“So you want to be an oncologist...”

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Oncology – commonly known to many as the medical specialty centered on the study of tumours and cancers – encompasses 2 main branches: Medical Oncology and Clinical Oncology. Medical Oncology involves non-surgical management of malignant diseases by using alternative therapies including chemotherapy, hormone therapy and biologics whilst the realm of Clinical Oncology includes both radiotherapy and systemic therapy in treatment methods. 

 

Training pathways in both Medical and Clinical Oncology comprise of core training and higher specialty training. Regardless of the branch of oncology one is looking to pursue, post foundation years training begins with core training which may be completed in either a 2-year Core Medical Training (CMT) programme or a 3-year Acute Care Common Stem (ACCS) training programme, during which trainees would be able to gain exposure to the investigation methods, treatment strategies and diagnosis processes for patients with acute and chronic medical symptoms while developing skills for managing inpatients and outpatients. Core training culminates in an examination for the Membership of the Royal College of Physicians UK, also known as  MRCP (UK) for short. 

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Following which, higher specialty training commences, enabling trainees to build on the skills acquire during core training to develop competencies required to practice independently as a clinical or medical oncologist. 

This is also where training pathways diverge for the two different branches of Oncology: 

 

Clinical Oncology training is supervised through the Royal College of Radiologists. Trainees have to complete the first Fellow of the Royal College of Radiologists (FRCR) examination – covering basic sciences of medical physics, medical statistics, radiobiology, cell biology and clinical pharmacology – during their clinical oncology intermediate training years (ST3 and 4). Most trainees then sit the final FRCR examination 2 years later. The final FRCR examination is divided into 2 parts, with the primary focus being on management of cancer patients. The final phase of Clinical Oncology training enables trainees to deepen their understanding in one or two disease sites and many trainees take the opportunity to participate in overseas electives or research projects. After the total duration of training, trainees are eligible for the Certificate of Completion of Training (CCT). 

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On the other hand, Medical Oncology training is supervised through the Royal College of Physicians and is a shorter training programme. Higher specialty training for Medical Oncology lasts for a duration of 4 years, after which trainees must sit a Specialist Certificate Examination (SCE) in Medical Oncology, which is a pre-requisite for attainment of CCT. Medical Oncology trainees are often encouraged to undertake research during their training years and in fact, some opt to take time out of training to complete an MD or PhD fellowship. 

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