1. No category

Residency Manual
Radiation Oncology Residency Program
Department of Radiation Medicine and Applied Sciences
University of California, San Diego
La Jolla, California
Revised 8/14
2
Table of Contents
I.
II.
III.
IV.
V.
VI.
Introduction………………………………………………………………... 5
A. Mission Statement……………………………………………………... 5
B. Duration/Scope of Training……………………………………………. 5
Residency Program Personnel & Resources……………………………….. 6
A. Program Director………………………………………………………. 6
B. Program Coordinator…………………………………………………...6
C. Faculty…………………………………………………………………. 6
D. Other Personnel………………………………………………………… 9
E. Resources………………………………………………………………. 10
Residency Appointments…………………………………………………... 11
A. Eligibility………………………………………………………………. 11
B. Number of Residents……………………………………………………11
C. Transfers……………………………………………………………….. 11
D. Fellows/Other Students………………………………………………... 12
Program Curriculum……………………………………………………….. 12
A. Format………………………………………………………………….. 12
B. Goals/Objectives……………………………………………………….. 12
C. Didactic Components………………………………………………….. 13
D. Clinical Components…………………………………………………… 17
1.Requirements………………………………………………...... 17
2.Clinical Curriculum…………………………………………… 19
3.Resident Logs…………………………………………………. 20
E. Resident Investigative Project…………………………………………..20
F. Resident Practice Quality Improvement Project (PQI)………………... 21
G. Examinations……………………………………………………………21
Clinical Responsibilities…………………………………………………… 21
A. Consultation……………………………………………………………. 21
B. Simulation……………………………………………………………… 21
C. Treatment Planning…………………………………………………….. 22
D. Treatment………………………………………………………………. 22
E. Follow-up………………………………………………………………. 24
F. Night/Weekend Call…………………………………………………….24
Department Policies………………………………………………………... 24
A. Vacation………………………………………………………………... 24
B. Holidays………………………………………………………………... 25
C. Professional Leave……………………………………………………... 25
D. Sick Leave……………………………………………………………… 25
E. Family Illness and Bereavement……………………………………….. 25
F. Personal Leave of Absence…………………………………………….. 26
G. Pregnancy/Childbearing Disability…………………………………….. 26
H. Paternity Leave………………………………………………………… 26
I. Family Medical Leave…………………………………………………. 26
J. Leave for Work-Incurred Disability…………………………………… 26
K. Military Leave………………………………………………………….. 26
L. Jury Duty……………………………………………………………….. 27
M. Ethics/Religious……………………………………………………….. 27
N. Harassment……………………………………………………………... 27
3
VII.
VIII.
IX.
X.
XI.
XII.
O. Licensure……………………………………………………………….. 27
P. HIPAA…………………………………………………………………. 27
Q. Appointment/Re-Appointment………………………………………… 28
Duty Hours/Working Environment…………………………………………29
A. Resident Supervision…………………………………………………... 29
B. Duty Hours…………………………………………………………….. 29
C. On-Call Activities……………………………………………………… 29
D. Moonlighting…………………………………………………………... 30
E. Stress/Fatigue…………………………………………………………... 30
F. Substance Abuse/Counseling…………………………………………….30
Evaluations…………………………………………………………………. 30
A. Resident ………………………………………………………………… 31
1. Rotation Evaluation…………………………………………………. 31
2. 360° Evaluations…………………………………………………….. 31
B. Faculty…………………………………………………………………... 31
C. Program…………………………………………………………………. 31
Disciplinary Action………………………………………………………… 32
Benefits…………………………………………………………………….. 32
A. Stipends………………………………………………………………... 32
B. Meetings/Travel……………………………………………………….. 32
C. Away Rotations………………………………………………………… 33
D. Books/Journals…………………………………………………………. 33
E. Lab Coats………………………………………………………………. 34
F. Identification Badges………………………………………………….. 34
G. Parking ………………………………………………………………… 34
H. Pagers………………………………………………………………….. 34
I. Email/Internet………………………………………………………….. 34
J. Insurance……………………………………………………………….. 35
K. Malpractice…………………………………………………………….. 35
L. Recreation Facilities…………………………………………………….35
M. Meal Allowance………………………………………………………... 36
Chief Resident……………………………………………………………… 36
Certification………………………………………………………………... 36
4
Appendices
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.
