Oncology as a career
• Managing and treating patients with cancer
• Two distinct career pathways – medical and clinical
oncology
• Medical oncology – use of chemotherapy and
targeted agents + involvement clinical trials
• Clinical oncology – radiotherapy mainly but also
some chemotherapy and trial involvement
• Don’t forget other specialties: haem/surgery/pall
care
Good points to the job
• High degree of patient involvement and
management
• Interesting and changing medical field – new
developments occurring continually
• Many opportunities to be involved in research
• Rewarding
Lung cancer: 1995
Advanced
NSCLC
Platinum doublet
chemotherapy1
Median survival
7.9 months1
Best supportive care
Lung cancer: 2009 and beyond
Advanced
NSCLC
Wild-type EGFR
NSCLC
Squamous
NSCLC
Mutant EGFR
NSCLC
Non-Squamous
NSCLC
gefitinib5
Platinum doublet
Chemo: not pem or bev1
Docetaxel2
monotherapy
Pem-cisplatin doublet
Chemo7 / carbo/taxol±
bev8
Erlotinib3
monotherapy
Erlotinib3
monotherapy
Best supportive care
Pemetrexed4
monotherapy
Median survival
24.3 months6
Maintenance
Difficult points to the job
• High degree of patient involvement and
management – can be intense!
• Can be emotionally stressful
• Hard work
Personal qualities which make it enjoyable
• Good communication skills
• Interest in academic medicine
• Enjoyment of working in multi-disciplinary
teams
• Commitment to the specialty including hard
work, both clinically and academically
• An ability to delegate and influence decisions
as well as to make sound clinical judgements
under difficult, emotional pressure
Average day as an oncology registrar
• Outpatient clinic – seeing new patients and patients
undergoing treatment
• Prescribing and planning new chemotherapy /
radiotherapy
• Ward based work – junior team + ward rounds /
family discussions
• Managing queries on patients and treatment from
day unit
• On-call overnight (from home)
My week
Monday
Tuesday
Wednesday
Thursday
Friday
Ward round
Journal club
Lower GI
clinic
Upper GI
MDM
Upper GI
clinic
Course/admin Ward round
HPB clinic
Lower GI
clinic
Ward round
Course
Admin
Medical oncology training pathway
Competition
Consider carefully the likely levels of competition involved and to be
prepared to be flexible about choices
2011: CLINICAL ONCOLOGY – ST3 national training numbers
TOTAL:
39
95
1:2.4
Competition
2011: MEDICAL ONCOLOGY – ST3 national training numbers
TOTAL:
33
92
1:2.8
Academic Clinical Fellowships
2013 in London/KSS
• Medical Oncology ST3+:
– 3 posts:
• Imperial College London at Hammersmith Hospital (1
post)
• ICR and Royal Marsden (2 posts); UCL (1 post)
• Clinical Oncology ST3+:
– 1 post:
• ICR and Royal Marsden
The Good News
MEDICAL SPECIALTY WORKFORCE FACTSHEET
The chart above shows an expansion in
the workforce since 1997, at an
increasing rate of change during the
past five years, and the supply of
Medical Oncology consultants is
forecast to increase during the next
decade
www.cfwi.org.uk/.../medical-oncology...medical.../attachment.
Academic training
2 pathways
-Most medical oncology trainees complete PhD degrees
-MSc. In oncology also during registrar years (everyone)
-2 pathways
- ‘normal’ training number, OOP for MD/PhD
- NIHR Academic Clinical Fellowship (ST3 onwards
for medical oncology)
Academic Pathway
FY 1 & 2
Academic foundation
programme in oncology
ST 1 & 2
Core medical
c training +
MRCP
ST 3, 4 & 5
Specialist training in
oncology + specialist
exam
Not required for entry into later
academic programme but an advantage
N.B in some deaneries run-through
programmes are available + Cambridge
integrated system
PhD or completion
of training
Academic Training
• Academic training available in oncology in
foundation years (FY1 and 2)
• Then can continue from ST3 after completing
core medical training
• Designed to allow doctors to gain experience of
research (though some already have experience
• Involves one block of 4months research in
foundation years
• Then 3 months each year during specialist
oncology training - (~3 available in London/yr)
• Designed to work up to starting a PhD (though
most non-academics also complete PhD’s)
Building CV…
•
•
•
•
•
•
•
FY/ST job in oncology/haematology
Case reports
Audit
Poster presentations
Clinics
MRCP
Trust oncology post
Our pathways
• Research degree prior to medicine, then academic
medical oncology training
• ACF medical oncology
• ‘Normal’ registrar, taken time out for PhD
Further info on academic programmes at
• http://www.stfs.org.uk/tfs-academic-foundationprogramme-recruitment
• http://www.londondeanery.ac.uk/var/recruitment/a
cademic-training/vacancies/medical-oncology-st3acf-2001
Related links
– Joint Royal Colleges of Physicians Training Board
http://www.jrcptb.org.uk/trainingandcert/ST3SpR/Pages/Oncology.aspx
– London Deanery
http://www.londondeanery.ac.uk/specialtyschools/medicine-and-medical-specialties
– Association of Cancer Physicians
http://www.cancerphysicians.org.uk/
– Academic training
http://www.nihrtcc.nhs.uk/intetacatrain/