I was granted an HMDP award to go to the UK to further my training in Clinical Oncology, which deals with all forms of non-surgical treatment of cancer, including radiotherapy, chemotherapy and hormonal therapy. I elected to go to Joint Cancer Centre of Guy's, King's and St Thomas' Hospitals in London. The centre serves a population of nearly 2 million people living in the south east of London. Most of the work in clinical oncology is done at St Thomas' Hospital, which is situated along the banks of the Thames, opposite the Houses of Parliament (Fig 1 and 2).

     
                                               Fig 1 & 2 respectively

The Joint Cancer Centre is a comprehensive cancer centre with facilities to treat most cancers. It also works closely with the Positron Emission Tomography Centre at St Thomas' Hospital, which is one of the busiest in the UK, and the St John's Institute of Dermatology, which treats a large variety of skin malignancies.

I was appointed a Clinical Fellow and had the opportunity to work with the various sub-specialty teams to manage different cancers. I also had a chance to join in the weekly multi-disciplinary team meetings, where we discuss the treatment for all newly diagnosed cancer patients. In addition, there was a weekly Journal Club organised jointly by the Medical and Clinical Oncology specialist registrars, and weekly specialist registrar teaching sessions.

As part of the preparation for the Clinical Oncology examinations, the Royal College of Radiologists organises full-day teaching sessions every week. Specialist Registrars based in London, Cambridge and other surrounding areas are taught in these intensive lecture and practical sessions by consultant medical / clinical oncologists. I found these sessions very useful as they outline the current UK practice of oncology.

I have completed almost a year out of my two-year HMDP. Overall, the experience has been a positive one. The practice of oncology from a UK perspective is interesting, and demonstrates many differences from the Singapore system. Though there are currently some problems with the UK National Health System, mostly to do with funding, there are also many positive aspects which we can emulate. The reliance on multi-disciplinary teams for the management of all oncology patients, and the active enrolment of a high proportion of patients into clinical trials are just two examples.

On the down side, there were some initial hiccups, but many things eventually sorted themselves out. The main problem for many of the trainees in the UK continues to be the high cost of living, in particular, in Central London. Accommodation is scarce, especially for families, and the rent expensive.

To summarise, the experience working in the UK is invaluable for all SingHealth trainees in Radiation Oncology, since we are expected to undertake the UK examinations presided by the Faculty of Clinical Oncology in the Royal College of Radiologists. I find that the training at the Joint Oncology Centre at Guy's, King's and St Thomas' Hospitals very useful both for the examinations and my future career, and would recommend an attachment here to any future trainee. On a personal note, St Thomas' Hospital will remain special to my family because it is also where my second child, Joshua, was born.