The Radiation Oncology Physics Residency Program is an official program within the Washington University Medical Center/Barnes-Jewish Hospital Radiation Oncology Department. Barnes-Jewish Hospital is responsible for all technical components of radiation oncology while Washington University is responsible for all professional components (including the employment of physicians, physicists, physics residents, cancer biologists, bioinformatics faculty, and other academic faculty and staff). In this academic medical center partnership, Barnes-Jewish Hospital and Washington University work together to provide the highest quality of patient care, conduct world-class research, and outstanding instruction in our education and training programs. The Department of Radiation Oncology is governed by Barnes-Jewish Hospital and the Washington University School of Medicine (WUSM) rules and policies. The physics residency program faculty consists of faculty within the Medical School and staff of the Barnes-Jewish Hospital Department of Radiation Oncology. In 2017, the Department of Radiation Oncology at Barnes-Jewish Hospital, as well as its related satellites, received APEx Accreditation through the American Society for Radiation Oncology (ASTRO).
The Washington University Medical Center is a federation of several institutions owned by the university and other independent institutions. It is the central radiation therapy and diagnosis facility for the entire complex of hospitals and clinics associated with Washington University School of Medicine, which combined have nearly 2,000 beds. The Department of Radiation Oncology resides in the new Siteman Cancer Center. Our facility is a designated NCI Comprehensive Cancer Center facility. The Physics Residency Program utilizes other facilities within the Washington University Medical Center including Barnes-Jewish Hospital.
The Department of Radiation Oncology operates one of the largest clinical services in the country. 22 faculty radiation oncologists and 12 physician residents are involved in the provision of patient care and intramural and cooperative group clinical protocols. The physician faculty is responsible for the treatment of approximately 3,500 new cancer patients per year, representing 50% of all cancer patients in the St. Louis area, or about 30% of all cancer patients in the state of Missouri requiring this form of treatment.
The Physics Division of the Department of Radiation Oncology includes 30 radiation oncology physicists, 3 imaging physicists, 2 computer scientists, 14 dosimetrists, 4 brachytherapy technicians, 4 clinical engineers, and 6 physics residents. The Physics Division is organized into three main activities: research, education, and clinical. The clinical activities include specific services: treatment planning, brachytherapy, imaging, treatment localization, stereotactic, protons, MR-Guided Therapy, and QA. All physics faculty participate in the various education and training programs that include the Physics Residency Program, Physician Residency Program, Dosimetrist Training Program through Southern Illinois University (SIU), and Therapist Training Program (SIU and Saint Louis University).
Residents have access to a wide range of dosimetry instrumentation, radiation treatment planning systems, imaging and localization systems, simulators, and treatment machines.
The faculty of the Radiation Oncology Physics Residency Program represents the foundation and strength of our Program. All of our faculty have appointments at Washington University and provide clinical support to the Barnes-Jewish Hospital radiation oncology clinic. The faculty has a broad teaching expertise and access to a wealth of clinical physics equipment and training resources.
The faculty and staff interact regularly through physics faculty meetings, seminars, case conferences, quarterly departmental faculty meetings, hospital or medical school committee meetings, Physics Residency Committee meetings, and annual retreats of the Department’s faculty.
The faculty‑resident interactions occur at clinical physics rotations, classroom environment, seminars, private appointments to discuss the designated comprehensions, clinical rotation, or personal problems, and social activities (division parties, etc.). In addition to the routine meetings, the residents also have access to the Program Director and Division Director to discuss sensitive personal or training problems. We feel there is relatively open communications between residents, faculty, Program Director, and the Division Director.
For an estimated Program capacity of 8 residents and 30 radiation oncology physics faculty, our resident to faculty ratio is approximately 1:4.
The Physics Residency Program provides a large, common office space for physics residents in the lower level of the Center for Advanced Medicine. Each resident will be assigned to a cubicle including a desk, file cabinet and bookcase, computer terminal connected to LAN, telephone access, and standard office supplies. Residents have access to departmental copying equipment. The Physics residents are also provided with a library account for electronic access to journals and journal searches (Medline, OVID).
Ample space is available for resident advisory meetings, didactic lectures, exams, seminars, and oral examinations. Three meeting rooms/classrooms are in the department. They each contain whiteboards, LCD video projectors, and computer or computer connections for LCD projection. Additional conference rooms are available on campus if needed.
