Veterinary Oncology: What to Expect in a Career Treating Cancer in Animals
By Dr. Zubair Khalid, DVM, MS, PhD ·

Quick Answer
- Veterinary oncology is a board-certified specialty focused on diagnosing and treating cancer in animals, requiring four years of veterinary school plus a multi-year residency program.
- Daily work involves chemotherapy administration, radiation therapy planning, diagnostic imaging interpretation, and extensive client communication about treatment goals and prognosis.
- The field carries significant emotional demands, and candidates should pursue oncology-specific mentorship and clinical exposure before committing to the specialty path.
Understanding Veterinary Oncology as a Specialty
Veterinary oncology emerged as a recognized specialty within veterinary medicine to address the growing need for cancer care in companion animals. The specialty focuses on the diagnosis, staging, and treatment of neoplasia in dogs, cats, and other animals. Veterinary oncologists work with solid tumors, hematologic malignancies, and metastatic disease using treatment modalities that include chemotherapy, radiation therapy, immunotherapy, and surgical collaboration.
The specialty requires advanced training beyond the Doctor of Veterinary Medicine degree. According to the Association of American Veterinary Medical Colleges, becoming a veterinarian requires completion of a four-year doctoral program following undergraduate education, and specialty training adds several more years of intensive clinical work. Veterinary oncology residencies typically span three years and include supervised clinical practice, research requirements, and preparation for board certification examinations.
The occupational outlook for veterinarians remains stable, with the U.S. Bureau of Labor Statistics tracking employment data for the broader veterinary profession. Veterinary oncologists work primarily in academic veterinary hospitals, private specialty referral practices, and research institutions. The specialty demands strong foundations in internal medicine, pathology, pharmacology, and diagnostic imaging.
Core Responsibilities in Veterinary Oncology Practice
Diagnostic Workup and Staging
The veterinary oncologist's first responsibility is establishing an accurate diagnosis. This process begins with a thorough physical examination and history, followed by diagnostic imaging such as radiography, ultrasound, and advanced imaging modalities. The oncologist obtains tissue samples through fine needle aspiration or biopsy for cytologic and histopathologic evaluation.
Staging determines the extent of cancer spread and guides treatment decisions. The oncologist evaluates regional lymph nodes, screens for distant metastasis, and assesses the patient's overall health status. Complete staging often requires blood work, urinalysis, and imaging studies. The information gathered during staging directly influences prognosis and treatment recommendations.
Treatment Planning and Protocol Selection
Treatment planning requires integrating tumor-specific factors with patient-specific considerations. The oncologist considers tumor type, grade, stage, and expected biologic behavior alongside the animal's age, breed, concurrent diseases, and quality of life. Treatment options may include surgery, chemotherapy, radiation therapy, or combinations of these modalities.
Chemotherapy protocols vary by tumor type and are selected based on published evidence and the individual patient's circumstances. The oncologist calculates drug dosages based on body surface area or weight, evaluates organ function before each treatment, and adjusts protocols when toxicity occurs. Radiation therapy planning involves precise tumor targeting while sparing surrounding healthy tissue.
Client Communication and Shared Decision Making
Client communication distinguishes veterinary oncology from many other specialties. The oncologist must convey complex medical information in accessible language while acknowledging the emotional weight of a cancer diagnosis. Discussions cover treatment goals, expected outcomes, potential side effects, financial considerations, and quality-of-life expectations.
The oncologist helps clients understand that cancer treatment in animals differs from human cancer care. Veterinary treatment goals prioritize quality of life and comfort, and the oncologist must help clients navigate decisions about treatment intensity, palliative care, and humane endpoints. These conversations require empathy, patience, and the ability to present options without imposing personal judgments.
Educational Pathway to Veterinary Oncology
Prerequisite Education and Veterinary School
The path to veterinary oncology begins with undergraduate education that includes prerequisite coursework in biology, chemistry, physics, and mathematics. Competitive applicants typically maintain strong grade point averages and gain animal-related experience before applying to veterinary school. The Association of American Veterinary Medical Colleges provides guidance on the application process and prerequisite requirements for prospective veterinary students.
Veterinary school itself spans four years and includes foundational sciences, clinical rotations, and elective opportunities. Students interested in oncology should seek elective rotations in oncology, seek research opportunities, and build relationships with faculty who can provide mentorship and letters of recommendation for residency applications.
