BONUS: The National Oncology Network for Students and Junior Doctors

We are really proud to present another article of ours published in Clinical Oncology. This outlines not only who we are but also what we have achieved so far as a national pan-oncology society for students and junior doctors.


Clinical Oncology, published on 7 July 2022

Original Article https://doi.org/10.1016/j.clon.2022.06.008

E.G. Khoury, S.R. Heritage, T. Fulton-Ward, P.J.S. Joseph, S.M. K. Selby


The British Oncology Network for Undergraduate Societies (BONUS) is a national oncology network for medical students and junior doctors. The network aims to promote careers and education in clinical, medical, surgical and interventional oncology, a subspecialty of interventional radiology, and is, therefore, a 'pan-oncology society' [1]. Both a recent Royal College of Radiologist (RCR) workforce report and the NHS Cancer Workforce plan have shown a shortage of oncologists, making initiatives such as BONUS that aim to promote oncology from an undergraduate level even more important [2, 3, 4]. BONUS recognises the importance of the multidisciplinary team within oncology, acknowledges the pace and scale of scientific and clinical research within the field and strives to provide early exposure to oncology, as well as accessible resources for education. In 2019, the RCR launched the Undergraduate Oncology Societies Association (UOSA), but we are not aware of any other undergraduate oncology schemes or initiatives similar to BONUS that exist in the UK [5]. BONUS was founded in 2016 by medical students from Scottish universities who felt that oncology teaching during undergraduate medical education was limited and that many students had a poor knowledge of a career in oncology [6. 7].


Aim

The aims of BONUS are:

  1. To promote a career in clinical, medical, surgical and interventional oncology.

  2. To develop a platform that allows those with an interest in oncology to network.

  3. To support undergraduate oncology education.

  4. To facilitate student involvement in cancer research.


Structure of BONUS

In 2020, the society underwent restructuring to create a national network of students and junior doctors who are interested in oncology careers, education and research (Figure 1) and are passionate about promoting oncology to others.


Figure 1 The organisational structure of the British Oncology Network for Undergraduate Societies (BONUS).


The BONUS core committee is composed of 12 medical students and junior doctors, while a further 19 medical students representing individual universities contribute to the society's activities. Each year, applications for the core committee occur in February. The outgoing committee assesses these and selects a new committee. However, in order to make this model more sustainable, as of the upcoming academic year (2022/23), we will be assessing applications and holding interviews led by the core committee and advisory board for these positions. The BONUS advisory board consists of five members from different hospitals in the UK: one honorary president at consultant level and four specialty ambassadors at registrar level, representing clinical, medical, surgical and interventional oncology. Each of the members of the advisory board was approached by the co-presidents in order to help guide the development of the society and serve as a point of contact for any queries. Over 700 medical students and doctors from 29 countries are subscribed to the BONUS mailing list.


We have recently recruited our new cohort of university representatives for 2021/22 from 19 universities throughout the UK. We currently have UK representatives from the following medical schools: Aberdeen, Aston, Birmingham, Bristol, Cambridge, Hull, York, Imperial College London, King's College London, Lancaster, Leeds, Liverpool, Manchester, Oxford, Plymouth, Queen Mary University of London, Swansea, University College London, University of East Anglia and Warwick. Ideally, we would like to have a representative from each medical school within the UK. We are proud to have delegates from across the world contribute to BONUS and we hope to continue developing this society.


BONUS collaborates in sharing oncology-related events and career promotion with the RCR, National Oncology Trainees Collaboratives for Healthcare Research (NOTCH) [8], Association of Cancer Physicians (ACP) – trainees' committee, British Association of Surgical Oncology (BASO) and the European Society of Surgical Oncology Young Surgeons and Alumni Club (ESSO-EYSAC) to promote oncology to medical students and junior doctors. BONUS is working to formalise its affiliation with the societies.


