The NHS offers an extensive training scheme and career development for medical oncologists, and the quality of this programme is recognised as a gold standard across the medical community.
The training provided to UK medical 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 medical oncologists in the UK, covering the following topics:
Skip ahead to the relevant section if you know what you’re looking for.
The NHS Medical Oncology Training Pathway
The NHS training pathway is the name given to the complete programme undertaken by UK trainees, from medical school to the completion of specialist training within i.e. within medical oncology.
It is important for IMGs to understand this as it helps to provide an understanding of at what stage they can most likely enter the system if they are interested in postgraduate training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors with receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).
Upon completion of the first year (FY1), doctors will gain full registration with the GMC 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 Medical Oncology
The Specialty Training programme in Medical 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 Joint Royal Colleges of Physicians Training Board 2021 Medical Oncology Curriculum, which sets the expected syllabus as well as required assessments and workload case numbers.
Medical oncology training as an uncoupled programme
As medical oncology is a medicine specialty, aspiring oncology trainees will complete a period of core/ internal medicine training that lasts a period of two years.
This is 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.
Medical oncology higher specialty training will be in total (including OCS) an indicative four-year clinical training programme leading to single accreditation in the specialty. There are no critical progression points during higher specialty medical oncology training, though trainees will be subject to an annual review of progress via the ARCP process and will have to complete all curriculum requirements including passing the medical oncology Specialty Certificate Examination (SCE) 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.
Here, trainees will either choose to enter into either Internal Medicine Training or into training to become a general practitioner.
Specialty Training (ST1 – ST6+)
Internal Medicine Stage 1 Training (ST1 – ST2)
In this first stage of the Internal Medicine training programme, 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. You can find the Curriculum for Internal Medicine Stage 1 Training here.
This will culminate 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 pass the MRCP examinations prior to beginning Specialty Training in Medical 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.
Medical oncology recruitment into ST4 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. Here, the focus is on a trainee’s development of the common oncology capabilities relating to the key areas of overlap between the two specialties (medical and clinical oncology), as well as continuing to develop the generic capabilities expected of all doctors.
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.
Medical oncologists will have the scientific understanding which underpins radiation-based cancer treatments. During the OCS training year, 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 curricula for medical and clinical oncology have been aligned to reflect this relationship and include aspects of common training that constitute the Oncology Common Stem (OCS), improving transferability and flexibility for trainees who wish to move between the two specialties.
Please note that medical oncology trainees will not be expected to independently plan or deliver radiation-based cancer treatments.
Medical Oncology Specialty Training & Maintenance of Common Capabilities (ST4 – ST6)
Following successful completion of OCS, medical oncology trainees will complete a subsequent higher specialty-specific programme, this takes place from year 4 – 6. The focus here for trainees is on acquiring medical oncology-specific capabilities, alongside consolidation and further development of the common oncology and generic capabilities.
Trainees will then sit the Medical Oncology Specialty Certificate Examination, usually in the penultimate year of higher specialty training. The globally-recognised exam offers medical oncologists a postgraduate qualification which demonstrates achievement of a standard required of UK specialist trainees.
Please note, the medical oncology SCE is a compulsory component of assessment for the achievement of Certificate of Completion of Training (CCT).
To learn more about the medical oncology SCE, read our detailed blog here.
Completion of the Medical Oncology Specialty Training Programme
Upon completion of the medical oncology training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in Medical 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, medical oncologists are recommended to the GMC for the award of CCT and entry onto the specialist register and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their medical 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 Medical Oncology Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Medical 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
12 months post-internship experience by the time you 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 without prior NHS experience.
So here you have it, the NHS Specialty Training pathway for medical oncology trainees in a nutshell. The training programme forms the basis of medical oncology training in the UK, and for overseas 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 medical oncology in the UK.
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