4-Year Educational Plan
In order to train future practitioners of radiation oncology, we provide a comprehensive educational experience that will expose residents to all aspects of radiation oncology. We have designed a curriculum that is innovative, individualized and integrative. The residency experience entails clinical rotations, didactics (graduate level courses and several weekly conferences and tumor boards) dedicated research time, and pathways that allow residents to specialize and focus on areas of interest within the specialty. Residents finish the program with a deep understanding of cancer including the biology, pathology, natural history, work-up and treatment approaches with radiation therapy, surgery and chemotherapy. Residents become competent in the delivery of radiation therapy including techniques of external beam radiotherapy as well as interstitial and intracavitary radiotherapy. Through a variety of experiences and resources available, residents become well prepared for their board examinations.
Clinical Rotations
Radiation Oncology Clinical Service
In order to obtain the essential skills and knowledge, residents will spend a significant portion of their residency on the Radiation Oncology Clinical Services. Each physician faculty runs their own clinical service specializing in specific disease sites. Residents will rotate through each service at least three times throughout residency and potentially more if interested in a specific service/disease. Clinical rotations will vary in length each training year in order to meet the overall educational learning goals.
Department faculty clinical services include:
| Faculty Clinical Service | Topics/Disease Sites | Special Procedures |
|---|---|---|
| Carryn Anderson, MD | Head and Neck, Melanoma, Sarcoma, Skin/Soft Tissues | Eye Plaque Brachytherapy, Spinal Stereotactic Radiosurgery |
| John Buatti, MD | Pediatrics, Head and Neck, Skin, Central Nervous System | Extracranial Stereotactic Radiosurgery, Craniospinal Stereotactic Radiosurgery, Radiation Therapy, and Eye Plaque Brachytherapy |
| Bryan Allen, MD | Thoracic Cavity, Lung | Thoracic Malignancies, Eye Plaque Brachytherapy, Pancreatic/Esophageal Stereotactic Radiosurgery |
| Mark Smith, MD | Brain, Central Nervous System, Genitourinary, Lymphomas and Leukemias, Palliation | Prostate Stereotactic Radiosurgery, Brachytherapy, Cardiospinal Radiation, Total Body Irradiation Therapy, and Eye Plaque Brachytherapy |
| Wenqing Sun, MD | Gynecology, Breast, Head and Neck | Gynecologic Brachytherapy, Breast Brachytherapy, and Eye Plaque Brachytherapy |
| Joseph Caster, MD, PhD | Gastrointestinal, Gynecologic | Eye Plaque and Gynecologic Brachytherapy, Prostate Stereotactic Radiosurgery, Pancreatic/Esophageal Stereotactic Radiosurgery |
| Kristin Plichta, MD, PhD | Thoracic Cavity, Breast | Breast and Eye Plaque Brachytherapy and Thoracic Malignancies |
Selectives
These blocks are additional clinical experiences that further enhance the understanding of Radiation Oncology.
- Radiology - An optional four-week rotation that consists of a combined experience in Diagnostic Radiology, PET/Nuclear Medicine and Neuroradiology taken in PGY3
- Dosimetry - A designated 4-week block that focuses on the clinical integration of Radiation Oncology taken in PGY2
Clinical Experience Overview
Learning Goals:
- PGY2: Foundation and Exposure
- PGY3 - PGY4: In-depth Understanding/Learning, Increase Responsibility
- PGY5: Specialize/Focus and Autonomy
| PGY2 | PGY3 | PGY4 | PGY5 | Total Weeks | ||
|---|---|---|---|---|---|---|
| Clinical Radiation Oncology (Faculty Services) | 44 weeks 5-6 8-week blocks Exposure to all clinics |
40 weeks 5 8-week blocks Increase depth of clinical understanding |
44 weeks 5-6 8-week blocks Repeat area of interest |
36 weeks 5 8-week blocks Resident choice of clinic based on career path |
164 weeks | |
| Selectives | 4 weeks Dosimetry |
4 weeks optional Radiology |
4 weeks optional Radiology |
8 weeks |
Conferences
Both conferences and courses are offered on a continual basis that residents are required to attend in order to be exposed to the full spectrum of content in Radiation Oncology.
Residents have the opportunity to learn from faculty, guest speakers, and peers in a myriad of venues, including several departmental as well as interdisciplinary conferences and tumor boards on a weekly basis. Residents also develop excellent presentation and speaking skills by frequently giving lectures and honing their teaching efforts.
