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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
Advanced NSCLC
Lung cancer: 1995
Platinum doublet chemotherapy1
Best supportive care
Median survival 7.9 months1
Lung cancer: 2009 and beyond
Advanced NSCLC
gefitinib5
Mutant EGFR NSCLC
Median survival24.3 months6
Wild-type EGFR NSCLC
Platinum doublet Chemo: not pem or
bev1
Pemetrexed4
monotherapy
Erlotinib3
monotherapy
Best supportive care
Docetaxel2
monotherapyErlotinib3
monotherapy
SquamousNSCLC
Non-SquamousNSCLC
Pem-cisplatin doublet Chemo7 / carbo/taxol± bev8
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 clubLower GI clinic
Upper GI MDMUpper GI clinic
Course/admin
Ward round
HPB clinic Lower GI clinic
Ward round Course Admin
CompetitionConsider 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
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 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.
The Good News
MEDICAL SPECIALTY WORKFORCE FACTSHEET
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
Academic foundation programme in oncology
FY 1 & 2
ccCore medical training + MRCP
ST 1 & 2
Specialist training in oncology + specialist
exam
ST 3, 4 & 5
PhD or completion of training
PhD or completion of training
Not required for entry into later academic programme but an advantage
N.B in some deaneries run-through programmes are available + Cambridge integrated system
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-foundation-pro
gramme-recruitment• http://www.londondeanery.ac.uk/var/recruitment/a
cademic-training/vacancies/medical-oncology-st3-acf-2001
Related links
– Joint Royal Colleges of Physicians Training Board http://www.jrcptb.org.uk/trainingandcert/ST3-SpR/Pages/Oncology.aspx
– London Deanery http://www.londondeanery.ac.uk/specialty-schools/medicine-and-medical-specialties
– Association of Cancer Physicians http://www.cancerphysicians.org.uk/
– Academic training http://www.nihrtcc.nhs.uk/intetacatrain/