Residency Training and Board Certification
After earning the Doctor of Veterinary Medicine degree, aspiring oncologists complete a three-year residency program at an approved training institution. Residency training includes supervised clinical case management, didactic instruction, research projects, and progressive responsibility in patient care. Residents gain experience across the spectrum of oncology practice, including medical oncology, radiation oncology, and interdisciplinary tumor board participation.
Board certification requires successful completion of the residency program and passing a rigorous examination administered by the American College of Veterinary Internal Medicine or the American College of Veterinary Radiology for radiation oncology. Certification demonstrates advanced knowledge and competence in the specialty and is recognized by academic institutions and specialty referral practices.
Alternative Pathways and Related Roles
Not all professionals working in veterinary oncology are board-certified oncologists. Veterinary technicians with oncology training administer treatments, manage patient care, and provide client education. Pathology residents and board-certified pathologists contribute diagnostic expertise. Research scientists study cancer biology and develop new therapeutic approaches. The National Institutes of Health Office of Intramural Training and Education describes research career development pathways that can complement clinical training for veterinarians interested in translational oncology research.
Daily Life in Veterinary Oncology
Clinical Practice Settings
Veterinary oncologists practice in several settings, each with distinct daily rhythms. Academic veterinary hospitals combine clinical service with teaching and research responsibilities. Private specialty referral practices focus on clinical care and often see higher patient volumes. Research institutions may emphasize laboratory work and clinical trials over direct patient care.
The U.S. Bureau of Labor Statistics notes that veterinarians work in various settings including clinics, hospitals, and research facilities. The specific work environment shapes the oncologist's daily schedule, case load, and professional responsibilities. Academic positions typically include protected time for research and teaching, while private practice positions emphasize clinical productivity.
Typical Daily Schedule
A clinical oncology day begins with reviewing hospitalized patients, checking blood work results, and assessing treatment responses. The oncologist sees scheduled appointments for new consultations, treatment rechecks, and chemotherapy administration. Each appointment includes physical examination, client communication, and treatment or monitoring as indicated.
Chemotherapy administration requires careful attention to safety protocols. The oncologist verifies drug calculations, confirms patient identification, and administers treatments while monitoring for adverse reactions. Between appointments, the oncologist reviews diagnostic images, communicates with referring veterinarians, and documents case findings in the medical record.
Interdisciplinary Collaboration
Oncology care requires collaboration with multiple veterinary specialists. Surgeons perform tumor resections and biopsies. Radiologists interpret imaging studies and may deliver radiation therapy. Pathologists provide histopathologic diagnoses and prognostic information. Internal medicine specialists manage concurrent diseases and complications.
Tumor board meetings bring these specialists together to discuss complex cases and develop coordinated treatment plans. The oncologist often serves as the central coordinator, synthesizing input from multiple disciplines and presenting a unified recommendation to the client.
Chemotherapy Administration and Safety
Chemotherapy Protocols and Drug Handling
Chemotherapy drugs are hazardous substances that require careful handling to protect patients, veterinary staff, and the environment. The oncologist and veterinary technicians follow established safety protocols for drug preparation, administration, and waste disposal. Personal protective equipment including gloves, gowns, and eye protection is standard during drug handling.
Treatment protocols are selected based on tumor type and published evidence. Common protocols combine multiple drugs with different mechanisms of action to maximize efficacy while managing toxicity. The oncologist monitors complete blood counts before each treatment to assess bone marrow function and adjusts dosages when necessary.
Managing Side Effects and Toxicities
Chemotherapy side effects in animals are generally less severe than in human patients, but they still require careful monitoring. Gastrointestinal effects such as vomiting, diarrhea, and decreased appetite are the most common. Bone marrow suppression can increase infection risk. Some drugs cause specific toxicities affecting the heart, bladder, or nervous system.
The oncologist provides clients with detailed instructions for monitoring side effects at home and clear criteria for when to seek emergency care. Anti-nausea medications, appetite stimulants, and supportive care measures are prescribed as needed. Dose reductions or treatment delays are implemented when toxicity exceeds acceptable thresholds.
Radiation Therapy in Veterinary Oncology
Radiation therapy uses targeted high-energy beams to destroy cancer cells while sparing surrounding tissues. Veterinary radiation oncology requires specialized equipment and training. Treatment planning involves advanced imaging to define tumor volumes and critical structures, followed by dosimetry calculations to determine optimal beam arrangements.
