Medical Oncology CESR Portfolio Guide

• Aware of, and adheres to, the GMC professional requirements
• Aware of public health issues including population health, social determinants of health and global health perspectives
• Demonstrates effective clinical leadership
• Demonstrates promotion of an open and transparent culture
• Keeps up to date through learning and teaching
• Demonstrates engagement in career planning
• Demonstrates capabilities in dealing with complexity and uncertainty
• Aware of the role and processes for commissioning
• Aware of the need to use resources wisely

• Aware of national legislation and legal responsibilities, including safeguarding vulnerable groups
• Behaves in accordance with ethical and legal requirements
• Demonstrates ability to offer apology or explanation when appropriate
• Demonstrate ability to lead the clinical team in ensuring that ethical and legal factors are considered openly and consistently

• Communicates clearly with patients and carers in a variety of settings
• Communicates effectively with clinical and other professional colleagues
• Identifies and manages barriers to communication (e.g. cognitive impairment, speech and hearing problems, capacity issues)
• Demonstrates effective consultation skills including effective verbal and non-verbal interpersonal skills
• Shares decision making by informing the patient, prioritising the patient’s goals and wishes, and respecting the patient’s beliefs, concerns and expectations
• Shares decision making with children and young people
• Applies management and team working skills appropriately, including influencing, negotiating, re-assessing priorities and effectively managing complex, dynamic situations

• Makes patient safety a priority in clinical practice
• Raises and escalates concerns where there is an issue with patient safety or quality of care
• Demonstrates commitment to learning from patient safety investigations and complaints
• Shares good practice appropriately
• Contributes to and delivers quality improvement
• Understands basic Human Factors principles and practice at individual, team, organisational and system levels
• Understands the importance of non-technical skills and crisis resource management
• Recognises and works within limit of personal competence
• Avoids organising unnecessary investigations or prescribing poorly evidenced treatments

• Manages clinical information / data appropriately
• Understands principles of research and academic writing
• Demonstrates ability to carry out critical appraisal of the literature
• Understands the role of evidence in clinical practice and demonstrates shared decision making with patients
• Understands public health epidemiology and global health patterns
• Demonstrates appropriate knowledge of research methods, including qualitative and quantitative approaches in scientific enquiry
• Demonstrates appropriate knowledge of research principles and concepts and the translation of research into practice
• Follows guidelines on ethical conduct in research and consent for research
• Recognises potential of applied informatics, genomics, stratified risk and personalised medicine and seeks advice for patient benefit when appropriate

• Delivers effective teaching and training to medical students, junior doctors and other healthcare professionals
• Delivers effective feedback with action plan
• Able to supervise less experienced trainees in their clinical assessment and management of patients
• Able to supervise less experienced trainees in carrying out appropriate practical procedures
• Able to act as a clinical supervisor to doctors in earlier stages of training

• Demonstrates knowledge of cancer biology at a molecular and cellular level and understands how this translates into targets for systemic anti-cancer treatments
• Demonstrates knowledge of radiation biology and understands how this translates into acute and late radiotherapy reactions to underpin their safe and effective management
• Demonstrates knowledge and understanding of the clinical pharmacology of systemic anti-cancer therapies to underpin their safe and effective use and the appropriate management of complications
• Demonstrates knowledge and understanding of the physics relevant to radiotherapy
• Demonstrates knowledge and understanding of the design and organization of clinical trials and the relevant statistical methodology to correctly interpret results and critically appraise the evidence base
• Demonstrates knowledge and understanding of causation and risk factors for developing cancer to be able to advise on appropriate strategies to reduce these
• Demonstrates knowledge and understanding of the principles underpinning cancer screening programmes to be able to counsel patients appropriately

• Safely assesses and manages the immediate and ongoing care of patients presenting acutely with complications of cancer and its treatment
• Manages targeted investigation and rapid triage of patients presenting with a possible new diagnosis of malignancy, malignancy of undefined origin (MUO) and carcinoma of unknown primary (CUP)
• Liaises effectively with other specialist services as appropriate, regarding ongoing management
• Assesses the appropriate ceiling of care taking the cancer context and the holistic patient assessment into account and sensitively discusses this with the patient and their advocates
• Participates effectively in decision-making with regard to resuscitation, including decisions not to attempt cardiopulmonary resuscitation (CPR), and communicates sensitively with patients and their advocates in regard to these decisions
• Ensures clear and adequate documentation of an acute event, appropriate follow up plans and clear and timely communication with community based teams and the responsible specialist team
• Understands the local and regional Acute Oncology Service and communicates effectively between the elements of the service, community based services, specialist teams and patients
• Leads the Acute Onclogy team when appropriate to monitor, maintain and develop a high quality service

