Apologize for not responding to any of the prior questions. If any of you need further advise, feel free to reach me at daiwee @ ummc (dot) edu (dot) my. I may not reply very quickly but I will try my best to answer any queries on oncology training in Malaysia.
7.5.21
Guidance in oncology training
It has been a long time since I last updated this blog. I have qualified as a clinical oncologist since December 2020 and I am currently practicing in Sabah.
5.8.18
How to pass FRCR Part 1?
The most common question I get is how to study for FRCR Part 1. So here are some pointers.
General recommendations
1. Just sign up for the exam. You won't study until you feel the pain of paying for the exam. Trust me.
2. I recommend attempting all 4 papers at the first attempt, regardless how unprepared you are. There are no formal question bank for you to practice thus attempting the exam is your only way of understanding the depth and breadth of the syllabus.
3. Go through the syllabus for every subject you are studying.
https://www.rcr.ac.uk/clinical-oncology/specialty-training/clinical-oncology-curriculum
Molecular biology
1. Most people will start with this subject. Large volume of knowledge to go through. Try to understand the molecular pathways. Lots of memorizing unfortunately but you just have to do it.
2. Recommended books
- Basic Science of Oncology by Ian Tannock. 5th Ed.
- Molecular Biology of Cancer by Lauren Pecorino. 3rd Ed.
Radiobiology
1. Took me forever to understand this subject but after going through the materials numerous times, I fell in love with it. Once you get it, it sticks with you forever.
2. Recommended books
- Radiobiology for the radiologist by Eric Hall.
- Basic Clinical Radiobiology by Albert J van der Kogel.
- ASTRO MCQ questions
3. I recommend starting with Eric Hall's book first. In fact some of the molecular biology topics are very well explained in this book.
4. Molecular biology and radiobiology are tested in 1 paper. Thus depending on your strength and weakness, one subject can help you to score more marks. I personally relied more on radiobiology.
5. Institut Kanser Negara organized a masterclass in radiobiology October last year, not sure if they will organize it again.
Pharmacology
1. Another subject you need to memorize a lot.
2. Make sure you check the updated list of drugs the RCR is including in the syllabus. It's updated almost yearly. They really do not test you on other drugs beyond the list.
3. Chemotherapy drugs constitute most of the questions but do not forget about basic pharmacology and supportive drugs i.e analgesia, bone targeting agents and anti-nausuea/vomiting.
4. Recommended books
- Basic Science of Oncology by Ian Tannock. 5th Ed (Many people are surprised but there are in fact 3 chapters of pharmacology in this book)
- ESMO Handbook on Clinical Pharmacology. https://oncologypro.esmo.org/Education-Library/Handbooks/Clinical-Pharmacology-of-Anti-Cancer-Agents
- BC Cancer Agency (google BCCA followed by cisplatin, docetaxel, epirucibin etc)
5. UM organizes a yearly pharmacology masterclass usually in March.
Physics
1. Weakness of many, but once you understand the subject, things will make sense.
2. Spend time in the radiotherapy suite and ask your radiographers and physicists about how things work. Dreadful in the beginning but this subject in the basis of your clinical radiotherapy practice.
3. If you can, I recommend attending the Physics course in the Christie Hospital in Manchester, organized in May every year. Cost a bomb but the quality is so good and everything made sense to me after attending the course.
4. Recommended books
- Physics for Clinical Oncology by Amen Sibtain (orange book)
- Radiation Oncology Physics: a handbook for teachers and students
Medical statistics
1. Try attending the research methodology and statistics course in your hospital.
2. Please be equipped with Good Clinical Practice course as early as possible. Understanding of clinical trials is integral in oncology. I am surprised that many who are pursuing oncology have not done the GCP. It is a requirement for conducting investigator-initiated trial and also participating in industry-sponsored clinical trials.
3. Recommended books
- Medical Statistics at a glance.
- The MCQ companion of 'at a glance' book. http://www.medstatsaag.com/mcqs3.asp
Summary
FRCR Part 1 is not an easy examination. But with hard work and perseverance, it can be achieved. Most people I know require 2 attempts to pass all subjects so do not be discouraged if you don't pass all during the first attempt. All the best if you're attempting the exam. May the odds be in your favor.
General recommendations
1. Just sign up for the exam. You won't study until you feel the pain of paying for the exam. Trust me.
2. I recommend attempting all 4 papers at the first attempt, regardless how unprepared you are. There are no formal question bank for you to practice thus attempting the exam is your only way of understanding the depth and breadth of the syllabus.
