Clinical Oncology

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Clinical Oncology

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

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Overview

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

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My Training

• GKT Medical School, 1999-2004
• House Officer, KCH Lewisham, 2004-05
• SHO Barts 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-

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Clinical Oncology

• 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), p355365

Henk JM. A brief history of British radiotherapy.
Int J Radiat Oncol Biol Phys  199636(1) 213-8.
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Multi-disciplinary Team for Radiotherapy

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

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Radiotherapy Planning
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Radiotherapy Set-up Delivery
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IMRT
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Typical Working Week
Mon Tues Weds Thurs Fri
RT Audit Meeting Ward Round MDM then Clinic Clinic Clinic
Clinic RT Planning RT Planning Ward Round Admin
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Clinical Oncology UK

• 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

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

• 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

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Research

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

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Clinical Oncology StR NTN Competition Ratios
Year Applicants Posts Competition Ratio
2012 R1 118 33 3.61
2011 R1 95 40 2.41
2011 R2 30 15 21
2010 117 47 2.51
http//oncologyrecruitment.nhs.uk/clinical/useful/
competition_ratios
http//careers.bmj.com/careers/advice/view-article
.html?id20004464
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Elective Opportunities

• 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/

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Resources

• 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.asp
  x
• 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/advic
  e/view-article.html?id725
• Institute of Cancer Research - Oncology MSc
• http//www.icr.ac.uk/education/clinical_trainees/m
  sc_oncology/index.shtml
• http//careers.bmj.com/careers/advice/view-article
  .html?id20001851