• Ensures continuity of patient care through safe and effective handover to hospital and community-based teams
• Safely and effectively manages disease and treatment-related complications in oncology patients taking into consideration acute and chronic medical co-morbidities and liaising with relevant specialty services when required
• Promptly identifies the acutely deteriorating patient, institutes the appropriate initial medical management and seeks appropriate advice, including from other specialties
• Communicates and works effectively with relevant multi-professional teams to provide appropriate holistic in-patient care and safe and timely hospital discharge
• Effectively manages the common physical symptoms in patients with advanced cancer, recognising the role for pain management, supportive medications, palliative radiotherapy and other approaches. Liaises with specialist palliative care teams when required
• Knows the prognoses and treatment options of different cancers and considers these, together with individual patient factors and wishes, to decide on an appropriate ceiling of care, including escalation to HDU/ITU
• Understands current guidance regarding CPR orders, participates in shared decision-making and involves other relevant professionals in complex cases
• Recognises when a patient is approaching the end of life, communicates effectively and compassionately with patients and carers regarding advanced care planning and individualised end of life care plans

• Presents new cases to the MDT in a clear and concise manner highlighting the relevant points and questions to be answered
• Understands the indications for all treatment options available for different types and stages of cancer within the tumour site, applying relevant guidelines and the most up-to-date evidence base to give an informed oncology opinion
• Assesses the risks and benefits of treatment options for each patient considering disease stage, tumour biology and individual patient factors to formulate an appropriate personalised management plan
• Recognises the limitations of clinical guidelines in cases of uncertainty or complexity
• Communicates views and recommendations clearly, promptly and effectively to all members of the MDT
• Respects the expertise, viewpoints and responsibilities of all MDT members and helps foster a supportive and collaborative environment for open discussion
• Understands the local, regional and supra-regional MDT network and communicates effectively between the elements of the service

• Formulates a holistic patient-centred diagnostic and management plan
• Determines when genetic testing and/or referral for genetic counselling is appropriate
• Correctly interprets the results of clinical, pathological, genomic and radiological investigations to accurately diagnose and stage cancer
• Accurately assesses the role of all treatment modalities relevant to the individual patient and ensures multidisciplinary team involvement
• Selects the most appropriate treatment regimen and associated supportive measures according to best available evidence, holistic patient assessment and patient preferences
• Applies evidence-based practice to management decisions
• Discusses prognosis and treatment aims with patients, giving due consideration to their values and priorities
• Understands and discusses the potential effects of treatment on fertility and pregnancy and where applicable refers for consideration of fertility preservation
• Ensures equitable patient access to relevant clinical trials
• Obtains informed consent, ensuring that patients have sufficient information and time to consider risks and benefits, including the possibility of no treatment
• Where patients lack capacity to give informed consent, make appropriate ‘best interest’ decisions, involving all relevant parties
• Recognises the psychological, financial and social impact of cancer on patients and their families and signpost to sources of ongoing support
• Recognises when further or continuing treatment is no longer appropriate and sensitively discusses this with patients and their advocates
• Recognises the need for tailored support for specific and/or vulnerable groups, showing sensitivity to issues of equality and diversity
• Recognises the limitations of clinical guidelines in certain complex situations

• Selects the most appropriate SACT regimen and associated supportive measures for the clinical situation according to available evidence, MDT discussion and holistic patient assessment
• Modifies approach to address the specific needs of individual patients, including vulnerable groups
• Clearly communicates the benefits and risks of available treatment options, including those available within clinical trials, to enable informed consent
• Applies the knowledge of mechanisms of action and treatment toxicities to pre-empt, monitor and manage these in patients receiving SACT
• Co-ordinates the appropriate investigations, procedures and logistic arrangements required for SACT delivery
• Generates a SACT prescription that is safe and accurate
• Evaluates toxicity and response during treatment and adapts SACT/supportive measures accordingly, balancing treatment goals with patient safety and priorities
• Assesses and reports SACT toxicity according to regulatory and, where relevant, research governance processes
• Collaborates effectively with members of the multi-disciplinary team when patients are receiving SACT as part of a multi-modality treatment pathway
• Proactively liaises with the relevant teams when SACT is completed or discontinued to enable co-ordinated ongoing management

• Recognises the factors affecting cancer health inequalities and the social determinants of health, including physical, economic and cultural factors, which impact on cancer risks
• Can give personalised risk reduction advice to patients taking into account lifestyle, environmental and genetic factors
• Is able to formulate a patient-centred follow up plan for patients who have completed a course of cancer treatment
• Promotes survivorship following cancer treatment
• Pro-actively manages and educates patients about the long-term sequelae of cancer treatments, in conjunction with other health professionals where relevant
• Provides specialist advice to other health professionals regarding cancer risks and appropriate investigation of patients following cancer treatment