3. Go through the syllabus for every subject you are studying.
https://www.rcr.ac.uk/clinical-oncology/specialty-training/clinical-oncology-curriculum
Molecular biology
1. Most people will start with this subject. Large volume of knowledge to go through. Try to understand the molecular pathways. Lots of memorizing unfortunately but you just have to do it.
2. Recommended books
- Basic Science of Oncology by Ian Tannock. 5th Ed.
- Molecular Biology of Cancer by Lauren Pecorino. 3rd Ed.
Radiobiology
1. Took me forever to understand this subject but after going through the materials numerous times, I fell in love with it. Once you get it, it sticks with you forever.
2. Recommended books
- Radiobiology for the radiologist by Eric Hall.
- Basic Clinical Radiobiology by Albert J van der Kogel.
- ASTRO MCQ questions
3. I recommend starting with Eric Hall's book first. In fact some of the molecular biology topics are very well explained in this book.
4. Molecular biology and radiobiology are tested in 1 paper. Thus depending on your strength and weakness, one subject can help you to score more marks. I personally relied more on radiobiology.
5. Institut Kanser Negara organized a masterclass in radiobiology October last year, not sure if they will organize it again.
Pharmacology
1. Another subject you need to memorize a lot.
2. Make sure you check the updated list of drugs the RCR is including in the syllabus. It's updated almost yearly. They really do not test you on other drugs beyond the list.
3. Chemotherapy drugs constitute most of the questions but do not forget about basic pharmacology and supportive drugs i.e analgesia, bone targeting agents and anti-nausuea/vomiting.
4. Recommended books
- Basic Science of Oncology by Ian Tannock. 5th Ed (Many people are surprised but there are in fact 3 chapters of pharmacology in this book)
- ESMO Handbook on Clinical Pharmacology. https://oncologypro.esmo.org/Education-Library/Handbooks/Clinical-Pharmacology-of-Anti-Cancer-Agents
- BC Cancer Agency (google BCCA followed by cisplatin, docetaxel, epirucibin etc)
5. UM organizes a yearly pharmacology masterclass usually in March.
Physics
1. Weakness of many, but once you understand the subject, things will make sense.
2. Spend time in the radiotherapy suite and ask your radiographers and physicists about how things work. Dreadful in the beginning but this subject in the basis of your clinical radiotherapy practice.
3. If you can, I recommend attending the Physics course in the Christie Hospital in Manchester, organized in May every year. Cost a bomb but the quality is so good and everything made sense to me after attending the course.
4. Recommended books
- Physics for Clinical Oncology by Amen Sibtain (orange book)
- Radiation Oncology Physics: a handbook for teachers and students
Medical statistics
1. Try attending the research methodology and statistics course in your hospital.
2. Please be equipped with Good Clinical Practice course as early as possible. Understanding of clinical trials is integral in oncology. I am surprised that many who are pursuing oncology have not done the GCP. It is a requirement for conducting investigator-initiated trial and also participating in industry-sponsored clinical trials.
3. Recommended books
- Medical Statistics at a glance.
- The MCQ companion of 'at a glance' book. http://www.medstatsaag.com/mcqs3.asp
Summary
FRCR Part 1 is not an easy examination. But with hard work and perseverance, it can be achieved. Most people I know require 2 attempts to pass all subjects so do not be discouraged if you don't pass all during the first attempt. All the best if you're attempting the exam. May the odds be in your favor.
16.7.17
Masters of Clinical Oncology in UM
So if you have decided to pursue Masters in Clinical Oncology (MCO) in UM
Let me take you through the process, speaking from my experience.
* Disclaimer: Please do check with the most current requirements, dates etc via KKM and UM websites. Things I say now may be outdated. Also I am not representing the faculty and/or MOH. It's all personal experience and my own opinion.
Step 1: Graduate from medical school.
If you're still in medical school and perhaps want a stint in oncology, you can consider doing an elective in an oncology department during your 4th or 5th year, whether in Malaysia or overseas.
Step 2: Finish your housemanship.
This will take 2 years.
Step 3: Being a medical officer
I know that the hospital and department that we get may not be in our control, if you have an interest you can always express them to the Jabatan Kesihatan Negeri (JKN) when you report for duty.
If you have decided to pursue oncology, there are 2 main ways to go around this.
A) Apply to be in oncology department after housemanship
This depends on vacancy. Currently there are 6 oncology departments in the country, Penang, HSI JB, HKL, IKN Putrajaya, Likas (Kota Kinabalu), and SGH (Kuching).