Radiation protocols vary from palliative single-fraction treatments to curative-intent fractionated protocols delivered over several weeks. Side effects depend on the treatment site and may include skin reactions, oral mucositis, or other localized effects. The radiation oncologist monitors patients throughout treatment and manages side effects as they arise.
Emotional Challenges and Professional Resilience
The Emotional Weight of Cancer Care
Veterinary oncology carries significant emotional demands. The oncologist forms relationships with clients during some of the most difficult periods of their lives. Despite advances in cancer treatment, many patients eventually succumb to their disease or are euthanized when quality of life declines. The cumulative experience of loss can affect even experienced clinicians.
The oncologist must maintain professional composure while delivering difficult news and supporting grieving clients. This emotional labor is a core component of the specialty and requires intentional self-awareness and coping strategies. Recognizing the emotional demands of the field before committing to the specialty is essential for career sustainability.
Compassion Fatigue and Burnout Prevention
Compassion fatigue and burnout are recognized occupational hazards in veterinary medicine, particularly in specialties with high emotional intensity. The oncologist must develop strategies for maintaining emotional boundaries while remaining present and compassionate with clients. Regular self-assessment of stress levels, work-life balance, and professional satisfaction is important.
Institutional support structures including peer support groups, employee assistance programs, and mental health resources can help mitigate burnout risk. The National Institutes of Health Office of Intramural Training and Education emphasizes the importance of mentoring and professional development support for sustaining research and clinical careers. Seeking mentorship from experienced oncologists can provide guidance on navigating the emotional challenges of the specialty.
Building Sustainable Professional Practices
Sustainable oncology practice requires intentional attention to professional well-being. This includes maintaining interests outside of work, cultivating supportive professional relationships, and recognizing personal limits. Some oncologists limit clinical hours, incorporate research or teaching into their practice, or pursue leadership roles to diversify their professional experience.
The oncologist should also recognize that emotional resilience develops over time. Early-career oncologists may find the emotional demands more challenging than expected, while experienced clinicians often develop effective coping strategies. Open discussion of these challenges within the profession helps normalize the experience and reduces stigma around seeking support.
Research Opportunities in Veterinary Oncology
Clinical Trials and Translational Research
Veterinary oncology offers substantial research opportunities, particularly in clinical trials evaluating new cancer treatments. Comparative oncology recognizes that naturally occurring cancers in companion animals share features with human cancers, making veterinary patients valuable models for translational research. The National Science Foundation describes research careers that span basic discovery, applied science, and program management within federal research organizations.
Clinical trials in veterinary oncology evaluate new chemotherapy agents, targeted therapies, immunotherapies, and combination approaches. The oncologist may serve as principal investigator, enrolling patients, monitoring treatment responses, and documenting outcomes. Research participation requires additional training in clinical trial design, regulatory compliance, and data management.
Laboratory Research and Basic Science
Some veterinary oncologists pursue laboratory-based research investigating cancer biology, drug development, or tumor immunology. This path typically requires additional research training beyond clinical residency, often including a PhD or postdoctoral fellowship. The National Institutes of Health Office of Intramural Training and Education provides information about research training opportunities and career development programs for biomedical scientists.
Laboratory research offers the opportunity to address fundamental questions about cancer development and treatment resistance. The oncologist-scientist may divide time between clinical practice and laboratory investigation, contributing to both patient care and scientific discovery. This career path requires strong research mentorship and institutional support.
Career Development and Funding
Research careers in veterinary oncology require skill in securing funding and building a publication record. Early-career investigators often begin with mentored awards and institutional support before pursuing independent funding. The National Science Foundation careers page illustrates the range of scientific and programmatic roles available within federal research organizations, providing context for the broader research career landscape.
The oncologist pursuing research should seek mentors who can provide guidance on grant writing, manuscript preparation, and career progression. Professional organizations and conferences provide networking opportunities and exposure to emerging research directions. Building a collaborative network across institutions enhances research productivity and career opportunities.
Financial Considerations and Career Outlook
Income Expectations and Compensation
Veterinary oncology compensation varies by practice setting, geographic region, and experience level. The U.S. Bureau of Labor Statistics provides occupational employment data for veterinarians generally, though specialty-specific salary information is not detailed in that source. Academic positions typically offer lower salaries than private practice but include benefits such as research time, teaching opportunities, and institutional support.
