Paediatric Oncology Sub-Speciality (GRID) Trainees

Paediatric Oncology CSAC 

The College Specialty Advisory Committees (CSACs) supervise the development and delivery of subspecialty training and assessment standards. CSACs are sub-committees of the RCPCH Education and Training Quality Committee, which helps the College set these standards within a training programme that is recognised by the General Medical Council. POTG works closely with trainee representatives on the RCPCH Oncology CSAC, helping ensure that trainee perspectives are represented in discussions around training and workforce development.  

The current CSAC members and their contact details are available on the RCPCH website. Tom Jackson is currently the trainee representative, so please feel free to contact him with any queries or concerns. We also organise virtual ‘Meet the CSAC’ sessions, which provide an opportunity to learn more about training and ask questions directly to the CSAC team. Details of these sessions are advertised through the POTG newsletters. 

Curriculum 

The paediatric oncology subspecialty training programme is designed to allow you to develop the knowledge, skills and behaviours to become a proficient Consultant Paediatric Oncologist in a Principal Treatment Centre (PTC). It is a good idea to download the Paediatric Oncology curriculum available on the college website, which is a more detailed mapping to the 4 broad learning outcomes within your Kaizen e-portfolio. 

Evidencing your learning, CSAC and Career Progression Reviews (“GRID Reviews”) 

The CSAC is responsible for assessing your progress during your GRID post. It is an ARCP requirement to have a CSAC review annually.    

The Oncology CSAC require trainees to have a full review every 1-year whole time equivalent (WTE). These are called Career Progression Interview (informally known as “GRID reviews”). These are held virtually 3 times a year, usually in February, June and October. Dates are advertised by the POTG, but if in doubt, please contact the CSAC co-chairs to arrange a GRID review at least 3 months prior to reaching 1 year WTE.  

If you are training at 100%, then your ARCP requirement for a CSAC review will align with your career progression interviews. If you are Less Than Full time (LTFT), or take time out of training, then these may not. If you require an ARCP CSAC review without a career progression interview, email the CSAC leads at least 6 weeks before your ARCP deadline to ask them to complete a CSAC review form (and send them a Kaizen Ticket).

Progression interviews can feel daunting, but remember their role is to ensure that each trainee is managing to access appropriate learning and feeling supported to gain the experience they need to function as a safe and effective paediatric oncology consultant. 

In addition to using Kaizen, it is recommended to keep a logbook of cases and learning points. Some of these can then be used for the four “long cases” you are required to prepare for the CSAC review. The long cases should demonstrate applied learning and ideally deal with an aspect of the case where things didn’t go as you might normally anticipate and the learning points from that. Examples of “long cases” are available in the “Educational Supervisor and Trainee Guide for Paediatric Sub-Specialty: Oncology” on the RCPCH website.  

It is recommended you arrange to meet with your educational supervisor as soon as you start your GRID training. They will be able to help you to understand the interplay between your overall paediatric training and your specialism in paediatric oncology. Training time can go by very fast so it is best to set realistic goals to enable you to focus your learning and get the most out of your GRID training. 

For more detailed information on what to expect in your career progression interview and ARCP requirements, see the “Educational Supervisor and Trainee Guide for Paediatric Sub-Specialty: Oncology” available on the RCPCH website.  

Educational Sessions 

POTG organises a 3-4 monthly afternoon virtual teaching that maps to the GRID curriculum and monthly virtual peer-to-peer Paediatric Oncology Education and Teaching sessions (POETs). GRID teaching is available to watch back on CCLG Connect. We also arrange an annual POTG Weekend educational meeting to provide education and training as well as a forum to discuss training issues and updates from the trainee representative.  

Mentorship 

You may have benefitted from the POTG mentorship scheme prior to attaining your GRID position. You are still able to join the scheme or gain further mentorship from more senior trainees or consultants. Please consider becoming a mentor to new prospective GRID trainees with the next call for mentees/mentors; your help would be invaluable. 