In order to reach out to students and junior doctors, increase accessibility and broaden engagement, BONUS uses social media to promote oncology-related events. By directly emailing supporting organisations, as well as using a mailing list, BONUS can easily spread awareness about upcoming events of interest to students. BONUS is highly active on social media and has developed a YouTube channel, which helps to engage a range of students and doctors.


BONUS oncology events are primarily delivered by UK-based specialists according to the UK system; however, these are shared with our international advocates to reach an audience of students and junior doctors overseas who may be interested in learning more about a career in oncology within the UK. BONUS welcomes international speakers to present oncology matters taking place on the global scale.


Outline of Activities to Date

BONUS facilitates education, networking, career promotion and research within oncology (Figure 2).


Figure 2 Overview of the activities the British Oncology Network for Undergraduate Societies (BONUS).

Career Promotion

Medical schools typically offer very little exposure to oncology, often limited to a couple of weeks in the undergraduate curriculum [6, 7, 9, 10, 11, 12, 13, 14, 15]. To increase student engagement with oncology early in their careers, BONUS has developed a series of events designed to promote a career in the field. During the academic year of 2021/22, BONUS organised a weekly oncology webinar series aimed at medical students and junior doctors. These engaging talks were delivered by specialists and focused on topics such as clinical neuro-oncology, immunotherapy, paediatric oncology and brachytherapy. The webinars were also attended by international delegates and had an average attendance of 60 students and junior doctors. Building upon this series, BONUS hosted a national surgical oncology evening to provide an overview of the key oncological concepts within general surgery, thoracic and gynaecological malignancies. BONUS has continued this series throughout the current academic year. BONUS has launched an oncology interview series, whereby students interview consultants and trainees on their experience of working in the field, which has been shared on the BONUS YouTube channel, with subsequent interviews in production. The committee is aware that a large proportion of students now rely upon online resources for their learning. Therefore, using YouTube as a platform will engage a wide and diverse group of students seeking to explore a career in oncology.


Oncology Network

BONUS utilises its subcommittee of regional undergraduate representatives to reach students nationally. Using this strong network, BONUS has implemented a platform to enable local oncology events to be advertised nationwide and for our national events to be advertised at local universities. Mentoring in oncology has been shown to increase interest in the field [6, 16] and BONUS has developed a national mentorship scheme, which launched in 2021. The scheme is based on three pilot programmes [10, 16, 17], including one virtual scheme. The scheme, spanning a period of 6 months, pairs mentors (consultants or specialty registrars) with mentees (medical students or junior doctors) based on location and speciality of interest. This short, but important, insight into oncology allows students to gain a better understanding of a career in oncology. Mentoring can take place either virtually or in-person. Mentors may provide career advice, tailored to the mentee's interests, deliver oncology teaching, include discussion of case studies or research papers and, if applicable, the opportunity to shadow ward rounds or clinics. Mentees may become involved in oncology research proposals or projects through participation in the scheme and active engagement provides substantial networking opportunities for both parties.


Undergraduate Oncology Education

Oncology resources relevant to medical students are limited, and placement time for medical students is typically short [6, 7]. In 2021, BONUS organised revision days for medical school final examinations, covering the subjects of oncology, haematology and palliative care, which 451 delegates registered to attend. These were primarily advertised to medical students. However, a small number of junior doctors and allied health professionals (AHPs) attended. Haematology and palliative care are disciplines that are related to oncology and are equally under-represented in medical school curricula [18]. Therefore, we have decided to incorporate these within our educational talks. BONUS plans to repeat these annually before summer examinations. BONUS has launched a series of educational videos to broaden the understanding of oncology, which are published on our website and YouTube channel alongside the script. Video content, design and recording are created by the BONUS education subcommittee. The content is checked for accuracy by oncologists affiliated with the RCR and the ACP. Additionally, the development of a mobile application will enhance the accessibility of these educational resources while improving the awareness of BONUS throughout undergraduate education. BONUS is funded by the RCR to support the production of educational materials. The Medical Defence Union (MDU) and Wesleyan have previously sponsored our events. We hope to use all the resources we have to support oncology education and encourage interest in oncology beyond the syllabus that is taught at most medical schools.