Clinical Case Conferences
Twice a week, residents and faculty present Case Conferences that pertain to specified disease sites and relevant patient cases. Residents present ½ hour, concise power point presentations on a disease site, while faculty facilitate discussion and present patient cases to engage all learners in this interactive learning session. Both residents and faculty come prepared to teach and learn! Topics are presented in a longitudinal curricular approach so residents are exposed to all topics throughout the year rather than one month at a time.
The following elements are included in each Case Conference pertaining to the disease site:
- Work up, diagnosis and staging of the patient’s case
- Treatment options
- Particular radiation plan used to treat the patient
- Review of relevant sentinel studies or literature supporting the use of radiation for the patient
- Potential acute and long-term complications of the treatment
- Prognosis and other expected outcomes
- Relevant patient cases
Chart Rounds
Chart Rounds occur once a week and focus on our clinic patients starting treatment. Residents briefly present the patient’s diagnosis, stage, brief history, and a description of the treatment plan. Input is provided from faculty, physicists, dosimetrists, and staff.
Residents become very familiar with the patient’s treatment plan by displaying and describing relevant treatment fields and dosimetry, understanding how the GTVs, CTVs, and PTVs were constructed, and awareness of the goal doses to each PTV along with the doses to each dose-limiting structure.
Journal Club
Journal Club meets at least six times a year to focus on Practice-Based Learning and Improvement skills. The curriculum prepares residents to effectively investigate and evaluate their patient care practices, and appraise/ assimilate scientific evidence by utilizing an Evidence Based Medicine approach. Residents will increase their EBM skills, effectively be able to facilitate a Journal Club discussion and ultimately apply their knowledge to improve their own patient care.
Tumor Boards
Residents are required to attend specific disease-site Tumor Boards. Medical and allied professionals from a variety of departments attend tumor board conferences and focus on the interdisciplinary nature of patient care. The following Tumor Boards are scheduled 2-4 times a month.
- Melanoma
- Thoracic
- Sarcoma
- Lymphoma
- Gyn Onc
- Peds Onc
- Neuro-Path
- Genitourinary
- Head and Neck
- Breast
- Hepatic
Personal and Professional Development Series
To help residents grow personally, professionally, and healthfully, the Department offers this series to cover a variety of issues relevant to a resident’s life, practice and health. Residents meet with a variety of in-house guest speakers and discuss topics listed below. Additionally, every year the department sponsors a Resident Retreat that focuses on resident wellness, team building and special topic issues.
- Giving Bad News
- Nursing Topics
- Impaired Residents/Faculty
- Billing and Coding
- Teaching Skills
- Cultural Diversity
- Pain Management
- Interviewing/CVs
- Stress Management
- Palliative Care and Hospice
- Ethics
- Finances
- Leadership Skills
Courses
The residency curriculum includes teaching of basic sciences essential to training in radiation oncology, including radiation biology and Medical Physics. These courses are taught by our own medical physics and Free Radical and Radiation Biology faculty. Residents are relieved of all clinical duties during course meeting times. Courses are required and taken the first two years of residency. PGY4 and PGY5 residents have the option of repeating the courses to further their understanding and learning. Departmental courses offered include:
| Course | Students | Offered |
|---|---|---|
| Medical Physics* | RTT Students Rad Onc Residents FRRB Graduate Students Dental Residents/Fellows |
Every Spring and Fall Semester |
| Radiation Biology* | Rad Onc Residents FRRB Graduate Students Other Graduate Students |
Fall Semester, Odd Years |
| Biostatistics | Rad Onc Residents | Spring Semester, Even Years |
* Graduate level course
Independent Study and Board Preparation
The field of Radiation Oncology is a highly academic specialty in which residents need to continually and consistently on their own, study the vast amount of content. For successful completion of the residency program, passing boards and effectively integrating knowledge into patient care – it is expected that each resident begins this independent study process from day one of residency. Residents will develop their own Learning Plan each year and will be monitored for progress by the Program Director semi-annually.
In addition to independent study, the program offers several exams annually to help prepare residents for boards. Residents are required to take and perform at an expected level for the following exams: In-Service, RAPHEX (physics), and Mock Orals. In-Service and RAPHEX exam scores allow residents to compare and gauge their performance nationally against their peers. The goal of mock oral exams is to simulate the actual board exam so residents are not only prepared for the medical knowledge but for the test-taking skill itself. Residents also have the opportunity to take the RABEX (radiation biology).