Informal support 

There is a WhatsApp Group for GRID trainees for more informal chats (training advice, GRID reviews, advice on different experiences in different PTCs) – if you aren’t already in the group and would like to be, just get in touch. 

Thinking of Applying to Paediatric Oncology Training (GRID and SPIN) 

How and where to experience paediatric oncology in your early medical career 

Children and young people with cancer are usually treated in Principal Treatment Centres (PTCs), although some receive shared care in smaller hospitals that act as Paediatric Oncology Shared Care Units (POSCUs). During your training, you may be able to request a placement in paediatric oncology. You may also gain experience caring for children with cancer during general paediatric placements or when patients present acutely unwell via their GP or the Emergency Department. There are also opportunities to explore the academic side of paediatric oncology by becoming involved in research or clinical trials. 

As a member of POTG, you will receive information about educational opportunities and meetings that can help you gain exposure to the specialty. These events provide opportunities to meet other trainees and resident doctors with a shared interest in paediatric oncology, who can offer guidance and career advice. You are also welcome to join our mentorship scheme. 

Applying to a paediatric oncology  

If you are considering a career in paediatric oncology, you will need to demonstrate a clear commitment to the specialty, good communication skills, and an understanding of research, teaching and quality improvement. Extensive oncology experience is not essential, but evidence of sustained interest through projects, audits, research or educational activities is highly valued. As a paediatric oncologist, you will also need empathy, teamwork, attention to detail, compassion and a commitment to lifelong learning, as you will build long-term relationships with children and their families while working in an emotionally demanding specialty. 

If you are planning a career in general paediatrics, the Paediatric Oncology SPIN programme offers additional training to develop expertise in caring for children with cancer within Paediatric Oncology Shared Care Units (POSCUs). 

How to apply for Paediatric Oncology Sub-Speciality Training (GRID) 

You can apply for paediatric oncology sub-speciality training (GRID) through the national recruitment process, after completing, or expected to complete, Core Level paediatric training by the time you enter the sub-speciality training programme. You will need to meet the eligibility criteria set by the RCPCH. Full details, including the applicant guide and current eligibility requirements, are available on the RCPCH website. 

Your application should include evidence of your clinical experience, leadership and management, quality improvement and audit, education, research, and presentations or publications. Reviewing the shortlisting criteria early can help you identify areas to strengthen before you apply. If you are shortlisted, you will be invited to interview, where you will be assessed on your motivation for the specialty, clinical reasoning, academic understanding, leadership and teamwork. 

Applications usually open in October, with interviews taking place between late January and early February. The number of training posts varies each year and is advertised on the RCPCH website when applications open. The RCPCH also hosts an annual sub-specialty careers event in June and an application webinar each autumn. You should refer to the RCPCH website for the latest timelines and guidance, and direct any questions to subspecialty@rcpch.ac.uk. 

How to apply for Paediatric Oncology Special Interest (SPIN) module 

From ST4 onwards, you may apply for a Special Interest (SPIN) module to gain additional expertise in Paediatric Oncology. The Paediatric Oncology SPIN module provides 12–18 months of focused clinical training and experience, enabling trainees to develop the skills required to deliver paediatric oncology care within a Paediatric Oncology Shared Care Unit (POSCU). 

Applications are typically open twice a year – usually November (for a February/March start the following year) and May (for an August/September start the same year). Submit applications through the RCPCH ePortfolio using the SPIN application form, available during the application windows.  

More information is available on the RCPCH website. Please also see the SPIN Trainees page for more information, resources and testimonials from Oncology SPIN Consultants.

How can the POTG help? 

Whether you are just beginning to explore paediatric oncology or preparing to apply for GRID, POTG is here to support you. We encourage you to: 

  • Join our mentorship scheme and be matched with an experienced mentor 
  • Attend POTG educational sessions and the annual POTG weekend 
  • Volunteer to present at POET teaching sessions - case exchange sessions are an excellent opportunity 
  • Contribute as a national or local lead for audits and service evaluations 
  • Get involved with the POTG committee  

Details of all these opportunities are advertised through the POTG newsletter. We also run an annual GRID interview Q&A session in January and offer mock interviews for shortlisted applicants.

