Radiation Oncology Program

Document Sample
Radiation Oncology Program Powered By Docstoc
					Radiation Oncology Program
Positions per year: 2
Number of Years: 5

Locations: Froedtert Memorial Lutheran Hospital (FMLH), VA Medical Center
(VAMC), Childrens Hospital of Wisconsin (CHW), Community Memorial Hospital

Chairman: J. Frank Wilson, MD, FACR, FASTRO
Program Director: Colleen A. Lawton, MD, FACR, FASTRO
Medical Education Coordinator: Cheri McElhatton
Telephone: (414) 805-4472

Goals and Objectives:
The Radiation Oncology Residency Program at the Medical College of Wisconsin Affiliated
Hospitals is a Residency Review Committee and American Board of Radiology fully
accredited program designed to educate residents in the current principles and practice of
radiation oncology. A four year program of post-internship radiation oncology is provided
with the goal of educating residents in all aspects of radiation oncology with special
emphasis on the multidisciplinary treatment of cancer patients and preparing them for
successful execution of the board exams. To meet the goals listed above the following five
years of training have been designed:

Five-Year Training Program:
The PGY-1 year can be completed at the Medical College of Wisconsin as a rotating
preliminary medicine internship with special focus on oncologic subspecialties.

The PGY-2 year consists of 9 months spent in radiation oncology doing clinical work, one
month in oncologic pathology, one month in oncologic imaging, and one month in adult
and/or pediatric medical oncology pending experience in the PGY I year. The
Hematology/Oncology experience in certain circumstances may be accomplished through
multidisciplinary conferences.

During the PGY-3 year, 10 months are spent in clinical radiation oncology, with the
remaining time devoted to a physics rotation.

The PGY-4 year consists of 12 months of clinical Radiation Oncology. The possibility of
limited research time arranged through the Program Director and the Chairman can be done
this year.

The PGY-5 year consists of 12 months of clinical radiation oncology. Six months are spent
at the Veterans Administration Medical Center with the remaining 6 months divided as
follows: 3 months with the resident's staff of choice (depending upon the availability) and 3
months in a clinical rotation designated by the Program Director. There is the possibility of
research time in this year also.

MCW radiation oncologists treat approximately 1800 new cancer patients annually. More
than 100 patients per year are accessioned to national cooperative group (RTOG, NSAPB,
ECOG) studies or institutional clinical studies.

Programs in Radiologic Physics and Radiation Biology are administered within the
department. Major areas for physics research include developing novel technology for
image-guided and adaptive radiation therapy, analyzing IGRT data for better treatment
strategies, improving 4D/gating methods to manage respiration motion during treatment in
thorax, abdomen and breast, integrating dose-response outcome into treatment planning
optimization, using functional imaging (MRI and PET) for treatment planning, and
developing MRI and CT guided brachytherapy. Laboratory research programs in radiation
biology include radiation induced normal tissue damages and the mitigation of these
damages, electron spin resonance and radiation chemistry, predictive assays of cellular
response and tumor and normal tissue effects of combined drugs with radiation.

Laboratory research programs in radiation biology are focused on radiation-induced
normal tissue injury, and on the mitigation and treatment of these injuries.

The Department also sponsors a recognized training program for Radiation Therapists.

The clinical and technical staff supporting these various activities include radiation
therapists, registered nurses, dosimetrists, biomedical engineers, medical physicists, research
associates, administrative and clerical personnel.

The Department of Radiation Oncology at Froedtert Memorial Lutheran Hospital is the core
training facility. Zablocki VA Medical Center, Children's Hospital of Wisconsin, and
Community Memorial Hospital compose integral parts of the training program. Thus, the
trainee is exposed to a wide variety of patients and to the spectrum of institutions where
radiation therapy is administered.