XIII.
XIV.
XV.
XVI.
XVII.
Driving Directions……………………………………………………………... 37
Faculty…………………………………………………………………………..40
Departmental Publications…………………………………………………….. 43
Goals/Objectives (by Residency Year)………………………………………… 68
Goals/Objectives (Example Rotations)………………………………………… 74
Medical Physics Class…………………………………………………………..82
Radiobiology Class…………………………………………………………….. 83
Biostatistics Class……………………………………………………………… 85
Disease Months………………………………………………………………… 86
Multidisciplinary Conferences…………………………………………………. 87
Quarterly Resident Evaluation by Attending………………………………….. 88
360° Evaluation……………………………………………………………….. 93
Semi-Annual Resident Evaluation Form……………………………………… 96
Final Summative Resident Evaluation Form………………………………….. 98
Annual Program Director Evaluation of the Faculty…………………………... 99
Annual Resident Evaluation of the Faculty……………………………………. 100
Year-End Program Evaluation Form………………………………………….. 101
5
I. Introduction
A. Mission Statement
The mission of the Radiation Oncology Residency Program in the Department of Radiation
Medicine and Applied Sciences at the University of California San Diego (UCSD) is to:
1. Educate and train residents to be skillful in the practice of clinical Radiation Oncology,
and to be caring and compassionate in the treatment of their patients
2. Expose residents to the practice of academic Radiation Oncology, including clinical,
technologic and biologic research
All requirements of the Residency
Program are in accordance with the
requirements of the Accreditation
Council for Graduate Medical
Education (ACGME) http://www.
acgme.org for Radiation Oncology.
These requirements are on file in
the Residency Coordinator’s Office
and are available for review. The
policies set forth in this manual are
supplemental to the institutional
policies of the UCSD Graduate Medical Education Office http://ogme.ucsd.edu/ as
specified in the UCSD House Officer Policy and Procedure Document
http://meded.ucsd.edu/assets/6/File/housestaff/HOPPD_2009_v3_posted+signatures.pdf
B. Duration/Scope of Training
Resident training in Radiation Oncology consists of
five years of accredited, clinically-oriented graduate
medical education.
The initial postgraduate year (PGY-1) must be spent
in an accredited internship in internal medicine,
family practice, obstetrics and gynecology, surgery or
surgical specialties, or in a transitional year program.
The PGY-1 year must include a minimum of nine
months of direct patient care in medical and/or
surgical specialties other than radiation oncology. The
UCSD Residency Program does not sponsor a PGY-1
year. All residents entering the program are thus
responsible for obtaining, and successfully
completing, an internship at an accredited program.
6
The PGY-1 year is followed by four years focused on Radiation Oncology. During this
time, all residents must complete a minimum of 36 months of clinical radiation oncology
training. This will be done throughout the PGY2-5 years.
At UCSD residents are offered a full 12 months devoted to clinical, technologic and/or
basic research. Residents are encouraged to participate in research projects within the
department. However, residents are also welcome to pursue research projects under the
mentorship of researchers throughout UCSD or affiliated institutes. Research projects are
selected by the resident in conjunction with the Department Chair and Program Director.
All research projects must be under the supervision of a UCSD faculty member. Although
they are relieved of daytime clinic responsibilities during research time, residents do
continue to participate in “call”.
II. Program Personnel and Resources
A. Program Director
The Residency Program Director is John Einck, M.D.
Dr. Einck is available at all times to discuss issues and concerns
regarding the residency program with residents and faculty. Dr.
Einck was named Program Director in March 2011. As Program
Director, he is responsible for the residency program as a whole
and is accountable for its operation. This includes activities related
to recruitment, selection, instruction, supervision, counseling,
evaluation and advancement of residents as well as the
maintenance of records related to program accreditation. Dr. Einck
meets with each resident individually on a semi-annual basis
(January and July) to review his/her progress in the residency, log
totals, review in-training exam results, and address any
educational concerns on the part of faculty, staff or the resident. He also participates in the
Clinical Competency Committee (CCC) and the Program Evaluation Committee (PEC).