As you work in the oncology department and if you really love it, express your interest to the head of department that you aim to pursue MCO. Then depending on the number of doctors in the department, the HOD will arrange for you to do 1 year of non-oncology posting to fulfill the MCO entry requirement. This 1 year may be segmented or continuous, as long as collectively you have 1 year.
Some examples are (Y = year, M = month)
1Y Oncology 1Y Medicine then back to Oncology
1Y Oncology 6M Medicine 6M Surgery then back to Oncology
1Y Oncology 4M Medicine 4M Oncology 4M Surgery 4M Oncology 4M ENT
For me I did
1.8Y Oncology 4M Medicine 2M Hemato 2M Chest 3M Surgery 1M Orthopedic Oncology
B) Apply to be medicine/surgery/O&G/pediatrics after housemanship.
This applies to be doctors who only gained interest in oncology later on, or those who are not in a place where there's no oncology service or those who are unable to get into oncology department.
What you can do is gain minimum 1 year of experience in those respective department, then apply for a transfer to oncology department later on.
What posting should I do?
This may or may not be in your control. Depending on the hospital and department heads. If you have a say, I strongly suggest a good mix of general medicine and general surgery. Yes these are busy departments but the knowledge and skills you gain in these core postings are very relevant later on because cancer patients have many general medical/surgical problems.
Step 4: Apply for MCO
So you have decided to apply. First make sure you're eligible ( this rule applies to all clinical masters program in Malaysia)
3 years SKT BY THE TIME OF APPLICATION
They must be 85 points and above, consecutively.
For example,
Started housemanship 1st May 2014, SKT 2014: 85 marks
Then SKT 2015: 85 marks
Then SKT 2016: 85 marks
At this juncture, technically you have 3 SKT scores but you're still NOT eligible for masters application, because your 2014 SKT is not a FULL year, i.e. from 1st Jan to 31st Dec.
Then SKT 2017: 85 marks
By this time, you may apply during July 2018 for the June 2019 intake. ( I hope you see the time gap)
So usually by the time you APPLY, you would have been an MO for minimum 1.5 - 2 years, and by the time you START masters, you would have been an MO for minimum 2.5 to 3 years if you get in by first attempt.
Once you fulfill the requirement, submit your application for Hadiah Latihan Persekutuan via MOH. Application opens in July each year (Google HLP KKM) Application period is only 1 month so do not wait until last minute because you need time to get some documents signed by the HOD and the Hospital Pengarah (director).
Then you wait. If you're shortlisted, then you will be called for an interview by the UM faculty. There's no entrance exam, and the interview is only 1 round. This is usually held in December or January, in UMMC or UM faculty of medicine.
Then you wait again, lots of waiting. Announcement of acceptance are usually released via the HLP website around end of April. Then in May there will be a lot of paperwork for submission to both MOH and UM, an orientation to attend, and lots of farewell!
I hope this gives you an insight of the whole process. Overall it's quite similar for all clinical masters program, just the entry pre-requisite may be slightly different.
Let me take you through the process, speaking from my experience.
* Disclaimer: Please do check with the most current requirements, dates etc via KKM and UM websites. Things I say now may be outdated. Also I am not representing the faculty and/or MOH. It's all personal experience and my own opinion.
Step 1: Graduate from medical school.
If you're still in medical school and perhaps want a stint in oncology, you can consider doing an elective in an oncology department during your 4th or 5th year, whether in Malaysia or overseas.
Step 2: Finish your housemanship.
This will take 2 years.
Step 3: Being a medical officer
I know that the hospital and department that we get may not be in our control, if you have an interest you can always express them to the Jabatan Kesihatan Negeri (JKN) when you report for duty.
If you have decided to pursue oncology, there are 2 main ways to go around this.
A) Apply to be in oncology department after housemanship
This depends on vacancy. Currently there are 6 oncology departments in the country, Penang, HSI JB, HKL, IKN Putrajaya, Likas (Kota Kinabalu), and SGH (Kuching).
As you work in the oncology department and if you really love it, express your interest to the head of department that you aim to pursue MCO. Then depending on the number of doctors in the department, the HOD will arrange for you to do 1 year of non-oncology posting to fulfill the MCO entry requirement. This 1 year may be segmented or continuous, as long as collectively you have 1 year.