Private specialty practice compensation often includes production-based incentives tied to clinical revenue. The oncologist should understand the compensation structure of any position and consider how it aligns with personal and professional goals. Geographic location significantly influences earning potential, with urban and specialty-dense markets typically offering higher compensation.
Educational Debt and Return on Investment
The educational pathway to veterinary oncology requires substantial financial investment. Veterinary school tuition, residency stipends, and examination fees accumulate over many years of training. The Association of American Veterinary Medical Colleges provides information about the cost of veterinary education and financial planning resources for prospective students.
Prospective oncologists should carefully evaluate the financial implications of the specialty path. Residency stipends are modest compared to clinical practice income, and the extended training period delays full earning potential. However, board-certified specialists typically earn higher incomes than general practitioners, potentially offsetting the additional educational investment over a career.
Job Market and Career Opportunities
The job market for veterinary oncologists remains favorable, with ongoing demand for specialty cancer care in companion animals. Academic institutions, private referral practices, and corporate veterinary groups all recruit board-certified oncologists. The U.S. Bureau of Labor Statistics projects continued employment growth for veterinarians, driven by increased spending on pet health care and expanding treatment options.
Career opportunities extend beyond clinical practice to include research, teaching, industry positions, and regulatory roles. The American Society for Microbiology careers page illustrates the range of professional pathways available to biomedical scientists, providing a model for the diverse opportunities open to veterinary oncologists with research interests.
Technology and Diagnostic Advances
Advanced Imaging in Oncology
Modern veterinary oncology relies on advanced imaging modalities for diagnosis, staging, and treatment planning. Computed tomography provides detailed cross-sectional images for surgical planning and radiation therapy targeting. Magnetic resonance imaging offers superior soft tissue contrast for brain and spinal cord tumors. Positron emission tomography, where available, provides functional information about tumor metabolism.
The oncologist interprets imaging studies in collaboration with veterinary radiologists and uses imaging findings to guide biopsy procedures and treatment decisions. Advanced imaging has improved the precision of cancer care and expanded treatment options for previously inoperable tumors.
Molecular Diagnostics and Personalized Medicine
Molecular diagnostics are increasingly integrated into veterinary oncology practice. Immunohistochemistry helps characterize tumor types and predict behavior. Genetic testing identifies mutations that may guide treatment selection. Flow cytometry characterizes hematologic malignancies. These tools enable more precise diagnosis and personalized treatment approaches.
The oncologist must understand the indications, limitations, and interpretation of molecular diagnostic tests. Not all tests are available or validated for all species, and the oncologist must weigh the clinical utility of each test against its cost. Consultation with veterinary pathologists and clinical pathologists supports appropriate test selection and interpretation.
Emerging Treatment Modalities
Veterinary oncology continues to evolve with new treatment approaches. Immunotherapy, including cancer vaccines and checkpoint inhibitors, is being evaluated in veterinary clinical trials. Metronomic chemotherapy uses low-dose continuous drug administration to target tumor angiogenesis. Electrochemotherapy combines electrical pulses with chemotherapy to enhance drug uptake.
The oncologist must stay current with emerging treatments while maintaining evidence-based practice standards. New treatments are evaluated through clinical trials before becoming standard of care. The oncologist should understand the evidence supporting each treatment option and communicate realistic expectations to clients.
Quality of Life Assessment and Palliative Care
Measuring Quality of Life in Cancer Patients
Quality of life assessment is central to veterinary oncology practice. The oncologist evaluates physical function, comfort, appetite, mobility, and engagement in normal activities. Standardized quality of life tools help track changes over time and guide treatment decisions. Client observations provide essential information about the patient's experience at home.
The oncologist should establish baseline quality of life measures at diagnosis and reassess at regular intervals throughout treatment. Deterioration in quality of life may indicate disease progression, treatment toxicity, or the need for palliative intervention. Objective assessment tools reduce the influence of emotional factors on treatment decisions.
Palliative Care and Pain Management
Palliative care focuses on comfort and quality of life when cure is not achievable. The oncologist manages cancer-related pain using analgesics, anti-inflammatory drugs, and adjunctive therapies. Other palliative interventions address nausea, appetite loss, and other symptoms affecting well-being.
