M.D. Overview

From Human Oncology

Radiation oncology is the branch of clinical medicine that utilizes ionizing radiation to treat patients with cancer and also, in specific instances, diseases other than cancer. Radiation oncologists are an integral part of the multidisciplinary management of the cancer patient and must collaborate closely with physicians in related disciplines and be familiar with their role in the management of the patient.

General Information

Residency applicants will be screened according to predefined criteria to insure that selection is on the basis of applicant preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity; there is no discrimination based on gender, ethnicity, race, cultural background, or disability. Applicants must meet one of the following criteria to be considered for a UWHC GME program in Radiation Oncology:

1. Graduate of a US or Canadian medical school accredited by the Liaison Committee for Medical Education (LCME),

2. Graduate of a US college of osteopathic medicine accredited by the American Osteopathic Association (AOA),

3. Graduate of a medical school outside the US or Canada certified by the Educational Commission for Foreign Medical Graduates (ECFMG) and meet one of the following criteria:

a. Have US citizenship,

b. Have permanent legal residency status in the US (green card),

c. Have or be eligible to hold a J-1 Clinical Visa sponsored by ECFMG

NOTE: H-1 (temporary worker visas) will not be accepted.

Exceptionally qualified graduates of foreign medical schools are eligible for appointment, provided they have been certified by the Educational Commission for Foreign Medical Graduates (ECFMG). For certification and examination information, contact ECFMG, 3624 Market Street, Philadelphia PA 19104-2685, USA, phone: 215-386-5900, or the nearest United States embassy or consulate.

Students applying for first-year positions are required to register with the National Resident Matching Program (NRMP). The Radiation Oncology program prefers completion of USMLE Step 2, but it is not required to apply. Wisconsin licensure is required of all house officers/residents who have completed one year of approved post-graduate training in the United States or Canada.

Additional information can be found at www.uwgme.com.

Program Goals and Objectives

Reading X-rays The University of Wisconsin Hospital and Clinics(UWHC) and its affiliates are committed to providing a training program for residents that meets all requirements, including work hours, published in the American Medical Association's Directory of Graduate Medical Education Programs. The Department Chair (Chair) or his/her designee will be responsible for determining the educational program, the professional responsibilities, specific hours of duty and the rotation schedules necessary to comply with the requirements listed.

Educate and train physicians to be skillful in the practice of radiation oncology and to be caring and compassionate in the treatment of patients. To accomplish this goal, adequate structure, facilities, faculty, patient resources and educational environment are provided. These components provide the optimal environment for Residents to acquire a solid foundation for the understanding of radiation oncology, a knowledge base necessary to practice clinical radiation oncology in either a private or academic setting as well as problem solving and critical analysis skills necessary for the practice of radiation oncology in a setting of graduated responsibilities.

Length and Scope of Training

Resident education in radiation oncology includes five years of accredited clinically oriented graduate medical education. The first year of postgraduate clinical training is spent in medicine, family practice, obstetrics/gynecology, surgery, pediatrics, or a transitional year program (PGY1). This clinical experience is then followed by four years focused in radiation oncology (PGY2-PGY5). No fewer than 42 months of the 4-year program are spent in the clinical core curriculum of radiation oncology. In addition, the program provides the equivalent of a 2-month rotation in hematology/medical oncology, to include adult and pediatric patients, and exposure to oncologic pathology, through its integration into specific conference schedules and tumor boards or by a 1-month rotation in oncologic pathology. The remaining months allow for in-depth experience in individually selected areas applicable to clinical radiation oncology.

House Officer Responsibilities and Expectations

• Develop a personal program of self-study and professional growth with guidance from the teaching staff.
• Participate in safe, compassionate and cost-effective patient care under a level of supervision commensurate with their achieved cognitive and procedural skills.
• Participate fully in the educational activities of their program and, as required, assume responsibility for teaching and supervising other house offers and students.
• Participate in institutional programs and activities involving the Medical Staff, and adhere to established practices, procedures, and policies of the institution.
• Participate in institutional committees and councils, especially those related to patient care review activities.
• Learn and apply reasonable cost containment measures in the provision of patient care.
• Fulfill the educational requirements of the training program established for their specialty.
• Observe the rules, regulations, policies and procedures of the hospital and other institutions where they are assigned.
• Observe applicable laws and regulations of the institutions in which they train.

