Curriculum and Courses

Curriculum:

The program consists of rotations where the resident is expected to spend the majority of the time in ‘hands-on’ clinical activities and responsibilities. The program includes courses which consist of applied and practical courses delivered within the Radiation Oncology Clinic as well as lecture-based and web-based didactic courses.

 

Clinical Rotations:

The resident will complete 8 three-month rotations. For each rotation, the resident will be under the supervision of a physics faculty chief mentor and additional physics faculty mentors as needed.

Training Period

Rotation Description

Year 1, Quarter 1

Rotation 1

 

Rotation Title: Introduction to Medical Physics in Radiation Oncology

Main Objectives:

  1. The resident shall receive the ethics and professionalism training as dictated in section I.A.
  2. The resident shall receive radiation safety trainings from the quarterly mentor and the RSO, and understand the safe practices in radiation oncology.
  3. The resident shall get familiar with the radiation therapy workflow including consults, nursing, simulation, treatment planning, treatment, and follow-up.
  4. The resident shall know the operations of Linac, CT Simulator, and HDR afterloader, and know how to perform daily QA for Linac, CT, and HDR as well as monthly QA for Linac and CT.
  5. The resident shall become independent in performing all activities related to patient specific QA.
  6. The resident shall know how to use the record & verify system, understand the treatment planning basics, and get ready for doing clinical plans in the next rotation.

Monthly Oral Exam Topic:

  • (Jul)  Basics of radiotherapy workflow; simulation and patient setup; basics of radiation safety
  • (Aug) Basics of QA: machine QA; patient specific QA; CT periodic QA;  HDR spot check
  • (Sep) Comprehensive quarterly exam

Year 1, Quarter 2

Rotation 2

 

Rotation Title: Treatment Planning I (2D, 3D, Electron, TBI)

Main Objectives:

  1. The resident shall know the conventional treatment planning terminology and methods for both photon and electron.
  2. The resident shall understand the dose calculation algorithms and MU calculation principles, and know how to use Rad Calc as well as how to do TBI MU calculation.
  3. The resident can independently plan 2D/3D/Electron/TBI treatments like a dosimetrist.

Monthly Oral Exam Topic:

  • (Oct)  Treatment planning concepts, terminology, methods
  • (Nov)  Dose calculation algorithm, MU calculation, TBI
  • (Dec)  Comprehensive quarterly exam

Year 1, Quarter 3

Rotation 3

 

Rotation Title: Treatment Planning II (IMRT, VMAT, SBRT, SRS)

Main Objectives:

  1. The resident shall understand IMRT/VMAT concepts, optimization methods, and delivery techniques.
  2. The resident shall know the details of simulation, planning, treatment, and QA for high-precision treatments.
  3. The residents can independently plan IMRT/VMAT/SBRT/SRS treatments like a dosimetrist/physicist.
  4. The residents shall know how to use other TPSs and record&verify systems that are not currently used clinically in the department.

Monthly Oral Exam Topic :

  • (Jan)   IMRT/VMAT planning, SBRT/SRS planning
  • (Feb)   Small field dosimetry
  • (Mar)  Comprehensive quarterly exam

Year 1, Quarter 4

Rotation 4

 

Rotation Title: Quality Assurance, Calibration, and Commissioning

Main Objectives:

  1. The resident shall know every detail of Linac daily, monthly and annual QA per TG40 and TG142.
  2. The resident shall know every detail of Linac output calibration per TG51.
  3. The resident shall understand the acceptance and commissioning process for Linac, TPS, CT, and HDR systems.
  4. The resident shall know the principles, use, QA, and calibration of all dosimetry equipment.

Monthly Oral Exam Topic :

  • (Apr)   Linac commissioning, QA, dosimetry equipment
  • (May)  TPS commissioning; TG 51 & Addendum
  • Jun)   Comprehensive quarterly exam

Year 2, Quarter 1

Rotation 5

 

Rotation Title: Brachytherapy and Radiation Safety/Protection

Main Objectives:

  1. The resident shall know the brachytherapy dose calculation per TG43.
  2. The resident shall know the LDR/HDR treatment workflow, equipment, QA.
  3. The resident can independently perform treatment planning for the LDR/HDR cases that occur in the department.
  4. The resident shall know the radiation safety principles, radiation survey, state and federal regulations, and shielding design theory.

Monthly Oral Exam Topic:

  • (Jul)    TG43, HDR treatment workflow
  • (Aug)   Radiation safety, regulations, protection, shielding design
  • (Sept)  Comprehensive quarterly exam

Year 2, Quarter 2

Rotation 6

 

Rotation Title: Medical Imaging & Informatics in Radiation Oncology

Main Objectives:

  1. The resident shall understand the imaging principles and clinical applications of imaging modalities including CT, MRI, Ultrasound, and PET/SPECT.
  2. The resident shall know the principle, use, QA, and calibration of the image guidance systems including kV imager, EPID, OSMS, Calypso.
  3. The resident shall understand the imaging registration theory and techniques, image processing principles, CT reconstruction algorithms, image dose reduction methods, and informatics in radiation oncology.