Core facilities at Froedtert Hospital provide the following types of major equipment: four
Siemens dual energy linear accelerator (three Primus and one Artiste) all with MLC and
electron capabilities, two with MV cone beam CT and one with CT-on-Rails for IGRT, one
with 160MLC with small leaf width, three with gating capability; one Tomotherapy unit;
One orthovoltage unit; GE HighSpeed CT simulator with 4D capability; Siemens Verio 3T
MRI simulator, Gamma Knife and Nucletron HDR. High-dose rate and low dose rate
brachytherapy treatments are offered. Treatment planning equipment includes CMS Xio for
3DCRT and IMRT, Prowess for IMRT, Corvus IMRT, Nucletron HDR and Variseed seed
implant systems. All other facilities are equipped with a Primus dual energy linear
accelerator with MV cone beam CT, Xio treatment planning capabilities and a CT
Inpatient facilities involve a dedicated interdisciplinary oncology unit staffed with specialist
in radiation oncology, medical oncology, and various surgical and medical subspecialties.
Pathologists with special interests in the study of human neoplasms, as well as diagnostic
radiologists with special expertise in oncologic imaging, compliment the clinical staff.
Nationally recognized authorities in all specialties concerned with cancer management work
together closely to insure optimal patient care and to provide teaching and continuing
medical education. They also collaborate in laboratory and clinical research.

Special Techniques:
    IGRT (CT-on-Rails, MV cone beam CT, Tomotherapy MV CT)
    4D/gating
    SBRT with Linac and Tomotherapy)
    IMRT
    IGRT
    KV and MVCT
    3T MRI for simulations
    HDR Brachytherapy
    LDR Brachytherapy
    Total Body Irradiation
    SRS with Gamma Knife

Selection of Residents:
It is the goal of the Department of Radiation Oncology at the Medical College of
Wisconsin to produce quality radiation oncologists who pursue either an academic or
private practice career. In order to accomplish this we feel that it is necessary to choose
high quality residents from the pool of applicants each year. Future residents are selected
based on academic achievements, personal qualities, and the faculty assessment of their
potential to excel in the residency program.

           Applications are accepted through ERAS starting July 1, two years before the
            anticipated starting date.
           The Program Director reviews each application in detail i.e., Medical School,
            Board Scores, Personal Statement, Letters of Recommendation, Clinical
            Research, Basic Research, and Publications.
           Thirty to 35 candidates are selected for interview with our faculty and
           The final selection of resident or residents is performed by the NRMP match
            and the department is informed in March of that academic year.


Case Conference:
Case Conferences are held Monday, Tuesday, and Wednesday mornings. Residents are
responsible for choosing conference topics, presenting patients, and leading discussions
regarding the epidemiology, presentation, workup and treatment of various malignancies.
Attending staff participate as moderators of the discussion.

Tumor Board:
Residents participate in multiple multi-disciplinary tumor boards. The conferences are
working tumor boards whose purpose is to discuss the management of patients currently
receiving treatment. Conferences are attended by attending staff from Radiation
Oncology, Medical Oncology, Surgery, Radiology, and Pathology. Tumor Boards

       ENT Tumor Board: 1st and 3rd Wednesday of month VA
       Multi-disciplinary Tumor Board: 1st and 3rd Friday morning FMLH
       Pediatric Tumor Board: Weekly, Thursday Morning CHW
       Gynecologic Tumor Board: Weekly, Thursday Morning FMLH
       Breast Tumor Board: Weekly, Monday, Noon FMLH
       Thoracic Tumor Board (VA): Alternating Thursdays with FMLH
       Grand Rounds: Weekly, Wednesday pm FMLH
       Physics Course Weekly, Thursday noon FMLH
       Radiation Biology Course: Weekly, Thursday pm FMLH

Didactic Lectures:
Clinical didactic lectures are given by attending staff at Grand Rounds. These hour-long
lectures take place Wednesday evenings at 5:00 pm, September through June. Topics
include reviews of the current status of treatment of various malignancies as well as
discussions of novel research concepts and data.

Didactic lectures in Physics are given twice per week Sept - June. Lectures cover topics
required for board exams including production of X-Rays, measurement, dosimetry,
radiation safety, etc.

Lectures in Radiation Biology are held weekly from October - June. Topics covered
include cell survival, response of normal tissues, radiation mutagenesis and
carcinogenesis, dose and fractionation response data, molecular biology, hyperthermia,

A Medical Statistics Course is held every other year consisting of several lectures on the
topic given weekly.