Stipends

University of Wisconsin Hospital and Clinics strives to maintain house officer stipend levels at the mean of state-owned Midwest hospitals. Annual mean rates are based on the Council of Teaching Hospitals annual stipend survey and adjusted as necessary. Stipend levels depend on individual entrance requirements and previous training applicable toward eligibility for board certification in the training specialty.

Promotions

Appointments beyond the initial appointment are made for one year. A resident is promoted to subsequent levels in the program unless the Chair or Director determines that the resident has demonstrated inadequate scholarship and professional growth. Semi-annual evaluations are provided to apprise residents of their progress.

Ethical/Religious Beliefs

No resident shall be penalized for refusing to perform medical procedures he/she finds contrary to his/her ethical or religious beliefs, provided that the resident has been given reasonable notice of such beliefs. However, residents must complete the training required by the applicable accreditation body before UWHC can certify that the resident has completed the training program.

Licensure

In the state of Wisconsin, all physicians beyond their first year of postgraduate training are required to obtain a Wisconsin medical license. There are two options for residents: a temporary educational permit (TEP) and full licensure. Failure to obtain and maintain a valid Wisconsin medical license will result in termination of appointment. As of July 1, 1997, UWHC will reimburse second year residents for the initial license application fee and TEP fee upon receipt of full licensure. All other licensure fees are the responsibility of the resident. Back to top Leaves

• Vacation: House officers are entitled to three weeks of paid vacation per training year.
• Professional Meetings: Levels 2 and above recieve a week of paid professional meeting time per training year.
• Family Leave: UW Hospital and Clinics grants family leave in compliance with state and federal laws.

Benefits

• Liability Insurance: Comprehensive liability protection is provided for house officers for training-related incidents. No protection is provided for activities outside the training program's scope, such as moonlighting.
• Disability Insurance: All house officers are covered by a hospital-paid long-term disability plan.
• Optional Insurance Plans: House officers are eligible for a variety of optional insurance plans, at additional cost. Contributions can be made through payroll deduction; these include: health insurance, life insurance, and accidental death and dismemberment insurance.
• Tax Sheltered/Deferred Programs: House officers are eligible for a variety of tax sheltered annuity (403b) and deferred compensation retirement plans.
• Employee Reimbursement Account (ERA): This program allows house officers to pay for approved dependent care and medical expenses using pre-tax income.
• Merck Loan: An emergency loan is available to house officers for $750 at 2 percent interest (amount and rates subject to change).
• Licensure: The hospital reimburses second-year house officers for initial license application fees and TEP upon receipt of full licensure. All other licensure fees are the house officer's responsibility.
• DEA Registration: All hosues officers are encouraged to obtain DEA registration. The hospital pays initial application and renewal fees to cover the training period at UW Hospital and Clinics.
• White Coats: White coats are provided and laundered by the hospital.
• On-Call Meals: House officers on-call at UW Hospital overnight are provided dinner that night and breakfast and lunch the next day. Those on-call from home and required to be at the hospital during the night and unable to return home are provided breakfast. The hospital delivers light evening snacks to the house staff lounge for on-call house officers who are unable to get an evening meal. Affiliated hospitals set their own limits for meals.
• House Officer Lounge: This lounge contains a television, refrigerator and microwave oven.
• UW Affiliate Photo ID: The UW affiliate photo ID allows house officers to access library services and recreational facilities on the UW campus. The ID also allows discounts at various local businesses.
• Membership on Medical Staff Committees: House officers have voting representation on the UW Hospital and Clinics Medical Board and its committees. These representaives are selected jointly by the chair of the Medical Board and the president of the Housestaff Association (HA).
• Counseling and Support: House officers and their immediate family are eligible for free confidential counseling, support and assistance with issues such as psychological, marital, legal and financial problems.
• Physician Impairment: The Physician Health Committee, a Medical Staff standing committee, assists house officers with impairment issues, including substance abuse, mental disorders and physical disabilites.

