The Faculty of Radiologists RCSI is the sole body responsible for the training of a specialist in radiation oncology in Ireland and sets the standards in radiation oncology leading to the award of the Fellowship of the Faculty of Radiologists RCSI (FFRRCSI) and the subsequent validation of 5 years of specialist training, recognised by the Medical Council of Ireland for entry onto the Specialist Register.

The objective of the training programme in radiation oncology is to educate and train physicians in the medical specialty of radiation oncology to a level of their recognition as a specialist.

The training programme in radiation oncology has the aim of imparting knowledge and experience in all aspects of the non surgical treatment of cancer, with a special focus on radiation oncology, in a monitored programme, leading to entry on to the Specialist Register of the Medical Council of Ireland, indicating competence to practice as a Consultant Radiation Oncologist.

To be eligible for a radiation oncology specialist training programme, candidates should have completed 3 years of clinical training (1year pre-registration and 2 years post-registration). Specialist training will therefore follow 2 completed years of General Professional Training (GPT), Trainees will hold the title of Specialist Registrar (SpR) and will be selected for training by open competition. They will be appointed following interview by the Faculty of Radiologists RCSI, and assigned to designated training departments.

Specialist Registrars (SpRs) in radiation oncology will undergo a training programme comprising 2 Parts:
(a) Pre FFRRCSI training
(b) Post FFRRCSI training

5 year SpR Training Program in Radiation Oncology Faculty Of Radiologists RCSI

Duties and responsibilities of SpRs

YEAR 1 SpR

It takes time to acquire both the knowledge and skills required in the field of radiation oncology to function independently. Year 1 SpRs are supervised by the consultant to whose team they are attached for a period of 6 months. In addition they are mentored by a more senior SpR attached to the team and by the Hospital Training Co-ordinator in their Radiotherapy Department

The following list serves as a guideline.

General Duties of year 1 SpRs:

• Mandatory infection control course
• Corporate Induction course
• Manual Handling course
• 3 yearly ACLS courses
• Pre-employment Medical Questionnaire

General Clinical Duties:

• Will attend OPD clinics in their Radiotherapy Department under supervision at all times.
• Will attend weekly or twice weekly ward rounds with their teams, and will be expected to support & supervise Medical Oncology SHOs attached to their teams in matters of patient care
• Will field phone calls from Doctors / paramedical staff and patients for the team

Specific Radiotherapy Duties:

• Will attend weekly CPC, lectures and special case conferences where they will be asked to participate in team presentations
• Will attend weekly planning meetings in their designated Radiotherapy Department, where they will be asked to participate in team
• case presentations Will attend weekly simulation and planning clinics under senior supervision
• Will attend weekly “on treatment” clinics

Not permitted to:

• Be “On Call” for the 1st year for Radiotherapy
• Simulate or CT plan alone
• Attend “off site” clinics alone
• Sign port films
• Sign / approve plans

Education & Training:

• Will attend the 1o FFRRCSI lecture course held on Wednesday afternoons for which they receive protected time.
• Will receive lectures during the September – June Academic year in
  • Physics,
  • Radio / Clinical Biology
  • Statistics
  • Pharmacology.
• Are required to attend at least 75% of all lectures. Attendance records are kept in the Medical Board Office.
• Only the Hospital Training Co-ordinator (HTC) is designated to sign out their compliance with this requirement to allow them to apply to the Royal College of Radiologists (RCR) London to sit the First FRCR / 1o FFRRCSI
• Only the HTC is designated to sign out their training grants & application to attend courses and conferences.

YEAR 2 & 3 SpRs

General Clinical Duties:

• Attend new patient assessment clinics
• Attend follow up OPD clinics
• Do twice weekly ward rounds with the SHO
• Have primary supervisory responsibility for the team SHO and report to their consultant
• Undertake general oncology second “on call” in their department, supervising SHOs “on call” in managing urgent medical patient care
• Discuss & organise urgent patient referrals to Radiotherapy Department with referring team members
• Maintain their medical oncology skills

Specific Radiotherapy Duties:

