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Careers in Oncology
Patients undergoing treatment for cancer are found in almost every facet of healthcare from acute medicine to general practice. Whilst oncologists are the primary co-ordinators of care in the treatment of most cancer cases, increasing multidisciplinary interaction has fortified the involvement of associated medical specialties like radiology, surgery and palliative care, alongside allied professions like nursing and pharmacy. Academic research is vital to the process, innovating and inspiring the therapies that provide lasting benefit for patients with cancer.
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Clinical and Medical Oncology
Oncology broadly divides into two specialties: Clinial Oncology and Medical Oncology. Whilst both involve the management of patients with cancer, each differs in the techniques and approaches used.
Medical Oncology
Medical oncologists specialise in the use of systemic treatments like chemotherapy, hormone therapies and biological therapies to combat cancer. A number of cancers are treated without radiotherapy and these are usually under the care of a medical oncologist.
A career in medical oncology is strongly rooted in academic work and many people who choose this specialty will have experience and interest in research as well as clinical work. Medical oncologists tend to be academic, enthusiastic doctors who are commited to patient care and have a strong interest in the introdution of promising new treatments following clinical trials. Their work is focused on evidence-based care, refining and improving therapies for patients with severe disease. Teaching opportunities at both undergraduate and postgraduate levels are plentiful and research is actively encouraged; large cancer charities are a brilliant source of funding for PhDs and MDs.
Qualities of an Oncologist:
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Academic - a strong focus on research and scientific advancement
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Enthusiastic - a hard-working individual commited to improving quality of life for patients
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Team Player - cancer care is extremely multi-disciplinary
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Good Communicator - understanding patient concers, explaining complex ideas and breaking bad news are all part of the job
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Compassionate - dealing with patients and their families affected by cancer requires empathy, tact and compassion
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Professional - a well-rounded physician
Medical Oncology involves the treatment of solid cancers such as breast, lung and bowel tumours. Often, oncologists sub-specialise to deal with specific types of cancer and most of their work is hospital based, either aiming to cure cancer or palliate symptoms to prolong survival. As such, oncology is an extremely rewarding specialty in which clinicians make an invaluable difference to patients and their families at some of the most difficult times in their lives. The specialty is also well-supported due to close interaction with multidisciplinary teams.
Cancer patients come in all shapes and sizes and from every kind of background. However, the variation in different tumours is mirrored by the variation in patients themselves; an ex-miner with lung cancer who has always smoked presents very different challenges to a breast cancer patient who is an adamant advocate of alternative therapies. Explaining complex treatment schedules and having difficult discussions mean that oncologists are often excellent communications who are both diplomatic and accomodating.
Training Programme: Core Medical Training then ST3+ in Medical Oncology +/- Academic Work
Postgraduate Exams: MRCP +/- PhD/MD
Clinical Oncology
Clinical oncologists specialise in the use of similar therapies but also incorporate radiotherapy into their management regimes. Like medical oncology, clinic oncology has strong links to research and provides an excellent balance between intellectual challenge and highly rewarding patient care.
Most of a clinical oncologist's work is outpatient-based although patients sometimes require admission as their cancer progresses or complications arise from treatment. Multidisciplinary involvement is crucial to the management of these patients and contact with professionals across the country allows the specialty to remain up-to-date with modern technological advances.
Like medical oncology, clinical oncology requires excellent patient skills. Patients' first appointment with an oncologist is often their first opportunity to raise their concerns and discuss questions about what lies ahead. The treatment process too is a frightening and intensive time which requires excellent, supportive care and a great deal of empathy and understanding. Clincal oncologists tend to be caring, empathetic, good at communicating and
excellent team players.
Training Programme: Core Medical Training then ST3+ in Clinical Oncology +/- Academic Work
Postgraduate Exams: MRCP and FRCR +/- PhD/MD
For Further Information
Oncology Training Wales - http://www.oncology-training-wales.org.uk/
BMJ Careers - http://careers.bmj.com/careers/advice/Training_in_clinical_oncology
GMC Oncology Careers - http://www.gmc-uk.org/education/medical_oncology.asp
Associated Medical Specialties
Palliative Care
Palliative care is the specialty concerned with the care of terminally ill patients and their families. A significant proportion of palliative care patients have active active cancer and holistic, multidisciplinary management of patients' final months requires compassionate and motivated doctors.
