Horia Vulpe, Senior Medical Director of Radiation Oncology at Southern Ohio Medical Center, shared on LinkedIn:
“I don’t often share personal stories, but this one directly relates to our recent paper on the UK’s radiotherapy workforce shortage.
In 2025, I was planning a move to London, where my partner lives. I had a job offer to deliver radiotherapy and a GMC license to practice. During credentialing, we learned that there is no pathway for a radiation oncologist to enter the GMC Specialist Register. The UK only recognizes clinical oncology, requiring competence in both RT and systemic therapy.
That led us to examine the workforce shortage and barriers facing internationally trained radiation oncologists.
The UK differs from its peer countries, where radiation oncology and medical oncology are separate specialties. The result is a one-way valve: clinical oncology specialists can leave the UK, while radiation oncologists cannot come in.
The 2025 RCR census reports a 17% consultant shortfall across the UK, projected to reach 26% by 2030. Regionally, it reaches 27% in the East Midlands and 39% in North Wales.
- 90% of cancer centers reported RT delays
- 51% of Heads of Service have seen patients’ conditions worsen because of workforce shortages
Year after year, RCR recommendations remain similar: more training posts, more oncology exposure in medical school, better retention, and better working conditions. But clinical oncology training takes at least 7 years and these measures would not beging to address the shortage until the mid-2030s.
Title: The UK’s radiotherapy workforce shortage: Reforming regulation to address the gap
Authors: Horia Vulpe, Alison Tree, Pat Price, David Abelson, Ajay Aggarwal, Richard Sullivan
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Our GMC Freedom of Information request found just 28 internationally trained clinical oncologists admitted to the Specialist Register from 2020-2024, from: India (12), Egypt (6), Pakistan (5), South Africa (2), Brazil (1), Hong Kong (1), and Jamaica (1).
Recruiting international radiation oncologists could help alleviate short- and medium-term radiotherapy staffing needs, yet a specialist registration pathway with a limited scope of practice to RT has not been created.
Meanwhile, Australia, New Zealand, and Canada are expanding fast-track pathways to recruit international specialists. In turn, the UK can make it difficult even for its own citizens who wish to return home after a period of training abroad in recognized specialities.
Our proposal:
Create a radiation oncology-specific specialist registration pathway, with robust credentialing and a defined scope of practice.
If a role exists to deliver radiotherapy, an internationally trained radiation oncologist should not need years of additional systemic therapy training to fill it.”
Title: The UK’s radiotherapy workforce shortage: a case for reform
Authors: Horia Vulpe, Alison Tree, Pat Price, David Abelson, Richard Sullivan
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