Part 1


The pursuit of a specialty qualification in radiation oncology is IDENTICAL TO the pursuit of a specialty qualification in any other area of medicine - Psychiatry, Colorectal Surgery, Head & Neck Surgery, ENT, Cardiothoracic Surgery, Cardiology, Radiology, Urology, Nephrology, Orthopaedics, Paediatrics, Paediatric Neurology, Internal Medicine, Gastroenterology, Rheumatology, Pathology, Medical Genetics, Obs & Gynae (OBGYN), Dermatology, Plastic Surgery, etc, etc. Don't kid yourself that this is the easy one! It is just as hard as all the others. Like all the others a bit of a personality disorder helps!

The first part is about learning the lingo and the meaning and reasons why things are done. This phase forms the BASIS of the clinical work that follows. And it is FUNDAMENTAL.

There has long been an unspoken tension between the Americans and the UK aligned jurisdictions on the emphasis of radiation oncology. The Americans are seen to be TOO technical and poorly done with respect to the clinical while the UK-aligned are seen to be TOO clinical and poorly done with respect to the technical. And I think that this is an accurate picture (although not complete with explanation!). The UK-aligned stance has always been "what's the point of applying technologically superlative treatment to the wrong patient?", while the American stance has been "what's the point of applying technologically inept treatment to the right patient?".

And guess what? They are both correct! What we should be doing is applying technologically superlative treatment to the right patient! And which group is likely to be able to do this???

Our discipline is highly technical and you cannot be an expert in any area without addressing the technological requirements of the planning and delivery process. This is all based on the Part 1 learning. You will not realise how much until some years into your specialist career. So get it right the first time. And what does this take? It takes work and a dedication to excellence. The attitude "I need to learn this for the exam" is hopefully not present in you, and if it is I hope you fail because you don't understand the subject matter! I don't want to sound harsh and nasty, but if you don't know your physics well, I don;t want you anywhere near my relatives. And I would expect you to feel exactly the same.

Can you be a surgeon if you can do a mastectomy but don't know which patients to do it on? Can you be a surgeon if you know which patients need a mastectomy but you can't do one? We are exactly the same - the clinical expertise and the technical expertise go hand in hand and can't be lop-sided.

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