• Attend Simulation clinics & conventionally simulate independantly
• Hand mark skin lesions for orthovoltage therapy (under supervision)
• Virtually simulate breast or pelvis plans independantly
• Part CT plan independently
• Sign port & verification films
• Sign / approve 2D plans
• Attend On treatment (TBS) clinics
• Observe at least 3 HDR cervix brachytherapy procedures (from insertion to check CT to planning to treatment delivery) in year 2
• They will present at weekly planning Meeting
• They will present at CPC conferences

YEAR 3 SpRs

• Will be proficient in Vaginal Vault brachytherapy procedures
• Will be present to sign out Vaginal Vault brachytherapy treatments
• Year 3 SpRs should be able to insert & remove the HDR cervix applicators under supervision, & have a comprehensive understanding of the subsequent process

Education & Training:

• Will undertake Audit in the Department in conjunction with HTC / consultant and present at the ASM
• Year 3 SpRs are expected to attend weekly tutorials with tutors in preparation for the Final FFRRCSI, and are given protected time, at least 1 afternoon per week to do so
• Year 3 SpRs are expected to sit the Final FFRRCSI after completion of a full 3 years of a formal training program

On call duties Year 2-5:

• After hours emergency simulation & RT dose prescription for emergency patients arriving after 5pm on weekdays
• All emergency simulations and treatments must be discussed with the consultant “on call”
• All emergency admissions must be discussed with the consultant “on call”
• Liasing with the SHO “on call” regarding any problems prior to departure from the hospital site
• “On call” from home from after departure from the Department until 9 am the following morning, i.e. being telephonically available to the SHO “on site” for advice regarding any in-patient, as well as being available to return to the hospital for any major problem that the SHO is unable to manage.
• Saturday ward rounds with the SHO “On call” This may include assessment of any outpatients that have called by phone with an urgent problem.
• Emergency simulation & dose prescription will take place at this time 11-13.00 hrs
• After this call is “off site”
• Sunday may involve a ward round of problem patients only, (at the discretion of the SHO and Nursing staff on duty), as well as emergency simulation
• Bank holidays will be treated as Sundays
• The roster will be managed by the Chief SpR, referring back to the Hospital Training Co-ordinator, ensuring that the hours worked do not exceed the EU Working Time Directive
• Each team will be obliged to leave a handover list of problem patients on the ward and short summary of the relevant problem requiring their attention

YEAR 4 & 5 SpRs

General Clinical duties:

• They will undertake the general organisation of the team. The level of responsibility will be at the discretion of the team consultant.
• Senior SpRs will be responsible for supervising the junior SpRs on the team.

• Attend new patient assessment clinics
• Attend follow up OPD clinics
• Do twice weekly ward rounds with the team
• Supervise team in managing urgent medical patient care
• Discuss & organise urgent patient referrals to hospital with referring team members
• Maintain their medical oncology skills

General Radiotherapy Duties:

• A wide range of areas in Radiation Oncology & able to function independently.
• 3D CRT planning of general tumour sites and will be responsible for signing off selected radiotherapy plans
• Complex 3D brachytherapy in breast & gynaecological malignancy

Management & Teaching:

• Participate in administration & work practice developments
• Participate in Risk Management Committees in the radiotherapy department
• Teach junior SpRs, SHOs, medical students, physicist, RTTs
• Undertake research (under supervision of Hospital Training Co-ordinator / supervising consultant)
• Undertake audit under supervision of the Hospital Training Co-ordinator / supervising consultant

YEAR 5 SpRs

• Year 5 SpRs will undertake a specialist subspeciality and modular training in addition to regular duties (See SpR Year 5 Modular training document)
• They will be expected to develop a specialist interest in a particular tumour sub-site and technological skills related to their area of interest
• They will be expected to gain detailed knowledge of current clinical & technical developments in their chosen sub-specialist interest

By completion of Year 5 of formal SpR training the SpR will be eligible to apply to the Irish Medical Council to be placed on the Irish Specialist Register as a “Radiation Oncologist” (See details on Faculty website www.radiology.ie)

They request the Irish Medical Council to request validation of the 5 years training from the Chair of the Faculty of Radiologists Validation Committee, who will consult with Faculty Radiation Oncologist trainers to confirm satisfactory completion of 5 years of formal training.