Cancer is no longer an automatic death sentence thanks to advances in treatment, but it's still a challenging adversary for the medical profession. That's especially true for pediatric oncologists, who treat children for cancers. Children's developing bodies are unusually susceptible to certain cancers, and they're less able to withstand some aggressive treatment options. Becoming a pediatric oncologist requires a medical license, like any other branch of medicine, as well as two levels of board certification.

Medical License

Each state has its own board of medicine to license doctors. To be eligible for licensing, candidates must first complete a four-year undergraduate degree. Next, they spend four years learning medicine in a medical or osteopathic college. All graduating students must then pass a national licensing examination. Osteopathic physicians take the Comprehensive Osteopathic Medical Licensing Examination or COMLEX-USA, while medical college graduates take the U.S. Medical Licensing Examination or USMLE. Once they've passed the exam, newly trained doctors can apply for their state-issued license and begin to treat patients.

Residency and Certification

Initially, they'll see patients in the supervised setting of a residency. For pediatricians, the residency period lasts three years. During that time they'll treat children for both routine and acute medical issues, learning clinical and diagnostic skills as well as the fine points of interacting with patients and their parents. The certification exam is in four sections, each taking one hour and 45 minutes to complete. Counting breaks, the examination process takes nine hours from start to finish. Candidates who pass become board-certified pediatricians.

Fellowship

Pediatricians who want to specialize in oncology must also complete either an oncology fellowship or a combined hematology/oncology fellowship. Hematologists treat cancers of the blood and lymphatic systems, so the two specialties share a common base of knowledge. A pure oncology fellowship takes two years to complete, while a combined hematology/oncology fellowship takes three. In either case the pediatrician treats children with cancers as part of a larger care team with other experienced providers. At the end of the residency, newly trained oncologists can take a second set of board certification exams in their specialty.

Maintenance of Certification

Because medicine is a rapidly-changing profession, physicians need to expend significant effort on remaining current in the field. Each state's board of medicine sets its own requirements for continuing medical education, or CME, which can include classes, seminars, teaching, research and many other activities. The Board of Pediatrics sets its own standards for board-certified pediatric oncologists to maintain their certification, which evolve over time. Physicians' CME requirements vary depending when their certification expires, or they can voluntarily opt for continuous maintenance of certification. In either case, oncologists must also pass a recertification exam every 10 years.