Program Curriculum

General Objectives of the Residency Training Program

1. Resident is expected to become competent in all areas related to the safe and efficacious use of ionizing radiation as it relates to simulation, planning and treatment of human disease. This is accomplished in part through routine evaluated clinical rotations.
2. Resident is expected to complete structured rotations that include written summaries/reports at the completion of the rotation. Evaluations will occur throughout each rotation in one-to-one and group settings.
3. Resident will present, review and defend his/her knowledge of a given rotation in oral-based sessions with the residency program faculty.
4. Scott & White Medical Physics Residency quarterly grades will be based on the results of ongoing evaluations and rotation-end oral evaluations.
5. Resident is expected to obtain an appropriate mastery of the physical principles (e.g. interactions of radiation in matter, radionuclidic decay therapy) associated with the use of radiation in treatment of human malignancy.
6. Resident is responsible for obtaining a level of training in anatomy, computer technology and diagnostic imaging appropriate for a position as a therapeutic radiological physicist. This is primarily accomplished during the clinical dosimetric treatment planning rotation and didactic courses on these topics.
7. Resident will demonstrate knowledge sufficient to insure he/she can manage the radiation safety aspects of a radiation oncology practice.
8. Resident is expected to attend department conferences and radiation physics section meetings.
9. Resident will understand the potential uses of – and hazards associated with – ionizing radiation and high voltage electronics as used in the practice of radiation oncology.
10. Radiobiological principles of the use of radiation will be understood by the resident, through both didactic and practical training.

Rotation Outline and Structure

There will be three essential phases of mentoring in each rotation

1. Initial observation, discussion and reading. A bibliography will be provided for the resident to read consisting of book chapters, salient papers and web-based instruction. At the same time, the resident will observe and receive explicit instruction on why, how, what with attention to making sure the resident understands the fundamental aspects of the current rotation. There will be a meeting with at least one of the Physics faculty members at the end of Phase I to review/document assessed resident progress. An evaluation will be written by the mentor, documenting progress.
2. Engaged in the rotation, but closely supervised, the resident will work hand in hand with the mentor, performing the tasks under direct supervision. This phase develops the confidence in the resident's ability to carry out the process. An evaluation will be written by the mentor, documenting progress. There will be a meeting with at least one of the Physics faculty members at the end of Phase II to review/document assessed resident progress.
3. During the final phase of each rotation the resident will perform the duties as a medical physicist would be expected, using the mentor as a consultant for questions. The mentor will evaluate the resident on the level of competence developed at this stage of the residency. For many rotations, a deliverable in the form of a written report or document, formatted data or computer printouts will be specified. A report and oral evaluation will be done as above at the end of Phase III. Each of these will be documented.

Report Structure and Oral Evaluation

Each resident will maintain a resident log, where activities for each day or week will be logged. These will be discussed and reviewed with the primary mentor during weekly meetings. Mentor comments will be logged in the file.

In addition, a written document outlining the material covered in a given rotation will be prepared and submitted by the resident at the end of a rotation. It is expected that the resident does understand the material outlined, without necessarily documenting every detail in the report.

The resident will deliver a short 30-minute talk on the topic of the rotation. The presentation will be followed by a 1½ – 2 hour oral exam by at least three of the Physics faculty members to complete the rotation.

Rotation Topics

• Detectors and dosimeters
  • Calibrate an ionization chamber and electrometer through an ADCL
  • Perform and report constancy checks between standard and field instruments
  • Compute parameters for TG-51 calibration procedures
  • Perform and report TLD exposures for RPC checks
  • Characterize film and/or CR scanner for quantitative measurements
  • Measure and report in vivo dose with MOSFETs
  • Measure and report GM measurements before an HDR treatment
  • Measure and report x-ray and neutron dose levels around a linear accelerator
• Radiation safety
  • Report primary calibration and QA checks of a GM system
  • Establish and maintain a mock personnel monitoring process
  • Establish and maintain mock radiation safety training for staff
• Treatment equipment
  • Establish action levels for daily linac output check system
  • Perform and report monthly linac and superficial QA
  • Perform and report annual linac QA
  • Design and document a linear accelerator vault
  • Write a mock license application to register a linear accelerator
  • Perform acceptance tests on a linac and accessories (e.g. MV-EPIDs, KV-EPIDs)
  • Perform and report calibration of dose/MU for linac x-ray and electron modes
• Imaging
  • Perform and report calibration of CR, CT, MRI, PET, and US systems
  • Measure and report MTF
• Conventional simulation
  • Design and document a conventional simulator room
  • Perform and report a conventional simulator acceptance test
  • Perform and report monthly conventional simulator QA
• CT simulation
  • Design and document a CT simulator room
  • Perform and report a CT simulator acceptance test
  • Perform and report monthly CT simulator QA
• Patient treatment
  • Attend and report on tumor board for treatment site
  • Observe immobilization, planning MRI, CT simulation for treatment site
  • Compute mock treatment plan for site (contouring, field placement, MUs, . . .)
  • Compute mock treatment plan for stereotactic radiosurgery
  • Perform and report weekly chart checks
  • Perform and report QA of treatment planning system
• IMRT
  • Compute mock IMRT inverse plan
  • Transfer IMRT plan data to information management system for delivery
  • Perform and report IMRT QA
• Brachytherapy
  • Perform and report calibration and contamination tests for sealed sources
  • Manage and report shipping and receiving of radioactive sources
  • Compute mock LDR and HDR treatment plans for specified sites
• Other duties
  • Teach classes to physician Residents
  • Review and revise CPT billing profiles for specific clinical procedures
  • Review and revise Policy and Procedure documents for ACR compliance
  • Time permitting, carry out and report on a small research project

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