• Selects the most appropriate intensive SACT regimen and associated supportive measures for the clinical situation according to best available evidence, holistic patient assessment and patient preferences.
• Clearly communicates the benefits and risks of available treatment options with patients and their advocates to enable informed consent.
• Co-ordinates the appropriate investigations, procedures and logistic arrangements required for intensive SACT delivery.
• Is able to safely deliver SACT in specific/ vulnerable patient groups.
• Reviews patients at initiation of, and during SACT and identifies the role of SACT/ supportive measure modification, balancing treatment goals with patient safety and disease response according to updated holistic assessment.
• Recognises the importance of maintaining dose intensity in the context of intensive SACT and proactively employs supportive therapy strategies in order to facilitate this.
• Understands and discusses the potential effects of SACT on fertility and pregnancy, supporting the patient through fertility preservation options.
• Collaborates effectively with members of the multi-disciplinary team when patients are receiving SACT as part of a multi-modality treatment pathway
• Generates a SACT prescription that is safe, accurate and meets local and national standards.
• Can recognize and manage pancytopenia and its sequelae related to intensive SACT, involving relevant specialist teams when required
• Is able to apply the knowledge of mechanisms of action and drug toxicities to pre-empt, monitor and manage these in patients receiving intensive SACT regimens
• Is able to apply knowledge of and pre-emptively manage the additional complications of stem cell transplant or other cellular therapies as part of an intensive SACT regimen
• Recognises the need for prompt escalation of care and liaison with relevant teams when clinically indicated in patients receiving intensive SACT regimens
• Recognises the social, financial and psychological effects of intensive SACT/prolonged hospital admission and involves appropriate teams to optimise patient care and support.
• Proactively liaises with the relevant teams when SACT is completed or discontinued to enable co-ordinated ongoing management.

• Understands the roles of regulatory agencies in the approval of novel therapeutic and diagnostic technologies for cancer treatment
• Can evaluate key clinical data and resource implications relevant to emerging SACT regimens and can use this information to design clear guidance for appropriate use of the treatment
• Able to collaborate and work effectively with other allied healthcare professionals, management teams and associated committee(s) to contribute to the development or renewal of guidelines and protocols.
• Is familiar with the processes involved in the introduction and review of SACT approvals within their specific healthcare organization
• Ensures availability of clear and comprehensive resources for patients in relation to new SACT protocols
• Evaluates implemented SACT protocols using audit/quality improvement methodology and adapts in response to emerging data

• Supports the training and supervision of NMPs in an environment that prioritises patient safety.
• Understands the governance structures, training pathway and assessments for NMP prescribing at local and national levels.
• Creates effective learning opportunities for NMPs in training within their scope of practice.
• Assesses the performance and competencies of NMPs, giving timely and appropriate feedback
• Provides mentorship and support for NMPs during training and in practice
• Promotes and participates in inter-professional learning

• Understands the principles of precision oncology, stratified and personalised medicine.
• Understands the principles of whole genome sequencing, gene expression and regulation in the context of cancer risk including inherited cancer predisposition syndromes and screening
• Applies knowledge of the multi-factorial basis of malignancy to discuss cancer risk with patients and their carers, taking into account ethical and confidentiality considerations
• Understands of the role of genomics and biomarkers in the cancer diagnostic pathway
• Understands the role of genomics and biomarkers in personalising therapeutic options and in the prediction and monitoring of response to SACT
• Understands the ethical issues associated with whole genome sequencing and management of genomic data
• Understands the basis for genomic profiling and biomarker utilisation in the design and delivery of clinical trials

• Demonstrates knowledge of the ethical and legal issues related to clinical research applying Good Clinical Practice principles.
• Understands that patient safety is the overriding priority in the conduct of clinical trials
• Understands the key processes for setting up a clinical trial at a new site
• Understands the roles and responsibilities of Principal and Sub-Investigators
• Able to participate in clinical research trials, including early phase trials (phase I/II), at Sub-Investigator level
• Understands appropriate delegation of trial-related duties and the need for training, supervision and oversight of the research team in carrying out trial activities
• Manages patients within a clinical trial from screening and eligibility assessment, through informed consent, to completion of trial related procedures
• Follows regulatory and research governance requirements with respect to safety reporting within a clinical trial
• Understands the particular regulatory issues regarding use of unlicensed agents within a clinical trial

Currency Window

Evidence of your recent practice will be given more weight to reflect current capabilities and we suggest that approximately 50% of your evidence for a curriculum outcome is drawn from within the last five years of clinical practice (WTE).

Evidence Volume

around 100 electronically uploaded documents