Striking the right balance in oncology

Career choice

After completing my two-year foundation training programme, I struggled with my next career steps. It wasn't until I worked in New Zealand that I really considered oncology. It felt truly unique as a specialty and when I returned to the UK to undertake core medical training, I was lucky enough to have a further oncology rotation. At that point, my career choice was cemented.

I find oncology truly interesting: the variety of patients, the challenge of disease and symptoms, together with a rapidly changing landscape with innovative treatments. Along with encouragement from great consultants, I applied for clinical oncology and it's a choice I haven't regretted.

It was in 2019, following the birth of my daughter that I returned to work at 60%, which felt like the right balance at that time. As life settled down and I welcomed my second child in 2021, I increased my workload to 80%. Now, in my final year of training, I work full-time, with 80% in training and one day a week out-of-programme.

Many people may worry that working LTFT may prevent them from acquiring the skills or confidence necessary to manage the changes happening within oncology. However, in my experience, LTFT trainees gain more radiotherapy experience and clinical acumen over time, which is advantageous for specific aspects of the curriculum, such as the FRCR Part 2 exams. LTFT trainees may also rotate through a tumour site more than once and have access to acute oncology training and project opportunities.

I know that many trainees are now choosing to work LTFT for a variety of reasons. Cancer centres may offer 'job-share' training, or - as in mine - standalone jobs ranging from 60-100% training. The Royal College of Radiologists actively acknowledges the importance of fair and high-quality training for LTFT trainees and has clear guidance and support for job plans. Oncology is also set up to support out-of-programme opportunities for LTFT trainees.

Supported by my peers

People may occasionally have perceptions that someone working LTFT is less ambitious, but such views are misguided and thankfully, few and far between. For much of my experience as an LTFT trainee, I have felt supported by my colleagues and peers. As professionals, it can be frustrating to see fellow full-time peers qualify ahead of you, but it's important to remember why you have chosen to work LTFT, whether for family, personal or other reasons. It's all about trying to strike the right balance.

Process

The process of applying to train LTFT was easy, but it is important to have those discussions with your training programme director (TPD) as early as possible. The process has changed recently, with two windows/sittings available each year. For anyone struggling, or if you have an unexpected change in circumstances, it's important to reach out to your TPD for support.

My advice for anyone who may be considering a career in oncology but is perhaps unsure about the feasibility of working LTFT is to 'go for it'. Oncology is a specialty that needs people with passion and enthusiasm for the job and there are well-established LTFT opportunities for both trainees and consultants.