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Vocational Training
Medical
Oncology and Haematology
Supervising Committee
Specialist Advisory Committee (JSAC) in Medical Oncology.
Definition
of Specialty
The paediatric oncologist/haematologist is a paediatrician
with specialised skills in the clinical management of solid tumours, malignant
and non malignant haematological diseases and with bone marrow transplantation
in children and adolescents.
General Principles
- Advanced
training in paediatric medical oncology and clinical haematology will be for at
least 3 years following satisfactory completion of basic paediatric training and
the FRACP Examination in Paediatrics.
- Training should encompass experience
with a broad range of malignancies and an understanding of the place of appropriate
methods of investigation, assessment and management. Trained paediatric haematologists/oncologists
will take their place with radiation oncologists, surgeons, and other health care
professionals in multidisciplinary programs to ensure optimal outcome for the
child/adolescent and their family.
- Trainees are expected to understand:
- the
biology and natural history of malignant disease
- the management of all
stages of common tumours
- the current specialist literature
- relevant
techniques of clinical research.
- All subspecialty
paediatric trainees must complete the community and child health requirements
for paediatric training.
Note that the guidelines differ between Australia
and New Zealand.
Components of Training
Core Training
A minimum of 2 years is required. During this period the
trainee shall:- acquire knowledge of the nature, pathology, natural history
and epidemiology of haematological and malignant disease in children and adolescents;
- gain
experience in the methods of investigation and management of patients with these
disorders, including clinical examination, laboratory investigation and diagnostic
imaging;
- acquire knowledge of the pharmacology, pharmacokinetics, use
and side effects of antineoplastic drugs and other drugs relevant to these disorders;
- obtain
experience in the multi-disciplinary approach to management of children and adolescents
with malignant disease or complicated haematological problems;
- trainees
are expected to achieve a high level of communication skills and to work within
a multi-disciplinary environment. Trainees are encouraged to participate in training
in communication skills, covering such areas as:
- breaking bad news
- discussing
treatment options
- clinical trials consent;
- gain an understanding
of the role of radiotherapy in the management of children and adolescents with
malignant disease in particular:
- an understanding of the basic principles
of radiobiology
- an understanding of the simulation and planning process
- an
understanding of the role of palliative radiotherapy
- management of radiotherapy
side effects;
- gain an understanding of the role of surgery in
the management of children and adolescents with malignant disease;
- be
proficient in the prevention and treatment of the complications of malignant disease
and its treatments;
- have an understanding of the potential late effects
of treatment, e.g. neurocognitive development, growth and endocrine effects, psychosocial
sequelae, and to participate in the long term follow up of patients;
- gain
experience in the role of haematopoietic stem cell transplantation in the management
of malignant, haematological and metabolic disorders in children and adolescents;
- acquire
knowledge of and experience in palliative care, including knowledge of the pathophysiology
and pharmacology of pain, constipation, nausea and vomiting, dyspnoea and other
common symptom problems. There should be an understanding of the roles of the
family, community and local health professionals caring for the child and family;
- gain
experience in the design, implementation and evaluation of clinical trials and
protocols for the management of haematological and malignant disease in children
and adolescents;
- develop an understanding of the appropriate methods of
statistical design and analysis. This should enable the trainee to evaluate research
reports with an appropriate depth of understanding.
Non
Core Training
Trainees may spend 12 months in a non core (elective)
position. This period may be used to gain further clinical or laboratory experience
in related specialities or to undertake a period of research in a field of direct
relevance to paediatric haematology and oncology. For example, this year could
constitute one year of full time research towards an MD or PhD.
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