Oncology in the NHS branches into two main sub-specialisms, medical oncology and clinical oncology. Clinical oncology is the branch of oncology more commonly referred to as radiation oncology outside the UK, though a clinical oncologist's duties encompass both systematic and radiotherapy treatments in the UK. Cancer waiting times are one of the most critical performance indicators an NHS trust is judged upon, and as such oncology is an area with significant demand, as despite large numbers of oncologists registered in the UK, the numbers of qualified oncologists is relatively low when compared to vacancy rates. This means there are many fantastic opportunities available both medical and clinical oncologists interested in joining the NHS, with many NHS trusts offering excellent support with CESR, specialty training applications and general career & sub-specialty development and registration support. Leadership roles with significant career development opportunities are also available to most specialists entering the UK system, and generally motivated clinicians looking to develop in any area of specialisation or leadership in the UK will be supported to do so.
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Clinical oncologists often work in specialist cancer hospitals, large acute teaching hospitals, district general hospitals or private sector clients. Radiotherapy treatments sessions, multidisciplinary team meetings, outpatient clinic, consultations and follow-ups, inpatient ward rounds, reports writing for GPs, teaching sessions for juniors and trainees and very importantly, research, will all form part of your working week. Research is an integral part of clinical oncology.
Medical oncologists work to provide the best possible outcome for cancer patients, whether that is cure, or palliation and prolongation of good quality life. In addition, they provide counselling for patients and their families, whilst clinical research is an important feature of their role like clinical oncologists. Clinical care, clinical trials, laboratory and translational cancer research form an integral part of the training, and they are trained to work as part of a multidisciplinary team, being able to advise on all aspects of treatment including surgery and radiotherapy as well as having the skills to administer systemic therapies. A medical oncologists work also includes diagnosing cancers, discussing treatment options with patients, arranging and supervising drug treatment and therapies including the management of any complications that may arise and supporting patients and overseeing their care, including their lives after treatment.
Medical oncologists treat patients who have localised or metastatic malignancy in need of systemic therapy. They also treat patients whose cancer has potentially been cured by surgery but for whom further therapy improves their outlook.
Medical and clinical oncologists often work in partnership together, and clinical oncology covers both the therapeutic administration of ionising radiation (radiotherapy) and cytotoxic chemotherapy. However, only clinical oncologists administer radiotherapy.
NHS Cancer targets work to 85% of patients to start their first cancer treatment for cancer within two months of an urgent GP referral. This timeframe is also applied to patients referred from an NHS cancer screening service however the operational threshold is set at 90%