House Officer Duty Hour Policy

I. PURPOSE

To ensure the quality of patient care and of medical education is never compromised by diminished function resulting from excessive fatigue and stress.

II. POLICY

The Radiation Oncology residency program shall meet ACGME institutional and program duty hour requirements. Excerpt from Common ACGME Program Requirements:

"Providing residents with a sound academic and clinical education must be carefully planned and balanced with concerns for patient safety and resident well being. Each program must ensure that the learning objectives of the program are not compromised by excessive reliance on residents to fulfill service obligations. Didactic and clinical education must have priority in the allotment of residents' time and energies. Duty hour assignments must recognize that faculty and residents collectively have responsibility for the safety and welfare of patients."

Duty hours are defined as all clinical and academic activities related to the residency program, i.e. patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

III. PROGRAM SPECIFIC DUTY HOUR PROCEDURE

The Radiation Oncology Residency Program shall maintain compliance with the UWHC Duty Hour Purpose and Policy stated in sections I and II above.

A. Program Director Responsibilities

1. Monitor house officer duty hours to assure that excessive fatigue or stress in the house officer does not adversely affect patient care.

2. Monitor house officer stress, including the possibility of mental or emotional condition, which might inhibit the performance of learning.

3. Monitor time allocation to provide appropriate scheduling that permits participation in educational activities.

4. Monitor distribution of policies to the residents and the faculty.

5. Ensure faculty and residents are educated to recognize the signs of fatigue and adopt and apply policies to prevent and counteract the potential negative effects.

6. Ensure duty hours are limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

7. Ensure residents are provided with one (1) day in seven (7) free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

8. Ensure adequate time for rest and personal activities is provided, when applicable, which shall consist of a 10-hour time period provided between all daily duty periods and after in-house call.

B. On-Call Activities

1. The objective of on-call activities is to provide residents with continuity of patient care experiences throughout a 24-hour period. In-house call is defined as those duty hours beyond the normal workday when residents are required to be immediately available in the assigned institution. Radiation Oncology Residents do not provide in-house call coverage at any time during their training.

2. At-home call (pager call) is defined as call taken from outside the assigned institution. The Radiation Oncology program falls in this category.

a. The frequency of at-home call is not subject to the every third night limitation. However, at-home call will not be so frequent as to preclude rest and reasonable personal time for each resident. Residents taking at-home call will be provided with one (1) day in seven (7) completely free from all educational and clinical responsibilities, averaged over a 4-week period.

b. When residents are called into the hospital from home, the hours residents spend in-house will be counted toward the 80-hour limit.

c. The Program Director and the faculty will monitor the demands of at-home call in this program and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.

IV. OUTSIDE ACTIVITIES Outside activities shall not adversely affect residents' primary responsibility to patients at the training institution. No compromise of a patient's medical care shall occur to fulfill an outside activity obligation. Residents are expected to take into consideration patient load, reading requirements, rotations, and other training responsibilities, when planning to schedule outside activities (e.g. moonlighting), so as not to compromise their capabilities. Individualization toward more restrictive or specific policies and procedures concerning outside activities on an annual basis may be applied, depending on specific circumstances relevant to training objectives. The House Staff Committee, a standing committee of the Medical Staff, is responsible for reviewing all alleged infractions of this policy if not resolved at the department level.

V. MONITORING To monitor program compliance, the UWHC Office of House Staff Administration will conduct an annual working conditions survey of house officers and report the results to the GME Oversight Committee. The annual house staff survey includes specific questions related to duty hours and working conditions. Programs will be advised of their compliance status annually.

House officer concerns regarding duty hours, stress, and working conditions should be submitted, in writing, to the Office of House Staff Administration. Those requiring GMEOC action will be presented for review.