Palliative radiation therapy can provide effective pain relief for bone metastases and other painful tumors. The oncologist coordinates palliative care with the primary care veterinarian and may refer patients for specialized pain management or hospice services. Clear communication about palliative goals and expected outcomes helps clients make informed decisions.
Euthanasia Decisions and End-of-Life Care
Euthanasia decisions are among the most challenging aspects of veterinary oncology. The oncologist helps clients recognize when treatment is no longer serving the patient's interests and when humane euthanasia is appropriate. This guidance requires clinical judgment, empathy, and the ability to communicate difficult information clearly.
The oncologist should discuss end-of-life preferences early in the treatment relationship, before crisis situations arise. Advance planning allows clients to make thoughtful decisions about euthanasia timing, location, and aftercare. The oncologist supports clients through the euthanasia process and provides resources for grief support.
Common Failure Patterns and How to Avoid Them
Incomplete Staging Leading to Suboptimal Treatment
One common failure in oncology practice is initiating treatment before complete staging is performed. Incomplete staging can lead to undertreatment of metastatic disease or overtreatment of localized disease. The oncologist should establish clear staging protocols and complete the diagnostic workup before recommending treatment.
Poor Client Communication and Unrealistic Expectations
Failure to communicate treatment goals and expected outcomes clearly can lead to client dissatisfaction and difficult treatment decisions. The oncologist should provide written treatment plans, discuss potential side effects and costs upfront, and document client understanding. Regular communication throughout treatment helps maintain alignment between client expectations and clinical reality.
Inadequate Toxicity Monitoring and Management
Chemotherapy toxicity can become serious when monitoring is inadequate. The oncologist should establish clear protocols for blood work monitoring, client reporting of side effects, and emergency management. Dose adjustments should follow established guidelines, and clients should receive written instructions for recognizing and reporting adverse effects.
Compassion Fatigue and Professional Burnout
The emotional demands of oncology practice can lead to burnout when not managed proactively. The oncologist should recognize early warning signs including emotional exhaustion, depersonalization, and reduced professional satisfaction. Seeking peer support, maintaining work-life boundaries, and accessing mental health resources are important protective strategies.
Professional Development and Continuing Education
Maintaining Board Certification
Board-certified veterinary oncologists must maintain certification through continuing education and professional development activities. The American College of Veterinary Internal Medicine requires diplomates to participate in ongoing learning and periodically demonstrate continued competence. Continuing education may include conferences, journal reading, and structured learning activities.
Specialty Conferences and Networking
Professional conferences provide opportunities for continuing education, networking, and exposure to emerging research. The Veterinary Cancer Society and other specialty organizations host annual meetings featuring research presentations, clinical updates, and professional development programming. The American Society for Microbiology careers page illustrates the value of professional networking for career development in biomedical fields.
Mentorship and Career Development
Mentorship is valuable throughout the oncology career, from veterinary school through specialty training and into practice. Mentors provide guidance on clinical decision making, career navigation, and professional development. The National Institutes of Health Office of Intramural Training and Education emphasizes the importance of mentoring for research career development, a principle that applies equally to clinical oncology careers.
At a Glance
| Aspect | Description | Key Consideration |
|---|---|---|
| Training pathway | Four-year DVM degree plus three-year oncology residency and board certification | Total training time typically exceeds seven years after undergraduate education |
| Primary work settings | Academic veterinary hospitals, private specialty practices, research institutions | Work environment shapes daily schedule, case load, and professional responsibilities |
| Core clinical activities | Diagnostic staging, chemotherapy administration, radiation therapy planning, client communication | Requires integration of medical knowledge with interpersonal skills |
| Emotional demands | High due to cancer diagnoses, treatment failures, and euthanasia decisions | Requires intentional strategies for compassion fatigue prevention |
| Research opportunities | Clinical trials, translational research, laboratory investigation | May require additional training beyond clinical residency |
| Financial considerations | Educational debt from extended training, specialty compensation typically higher than general practice | Evaluate return on investment before committing to the specialty path |
Practical Steps for Exploring Veterinary Oncology
Gain Clinical Exposure
Prospective oncologists should seek clinical exposure to oncology practice before committing to the specialty. Veterinary school electives, externships, and shadowing opportunities provide firsthand experience with the daily realities of oncology practice. The Association of American Veterinary Medical Colleges provides information about veterinary education pathways and opportunities for clinical exposure.
