Consultant physicians working with patients - Royal College of ...

2 Specialties Medical oncologyset by the ACP and the medical oncology specialistadvisory committee (SAC).The academic nature of medical oncology is recognisedwithin the curriculum and the award of a Certificate ofCompletion of Training (CCT) recognises time spent inresearch. In addition, the National Institute for HealthResearch (NIHR) has established a number ofacademically based training opportunities in which 30current trainees have basic and translational researchembedded in their training programme.Clinical governanceWith its tradition of audit and research, medicaloncology is strongly oriented towards maintainingclinical standards and effectiveness. The rigours ofresearch governance through good clinical practice(GCP), 10,11 which defines standards for the conduct ofclinical research, prepare medical oncologists fordelivery of high standards in routine practice. Medicaloncologists lead and support audits which are anessential part of the peer-review process; these includethe NICE assessment and implementation of new drugs.Research – clinical studies and basic science Medical oncology is a research-based specialty.Therapy is in a constant state of evolution,depending on the latest, validated, clinical research.Medical oncologists must be competent andcommitted clinical scientists, whether working inacademiccentresorcancerunits. Ithasbeendemonstratedthatpatientstreatedwithin a clinical trial fare better. The NationalCancer Research Network (NCRN) has set a targetof 10% of cancer patients to be entered intorandomised clinical trials. All medical oncologistsare expected to support this activity. Many will haveundertaken laboratory research during training(obtaining a PhD or MD) and can develop andsupport translational, pharmacological and basicclinical research.Local, regional and national dutiesMedical oncologists are increasingly involved in rolessuch as: leadership of tumour group at trust or network level leadership and involvement in drug and therapeuticcommittees leadership of acute oncology teams leadership in guideline development clinical service lead/medical director roles regional specialty advisers education programme leadership/trainingprogramme directors educational and clinical supervisors for trainees leads for tumour-specific research groups – local,network and national regional and national committees – RCP, ACP, JCCOand national working parties.Specialty and national guidelinesMost medical oncologists contribute to continuingdevelopment of comprehensive guidelines for themanagement of different cancers through regionalprotocols and national guidelines, often through NICE,IOG, 5 specialist societies, JCCO and NCRN.Medical oncologists have also led work for the ‘Map ofMedicine’ and national information pathways tosupport patients at key points during their cancerjourney, through partnership with Cancer Research UK(www.cancerresearch.org) and Macmillan CancerSupport (www.macmillan.org.uk).Quality tools and frameworksAs indicated in other sections, through development ofrobust databases and prescribing systems andcontribution to the development of guidelines that arefollowed nationally, medical oncologists are at theforefront of creating benchmarks for clinicallymeaningful outcomes through audit, peer review andother quality assessment tools.6 Clinical work of consultantsHow a consultant works in this specialtyThe medical oncologist is the leader and coordinator ofan extended team of professionals through regularMDT meetings, and will attend one or more each weekdepending on the volume of work and sitespecialisation. This should be a maximum of threetumour sites because of the increasing range andcomplexity of treatments and patient numbers.Most cancer patients receive their care in the outpatientsetting and day-care wards. Patients may be admitted fordiagnosis, treatment and management of complications.All medical oncologists manage patients with multiplecomorbidities and treat critically ill patients withoncological emergencies. Medical oncologists supportacute medicine through provision of the acute oncologyservice.C○ Royal College of Physicians 2013 157