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

Medical oncology training pathway

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

Competition2011: 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 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/