopsies).
  • Determine cancer type and stage.
  • Create individualized treatment plans.
  • Prescribe and monitor chemotherapy, immunotherapy, targeted therapy, or radiation therapy as appropriate.
  • Refer for and collaborate on surgery where indicated.
  • Manage treatment side effects and complications.
  • Provide prognostic counselling and discuss goals of care.
  • Coordinate clinical trials enrollment when suitable.
  • Document care and communicate with primary care providers and other specialists.
  • Support survivorship planning and palliative care when needed.

Required Education

Becoming an oncologist in Ontario requires a long, structured educational path, postgraduate medical Training, and licensing.

Diplomas and degrees

  • High School Diploma (Ontario Secondary School Diploma or equivalent) — foundational courses in biology, chemistry, physics, and advanced math are helpful.
  • Bachelor’s Degree (commonly 3–4 years) — most applicants complete a Bachelor’s (BSc/BA) with strong performance; no specific major is mandatory, but many choose sciences.
  • Doctor of Medicine (MD, 4 years in Ontario) — required to become a physician.
  • Postgraduate Medical Training (Residency and possibly Fellowship) — length varies by oncology path.
  • Certification by the Royal College of Physicians and Surgeons of Canada (RCPSC) in your specialty.
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Note: A college diploma alone does not qualify you for medical school or oncology; it can, however, support related roles (e.g., radiation therapy, Nursing, medical laboratory technology).

Length of studies (typical timelines)

  • Bachelor’s degree: 3–4 years
  • MD program: 4 years
  • Residency:
    • Medical Oncology: 3 years Internal Medicine + 2 years Medical Oncology (total ~5 years after MD)
    • Radiation Oncology: 5 years (direct entry after MD)
    • Surgical Oncology: 5 years General Surgery + 1–2 years Surgical Oncology fellowship (after RCPSC certification in General Surgery)
  • Optional research Master’s/PhD or additional fellowships: 1–3+ years
  • Total time post–high school: approximately 12–15+ years, depending on the path.

Where to study? (Ontario programs and useful links)

Medical School (MD programs):

Residency and Certification:

Licensing and Registration (Ontario):

Cancer Centres and Training Environments in Ontario:

Tip: When you are exploring programs, look for mentorship, research opportunities, simulation facilities, and access to multidisciplinary clinics. These make a big difference in your training experience.

Salary and Working Conditions

Entry-level vs experienced salary

Physician income in Ontario varies widely by specialty, practice model (fee-for-service, alternative funding plans), academic appointments, call stipends, and the mix of inpatient/outpatient work.

  • Medical Oncologists and Radiation Oncologists in Ontario commonly have gross clinical billings that can range from approximately $300,000 to $600,000+ per year. New graduates often start in the lower end of this range while they build their practice.
  • Surgical oncologists (after general surgery training) may have incomes equal to or higher than other oncologic specialties, depending on volume and case complexity.
  • Keep in mind: gross billings are not net income. Physicians pay overhead (clinic/staff costs), CMPA fees, and taxes. Overhead can vary from 15% to 35%+ depending on the practice.

For national context and the latest data on physician payments by specialty and province, see the Canadian Institute for Health Information (CIHI): https://www.cihi.ca/en/physicians-in-canada

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Working conditions

  • Settings: large hospitals and regional cancer centres, academic health sciences centres, and sometimes community hospitals with oncology services.
  • Schedule: full-time work often ranges from 40–60+ hours/week with clinic days, inpatient consults, academic duties, and on-call rotations (especially for surgical oncology and inpatient services).
  • Teamwork: you will work daily with nurses, radiation therapists, medical physicists, pharmacists, social workers, genetic counselors, and palliative care teams.
  • Emotional demands: conversations can be intense and require empathy, resilience, and excellent communication.
  • Safety and protocols: strict chemotherapy handling, radiation safety, and infection control procedures protect patients and staff.

Job outlook in Ontario

  • The demand for oncologists is influenced by Ontario’s aging population, advances in treatments (e.g., immunotherapy), survivorship care, and regional needs across the province.
  • Radiation oncology positions can be tied to equipment capacity and regional cancer centre planning. Medical oncology demand is closely tied to new systemic therapy indications.
  • For evidence-based labour market trends, consult the Government of Canada Job Bank (Specialists in clinical and laboratory medicine – NOC 31100; Specialists in surgery – NOC 31101) and filter to Ontario:
  • You can also review Ontario Health (Cancer Care Ontario) reports and regional planning documents via: https://www.cancercareontario.ca/

Networking with Ontario program directors, attending career fairs, and contacting regional cancer centres directly can give you the most current hiring picture.

Key Skills

Soft skills

  • Empathy and compassion: supporting patients and families through uncertainty and change.
  • Communication: translating complex science into clear, respectful conversations.
  • Teamwork: collaborating with a wide interprofessional team.
  • Ethical judgment: navigating consent, equity, and end-of-life decisions.
  • Resilience and self-care: coping with emotional intensity and maintaining well-being.
  • Cultural humility: providing inclusive care to Ontario’s diverse populations, including Indigenous, Francophone, newcomer, and rural communities.
  • Time management: balancing clinic, inpatient care, research, and teaching.

