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Physics Residency Program: Training Requirements

Requirements for Program Completion

In order to complete the Physics Residency Program, the Physics Resident must:

  • Successfully complete the clinical rotations listed in the tables that follow
  • Pass the special training sessions and didactic courses listed in below
    • Orientation (first 2 weeks of 1st year)
    • 10 day course on planning
    • Radiation Safety Exam (within 30 days beginning 1st year
    • Physics Didactic Course (Sept-Mar. during 1st year)
    • Radiation Biology Course (April of 1st year)
    • Biostatistics (12 lectures)
    • Academic Update Conference (every Friday 8-9:00 am for 2 years)
  • Participates/attend the conferences and special lectures listed below
    • Patient Management Conference (Monday, Tuesday, Wednesday for 2 years)
    • Current Case Review Conference (every Tuesday 7:30-8:30 am for 2 years)
    • Morbidity conference (one Thursday a month 12:00-1:00 pm for 2 years)
    • New Topic Conference (every Thursday 12:00-1:00 pm for 2 years)
    • Resident Lecture (MD) Education Course (each Thursday 7:30-8:30 am for 2 years)
    • Physics Resident Seminars (resident presentation once a month Sept.-June for 2 years). 
    • Physician Resident Physics Seminars (once a month for 2 years)
    • Machine Operation and Safety Orientation (during 1st month)
    • Annual Radiation Safety on-line training (presentation by WU Radiation Safety once a year)
    • Annual Fire, Chemical, Biohazard on-line training (yearly presentation by Environmental Safety)
    • Advanced Physics Resident Course (10 Lectures)
  • Prepare handout for 3 assigned topics for presentation at Physics Resident Seminar
  • 12 Site Reports (8 clinical external beam, 2 brachytherapy, 2 delivery systems)
  • Pass end-of-rotation exams (3 in 1st year, 2 in 2nd year)
  • Completion of comprehensions (1 per month in 1st year)
  • Pass Year 1 Oral Exam
  • Pass Year 2 Oral Exam

Typical Two Year Physics Resident Rotation Assignments

1st Year Rotations

Length

Orientation

1 month

Conventional TP

2 months

IMRT (Pinnacle, Eclipse)

4 months

Brachytherapy

3 months

Patient QA & Special Procedures 2 months

2nd Year Rotations

July

External Beam Concentration

August

Sept.

Oct.

IMRT Concentration

Nov.

Dec.

MR Guided RT

Jan.

Developmental

Feb.

Brachytherapy Concentration

Mar.

"

Apr.

Imaging/Localization

May

ESRT/SRS

June

Protons

 

 

The resident is given a certificate upon completion of the program.

Training Essentials - Design and Content

During the first year, the physics attends didactic lectures, special training sessions, conferences, and participates directly in the clinic through a series of treatment planning, special procedures, and brachytherapy rotations.  The resident works closely with staff physicists and dosimetrists to observe and participate in conventional and IMRT treatment planning, image acquisition, on-board imaging CBCT, fusion, registration, image guidance, dose calculations, design and fabrication of patient treatment aids, and special bolus; treatment machine calibrations; patient and phantom dose measurements, quality assurance procedures, brachytherapy procedures, and other physical and technical tasks performed in the clinic. During this time, the resident should develop basic radiation oncology physics skills and also should develop an overall understanding of the radiation oncology physicist's and dosimetrist's role in the clinic.
At the beginning of the second year, the successful physics resident is given more responsibility (but always under the direct supervision of a physics faculty member). During the second year, the resident should develop confidence and continue the development of the necessary skills and experience to be prepared for independent clinical physics practice.
During the two-year period, the physics resident will receive didactic instruction in the following areas:

  • Basic Radiological Physics
  • External Beam Radiation Oncology Physics
  • IMRT
  • Advanced special procedures (e.g. TBI, stereotactic radiosurgery,…)
  • Imaging for Planning and Localization
  • Brachytherapy Physics
  • Radiation Safety
  • Radiation Biology
  • Clinical Radiation Oncology
  • Statistics

Most topics are covered in the Physics Residents Course attended by our physician and physics residents.  This Physics Course is taught each year and lectures are given 2 days a week 7:30 AM - 8:30 AM in our Perez Conference Room designated located in the new CAM building.  The course utilizes the textbook by Faiz Khan, Radiation Therapy Physics, 5th Ed, published by Williams and Wilkins.  It is supplemented by handouts provided by the lecturer.  The lectures are posted on a shareable drive.  Homework is assigned and typically 3 to 4 exams and a final exam are given. 