B. Residency Program Coordinator
The Residency Program Coordinator is Jessica Bazo. Ms. Bazo maintains all resident
academic files, confidential correspondence, and evaluations. She may be contacted to
make an appointment to review the contents of selected files. She provides organizational
support for the residency program and assists the Program Director, including the
recruitment and interview process for residency applicants.
C. Faculty
The Department is divided into the following academic divisions: 1) Clinical Radiation
Oncology, 2) Medical Physics and Technology, 4) Clinical and Translational Research, 5)
Proton Therapy and Particle Research, and 6) Veterinary Oncology (Appendix II)
7
The faculty as a whole has a strong interest in the education of residents and supports the
goals and objectives of the educational program. Moreover, all members of the faculty
devote sufficient time to the educational program to fulfill their supervisory and teaching
responsibilities. The faculty is committed to establishing and maintaining an environment
of inquiry and scholarship,
including
discovery,
dissemination, and application.
A summary of original research
article
publications,
review
articles, book chapters and
presentations at national and
international
meetings
and
scientific societies between 20102012 is summarized in Appendix
III. The faculty is regularly
involved in clinical discussions,
chart rounds, journal clubs, and
research conferences in a manner
promoting a spirit of inquiry and scholarship, including offering mentorship and guidance
in research projects.
D.
Other Personnel
Nursing
The Clinic is staffed by Registered Nurses and Medical Assistants. Nurses provide
counseling to patients and their families with regard to radiation side effects and supportive
care. Nurses are responsible for the scheduling of all consults and for the intake and care of
patients who present for consultation, follow-up and on-treatment visits. Nurses are
responsible for assisting physicians during procedures and in the scheduling of laboratory
and x-ray studies. They are also responsible for supplies within the examination rooms.
Radiation Therapists
The Department is staffed by a
large trained staff of Radiation
Therapists They are responsible
for the delivery of the prescribed
treatments, acquiring weekly
portal images for quality
assurance, emergency treatments
on nights and weekends,
simulations and out-patient highdose-rate (HDR) brachytherapy
procedures.
8
Medical Dosimetrists
The Department is currently staffed
by both Photon and Proton Medical
Dosimetrists. The Dosimetry staff
use computers and 3D graphics to
design the optimum treatment plan,
including selecting the number of
beams and the directions from
which they will enter and exit the
body, and determining the machine
settings necessary to deliver the
dose prescribed by the physician.
They also design the shaping of the
beams to block normal tissue while
irradiating the target tissue based
on the intent of the physician.
Technical Support Staff
The Department is currently staffed by multiple I.T. specialists at the various facilities and
Proton Center. The I.T. specialists are involved in maintaining all the computer software
and hardware in the department.
Patient Services Staff
The Department is currently staffed by Patient Services Staff at the photon and proton
treatment centers. The Patient Services Manager oversees the flow of patients in the clinic
from consultation to treatment and manages a team of front desk personnel, patient
scheduler, nurses and the Radiation Therapy staff. The Scheduler is responsible for
scheduling all patient appointments including radiologic studies and simulations.
Administrative Staff
The administrative staff includes a Chief of Business Development and Administrative
Officer (CBDAO), Biller/Coders, Staff and Faculty HR personnel, Grants Management,
and Administrative Assistants.
The CBDAO is Casey Sandack MBA who is also the Vice-Chair
for Administration and Finance. He is involved in all financial
aspects of the department including billing, reimbursement,
compliance, and contracts. The Biller/Coder is responsible for the
professional and technical bills submitted by the Department. The
secretarial staff provides academic and clerical support for the staff
physicians. They are also responsible for transcriptions and
correspondence for both the staff physician and the resident
assigned to his/her service. Mr. Sandack also participates in
resident education by overseeing the Business of Radiation
Oncology Course along with Dr. Mundt.
9
Social Services
The department is staffed by dedicated and experienced Social
Work services.