Monthly Oral Exam Topic :

  • (Oct)  CT imaging, IGRT
  • (Nov)  MRI, ultrasound, PET/SPECT
  • (Dec)  Comprehensive quarterly exam

Year 2, Quarter 3

Rotation 7

 

Rotation Title: Proton, Radiobiology, and Special Topics

Main Objectives:

  1. The resident shall learn the basics of proton therapy.
  2. The resident shall understand the radiobiology theory and applications.
  3. The resident shall receive didactic training from the quarterly mentor on the special topics including COMS eye plaque treatment, prostate seed implant, total skin electron therapy, radiopharmaceutical therapy, pregnant patient.
  4. The resident shall learn special modalities not available in our department, such as CyberKnife, GammaKnife, Tomotherapy, and MR-LINAC.
  5. The resident shall make use of this rotation to strengthen the weakness of previous rotations.

Monthly Oral Exam Topic :

  • (Jan)   Proton therapy, radiobiology
  • (Feb)   Special topics
  • (Mar)  Comprehensive quarterly exam

Year 2, Quarter 4

Rotation 8

 

Rotation Title: Clinical physics support

Main Objectives:

  1. The resident shall know how to perform 2nd check, weekly chart check, final physics check.
  2. The resident can provide full clinical physics support.
  3. The resident shall receive professionalism trainings from the quarterly mentor on career development, career planning, interview skills, and oral exam skills.
  4. The resident shall make use of this rotation to strengthen the weakness of previous rotations.

Monthly Oral Exam Topic:

  • (Apr)   ABR oral exam practice 1
  • (May)  ABR oral exam practice 2
  • (June)  Exit oral exam

 

Clinical Responsiblities:

Activity Minimum Requirements
CT Simulation Observe three weeks of CT Sim procedures
Linac Treatment Delivery Observe three weeks of treatments on the linacs
Patient Specific QA Routine work throughout residency (analyze portal dosimetry, delivery is done by therapists)
In-vivo dosimetry Routine work throughout residency 
CT Routine QA Serve as primary physicist for one CT simulator in the 1st year
Linac Monthly QA Serve as primary physicist for one Linac machine in the 2nd year
Linac Annual QA Participate in at least 5 annual QAs, finish at least 2 annual QA reports. Independently perform 4 TG51 calibrations.
Treatment Planning Finish at least 30 (3D) + 30 (non-3D) clinical-quality plans and document
TBI Cases Senior in charge of planning for TBI until the junior starts Rotation 3
HDR Spot check Routine work throughout residency
HDR Treatment Participate in every case during Rotation 4
HDR Source Exchange QA Independently perform 3 HDR source exchange QAs
Chart Check Cases 30 2nd check + 30 final physics check + 60 weekly chart check

 

Research:

Residents are encouraged to initiate their own clinical research projects or work on research projects under the supervision of staff physicists. The research project requirement is optional and shall not compromise the residents’ clinical training. Projects can be initiated any time during the residency, as long as the clinical training objectives are met and the training requirements are fulfilled. Many past residents have published manuscripts and successfully presented their research at local and national conferences. See the list of publications here

 

Conferences, Meetings, and Journal Club:

Residents are required to attend the educational conferences, lectures, and meetings that regularly take place within the UNMC campus. A list of such conferences or meetings is shown below with the minimum attendance requirement specified. Attendance at all conferences, lectures, and meetings must be documented by the residents. The residents shall submit a summary of cases reviewed in chart rounds to the program director at the end of the 1st year.

 

Didactic Training:

Residents are required to audit MITS 424T/624T Clinical Oncology I and MITS 425T/625T Clinical Oncology II taught by the physician faculty in the department.

Residents are recommended to audit MITS 414T/614T Sectional Anatomy and Pathology I and MITS 415T/615T Sectional Anatomy and Pathology II.

If residents demonstrate a deficiency, they are also required to audit MITS 408T/608T Radiation Therapy Physics.

MITS 424T/624T, MITS 425T/625T: Clinical Oncology I and II

These lecture-based courses present the general principles, aims, and detailed techniques of proper application of ionizing radiation to the human body. Epidemiology, etiology, pathology, diagnosis and treatment of malignancies are addressed. Recognition of the invasive and metastatic patterns for various tumors, staging and grading procedures and their roles in determining prognosis is stressed. Appropriate chemotherapy agents for each site, their interactions with radiotherapy and side effects are discussed. Standard and emerging applications of radiation therapy will be emphasized.

MITS 414T/614T, MITS 415T/615T: Sectional Anatomy and Pathology I and II

These web-based courses are designed as an independent study and will include introductory concepts of cell biology & pathology, as well as concepts regarding neoplasia, fluid and hemodynamic disorders.

Additional instruction on sectional anatomy and pathology of the chest, abdomen, hematopoietic& lymphoid systems, GI tract, liver & biliary systems, and pancreas are also included. Sectional Anatomy & Pathology II is a continuation of Sectional Anatomy & Pathology I and will include instruction on sectional anatomy and pathology of the pelvis, urinary tract, male & female productive systems, spine, bones & joints and CNS.

Residents will also participate in educational conferences and meetings within the Department of Radiation Oncology as well as specialty oncology conferences. Conferences within the department include new patient and mortality and morbidity conference, chart rounds, physics meetings, journal club. Specialty oncology conferences include head & neck, pediatric, gynecological, neuro-oncology, breast, and GI oncology.