Paediatric Trainees with Special Interest in Paediatric Oncology (SPIN)

Completing a SPIN Module in Paediatric Oncology is a great way to increase experience and exposure in this area whilst continuing general paediatric training. It allows trainees to work in a specialised environment for a prolonged period of time. It will expand a trainee’s knowledge and expertise, allow networking with specialist colleagues and make a trainee a more competitive candidate when applying for a shared care Consultant post.

The POTG promotes interest and education in paediatric oncology. As trainees with an interest in oncology, this group aims to help people network and share resources.

We are always keen to hear trainees’ opinions and would welcome people to get in touch. We would love trainees to share learning opportunities and quality improvement projects that could be spread on a wider scale or need collaboration.

Contact details for POTG SPIN Lead: Rachel Poffley (Severn Trainee ST7), potg@cclg.org.uk.

We also have a WhatsApp group to share tips and support for all oncology SPIN trainees around the UK. Please contact us if you would like to be part of this.

Oncology SPIN Learning Resources

•    Monthly virtual Paediatric Oncology Education and Training (POET) sessions on a variety of clinical topics, audit updates, preparation for START assessment and dedicated sessions for SPIN trainees. These sessions typically last for an hour and run on a weekday from 8 to 9 pm. SPIN trainees are welcome to join any of these sessions 
•    Quarterly teaching sessions mapped to the paediatric oncology subspecialty curriculum. These sessions typically last two to three hours and run on a weekday afternoon from 2–5 pm and are available to watch back at a later date on CCLG Connect. SPIN Trainees are welcome to join these sessions. 
•    Annual POTG Weekend
•    International Society of Paediatric Oncology (SIOP) Meeting – Annual
•    CCLG Meetings – advertised on CCLG and POTG newsletters
•    CCLG POSCU Group

  • RCPCH: How to Manage Advance Care Planning in Paediatric Palliative Care
  • Study Days: APPM Study Days 
  • Child bereavement UK Courses: (Eg. MAPLE – Improving Paediatric End of Life 3-day in-person course)
  • Information about NHS England Service Specification for Level A and B POSCU consultant requirements. 

Oncology SPIN Consultants Testimonials

  • Laura Doherty, Consultant Paediatrician and shared care consultant, Exeter.

    "I CCT'd after completing a paediatric oncology SPIN in the South West. Following CCT, I did a Clinical Fellow job for 6 months in a DGH in general paediatrics, where I was able to do some oncology clinics as well as some consultant acting-up shifts - which definitely gave me examples to use in consultant interviews and allowed me time to look for jobs!

    My advice would be to consider whether you would be willing to move/commute for your ideal job or if staying in your current area is more important, accepting there may be a bit of a compromise. I think there is some element of luck regarding a particular job coming up when you are ready to apply, but it's definitely worth, in the last year or two of training, making it known to the department that you're interested and when your CCT date is. It's definitely ok to approach multiple places informally to see what potentially will be available, especially if you are keen to stay in a particular area.

    I am now a Shared Care paediatric consultant in Exeter, alongside 2 other consultants and an SAS doctor. It is a busy POSCU which provides day case and inpatient infusional chemotherapy, intrathecal chemotherapy and supportive care. It can be intense, and we have recently had a high workload with complex patients, but I love being part of a close team who support each other, especially in the tougher times. We are well supported by our colleagues in the PTC with visiting haematology and oncology clinics around 4 times a year each. Whilst the job can be challenging at times, especially as a first consultant job, it provides good job satisfaction as you get to know the families really well and they appreciate the continuity of care.

    Tips for during SPIN training - make sure you have a copy of the curriculum and try to work out what bits you need to complete during your PTC job Vs in a shared care centre (where you will be juggling general paeds commitments and portfolio as well as your SPIN!) Keep a log of procedures which can be uploaded to your portfolio as evidence when you are completing your SPIN, as well as for consultant job applications. Good luck and I'm very happy to be contacted if you have any questions!” 