Some examples are (Y = year, M = month)
1Y Oncology 1Y Medicine then back to Oncology
1Y Oncology 6M Medicine 6M Surgery then back to Oncology
1Y Oncology 4M Medicine 4M Oncology 4M Surgery 4M Oncology 4M ENT
For me I did
1.8Y Oncology 4M Medicine 2M Hemato 2M Chest 3M Surgery 1M Orthopedic Oncology
B) Apply to be medicine/surgery/O&G/pediatrics after housemanship.
This applies to be doctors who only gained interest in oncology later on, or those who are not in a place where there's no oncology service or those who are unable to get into oncology department.
What you can do is gain minimum 1 year of experience in those respective department, then apply for a transfer to oncology department later on.
What posting should I do?
This may or may not be in your control. Depending on the hospital and department heads. If you have a say, I strongly suggest a good mix of general medicine and general surgery. Yes these are busy departments but the knowledge and skills you gain in these core postings are very relevant later on because cancer patients have many general medical/surgical problems.
Step 4: Apply for MCO
So you have decided to apply. First make sure you're eligible ( this rule applies to all clinical masters program in Malaysia)
3 years SKT BY THE TIME OF APPLICATION
They must be 85 points and above, consecutively.
For example,
Started housemanship 1st May 2014, SKT 2014: 85 marks
Then SKT 2015: 85 marks
Then SKT 2016: 85 marks
At this juncture, technically you have 3 SKT scores but you're still NOT eligible for masters application, because your 2014 SKT is not a FULL year, i.e. from 1st Jan to 31st Dec.
Then SKT 2017: 85 marks
By this time, you may apply during July 2018 for the June 2019 intake. ( I hope you see the time gap)
So usually by the time you APPLY, you would have been an MO for minimum 1.5 - 2 years, and by the time you START masters, you would have been an MO for minimum 2.5 to 3 years if you get in by first attempt.
Once you fulfill the requirement, submit your application for Hadiah Latihan Persekutuan via MOH. Application opens in July each year (Google HLP KKM) Application period is only 1 month so do not wait until last minute because you need time to get some documents signed by the HOD and the Hospital Pengarah (director).
Then you wait. If you're shortlisted, then you will be called for an interview by the UM faculty. There's no entrance exam, and the interview is only 1 round. This is usually held in December or January, in UMMC or UM faculty of medicine.
Then you wait again, lots of waiting. Announcement of acceptance are usually released via the HLP website around end of April. Then in May there will be a lot of paperwork for submission to both MOH and UM, an orientation to attend, and lots of farewell!
I hope this gives you an insight of the whole process. Overall it's quite similar for all clinical masters program, just the entry pre-requisite may be slightly different.
15.7.17
How to become an oncologist in Malaysia?
This is a common question I get from fellow doctors who are considering oncology as a career.
In Malaysia there is only training in clinical oncology ( i.e. we do both medical and radiation oncology). There are a few medical oncologists in the country and they were all trained abroad e.g. Singapore, this is consider a sub specialty training within internal medicine.
There are two pathways to qualify as oncologist in Malaysia.
1. Masters in Clinical Oncology awarded by Universiti Malaya.
This is the main pathway and I strongly recommend this route.
Duration - 4 years
Institution - Universiti Malaya (the only university that offers this)
Hospitals - UM medical center, UKM medical center, Institut Kanser Negara in Putrajaya, Hospital Kuala Lumpur ( rotate between these hospitals)
Number of candidates per year: 16 in the latest cohort, has been increasing over the years.
Entry requirement (not exclusive, just highlighting the key points here)
- For Hadiah Latihan Persukutuan (scholarship from MOH): Minimum 3 years SKT, 85 marks and above ( full year means that the SKT was given to a full year of service, if one of the SKT was given to an incomplete year then it doesn't count). You must have this BY THE TIME OF APPLICATION
- For Universiti Malaya: Minimum 1 year of non-oncology experience (as a medical officer) within internal medicine, surgery, O&G or pediatrics (sub specialty within these fields also counted). Can be 1 year in 1 department, combination of different postings. This 1 year experience must be done within the last 5 years. You must have this experience BY THE TIME OF ENROLLMENT. (which means you may be in the midst of this non-oncology posting by the time you APPLY, and that's OK)
Oncology experience is PREFERRED.
Application opens around July every year, for enrollment in the subsequent June. If shortlisted you will be called for an interview in December or January by the faculty. Application is via HLP and not via UM. Search HLP KKM regularly to check.
2. Fellowship in Royal College of Radiologist (FRCR - Clinical Oncology)
This is an external examination offered by the Royal College of Radiologist. We are governed under the same Royal College as the radiologists but it's not the same exam.
