This is a 5 year training programme (ST3 – ST7) leading to the acquisition of the Fellowship of the Royal College of Radiologists (FRCR) and to the award of the Certificate of Completion of Specialist Training (CCST) in clinical oncology. The training programme consists of 6 monthly rotations through different tumour sites to acquire a broad knowledge of cancer and gain clinical experience in all aspects of clinical oncology, as per the 2010 Specialty Training Curriculum.
Severn Postgraduate Medical Education's Clinical Oncology Training Programme has 9 whole time equivalent trainees.
Please use the links below to find out more.
Hospitals in the training programme
Our trainees are based at the Bristol Haematology and Oncology Centre (BHOC) for at least 3 years with rotations to the Department of Oncology at the Royal United Hospital (RUH), Bath (6 months to 1 year) and to the Gloucestershire Oncology Centre located at Cheltenham General Hospital (CGH) (1 year). This ensures a wide exposure to cancer practice across the region. Both Cheltenham and Bath are within commutable distance from Bristol.
Please see below for more information about the training offered at each of these Centres.
Bristol Haematology and Oncology Centre
BHOC is the cancer treatment centre for Bristol, North Somerset and South Gloucestershire and is part of the Avon, Somerset and Wiltshire Cancer Network. The centre serves a catchment population of about 2.2 million people and receives about 6000 new referrals each year. There are 13 consultant clinical oncologists and 4 consultant medical oncologists.
It has 6 linear accelerators (linacs), 4 with electron facilities and all with on-set verification. One linac has on board cone beam imaging. Intensity Modulated Radiotherapy (IMRT) is used extensively in the treatment of patients with head and neck cancers and prostate cancers. BHOC is a specialist centre for stereotactic radiosurgery and stereotactic radiotherapy for brain tumours. There is a dedicated theatre suite for administering gynaecology and prostate high dose rate brachytherapy. There are 2 conventional simulators and one CT simulator. Outlining is done using the Oncentra treatment planning system, which also allows fusion with MRI images. An open MRI scanner is housed in the building.
BHOC is also the specialist centre in the South West for patients with testicular cancer and sarcoma. It also delivers radiotherapy for children in the region and is the designated centre for teenage and young adult cancer services.
There are 2 wards with 45 oncology/haematology beds to care for patients receiving treatment and for those who develop treatment side effects. There are 2 ‘hot’ rooms for radioisotope treatments. In addition, there is an acute oncology 4 bedded bay. Chemotherapy is delivered mostly on an outpatient basis in the chemotherapy day unit, but also in a satellite clinic in the community and at home in partnership with Healthcare at Home. There is a very close working relationship with the palliative care team and the psychological health services, both of which are based within the building. The clinical trials unit is very active at recruiting patients into National Cancer Research Institute (NCRI) and commercial trials.
Department of Oncology at the Royal United Hospital, Bath
The RUH oncology team provides a comprehensive service for the Bath, Somerset and Wiltshire local health community and is also part of the Avon, Somerset and Wiltshire Cancer Network. It provides cancer services for a population of 500,000 and diagnoses approximately 2200 new cases of cancer each year. The RUH oncology service is closely linked with BHOC. The oncology team is made of 4 consultant clinical oncologists, 2 consultant medical oncologists, 1 associate specialist and 1 specialty doctor. One of the 2 linacs has on board cone beam imaging and volume modulated arc therapy (VMAT) capability. This is currently being used to deliver more precise and quicker IMRT treatment for head and neck cancers and will soon be extended to the treatment of prostate cancers. There is also 1 superficial voltage machine and a conventional simulator. William Budd ward houses 21 oncology/haematology beds. Over the next few years, the Cancer Services in Bath will be expanding to a new building.
Gloucestershire Oncology Centre at Cheltenham General Hospital
The Gloucestershire Oncology Centre is located at Cheltenham General Hospital and serves a catchment population of just over 1 million people living in Gloucestershire, Herefordshire and South Worcestershire and parts of Shropshire and Powys. It is part of the 3 Counties Cancer Network. The team is made of 11 consultant clinical oncologists, 1 consultant medical oncologist and 6 specialty doctors.
