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Radonc Program and Rotations

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Radiation Oncology Residency


The radiation oncology residency program provides the resident with the opportunity to gain in-depth knowledge of clinical radiation oncology, including the indications for irradiation and special therapeutic considerations unique to each site and stage of disease. The resident is trained in standard radiation techniques as well as in the use of treatment aids and treatment planning to optimize the distribution of the radiation dose. The principles of normal tissue tolerance to radiation and tumor dose-response are taught. The use of combined modality therapy and altered fractionation schemes are also part of the clinical curriculum.


The clinical core curriculum includes experience with gastrointestinal, gynecologic, genitourinary, reticuloendothelial, breast, soft tissue and bone, skin, head and neck, lung, pediatric, and central nervous system tumors. In addition, the curriculum provides instruction in the physics, biology, and clinical applicability of the following areas: radiosurgery, fractionated stereotactic radiotherapy, conformal therapy, three-dimensional treatment planning, intensity-modulated radiotherapy, radioimmunotherapy, total body irradiation as used in bone-marrow transplantation, total skin irradiation, high-dose-rate brachytherapy, hyperthermia, plaque therapy, and others that may be developed, as they apply to the core curriculum.

The resident is also trained in the use of external beam modalities, including superficial irradiation; mega-voltage irradiation, such as low-and high-energy x-rays; electron beam; simulation to localize anatomy; and computerized treatment planning. The faculty will ensure that the resident personally performs technical procedures, including treatment setups as well as intracavitary and interstitial placement of radiation sources, and that the resident keeps a detailed log of these procedures. It is required that a resident perform no fewer than five interstitial implants in at least five patients and ten intracavitary implants in at least ten patients, assist in an additional five interstitial implants in at least five patients and ten intracavitary implants in at least ten patients during the course of training.

Follow-up of the irradiated patients by the resident, including pediatric patients, on an inpatient or outpatient basis is a required part of resident training and must be demonstrated by the program to ensure that residents have the opportunity to learn about the problems of recurrent and disseminated tumors and of late aftereffects and complications of radiation therapy.


Program Schedule

PGY-2 First Year - Time Spent

  • Orientation (1 week)
  • Brain Tumors (2 monts)
  • Lung Cancer (2 months)
  • Pediatric Tumors (3 weeks)
  • Breast Cancer (2 months)
  • GI Neoplasms (2 months)
  • GU Neoplasms (2 months)
  • National Meeting (1 week) and Vacation (3 weeks)

PGY-3 Second Year - Time Spent

  • Gynecology and Brachytherapy (3 months)
  • Melanoma/Sarcoma/Lymphoma (3 months)
  • Brain/Lung/Peds/Radiosurgery: Introduction (2 1/2 monhs)
  • Breast/Hyperthermia (2 1/2 months)
  • National Meeting (1 week) and Vacation (3 weeks)

PGY-4 Third Year - Time Spent

  • Advanced Radiosurgery (2 months)
  • 3-D Treatment Planning (2 months)
  • Advanced Brachytherapy (1 months)
  • Research (6 months)
  • National Meeting (1 week) and Vacation (3 weeks)

PGY-5 Fourth Year - Time Spent

  • GI/GU (3 months)
  • Head and Neck (3 months)
  • Gynecology and Brachytherapy (3 months)
  • Breast, Including Brachytherapy (2 months)
  • National Meeting (1 week) and Vacation (3 weeks)

Rotations - Goals and Objectives

Please select a link to view information on a specific rotation


Didactic Components

Presentations

A number of sessions are presented over a period of time which address equipment acquisition and validation, laboratory information systems, Medicare issues, regulations and inspections, professional activities, general administration, labor issues, budget development and monitoring, and relationships with outside facilities and vendors.

Conferences and Teaching Rounds

There is adequate frequency of conferences, with attendance by residents documented, which provide for progressive resident participation. Adequate conference room and audiovisual facilities are provided. The clinical and basic sciences are taught through regularly scheduled lectures, case presentations, conferences, and discussions relevant to the practice of radiation oncology. The training program provides curricula for the teaching of basic sciences essential to training in radiation oncology, including radiation biology and medical physics. The curriculum in medical physics includes didactic lectures and laboratory demonstrations of radiation safety procedures, calibration of radiation therapy machines, the use of the computer for treatment planning, the construction of treatment aids, and the safe handling of sealed and unsealed radionuclides. The radiation biology curriculum includes didactic lectures on all aspects of radiation effects on normal and neoplastic tissues. The program also familiarizes the resident with medical statistics, through an organized program of lectures or conferences, and oncologic pathology, with special emphasis on neoplasia and radiation effects. There is didactic instruction in the potential value and limitations of other oncologic disciplines, such as medical oncology, surgical oncology, gynecologic oncology, hematologic oncology, pediatric oncology, and the various surgical subspecialties that play a role in the management of the patient. This is accomplished by attendance at multidisciplinary and departmental conferences. There is intradepartmental clinical oncology conferences, including new patient conferences, weekly chart reviews, problem case conferences, morbidity and mortality, physics, dosimetry, radiation biology, and journal review.

