UK Training Pathway for Clinical Oncologists

  • May 02, 2022

The NHS specialty training programme for clinical oncologists is recognised around the world. The quality and depth of oncology training and career development in the UK is recognised as a gold standard across the globe, making it a major attraction for many IMGs when considering a career in the UK. 

The NHS training programme for oncology trainees is regularly reviewed and updated, in keeping with advances and progression in the landscape of oncology around the world and throughout the profession.  

In this article, we will explore the training pathway for clinical oncologists in the UK, covering the following topics: 

Skip ahead to the relevant section if you know what you’re looking for. 

The NHS Training Pathway for Clinical Oncologists 

The NHS training pathway refers to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training and being awarded a CCT. 

It is a good idea for overseas trainees to familiarise themselves with this as it helps to provide an understanding of at what stage they can most likely enter the system, either in a training or non-training post.  

Entering the NHS Training Pathway 

After graduating from medical school, doctors receive provisional GMC registration, allowing them to enter the Foundation programme (a two-year work-based training programme). 

Upon completion of the first year of this programme (FY1), doctors will gain full GMC registration with license to practice and will be able to apply for further study and training in a specialised area i.e. medicine. This is known as Internal Medicine Training (IMT), formerly known as Core Training (CT). 

Specialty Training in Clinical Oncology 

The Specialty Training programme in Clinical Oncology runs over a 6-year period, and doctors will usually take the indicated time, or slightly longer to complete the Specialty Training programme. 

Successful applicants entering into year one of specialty training (ST1), will follow the Royal College of Radiologists’ 2021 Clinical Oncology Specialty Training Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.  

Clinical oncology training as an uncoupled programme 

Clinical oncology specialty training begins at ST3, so after foundation training, there are two options open to trainees before they can start specialist clinical oncology training: 

  • Internal Medical Training (IMT) 
  • Acute Care Common Stem (ACCS) 

For IMT, this is a two-year training period and the ACCS training programme lasts 3 years. 

Both pathways are followed by an open competition to enter a higher specialty training post. It is important to note that the application following core training is competitive and does not guarantee a specialty training post. 

Clinical oncology higher specialty training is indicatively a five-year clinical training programme (including Oncology Common Stem), leading to single accreditation in clinical oncology. 

There are a few critical progression points during higher specialty training in clinical oncology, and trainees will also be subject to an annual review of progress via the ARCP process. They will have to complete all the curriculum requirements including passing the MRCP and FRCR (Oncology) exams prior to obtaining CCT

Foundation Training (FY1 – FY2) 

The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills and forms the bridge between medical school and speciality training. 

This first year of Foundation Training (or FY1) is referred to as an internship. For IMGs applying for GMC registration, it is essential you can meet the requirements for an internship.  


Here, trainees will either choose to either Internal Medicine Training (IMT), Acute Care Common Stem training (ACCS), or training to become a general practitioner (GP Training).  

Specialty Training (ST1 – ST7) 

Internal Medicine Stage 1 Training (ST1 – ST2)  

Year one trainees begin at ST1 of the Internal Medicine Training Programme. In this first stage, trainees develop a solid foundation of professional and generic clinical capabilities, preparing them for participation in acute medicine at a senior level and to manage patients with acute and chronic medical problems in outpatient and inpatient settings. The curriculum for IMT Stage 1 Training can be found here

The two-year training period culminates in trainees sitting the MRCP (UK) exams. For more information on the Royal College of Physicians examination suite, take a look at our IMG Resources library here

Please note, trainees must have gained full MRCP prior to beginning Specialty Training in Oncology. 


Here, trainees will either choose to continue with Internal Medicine Training for a further year, to continue with training in a specialty that supports acute hospital care, or to provide primarily out-patient based services in e.g. oncology. 

Clinical oncology recruitment into ST3 posts usually occurs after 2 years of Internal Medicine Stage 1 training. However, trainees who complete the full three-year IMT programme are also eligible and there is no preferential selection for trainees who have completed either two or three years of training. 

Oncology Common Stem (ST3) 

The Oncology Common Stem (OCS) has a duration of one year and usually takes place in year 3 of specialty training (ST3). Here, the focus is on a trainee’s development of generic capabilities-in-practice (CiPs) expected of all doctors, as well as the common CiPs relating to the key areas of overlap between medical and clinical oncology. 

Clinical Oncology and Medical Oncology are the two main medical specialities that manage patients with non-haematological malignancy. They often work in partnership with each other, and both offer systemic therapy to patients, but only clinical oncologists administer radiotherapy and there are other differences in work-pattern, approach and focus. 

During OCS training, trainees will gain knowledge of radiotherapy planning and delivery. This will enable them to coordinate the care of cancer patients with the wider multidisciplinary team (MDT), managing patients throughout a treatment pathway. 

The new curricular structure of the OCS means that trainees who successfully complete the training year will have gained the necessary competencies to progress to ST4 in either clinical or medical oncology. 

For oncologists wishing to pursue clinical oncology, the first exam in the Fellowship of the Royal College of Radiologists assessment series, First FRCR (Oncology) (Part 1/ CO1), must be passed by the end of ST4. 

Candidates do not need to have held a clinical oncology training post to attempt the exam however, so candidates are eligible to sit the exam during ST3. 

Click here to learn more about the full FRCR (Oncology) examination suite. 

Clinical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST7) 

Once trainees have completed the OCS, they will then move onto a subsequent higher specialty-specific programme of their choice I.e. clinical oncology. This programme lasts for four years and takes place from ST4 to ST7, the focus here being to acquire clinical oncology specific CiPs, culminating in trainees’ achievement of Fellowship of the Royal College of Radiologists (FRCR Oncology)

The higher specialty-specific programme for clinical oncologists is administered by the Royal College of Radiologists, so the Medical Oncology SCE is not a requirement for clinical oncologists. 

Trainees will then sit the Final FRCR (Oncology) Part 2A and 2B exams (CO2A and CO2B), usually from ST6 to ST7. This is to assess their knowledge and skills related to the investigation of malignant disease and the care and management of patients with cancer. 

Completion of the Clinical Oncology Specialty Training Programme 

Upon completion of the clinical oncology training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Clinical Oncology. This will be based on high-level learning outcomes – capabilities in practice (CiPs) set out in the curriculum by the Royal College. You can find the 2021 curriculum here

At this point, clinical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register for clinical oncology and can now take permanent consultant posts in the NHS. 

Specialist Registration for overseas doctors 

Doctors who completed part or all of their clinical or radiation oncology training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here

Joining the Clinical Oncology Specialty Training Programme as an IMG 

It is possible for overseas doctors to join the Specialty Training programme in Clinical Oncology in the UK, however it is very competitive.  

IMGs interested in UK specialty training must have: 

  • Full GMC registration  
    • Completion of a minimum 12-month (FY1 equivalent) internship 
    • English language test 
    • PLAB or a recognised European Medical Degree 


  • 12 months post-internship experience by the time you start begin ST1 

Please note, whilst UK trainees are not given priority for specialty training spaces, it can be extremely difficult to join the Specialty Training programme if you do not have previous NHS experience. 

So there you have it, the NHS Specialty Training pathway for clinical oncology trainees. The training programme forms the basis of clinical oncology training in the UK, and for overseas clinical or radiation oncologists interested in joining the training programme, good knowledge of the pathway allows you to better understand the alignment of your overseas training with the relevant stage of Specialty Training for clinical oncology in the UK. 

For regular news and updates on the Royal College and all things oncology, follow IMG Connect on social media using the links below: 



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