Facilitating Exposure and Experience of Research

BONUS aims to provide opportunities for students to engage in research and develop their critical analysis skills. In 2021, BONUS hosted its first national virtual research day, which was attended by 35 medical students and junior doctors, whereby several talks delivered by specialists, focusing on the role of research in clinical, medical and surgical oncology, were given. A panel discussion allowed students to ask questions about opportunities to become involved in cancer research. Finally, students were invited to present their own research. Winners of oral and poster presentations were chosen by clinical, medical and surgical oncology trainees. Feedback showed increased student insight into oncology research and improved understanding of different research methods. BONUS has developed a journal club series, with the aim of advancing research skills beyond those outlined within the medical curriculum. The two BONUS journal club sessions to date have focused on the use of artificial intelligence within oncology. Future monthly virtual sessions are planned, and we hope to encourage participation of students and junior doctors both nationally and internationally. BONUS aims to encourage students to become involved in national, collaborative research projects [19]. Our research is primarily focussed on improving oncology education. However, we help students to become involved with national research projects led by NOTCH, a trainee-led research collaborative, which allows students to get in touch with oncology trainees and become embedded in a research network under the supervision of oncology trainees locally [8]. BONUS held its first pan-oncology international conference in October 2021. The conference theme was ‘teamwork in oncology’. We hosted a range of national and international speakers from each subspecialty within oncology and held a variety of workshops; these included a model multidisciplinary team meeting, careers advice, building an oncology career portfolio as a medical student and junior doctor, and research within oncology. Additionally, we ran a poster and oral presentation session to celebrate students' work within the field of oncology.


Future Work and Impact

BONUS measures its success and impact primarily through responses received on feedback forms and comments from participants who have attended our events. Forms are distributed after each event, and feedback is used to inform improvements for future events. Typical questions assess oncology knowledge and interest before and after the session, and qualitative data are collected through open-text comment questions. BONUS also measures its reach by having a good understanding of the numbers in attendance at each event, with an increase in participants suggesting a greater reach and success.


For the forthcoming year, BONUS aims to continue producing educational videos, which will be made freely available on social media platforms, and to embed these into our application. Events such as the educational revision day will be repeated with the aim to expand our reach compared with previous years, both in number and diversity of AHPs. In order to ensure sustainability and longevity of the society, past presidents remain on the committee in an advisory capacity. We hold regular meetings with consultant and trainee advocates/other societies to keep the BONUS team accountable. We are excited about our future plans and how BONUS can inspire the next generation of clinicians delivering cancer care.


We value the opportunity to increase the exposure of BONUS and reach a wider audience. BONUS is receptive to new ideas for promoting oncology among students and junior doctors and we are delighted to be contacted at bonus.oncology@gmail.com. We would be honoured to work with clinicians, AHPs, students and patients to help develop oncology events.


E-mail: bonus.oncology@gmail.com

Twitter/Facebook/Instagram: @bonusoncsoc

Website: www.bonus-oncology.co.uk

Youtube channel: https://www.youtube.com/channel/UCcQjB8DAtUvAba0CHC5AkGA


Conflicts of Interest

The authors declare no conflicts of interest


Funding

BONUS has received funding from the Royal College of Radiologist (RCR) to support out education resources.


Author Contributions 

EK, SK, PJJ and PS are guarantors of integrity of the entire study. EK, SH, TF-W, SK and PJJ were responsible for study conceptions and design. EK, SH and TF-W carried out literature research. EK, SH, TF-W, SK, PJJ and PS prepared the manuscript. EK, SH, TF-W, SK, PJJ and PS edited the manuscript.


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Original Article https://doi.org/10.1016/j.clon.2022.06.008

Published on 7 July 2022


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