The residents have access to a myriad of laboratory and shop facilities including: (1) a dosimetry instrumentation lab in the physics research area; (2) a brachytherapy lab in the Brachytherapy Suite; and (3) other research labs and offices in the Clinical Science Research Building. Residents submit work orders to a campus machine shop as required. In all, the availability of dosimetry and clinical treatment areas and equipment is more than adequate to serve the needs of the residency training program. Procedures are in place that (1) allow the resident reasonable access time to clinical equipment, (2) provide residents sufficient training and technical support to ensure safe and proper use of equipment, and (3) to ensure equipment is left in the proper state for clinical use.
Treatment planning and external beam delivery equipment utilized in the training program include 7 Varian (incl. 2 Trilogy units, 2 True Beam, and 1 Edge), Gamma Knife planning and delivery, a therapeutic x-ray unit, 2 Philips Brilliance CT-simulators (16-slice-large and 64-slice-small “bore”), a 1.5T MRI simulator capable of HiFu, 26 Pinnacle TP workstations, and Varian Eclipse workstations.
We have the world’s first compact, single room proton machine from Mevion Medical Systems that began clinical use in December of 2013, and recently completed their 500th patient treatment. In 2014, we began treatment with the world’s first combination real-time MRI and IMRT system from ViewRay. The founder and Chief Scientific Officer is a former resident. Specialized equipment and features include the DMLC-IMRT delivery, linac and Gamma Knife stereotactic radio-surgery/therapy, and image guidance provided by on-board x-ray imaging, portal photon imaging, video surface imaging, internal transponders for tracking, and kV-CT systems. Clinical rotations are also provided within our HDR, LDR, prostate seed, and radiopharmaceutical program, including image guided interstitial, intracavitary and surface implant planning and delivery.
External beam treatment machines
- 4 Varian Trilogy/TrueBeam IGRT Linear Accelerator (including kv imager and portal imager)
- 3 Varian Clinac 21EX Linear Accelerator (DM – IMRT)
- 1 Elekta Gamma Knife Unit – Perfexion
- 1 Xoft Electronic Brachytherapy System
- 1 Philips ACQSIM CT Simulator (Large-bore, 16 slice)
- 1 Philips Brilliance CT Simulator (64 slice)
Treatment planning systems
- Philips Pinnacle Treatment Planning Workstation (14)
- Varian HDR Treatment Planning Workstation
- Varian Eclipse (Eclipse IMRT) Workstation (8)
- Variseed Transperineal Ultrasound-guided Implant Treatment Planning System
- Varian Fastplan Stereotactic Radiosurgery Treatment Planning System
- Gamma Knife Stereotactic Radiosurgery Treatment Planning System
- Varian Eclipse Proton Planning Workstations (4)
- ViewRay Planning Systems (2)
- Varisource/HDR Remote Afterloading Machine
- Ultrasound guided interstitial implant (I-125 or Pd-103) system
- Traditional intracavitary (Cs-137) and interstitial (Ir-192) brachytherapy sources
- Eye Plaques
- Radiopharmaceuticals (i.e., monoclonal antibody agents, and SirSpheres)
- 1 Xoft Electronic Brachytherapy System
- NIST-calibrated ion chamber and electrometer dosimetry systems (3)
- Farmer type ion chamber and Keithley 602 electrometer dosimetry systems
- Parallel-plate ion chamber
- TLD dosimetry facility – Harshaw 2000 A-B
- Radiochromic film dosimetry system-Molecular Dynamics 2D laser densitometer
- Si diode dosimetry systems
- Welhoffer water phantom scanning systems
- Sun Nuclear Radiation QA Devices
- Mercury barometer
- Multiple Aneroid barometers and numerous thermometers
- Multiple anthropomorphic phantoms
- Multiple water and polystyreen phantoms of varying sizes
- Solid-water, lung, and bone phantoms
- Multiple radiation survey meters
- RITT film dosimetry system
- Multi-diode System (MapCheck), Matrixx
- Multi IC Systems
- Pinnacle MLC based IMRT
- Eclipse based MLC IMRT
- Total Body Irradiation
- MR-guided RT (ViewRay)
- Proton RT (Mevion)
- Cranial Stereotactic Radiosurgery
- Extra-cranial Linac Radiosurgery
- Extensive Pediatric Service
- Sealed Source Brachytherapy
- Prostate Seed Implant
- HDR for GYN, Thorax, Breast
- LDR for GYN, Colorectal
- Radiotherapy Cervical Therapy
- P-32 for cystic lesions
- I-131 for carcinoma
- Y-90 with Monoclonal Antibodies
- Sm-153 for metastatic disease
The major libraries available to students are the Washington University Medical School Library and the Washington University Main Campus Library. Medline accounts are available for the residents for manuscript keyword/author searches.