The radiotherapy department has 5 linacs, 3 of which have electron facilities and on board cone beam imaging. A sixth linac operates as a backup. There is one superficial voltage machine, one conventional simulator and one CT simulator. Outlining is done using the Pinnacle treatment planning system. The Centre offers high dose rate brachytherapy for gynaecological cancers and permanent iodine seed low dose rate brachytherapy for patients with prostate cancer.
Chemotherapy is delivered in the chemotherapy day units at Cheltenham, Hereford and Worcester and on mobile units around the 3 counties. There are 2 oncology wards, Lilleybrook and Rendcombe with 44 haematology/oncology beds. In addition, there is a 4 bedded chemotherapy helpline bay. The Clinical Trials department is very active at recruiting patients on trials.
Education and training
Clinical oncology trainees are required to pass the FRCR examination. The Part 1 FRCR examination consists of 4 modules - Cancer Biology and Radiobiology, Pharmacology, Medical Statistics and Physics - and can be taken at the end of the first year of training. The Part 2 FRCR examination can be taken after 3 years of training and consists of a written component (part A) and of a clinical component (part B). In the first year, our trainees attend a formal teaching programme that covers all the basic science needed for the training and examination. Within Severn Postgraduate Medical Education, the trainee attends the weekly teaching course organised by the London Institute of Cancer Research (ICR).
Some trainees choose to attend the 2nd year of the ICR teaching course as preparation for the Part 2 FRCR. Trainees are also encouraged to attend the South West regional FRCR Part 2 preparatory course. This is a ‘third year course’, which runs over 4 months across Bristol, Cheltenham and Cardiff. Trainees’ timetables are adjusted so they can attend the relevant courses. All the consultants are committed to one to one teaching nearer the exams.
In house teaching
In addition to the above, there is in house StR teaching, which consists of a half day protected teaching every month in Bristol. Regional training days rotate monthly across the South West and South Wales and cover a wide range of oncology topics and more generic skills. Over the last year, we have successfully implemented a 2 week rotation in physics pre part 1 and part 2 exams. There is excellent clinical supervision from all consultants throughout the training.
Trainees are assigned an educational supervisor as well as clinical supervisors and have access to the RCR eportfolio. They are expected to keep a record of their progress and to complete workplace based assessments. These include Case-Based Discussion, miniCEX, DORPS (assessment of radiotherapy planning), DOST (assessment of systemic therapy planning), Multi-Source Feedback, Teaching Observation and Audit Assessment and will be used during the annual review of competence progression (ARCP).
Research, audit and teaching
There is plenty of opportunity throughout the training to take part in clinical audits, teaching and research projects. Some of our trainees have chosen to complete the 3 year MSc in oncology with the ICR. Others have obtained postgraduate qualifications via distance learning courses in medical education, law and ethics. Following attainment of the FRCR, trainees are encouraged to develop their own subspecialty interest and there is support for out of programme experience. Severn PGME trainees have taken time out of programme to undertake either a period of research (MD or PhD in translational or clinical research or in psychosocial oncology) or a fellowship in a cancer centre of excellence (in the UK or abroad).
An example of a job plan
The training programme consists of 6 monthly rotations through different tumour sites to acquire a broad knowledge of cancer and gain clinical experience in all aspects of clinical oncology, as per the 2010 Specialty Training Curriculum. Trainees rotate through core cancer sites in the first 3 years and more specialised cancer sites in years 4 and 5.
The job plan is adjusted so trainees can attend relevant courses. There are dedicated radiotherapy planning sessions (radical physics planning and simulator sessions).
For a first year trainee, this would be a typical job plan:
Lung new patient
FRCR part 1 course
Breast chemotherapy and follow up clinic
Breast new patient clinic
Lung follow up and chemotherapy
Radiotherapy physics planning
FRCR part 1 course
Less than full time training and application for out of programme experience are fully supported by Severn PGME.