FRCR P2A. 15 weeks to go. New clinical rotation, new tumour sites.

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.

From the Royal College of Radiologists

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?