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Clinical oncology (Radiotherapy)

There are 14 (whole-time equivalent) clinical oncology trainee posts in south Wales, divided between two training centres; Velindre Cancer Centre in Cardiff and Singleton Oncology Centre in Swansea.

There is a separate Clinical Oncology training programme in North Wales with three posts (whole time equivalent). Trainees are based at the North Wales Cancer Treatment Centre, Glan Clwyd Hospital, and link in with the Clatterbridge Cancer Treatment Centre. Trainees gain experience in Clatterbirdge in Paediatric Radiation Oncology and Brachytherapy.

South Wales programme: In addition, trainees attend out-patient clinics in most of the district general hospitals in South and West Wales.

The South Wales Clinical Oncology Training programme prides itself on its flexibility and its trainee centred approach. Many trainees take advantage of research fellowships, out-of programme activities and less than full time training to provide them with strong CVs, excellent clinical skills and unique experiences, also enabling them to achieve a good work-life balance.

Trainees are well supported by a structured local educational programme, regional training days and attendance at key courses nationally. With the annual Ian Kirby Travel prize or the support of your consultants, it may also be possible to attend or present at international meetings.

What is clinical oncology?

Clinical oncology is the non-surgical management of malignant disease, using both radiotherapy and systemic therapy (chemotherapy, hormone therapy and biological agents). Managing cancer in all its various forms requires an enquiring mind, a secure general medical background, good practical skills and a commitment to patient care.

Due to an ageing population, new therapeutic advances and an increased number of survivors, clinical oncology is an expanding speciality. The speciality attracts high levels of support from the public and cancer charities enabling research and service development to continue in the current financial climate.

Clinical oncology is a clinically focused specialty, with much of the working week spent in direct patient contact in outpatient clinics and on the wards. Some practical skills are required for instance in brachytherapy (internal radiotherapy) where radioactive implants are inserted under radiological guidance.

The challenging nature of the diseases means that using and contributing to research through clinical trials or translational research is integral to patient management. A period of time in research during training is encouraged and may lead to a higher degree.

Teamwork is very important. Most clinical oncologists work in multidisciplinary teams of specialist nurses, radiographers, physicists, surgeons and other clinicians, all of whom must integrate and communicate effectively. Good communication skills are important, both in patient management and team working.

Clinical oncology specialist training begins after Core Medical Training (CMT) and MRCP is required for entry. Applicants are advised to obtain some experience in clinical or medical oncology or palliative care during their pre-specialist training, but this is not mandatory.

The Royal College of Radiologists sets the standards and curriculum for specialist training in clinical oncology, leading to the award of a Certificate of Completion of Training (CCT).

During specialist training, success must be achieved in the Fellowship Examination of The Royal College of Radiologists (FRCR). The First FRCR Examination covers the cancer basic sciences of medical physics, medical statistics, radiobiology, cell biology and clinical pharmacology. It is usually taken after a year of specialist training. All trainees will receive comprehensive teaching on these topics, usually within their weekly timetable.

Most trainees are ready to sit the final FRCR examination two years later, having learnt the basic management of all common and some less common malignant diseases.

The final phase of training after the FRCR Examination allows the trainee to broaden and deepen his or her experience, and provides time for research and gaining the management skills that are so important to a career as an NHS consultant.

The total duration of training is five years but this is often extended by periods out of programme for research or by less than full time training.

Post CCT, most clinical oncologists will develop a sub-specialist interest in a smaller number of tumour sites and nearly all clinical oncologists are actively involved in clinical trials or other research activity.

With rapid advances in many aspects of oncology including new radiotherapy techniques and pharmacological advances you will find that you will continue to learn and develop throughout your career.

There is a uniqueness about patients with malignant disease that is powerfully motivating to cancer specialists. Training has never been better or more tightly supervised, and the potential for effective and enlightened management of cancer is enormous at a time when research is at last helping us to understand the biology of these diseases and find effective ways of treating them.

What to do next

Competition for clinical oncology training posts is similar to that for most medical specialties. Prospective trainees are advised to:

  • Get a good CV as a medical student
  • Consider taking an intercalated BSc to learn research and laboratory skills
  • Gain a good grounding in general medicine and surgery during the Foundation Programme
  • Get a place on a Core Medical Training (CMT) rotation, ideally including a placement in medical or clinical oncology or palliative medicine
  • Do some clinical or medical audits
  • Spend some time finding out about how cancer services work in the UK
  • Pass the MRCP examination.

We welcome queries from anyone considering a career in clinical oncology. If you would like advice or would like to discuss getting oncology experience, please contact the Training Programme Director Dr Nachi Palaniappan.

STC Chair for Medical and Clinical Oncology in Wales is Dr Rachel Jones based at Singleton Hospital.

For advice and guidance on becoming a Clinical Oncologist, please go to RCR Advice