The Radiation Biology Course typically follows the Physics Course each year and is customized for physics residents.  The course utilizes the textbook by Eric Hall, Radiation Biology for the Radiologist, 4th Edition, published by J.P. Lippincott.  It is supplemented by handouts provided by the lecturer.  Physics residents must pass a final exam for this course to complete their residency training program. 

Instruction in anatomy and physiology is provided by a number of means.  This subject area is covered by the resident’s attendance of Patient Management Conference, Radiation Education Course (Treatment Techniques) Morbidity Conference, and Current Case Review Conference.  Over the two year period, these conferences provide the resident exposure to a considerable number of patient related case management discussions involving the use of simulation films, port films (KV and MV), CT scans, MR scans, and PET scans in which anatomical and physiological issues are discussed.  In addition, our clinic currently provides one of the largest conventional and IMRT planning and virtual simulation services in the country.  This form of image based planning provides the resident with a rich experience in radiologic anatomy.  In addition, one of the changes we have implemented since our 1997 accreditation is that we now require the physics resident to prepare detailed reports for selected treatment sites that review pertinent anatomy (critical organs, primary tumor sites, and nodal regions), oncological aspects, and related technical parameters related to a particular treatment site.  Each report is reviewed by a clinical physicist for thoroughness.  The clinical physicist will review with the resident any inadequacies and remedies.  First year residents will cover all major treatment sites. 

The Academic Update Conference which is conducted every Friday morning 8:00 - 9:00 AM provides the physician and physics resident a series of didactic lectures covering the clinical physics and biological aspects of radiation oncology. 

The clinical rotations are the core element of the 1st year of residency training.  They have 4 core elements to them; a) the actual assigned rotation, b) the assigned readings, c) assigned comprehensions with assigned faculty, and d) testing. 

  1. For each rotation, there are particular training essentials that include references.  The training essentials may or may not include a check-off list of mastered tasks, depending on the rotation.
  2. There are mandatory minimal readings that are assigned for each rotation, additional suggested readings as part of the comprehensions and training essentials.
  3. The comprehensions were developed in 2007 to foster faculty-resident interaction, and to ensure the resident understands the background and details.  The comprehensions are assigned coinciding with the rotations.  Resident and the assigned Faculty are to meet 3-4 times in the scheduled month to discuss the particular subject.  If need be, additional meetings cane be scheduled, if the resident is struggling.
  4. At the close of most rotations, there is a short exam that covers the rotation and the comprehension.  This is conducted by 2 faculty members and the resident.  If the faculty feels additional studying and reading is necessary, the resident will do so and retake the rotation based exam.
  5. A Physics journal club is held monthly with presentations by Residents and Post Doctoral Fellows.

In the 2nd year, the specific rotations also end with a short exam based on the rotation.  Additional readings are typically assigned, especially if the resident does not pass the rotation based exam.

In addition to the clinical physics rotations and didactic lectures, the physics resident is assigned topics for 3 seminar presentations each year.  The physics resident, working closely with an assigned staff physicist advisor, is expected to prepare a detailed handout with a well researched bibliography that contains both "classic" papers and state-of-the-art references.

Physics residents participate in all department conferences in which the physics faculty is expected to attend.  These include (1) Patient Management Conference, (2) Resident Education Course, (3) Special Physics Seminars, (4) Academic Update Conference, (5) Morbidity Conference, and (6) Current Case Review Conference. 

Examples of past clinical rotation assignments, reports, lecture handouts, and examinations are available for review. Resident evaluations of clinical rotations are discussed in regularly scheduled meetings held with the resident.

Program Length and Sample Training Plans

The length of the residency education program is two years and the training calendar starts on July 1 of each year. In special cases, the start date can be delayed.  Thus far we have not distinguished between those physicists entering with didactic training in medical physics, as evidenced by graduation from an accredited medical physics graduate education program, and those entering without didactic training in medical physics. This training program has resulted in a 97% success rate for our graduates obtaining board certification.  During the second year of residency, there is one month allocated for either clinical research and special rotation, or “catch-up”.  Clinical research projects and special rotations must be approved by the Program Director.  A resident who is struggling will use the month for ‘catch-up,” i.e. an additional rotation.

Training Administration

Training program review is an ongoing task and the responsibility of the Program Director, Associate Directors, and the Physics Residency Committee. The training essentials and clinical physics rotations are generally reviewed once a year. If changes are needed to meet the needs of the Program, then the Physics Residency Program Director targets the appropriate faculty for that task. Modifications require submission by the faculty to and subsequent approval by the Physics Residency Committee and/or Program Director and Associate Directors.