Hard skills

  • Oncologic diagnostics: staging, risk stratification, interpretation of imaging and pathology.
  • Therapeutics: chemotherapy, immunotherapy, targeted therapy, radiation planning principles, and perioperative cancer care (depending on specialty).
  • Clinical trials and research literacy: reading evidence, obtaining consent, and applying trial protocols.
  • Supportive care: symptom management (pain, nausea, fatigue), survivorship planning.
  • Procedural skills: central line management, biopsies, or surgeries (depending on path).
  • Health informatics: using EMRs, ordering systems, and provincial e-health tools.
  • Quality improvement and patient safety: protocols, incident reviews, and continuous improvement.

Advantages and Disadvantages

Advantages

  • Meaningful impact: you help patients navigate one of life’s most challenging diagnoses.
  • Intellectual challenge: rapidly evolving science (genomics, immuno-oncology, precision medicine).
  • Team-based care: rich interprofessional collaboration.
  • Academic opportunities: research, teaching, and Leadership roles in Ontario’s major centres.
  • Diverse practice options: sub-specialization (breast, GI, GU, hematologic malignancies, Pediatrics), community vs academic settings.

Disadvantages

  • Lengthy training: often 12–15+ years post-secondary.
  • Emotional strain: frequent exposure to serious illness and end-of-life care.
  • Workload and call: can be heavy, especially in inpatient and surgical services.
  • Variable job market by region: positions may be more available in certain centres or communities; timing matters.
  • Administrative burden: documentation, protocols, and regulatory requirements can be substantial.

Expert Opinion

If you’re considering oncology in Ontario, start building a track record in three areas: patient-centred communication, evidence-based thinking, and teamwork. Shadow in a regional cancer centre, volunteer with patient support organizations, and join research projects early. During medical school, seek rotations at centres like Princess Margaret, Sunnybrook, Juravinski, The Ottawa Hospital, LRCP, or Kingston’s Cancer Centre to experience different models of care.

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When choosing between medical, radiation, or surgical oncology, think about:

  • Do you enjoy longitudinal care with systemic therapies (medical oncology)?
  • Are you drawn to technology, imaging, and treatment planning (radiation oncology)?
  • Do you love the OR, perioperative care, and procedural mastery (surgical oncology)?

In Ontario, mentorship matters. Ask attendings and residents candid questions about lifestyle, call schedules, and the local job market. Finally, commit to lifelong learning—cancer care evolves fast, and Maintenance of Certification through the Royal College will keep your knowledge current.

FAQ

How competitive are oncology residency programs in Ontario, and how can I stand out?

Oncology specialties are competitive, especially at major academic centres. You can stand out by:

  • Earning strong evaluations in internal medicine, surgery, or radiation oncology rotations.
  • Completing peer-reviewed research, quality improvement work, or meaningful scholarly projects.
  • Demonstrating sustained interest (electives at multiple Ontario cancer centres, oncology student groups).
  • Showing excellence in communication and patient advocacy, with references from oncologists.
    Explore program details and timelines through CaRMS: https://www.carms.ca/

I’m an International Medical Graduate (IMG). What should I know about practicing oncology in Ontario?

Pathways depend on your training and certification. In general:

What’s the difference between hematology and medical oncology in Ontario?

They are separate RCPSC subspecialties in Canada:

  • Medical Oncology focuses on solid tumours and systemic therapies (chemotherapy, immunotherapy, targeted therapies).
  • Hematology addresses blood disorders, including leukemias, lymphomas, myeloma, and benign hematology (clotting disorders).
    Many centres have joint “hematology-oncology” services, and solid collaboration is routine, but residency training and certification are distinct.

Can oncologists in Ontario be involved in Medical Assistance in Dying (MAiD)?

Yes. Oncologists may be involved in MAiD assessments or procedures, depending on personal choice, institutional policies, and legal requirements. Participation is voluntary, and patients have access to care Coordination services. For information and resources, see Ontario Health’s MAiD page: https://www.ontariohealth.ca/our-work/connected-care/maid

Where can I find Ontario-specific cancer care guidelines and clinical resources as a trainee?

Ontario Health (Cancer Care Ontario) publishes evidence-based guidelines, pathways, and quality standards used across the province:

  • Ontario Health (Cancer Care Ontario) Guidelines: https://www.cancercareontario.ca/
    These resources support consistent, high-quality cancer treatment in Ontario and are widely referenced in training and practice.

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Additional Ontario-specific tips for your journey

  • Admission tests: Most Ontario MD programs require the MCAT (McMaster focuses on the CARS section; uOttawa does not require the MCAT for many streams—always check current policies).
  • French-language advantage: If you speak French and English, you may have added opportunities in Ottawa and other Francophone communities.
  • Indigenous and rural practice: NOSM University emphasizes training for northern and rural communities; oncology services in these regions rely on strong partnerships with larger centres and telemedicine.
  • Professional Development: After certification, you’ll maintain competence through the Royal College Maintenance of Certification (MOC) framework.
  • Networking: Attend Ontario oncology conferences and grand rounds at centres like UHN/Princess Margaret, Sunnybrook, Juravinski, The Ottawa Hospital, LRCP, and Kingston HSC to meet mentors and potential future colleagues.

By aligning your training, mentorship, and research with Ontario’s cancer system, you can build a rewarding, patient-centred career as an Oncologist in this province.

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