In medical training, there are neverending clinical rotations. I completed 4 years of medical school in 2017 (9 years ago). There were 2 maternity leaves along the way.
Foundation Training
Fresh out of medical school, as newly-qualified doctors in the UK, we go through Foundation Training (4 monthly rotations over 2 years) covering different medical, surgical, psychiatric, general practice jobs. Still broad strokes training.
Core Training
Then we decide a path – whether medical, surgical, acute care, etc… Internal Medical Training now just covering solely medical specialties – Resp, Cardio, Gastro, Renal, etc. (4-monthly rotations over 2 or 3 years). As I was heading towards Oncology, I chose the Internal Medical Training (2 years). The road starts to narrow.
Specialty Training
Then we decide our specialty – Resp, Cardio, Gastro, Renal, etc. Most Medical Specialty Training is 4 years, still with rotations. I chose Oncology.
Medical Oncology vs Clinical Oncology Training
When choosing Oncology, training paths further diverge. Medical Oncology training, which entails purely systemic treatment (i.e. whole body treatment, the anti-cancer drugs), with 6-monthly rotations covering different tumour sites over 4 years. Clinical Oncology Training entails systemic AND localised treatment (i.e. the anti-cancer drugs and radiation), with 6-monthly rotations covering different tumour sites over 5 years. The extra year compared with Med Onc training is learning the radiotherapy bit. In other countries, the split is Medical Oncology and Radiation Oncology – the Rad Oncs solely do radiotherapy and leave the drugs to the Med Oncs.
9 years of training, with 2 more to go (on top of 4 years pre-med and 1 year Masters), only to be threatened by Google and AI.
Tumour Sites
Our 6-monthly rotations (November and May) are then tumour sites-specific. I am now midway through training and I have covered Breast, Lower and Upper GI, Lung, Brain, Skin. I just completed Uro-Oncology and have now rotated into Gynae-Oncology and Anal Cancer, continuing on the theme of ‘below the belt’ tumour sites.
Last Tuesday, I joined the Gynae team at the operating theatre for brachytherapy – another form of radiotherapy (i.e. very close proximity radiotherapy). It’s been a while since I’ve been in theatre (Foundation Training). And maybe it’s the novelty of it again. But I enjoyed it. And who knows… Gynae may join the further narrowed path towards the top 2 tumour sites I’d like to finally specialise in.
Flashback: I decided I was heading towards Oncology during my last year in medical school, after an Oncology rotation and managing to publish a Gynae-Onc/Melanoma case report.
Are things going to come full circle? Who knows?
Reach for the Seven Stars 
Ah, this is such a helpful overview, Monica! I’ll have to tell Kai to read it, too. I finally understand the layers of training and how much narrowing down and rotating keeps happening over the years. It’s staggering when you see it all laid out like that!
Ha, “9 years of training, only to be threatened by Google and AI”!! 😂 I always feel slightly guilty when I ask Dr Google… as though a quick search could somehow replace people who’ve spent well over a decade learning how to interpret and safely use all that knowledge in real life!
Also, the possible full-circle moment with Gynae-Onc is really cool. I’m excited to see which route you will take!
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