  • Dr Thomas Kus, Consultant Paediatrician, Oncology Lead Gloucester.

    "Paediatric Oncology is where I started out after medical school and where I always wanted to be as a Consultant in some form. For me it was then a question between grid training or shared care work. The main reason for choosing the latter was a strong leaning towards hands-on “roll up your sleeves” clinical work and a real enjoyment of the breadth of general paediatrics. The main reasons against full specialisation were a preference for being in a non-urban environment and a limited interest in spending a lot of time in research.

    From a trainee perspective, it is important to have at least 12 months in a tertiary centre and another 12 months in a POSCU, ideally with a proactive interest in an oncology-related QI project or service development.

    When going for a Consultant post, it is important to choose a big enough unit with sufficient numbers of new oncology patients/year (ideally 15+) to ensure a sustainable service. I was lucky enough to get a post within an established service where the outgoing Consultant retired so the resources and processes for effective shared care were already in place. With the post came a lead role for non-malignant haematology, something that I hadn’t done much of in my training but that I have grown to love over the years, so limited experience should not be a major concern when picking a post."

  • Dr Rebecca Proudfoot, shared care consultant for York and Scarborough Hospitals (sub level 1 shared care with Leeds) and previously lead for oncology in Gloucester (level 3 shared care with Bristol) for one year as a locum consultant covering maternity.

    "As a trainee, you probably do not get much experience of shared care yet if you plan to work in a DGH and want to do some oncology, this will be your role. There is a lot of variation in the level of care provided by different DGHs. The examples from my own experience are Gloucester and York/Scarborough and are at opposite ends of the scale. The former is level 3 and provides inpatient and outpatient chemotherapy and intrathecal lists. Essentially, most children go to Bristol for their initial diagnostic workup and, following that, most of their treatment can be delivered in Gloucester. 

    My role there was to see all the routine admissions for chemotherapy, prescribe chemotherapy using Chemocare, and run the intrathecal lists. I would also do an oncology follow-up clinic and a large part of my time was taken up with ordering and checking follow-up imaging. All this was very well supported by Bristol, with visiting joint haematology and oncology clinics several times a year. I had one other colleague to share the workload. This kind of job is ideal for someone who has done the SPIN and has a reasonable amount of experience in oncology. It provided a lot of job satisfaction as I was able to get to know the patients very well, and they really appreciated only ever really seeing two doctors, who knew them well. However, a lot of the work we did, like routine fit for chemo, is devolved to SHOs in tertiary centres, but this is not usually possible in a DGH. This kind of job is rare. There are not many level 3 units, and each usually has 2 consultants, so your chance of a job coming up in one of these places is small.

    By contrast, York/Scarborough does not even provide level 1 care. Essentially, York can manage febrile neutropaenia and do a small amount of supportive care (blood products, etc.), and that is it. No chemo is prescribed from level 1 units. Level 2 may give day case chemo (eg vincristine for ALL). Almost all the DGHs attached to Leeds are level 1. The role of Haem/onc lead in these units can be pretty minimal. Nonetheless, I am discovering ways in which I can improve the delivery of services, taking good practice and common sense from elsewhere. For example, I’m introducing the febrile neutropaenia proforma that is already used in Leeds and creating an 'oncology passport’ for patients to hold, with a copy in the notes detailing their diagnosis, treatment, PHx, etc so they don’t have to repeat their story every time they come in with a fever. Many units already have this kind of paperwork. However, I rarely ever actually see the oncology patients for whom I am the named consultant. This is not a great job for anyone who really wants to do oncology.

    Essentially, unless you are willing to move anywhere in the country to seek your ideal post, there is an element of luck involved in what jobs are available where you want to live when you finish training. Setting your heart on doing oncology if you are geographically limited may be unrealistic. You may need to be flexible - I’m doing some rheumatology now and having to get trained up.

    I’m happy to be contacted personally with any specific queries. Good luck!"