FRCR - Clinical Oncology has 3 parts i.e. part 1, 2a and 2b.
There are two ways to go about this if you're based in Malaysia.
A) Sit for all 3 parts on your own. That's if you're very determined. Part 2a and 2b can be challenging without UK experience. (that's what I heard anyway, I am not there yet) I have only heard about 1 person passing all parts without UK experience. Upon passing the whole FRCR, you may apply to gazette as an oncologist.
For me I feel this pathway is very difficult as there's no formal training. Clinical oncology training involves a lot of skills development ( a bit like surgeon) in radiotherapy planning. It's unlike any other Royal College examination that you just study and pass.
B) Sit and pass part 1 on your own, then apply for an overseas HLP. Only very few candidates have been through this pathway. Essentially the idea is MOH let you go off for 2 years in the UK (you will need to secure the position in UK on your own) and pass part 2a and 2b within those two years and return to Malaysia.
I feel there are a few limitations with this pathway. Mainly the budget constraint. MOH has cut down a lot of overseas HLP due to budget constraint and given that the UM Masters is getting more established, it's very uncertain whether this pathway will be readily available. Imagine investing all your effort in this path, and then you get denied by HLP, or unable to get a training position in UK... the possibility seems quite high.
Many people asked me about FRCR. My personal take is do not depend on FRCR alone. My guess is many people are trying to avoid masters altogether, the stress, the relocation, the exams plus thesis, family commitment etc. But I think it just make sense to do masters, 'cause oncology training is a bit like surgical training, the skill development is so important. An oncologist who doesn't know how to do radiotherapy is like a surgeon who doesn't know how to cut.
Aim to do the masters in clinical oncology in UM ( reason being it's a safe option and training is structured). And if you want to do both masters and FRCR, you're more than welcomed to.
I will blog about how to study for FRCR part 1 in the next post, stay tuned.
In Malaysia there is only training in clinical oncology ( i.e. we do both medical and radiation oncology). There are a few medical oncologists in the country and they were all trained abroad e.g. Singapore, this is consider a sub specialty training within internal medicine.
There are two pathways to qualify as oncologist in Malaysia.
1. Masters in Clinical Oncology awarded by Universiti Malaya.
This is the main pathway and I strongly recommend this route.
Duration - 4 years
Institution - Universiti Malaya (the only university that offers this)
Hospitals - UM medical center, UKM medical center, Institut Kanser Negara in Putrajaya, Hospital Kuala Lumpur ( rotate between these hospitals)
Number of candidates per year: 16 in the latest cohort, has been increasing over the years.
Entry requirement (not exclusive, just highlighting the key points here)
- For Hadiah Latihan Persukutuan (scholarship from MOH): Minimum 3 years SKT, 85 marks and above ( full year means that the SKT was given to a full year of service, if one of the SKT was given to an incomplete year then it doesn't count). You must have this BY THE TIME OF APPLICATION
- For Universiti Malaya: Minimum 1 year of non-oncology experience (as a medical officer) within internal medicine, surgery, O&G or pediatrics (sub specialty within these fields also counted). Can be 1 year in 1 department, combination of different postings. This 1 year experience must be done within the last 5 years. You must have this experience BY THE TIME OF ENROLLMENT. (which means you may be in the midst of this non-oncology posting by the time you APPLY, and that's OK)
Oncology experience is PREFERRED.
Application opens around July every year, for enrollment in the subsequent June. If shortlisted you will be called for an interview in December or January by the faculty. Application is via HLP and not via UM. Search HLP KKM regularly to check.
2. Fellowship in Royal College of Radiologist (FRCR - Clinical Oncology)
This is an external examination offered by the Royal College of Radiologist. We are governed under the same Royal College as the radiologists but it's not the same exam.
FRCR - Clinical Oncology has 3 parts i.e. part 1, 2a and 2b.
There are two ways to go about this if you're based in Malaysia.
A) Sit for all 3 parts on your own. That's if you're very determined. Part 2a and 2b can be challenging without UK experience. (that's what I heard anyway, I am not there yet) I have only heard about 1 person passing all parts without UK experience. Upon passing the whole FRCR, you may apply to gazette as an oncologist.
For me I feel this pathway is very difficult as there's no formal training. Clinical oncology training involves a lot of skills development ( a bit like surgeon) in radiotherapy planning. It's unlike any other Royal College examination that you just study and pass.