  • Radiotherapy Teaching Conference: Presentations will be given on various topics relating to radiation oncology (2 hours per week).
  • Radiation Oncology Case Conference: Patients recently consulted will be presented by the resident or responsible staff member. This should include brief history and physical, pertinent lab tests, x-rays and port films. Polaroid photographs and drawings may also be advisable in certain cases. Discussion of the case and management will follow. (1 hour per week; alternates with administrative meeting, Journal Club and didactic faculty presentations).
  • Gyn Tumor Conference: A similar presentation of all new gynecological cases, ongoing problems and intracavitary applications, held jointly with the gynecologic oncology staff and residents (1 hour per week).
  • Human Oncology Grand Rounds: Presentations, lectures and discussion of timely and interesting topics related to the specialty of Oncology and other closely associated specialty topics (1 hour per week).
  • Journal Club: Discussion of classical and current journal articles. Presentation made by staff, a resident, a radiobiologist and a med physicist on a weekly rotating fashion. Copies of articles to be discussed should be distributed one week prior to the conference. (1 hour per week).
  • Pathology Conference: Review of slides for patients who have been seen in Radiation Oncology including pertinent teaching material (1 hour per week).
  • Chart Rounds/Quality Assurance Conference: Quality assurance conference and a discussion of patients who are presently undergoing radiotherapy treatment. The Radiation Oncology faculty preside and all residents and staff M.D.'s are required to attend. Charts from three treatment units are reviewed for correctness of the prescription from a clinical and physics perspective. There are no scheduled appointments during Chart Rounds. The medical, nursing and technical staff are expected to participate in discussions of the quality of prescribed treatment, beam films and patient management. (1 hour per week).
  • Meriter Hospital Tumor Board: This community hospital based multi-disciplinary tumor board meets for 1 hour, 3 times per month, and provides residents a unique opportunity for case discussion from a community practice perspective.
  • UW Multi-Disciplinary Tumor Board: Meets every other week for one hour, and using innovative distance-education tools links multiple regional cancer centers for case discussions.
  • Radiation Physics: Course in radiation and medical physics (1 hour per week).
  • Radiation Biology: Course in radiation biology (2 hours per week).
  • Biostatistics Training Program: All residents participate in research projects and this requires rigorous biostatistical analysis, one-one-one, with mentor faculty. Residents are trained in clinically relevant biostatistical approaches using both Socratic and didactic approaches.
  • Head and Neck Oncology Multidisciplinary Tumor Board: Presentations of cases with treatment recommendations (1 hour per week).
  • Pediatric Oncology Brain Tumor Clinic: Involves multi-disciplinary pediatric oncology brain tumor management discussion (1 hour per week).
  • Pediatric Oncology Tumor Board: Participation in pediatric oncology patients cases. Exposure to all types of pediatric oncology diagnosis and treatment. Extra training in pediatric late effects, enhancing training in Pediatric Oncology. (1 hour per week).
  • Neuro-Oncology Conference: Presentation and review of neuro-oncology patients with treatment recommendations, literature review and clinical trial discussion (1 hour per week).
  • GI Conference: Review of cases (primarily hepatobiliary/ pancreatic) and treatment recommendations (1 hour per week).
  • GU Conference: Urology Conference Room. Protocol review, journal club, review of cases (1 hour per week).

Resident Investigative Project

During their training, residents are required to engage in an investigative project under faculty supervision. It can take the form of laboratory or clinical research, or the retrospective analysis of data from treated patients, and results of such projects shall be suitable for publication or presentation at local, regional, or national scientific meetings.

Radiation Oncology Residents' Forum

Senior residents and all research residents shall make formal presentations of their basic science and/or clinical work performed during their research year and/or clinical training. A DHO faculty discussant would be designated for each presentation to lead comments regarding the topic of presentation.

Evaluations

Evaluation of Residents by Faculty/Teaching Staff

Evaluations of each resident's progress and competence is conducted mid-rotation, at the end of rotation, and as needed. The evaluations include an assessment of intellectual abilities, attitudes, and interpersonal relationships as well as clinical competence, decision-making, and clinical management skills. There is provision for appropriate and timely feedback of the content of these evaluations to the resident. Residents are advanced to positions of higher responsibility only on the basis of evidence of their satisfactory progressive scholarship and professional growth. The program maintains a permanent record of the evaluation and counseling process for each resident. Such records are accessible to the resident and other authorized personnel. The Director provides a written final evaluation for each resident who completes the program. It shall include a review of the resident's performance during the final period of training and verifies the resident has demonstrated sufficient professional ability to practice competently and independently. This final evaluation is part of the resident's permanent record maintained by the institution.

Evaluation of Faculty/Teaching Staff by Residents

Evaluations of the faculty and teaching staff are completed by the residents at the end of each rotation and are utilized to give feedback to the faculty/teaching staff on areas of strength as well as improvement; they are also utilized in the program's evaluation process.

Evaluation of Program by Residents

The educational effectiveness of the program must be evaluated; in particular, assessing the quality of the curriculum and the extent to which the educational goals have been met by residents. Residents have the opportunity to evaluate the program at the end of each program year and upon completion of the program. Written evaluations by residents are utilized in the program evaluation process.