The Board of Study in Clinical Oncology (BOCO), from its inception in late 1980s, has endeavoured meticulously to train and provide our country with well trained and Board Certified Specialists in General Clinical Oncology. The BOCO can now justifiably be proud of its achievement in establishing and of all of its efforts towards providing specialist Oncology services in all areas of Sri Lanka. Currently, Board Certified Specialist General Clinical Oncologists provide specialist Oncology services in all areas of the country.
Although General Clinical Oncologists are able to provide optimal cover for the majority of clinical problems that come up in Clinical Oncology, ultra-specialist care and high-powered services are required in certain well defined specialized areas. To cater to this need, over the last few years, the BOCO has commenced in stages, training programs for different sub specialties in Clinical Oncology. Paediatric Oncology sub-speciality was incorporated into the current training programmes of the Board of Study in Clinical Oncology in 2010. As a further step in this direction the BOCO has now decided to request for the inclusion into its curriculum, Haemato-Oncology Training leading to Board Certification in this sub-specialty.
The mission of this endeavour is to ultimately produce appropriately selected, properly trained, exquisitely competent and holistically caring Haemato-Oncologists who would be able to satisfy the needs of the country in providing the best possible state-of-the-art care and follow up for those patients with Haematological Malignancies who need expert attention.
The workload of anyone involved in the care of Haematological Malignancies, in the medical and para-medical modalities, consists of a considerable proportion of Cancer Problem. It has been empirically estimated that around 30 per cent of the workload of a Cancer unit in Sri Lanka involves Haematological Malignancies. In addition, the picture reported globally, especially from the developing nations, is that many of the Haematological malignancies are getting cured, with very much less treatment related morbidity and mortality. Sri Lanka should endeavour to further improve the cure rate and towards that end, skilled specialist care of major Haematological Malignancies is of utmost importance.
While the major portion of these Haematological Malignancies could be handled adequately by Clinical Oncologists, there are those that require the expertise of highly trained Haemato Oncologists. Such a person will be able to use his or her training, experience and the infrastructure facilities available in a highly specialised unit to cater to the needs of Haematological Malignancies. Haemato-Oncology is an established sub-specialty in the West for a long time and it is now a sub specialty in all countries in Asia. There are around 1000 patients annually who are diagnosed with Haematological Malignancies, admitted to National Cancer Institute, Maharagama. It is expected that there will be cadre provision for up to 8 Haemato-Oncologists in the Ministry of Health within the next 10 – 15 years, to man Haemato-Oncology Units and Bone Marrow Transplantation Units.
The Haemato-Oncologists are expected to provide a specialty service to those Haematological Malignancies who need expert care in the management of their cancers. The range of the functions of the said specialist would also include cooperating with and assisting other sub-specialities as well as General Clinical Oncology.
The broad core objectives of the entire training programme are as follows:
- Patient care
- The ultimate aim is to provide comprehensive care and specialised services to Haemato-Oncology. The trainees are expected to acquire the necessary knowledge and expertise in dealing with Haematological Cancers. The trainees would need to determine the infrastructure facilities required for optimal care to these patients and make personal and fervent efforts to acquire them into the specialised Haemato-Oncology units through the agencies that are responsible for the provision of these amenities.
- Medical knowledge
- It is expected that the trainees should acquire extensive and up-to-date knowledge on Haemato-Oncology during the course of the training programme.
- Wide reading and critical thinking together with reflective documentation would be essential attributes that should be developed during the programme.
- Interpersonal and communication skills
- It is essential that the trainees develop the indispensable skills in communication and liaison with other colleagues and the staff of the different units of a medical facility with whom they have to have a constant dialogue. It is most likely that the work of the Haemato-Oncologists would involve a multi disciplinary approach in many instances and towards that end, proper communication with all those involved in the care of a patient with Haematological Malignancies would be crucial to the provision of optimal care.
- The trainees should also acquire the necessary skills and attitudes in maintaining a dialogue with the affected patients, their families and care givers. Development of empathy and understanding of the problems faced by them would be an essential prerequisite to being a competent and successful Haemato-Oncologist.
- It is envisaged that the trainees in Haemato-Oncology would act and behave in a most professional manner in all dealings with senior and junior colleagues and others involved in the management of patients with Haematological Malignancies. This is particularly relevant in Haematological Malignancies as one need to secure the services of several other para-medical categories of staff in the provision of comprehensive care to those with Haematological Malignancies.
These attitudes and skills need to be carefully nurtured during the training programme.
Practice-based and Evidence-based approach
The trainees are expected to acquire these approaches to the ways in which the myriad of Haematological Malignancies could be handled. Although evidence-based medicine is the cornerstone on which optimal care is based, a practice-based approach may be appropriate in certain circumstances. The skills based on both approaches need to be developed during the training programme.
Board Certified Specialists in Haemato-Oncology are not expected to engage in laboratory based diagnosis and issue of laboratory reports, but will engage in all aspects of treatment and Bone Marrow transplantation.
- Trainees should have passed the MD (Clinical Oncology) Part II examination
- Trainees should not be Board Certified by the PGIM in any Speciality or Subspeciality
Please refer to the relevant prospectus for the most up to date information. The prospectus of a particular programme contains official information pertaining to a programme approved by the Board of Management, University Senate and the University Grants Commission