Training programme: CMT, CST or GPVT, then ST3+ in Palliative Medicine
Postgraduate Exams: MRCP or nMRCGP
Useful information: https://www.jrcptb.org.uk/specialties/palliative-medicine
Surgery
Surgery encompasses a broad range of inter-related subspecialties managing many patients with solid tumours. Whilst cancer treatment commonly includes chemo-therapy and radiotherapy, surgery remains integral to successful management.
Training programme: CT + ST in General/Specialised Surgery +/- Academic Work
Postgraduate Exams: MRCS (+/- PhD)
Useful information: http://surgicalcareers.rcseng.ac.uk/trainees/foundation-core-trainee/whats-my-next-step
Radiology
Haematology
Radiologists are experts in the use of imaging tests which are essential to the accurate diagnosis, staging and treatment of most cancers. Radiology is an invaluable tool in the arsenal against cancer and is a specialty well-suited to those with analytical minds and a keen eye for detail.
Training programme: CT, then ST1-ST5 in Clinical Radiology
Postgraduate Exams: FRCR
Useful information: http://careers.bmj.com/careers/advice/A_career_in_radiology
General Medicine
Haemato-oncology is a specialised branch of haematology dealing with haematological malignancies like the leukaemias and lymphomas. This is a rapdily evolving specialty with many exciting new breakthroughs that have significantly accelerated both understanding and treatment of these diseases in recent years.
Training programme: CMT, then ST3+ Haematology
Postgraduate Exams: MRCP and FRCPath exams (+/- PhD)
Useful information: https://www.jrcptb.org.uk/specialties/haematology
General Practice
General medical physicians regularly encounter cancer in many forms, be it small cell lung cancer on a respiratory ward or hepatocellular carcinoma on a gastro ward. Since different cancers can affect patients of all ages and backgrounds, every facet of general medicine involves the recognition and care of those with cancer.
Training programme: CT + ST in General/Specialised Medicine +/- Academic Work
Postgraduate Exams: MRCP (+/- PhD)
Useful information: https://www.jrcptb.org.uk/specialties/general-internal-medicine-gim
General practitioners are often the first clinician to suspect and discover active cancer when an unwell patient first sees them. Their roles in screening, diagnosis, referal and public education award them a vital role in the recognition and treatment of cancer, as well as in its prevention.
Training programme: GP Vocational Training
Postgraduate Exams: nMRCGP
Useful information: http://www.rcgp.org.uk/membership/~/media/Files/Membership/RCGP-So-you-want-to-become-a-GP-2013.ashx
CMT - Core Medical Training
CST - Core Surgical Training
GPVT - General Practitioner Vocational Training
CT - Core Training
ST - Specialty Training
MRCP - Membership to the Royal College of Physicians
MRCS - Membership to the Royal College of Surgeons
FRCR - Fellow of the Royal College of Radiologists
nMRCGP - Membership to the Royal College of GPs
FRCPath - Fellow of the Royal College of Pathologists
Academic Research
Purely academic careers are the remit of talented scholars and researchers from either a clinical background or a scientific one. Some healthcare professionals decide to focus primarily on laboratory work after a fulfilling career in clinical practice whilst others take a dedicated career break to pursue academic interests.
Scientists usually progress from undergraduate to masters level and then to doctoral (PhD) level during their careers. Broadly speaking, biomedical scientists choose either an industry-focused pathway, such as working for a pharmaceutical company, or an academic-focused pathway, centred around disease research. Most researchers will earn their doctoral degree and then go on to pursue an area of research interest such as the role of a specific molecule in a type of human cancer, researching intensively and testing hypotheses experimentally.
Traditionally, medicine and the scientific disciplines are closely intertwined. Modern medical practice links 'bench' and 'bedside' together in a way that allows practice to inspire research whilst research itself benefits practice. Indeed the General Medical Council identify that doctors are to be both scientists and scholars as well as physicians.
Academic work, to varying degrees, is an accessible and important aspect of most doctors' careers. Certain training programmes, such as the Academic F1 or Clinical Academic Training (CAT) schemes, incorporate academic rotations and research alongside clinical medicine, and laboratory research projects and audits are a common feature of most careers in medicine. Many consultants are also doctoral (PhD) scholars and have extensively researched an area of particular relevance to their own niche of clinical practice.
Training Programme: Academic Foundation Programme, then an Academic Clinical Fellowship with a Higher Degree. It is possible to transfer to an academic career path at any stage in a medical career
Postgraduate Exams: Membership/Fellowship Exams +/- Masters +/- PhD/MD
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