Liam Welsh
Clinical Research Fellow & Honorary Senior Registrar
Institute of Cancer Research and
Head & Neck Unit, Royal Marsden Hospital

• My medical training
• About Clinical Oncology
• Radiotherapy Treatment
• Working in Clinical Oncology
• Training in Clinical Oncology
• Opportunities to gain experience

• GKT Medical School, 1999-2004
• House Officer, KCH & Lewisham, 2004-05
• SHO Bart’s SHO Rotation, 2005-07
– Elderly Medicine; Endocrinology & Diabetes
– HIV Medicine; Medical Oncology
• ST2 Royal Free Hospital, 2007-08
– Cardiology; Clinical Oncology
• ST3 Clinical Oncology, RMH, 2008-

• “The total non-surgical management of cancer”
– Curative treatment
– Palliative treatment
– Radiotherapy, chemotherapy, biological therapies, combined treatments
• “Of those cancer patients who are cured it is estimated that 49% are cured by surgery, 40% by radiotherapy alone or combined with other modalities and 11% by chemotherapy alone or combined with other modalities”
– Bentzen et al., (2005) Radiotherapy and Oncology, v75(3), p355 –365
Henk JM. A brief history of British radiotherapy. Int J Radiat Oncol Biol Phys 1996;36(1): 213-8.

• Clinical Oncologists
• Medical Physicists
• Radiotherapy Radiographers
• Radiotherapy Nurses
• Administrative Staff

Mon
Tues Weds Thurs Fri
RT Audit
Meeting
Clinic
Ward
Round
RT
Planning
MDM then
Clinic
RT
Planning
Clinic
Ward
Round
Clinic
Admin

• 2010 RCR Census
– Consultants – 687
– Registrars – 315
– Other grades – 88
• Clinical Oncology Consultants
– 10.6 WTE per million population in UK
– 58% men, 42% women
– 19% work part-time
– Majority of UK cancer centres have 8-14 WTE
Consultant Clinical Oncologists

Foundation Training - FY1 & FY2
Core Medical Training
CMT1 & CMT2
Acute Care Common Stem
ACCS1-3
MRCP
Specialty Registrar Clinical Oncology
StR3-7
FRCR MSc
Research – MD/PhD

StR 1
StR 2
StR3
StR4
First FRCR
ICR MSc Part A
ICR MSc Part B
ICR MSc Part C
Final FRCR Part A (MCQs)
Final FRCR Part B (Clinical & Vivas)
(Research – MD or PhD) StR5
CCT

• First FRCR Examination
– SBA MCQs – 4 papers over 2 days
• Cancer Biology & Radiobiology
• Clinical Pharmacology
• Physics
• Medical Statistics
• Final FRCR Examination
– Part A
• SBA MCQs – 2 papers over 1 day
– Part B
• Clinical cases
• Vivas

• During Clinical Training
– NIHR Academic Clinical Fellowships
• ICR MSc – Part C Research Project
• Post FRCR
– MD (2years) or PhD (3 years)

Year
2012 R1
Applicants Posts Competition
Ratio
118 33 3.6:1
2011 R1
2011 R2
2010
95
30
117
40
15
47
2.4:1
2:1
2.5:1 http://oncologyrecruitment.nhs.uk/clinical/useful/competition_ratios http://careers.bmj.com/careers/advice/view-article.html?id=20004464

• UK Centres
– RMH, Mount Vernon, Christie, Beatson
• Johns Hopkins, Baltimore USA
– GKT Elective Exchange Programme
• Mayo Clinic, Rochester USA
– Visiting Medical Student Clerkships
– http://www.mayo.edu/msgme/visiting-medical-student-clerkships
• University of Toronto, Canada
– https://admin.med.utoronto.ca/utme/
– http://www.radonc.utoronto.ca/

• Royal College of Radiology
– www.rcr.ac.uk
– http://oncologyrecruitment.nhs.uk/clinical/home
• NHS Medical Careers http://www.medicalcareers.nhs.uk/specialty_pages/radiology/clinical_oncology
.aspx
• London Deanery http://oncologyrecruitment.nhs.uk/Clinical/london
• NIHR Academic Clinical Fellowships http://www.nihrtcc.nhs.uk/intetacatrain/
• National Radiotherapy Implementation Group (NRIG) http://ncat.nhs.uk/
• BMJ Careers http://careers.bmj.com/careers/advice/view-article.html?id=725
• Institute of Cancer Research - Oncology MSc
– http://www.icr.ac.uk/education/clinical_trainees/msc_oncology/index.shtml
– http://careers.bmj.com/careers/advice/view-article.html?id=20001851