Seek Mentorship Early
Identifying mentors in veterinary oncology provides guidance on the specialty path and helps prospective oncologists understand the field's demands and rewards. Mentors can provide letters of recommendation, research opportunities, and career advice. Building relationships with oncology faculty during veterinary school is an important early step.
Develop Relevant Skills
Prospective oncologists should develop skills relevant to oncology practice including strong communication abilities, attention to detail, and emotional resilience. Coursework in pharmacology, pathology, and internal medicine provides foundational knowledge. Research experience develops critical thinking and scientific writing skills valued in residency applications.
Evaluate Personal Fit
The decision to pursue veterinary oncology requires honest self-assessment of personal fit. The specialty demands comfort with uncertainty, ability to deliver difficult news, and capacity to manage cumulative emotional stress. Prospective oncologists should consider whether the rewards of the specialty outweigh its challenges for their individual circumstances.
Frequently Asked Questions
What is the difference between a veterinary oncologist and a general practice veterinarian?
A veterinary oncologist completes a three-year residency and board certification in oncology after veterinary school, providing specialized expertise in cancer diagnosis and treatment. General practice veterinarians provide primary care and may manage some cancer cases but refer complex cases to oncologists for specialized treatment.
How long does it take to become a veterinary oncologist?
The pathway requires four years of veterinary school plus a three-year oncology residency, following undergraduate education. Board certification requires passing a specialty examination after completing the residency. Total training time from undergraduate entry typically exceeds ten years.
What types of cancer do veterinary oncologists treat?
Veterinary oncologists treat a wide range of cancers including lymphoma, mast cell tumors, osteosarcoma, hemangiosarcoma, mammary tumors, and brain tumors. They manage both solid tumors and hematologic malignancies using surgery, chemotherapy, radiation therapy, and emerging treatments.
Do animals experience chemotherapy side effects like humans do?
Animals generally tolerate chemotherapy better than humans, with less severe side effects. Common side effects include mild gastrointestinal upset and temporary decreases in white blood cell counts. The oncologist monitors blood work and adjusts treatment to manage toxicity while maintaining quality of life.
What is the job outlook for veterinary oncologists?
The job market for veterinary oncologists remains favorable with ongoing demand for specialty cancer care. The U.S. Bureau of Labor Statistics projects continued employment growth for veterinarians overall, and specialty services including oncology are expanding in academic and private practice settings.
How much does a veterinary oncologist earn?
Veterinary oncologist salaries vary by practice setting, geographic region, and experience. Board-certified specialists typically earn more than general practice veterinarians, though the U.S. Bureau of Labor Statistics does not provide specialty-specific salary data. Academic positions may offer lower salaries with additional benefits.
What skills are most important for success in veterinary oncology?
Strong communication skills, attention to detail, and emotional resilience are essential for oncology practice. The oncologist must convey complex information clearly, manage treatment protocols precisely, and cope with the emotional demands of cancer care. Research skills are valuable for academic and translational careers.
Can veterinary oncologists work in research instead of clinical practice?
Yes, veterinary oncologists can pursue research careers in academic institutions, government agencies, or industry. Research may focus on clinical trials, cancer biology, drug development, or translational research. Additional research training such as a PhD or postdoctoral fellowship may be required for research-intensive positions.
Using the Evidence
| Source | Best use in this topic | Important limitation |
|---|---|---|
| Occupational Outlook Handbook | official guidance | Check the linked page for current local requirements |
| O*NET OnLine | official guidance | Check the linked page for current local requirements |
| Office of Intramural Training and Education | official guidance | Check the linked page for current local requirements |
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References and Further Reading
- Occupational Outlook Handbook. U.S. Bureau of Labor Statistics.
- O*NET OnLine. U.S. Department of Labor.
- Office of Intramural Training and Education. National Institutes of Health.
- Careers at NSF. U.S. National Science Foundation.
- Career Services. American Society for Microbiology.
- AAVMC Career Resources. Association of American Veterinary Medical Colleges.
- NCBI Literature Resources. National Center for Biotechnology Information.
- PubMed. National Library of Medicine.
This article is educational and does not replace institutional policy, professional advice, or applicable safety and regulatory requirements.