So You Want to be An Oncologist?

What Is An Oncologist?

The term Oncologist is an umbrella term which includes the specialities of Medical Oncology and Clinical Oncology. Medical Oncology is the non-surgical management of malignant disease, using systemic therapy (chemotherapy, hormone therapy and biological agents), whilst Clinical Oncology utilises both radiotherapy and systemic therapy in the treatment of malignant disease.

Why Oncology?

Cancer is a common disease with an estimated 1 in 3 persons in the UK likely to be diagnosed with a malignancy in their life-time¹. Nearly all of us will have had the experience of a close friend or family member who has been diagnosed with cancer. Such a diagnosis is associated with anxiety and concern for the future. It is this uniqueness about patients with cancer that is powerfully motivating to Oncologists. Oncologists have a deep desire to change the course of the disease for patients with cancer; cure where possible and when a cure is not possible to extend and improve the quality of life remaining and provide effective palliation of symptoms. This was my motivation for considering a career in Oncology.

Training

Both Clinical and Medical Oncology specialty training begins after Core Medical Training (CMT) which includes completion of MRCP(UK). Clinical Oncology training is supervised through the Royal College of Radiologists and Medical Oncology through the Royal College of Physicians. All Oncology Training schemes follow a structured curriculum and deliver training in cancer basic sciences and the management of malignant disease. During training, most trainees rotate from the main (base) hospital to other hospitals in order to gain a wide experience of practice. In Northern Ireland, trainees are based at the Cancer Centre, Belfast City Hospital and attend clinics at each of the four Cancer Units.

During Clinical Oncology specialty training, the Fellowship Examination of The Royal College of Radiologists (FRCR) must be attained. The First FRCR Examination, taken after one year of speciality training covers the basic sciences of medical physics, medical statistics, radiobiology, cell biology and clinical pharmacology. Most trainees sit the Final FRCR Examination two years later and this tests the basic management of most common and some less common malignant diseases. The final phase of training after FRCR allows the trainee to broaden and deepen their experience in one or two disease sites. Most trainees spend some time abroad to gain experience with a novel treatment technique and some will use this time for research. The minimum total duration of training is five years before becoming eligible for the Certificate of Completion of Training (CCT). Medical Oncology training is shorter with a minimum of 4 years to CCT. Medical Oncology trainees are strongly encouraged to undertake a period of research during their specialist training and many take time out to complete an MD or PhD fellowship. Medical Oncology trainees must sit a Speciality Certificate Examination, usually in their penultimate year of training.

What Is An Oncologist's Working Week Like?

Oncology is a very clinically focused specialty, with much of the working week spent in direct patient contact in outpatient clinics, in the radiotherapy department, and on the wards. Clinical Oncologists will spend at least one session per week in the technical planning of radiotherapy for individual patients. Contributing to research through clinical trials or translational research is integral to patient management so Oncologists, and in particular Medical Oncologists, will devote some time to this during the working week.

What Qualiities Are Necessary For Being An Oncologist?

Teamwork is very important for both specialities and most oncologists work as part of a tumour site-specific multidisciplinary team of specialty nurses, radiographers, physicists, surgeons and other clinicians, all of whom must integrate and communicate effectively. Good communication skills are essential to patient management and team-working. Given the accelerating rate of new drug and radiotherapy technologies, Oncologists must have a desire to develop and implement new treatments in their clinic. Above all an Oncologist must have empathy for patients facing what may be a concerning and serious diagnosis.

How To Apply?

If you think Oncology is for you, speak to Consultants and Trainees in the speciality. General advice includes gaining a good grounding in general medicine and surgery during the Foundation Programme, getting a place on a Core Medical Training (CMT) rotation (possibly including a placement in medical or clinical oncology or palliative medicine), undertaking clinical audit, spending some time finding out about how the cancer services work in the UK and passing the MRCP examination. Recruitment and selection into both specialities in England, Wales and Northern Ireland is carried out through a nationally coordinated process run on behalf of the Colleges by the Kent, Surrey and Sussex (KSS) Deanery and applications are via a dedicated website: http:// oncologyrecruitment.nhs.uk/.

Finally...

Fancy pursuing an exciting career with new therapeutic opportunities at frontier of human biology? Considering doing a job that can make a huge difference to patients? Then come do Oncology!