B) Sit and pass part 1 on your own, then apply for an overseas HLP. Only very few candidates have been through this pathway. Essentially the idea is MOH let you go off for 2 years in the UK (you will need to secure the position in UK on your own) and pass part 2a and 2b within those two years and return to Malaysia.
I feel there are a few limitations with this pathway. Mainly the budget constraint. MOH has cut down a lot of overseas HLP due to budget constraint and given that the UM Masters is getting more established, it's very uncertain whether this pathway will be readily available. Imagine investing all your effort in this path, and then you get denied by HLP, or unable to get a training position in UK... the possibility seems quite high.
Many people asked me about FRCR. My personal take is do not depend on FRCR alone. My guess is many people are trying to avoid masters altogether, the stress, the relocation, the exams plus thesis, family commitment etc. But I think it just make sense to do masters, 'cause oncology training is a bit like surgical training, the skill development is so important. An oncologist who doesn't know how to do radiotherapy is like a surgeon who doesn't know how to cut.
Aim to do the masters in clinical oncology in UM ( reason being it's a safe option and training is structured). And if you want to do both masters and FRCR, you're more than welcomed to.
I will blog about how to study for FRCR part 1 in the next post, stay tuned.
12.7.17
What is oncology?
Oncology - a branch of medicine specialized in cancer
Oncologist - a doctor that is specialized in oncology
What kind of oncologist are you?
Within the oncology world, there are a few type of doctors with different area of specialization.
1. Medical oncologist
Oncologist that treat cancer with systemic treatment e.g. chemotherapy, hormonal therapy, targeted therapy, immunotherapy etc.
2. Radiation oncologist
Oncologist that treat cancer with radiation e.g. external beam radiotherapy, brachytherapy etc.
3. Clinical oncologist
Oncologist that is a hybrid between medical oncologist and radiation oncologist. Trained to do both systemic treatment and radiation.
4. Oncology surgeon
A surgeon that is specialized performing surgery for cancers.
They are divided according to the body site i.e. breast and endocrine surgeon, neurosurgeon, ENT surgeon, colorectal surgeon etc.
5. Gynecology oncologist
A special mention of this area. Gynecology oncologists are first trained as obstetrics & gynecology, thereafter further train in gynecology oncology i.e. female genital tract cancers. They are also a hybrid of a medical oncologist and oncology surgeon i.e. giving chemotherapy and performing surgeries for female genital tract cancers
Why the differences between medical, radiation and clinical oncologists?
Some feel that oncology is too broad and should be separated between medical and radiation oncology. Some feel that 1 oncologist should do both.
Currently, UK and Malaysia train mainly clinical oncologists. (not sure about other countries).
Whereas US, Singapore, Australia train medical and radiation oncologist.
For me I feel there are pros and cons in both approaches. I enjoy being a clinical oncology trainee as I get best of both worlds but the downside is there's so much to do!
I will blog about the pathways of becoming an oncologist in Malaysia in the next post. Stay tuned.
Oncologist - a doctor that is specialized in oncology
What kind of oncologist are you?
Within the oncology world, there are a few type of doctors with different area of specialization.
1. Medical oncologist
Oncologist that treat cancer with systemic treatment e.g. chemotherapy, hormonal therapy, targeted therapy, immunotherapy etc.
2. Radiation oncologist
Oncologist that treat cancer with radiation e.g. external beam radiotherapy, brachytherapy etc.
3. Clinical oncologist
Oncologist that is a hybrid between medical oncologist and radiation oncologist. Trained to do both systemic treatment and radiation.
4. Oncology surgeon
A surgeon that is specialized performing surgery for cancers.
They are divided according to the body site i.e. breast and endocrine surgeon, neurosurgeon, ENT surgeon, colorectal surgeon etc.
5. Gynecology oncologist
A special mention of this area. Gynecology oncologists are first trained as obstetrics & gynecology, thereafter further train in gynecology oncology i.e. female genital tract cancers. They are also a hybrid of a medical oncologist and oncology surgeon i.e. giving chemotherapy and performing surgeries for female genital tract cancers
Why the differences between medical, radiation and clinical oncologists?
Some feel that oncology is too broad and should be separated between medical and radiation oncology. Some feel that 1 oncologist should do both.
Currently, UK and Malaysia train mainly clinical oncologists. (not sure about other countries).
Whereas US, Singapore, Australia train medical and radiation oncologist.
For me I feel there are pros and cons in both approaches. I enjoy being a clinical oncology trainee as I get best of both worlds but the downside is there's so much to do!
I will blog about the pathways of becoming an oncologist in Malaysia in the next post. Stay tuned.
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