Carmen Ayala MSW LCSW is available to help patients and their
families recognize and articulate their questions, concerns and
fears regarding treatment and prognosis. The social worker acts as
a liaison between the patient and family and various agencies
within the community including nursing facilities, counseling
agencies, centers for financial assistance, and transportation
services to and from the hospital, as needed.
Medical Physics Residents
In July 2007, the department inaugurated its Medical Physics Residency Program with its
first resident. During their training, the Medical Physics Residents work closely with the
Physics staff on all technical aspects of patient care including treatment planning and
quality assurance (QA). Each year, the program admits one new resident. The Physics
Residents will also be involved in the didactic program offered to the Medical Radiation
Oncology Residents. The Department currently includes two Physics Residents. The
Physics residents attend many of the medical resident education programs and also
participate in the Joint Clinical Case Conference.
Research Staff
The Department is home to a large number of researchers organized into several research
units (Medical Physics and Technology and Clinical and Translational Research which also
includes Basic Science). Research personnel include faculty, post-doc fellows, graduate
students, medical students, visiting scholars and researchers, undergraduate students, and
support staff (i.e. administrative assistants and Clinical Trials Coordinator).
E.
Resources
Facilities
The UCSD Department of Radiation Medicine and Applied Sciences operates four photon
treatment centers in the San Diego region: La Jolla, North County Coastal (Encinitas),
North County Inland (4S Ranch) and South Bay (Eastlake). In 2013, the Department also
formed an affiliation with the Scripps Proton Therapy Center (Appendix I).
10
Facilities are available for the fabrication of treatment aids and, in La Jolla, for performing
intracavitary and interstitial brachytherapy. Stereotactic radiosurgery (using a modified
linear accelerator) is performed at the Moores Cancer Center.
Linacs
CT-Simulators
PET-CT1
3T MRI1
Proton Rooms
HDR Suite
Xoft
Radiosurgery
IMRT
IGRT
1
La Jolla
4
1
1
1
0
Yes
No
Yes
Yes
Yes
North
Coastal
1
1
0
0
0
No
No
Yes
Yes
Yes
North
Inland
1
1
0
0
0
No
No
Yes
Yes
Yes
South
Bay
2
1
0
0
0
No
Yes
Yes
Yes
Yes
Proton
Center
0
1
1
1
5
No
No
No
Yes
Yes
Diagnostic unit equipped for simulation (shared with Radiology)
Other Services
The UCSD Moores Cancer Center has a full complement of specialists in medical
oncology, surgical oncology and its subspecialties, gynecologic oncology, and pediatric
oncology. In addition, there is full access to state-of-the-art imaging techniques, nuclear
medicine, pathology, a clinical laboratory and a tumor registry.
Library Resources
A variety of journals (hard copy and online), reference textbooks, and resource
materials pertinent to radiation oncology,
associated fields of oncology and basic
sciences are available in the Residents
Room. These resources are immediately
accessible at all times, including nights
and weekends, for resident study. All
residents also have access to the UCSD
Biomedical library at the UCSD School
of Medicine.
Twenty four hour access is available with University ID. Renewable Xerox cards are
available for all residents. All resident cubicles have individual computers with full access
to computerized search systems and rapid access to national databases in medicine.
Pub Med
Oncolink
UpToDate
Medline – Ovid
http://www.ncbi.nlm.nih.gov/entrez/query
http://www.oncolink.upenn.edu/
http://www.uptodate.com
http://www.ovid.com
11
III. Residency Appointments
A. Eligibility Criteria
The Radiation Oncology Residency
Program accepts new residents through
the National Residency Matching
Program (NRMP), using the Electronic
Residency Application Service (ERAS).
All inquiries for program information are
answered by the Residency Program
Coordinator. Applicants should refer to
the Radiation Oncology departmental
website http://radonc.ucsd.edu or can
request receive program information by
mail.
All
applicants
are
given
equal
consideration based on merit regardless of race, gender, origin, disability, age, sexual
orientation, or faith.
The entire applicant pool is reviewed by the Residency Program Director and members of
the Education Committee and ranked based on personal statements, board scores, medical
school grades, recommendation letters and other application materials. The top 30
applicants are invited for an interview. Interviews are conducted on Mondays and Fridays
in December and January. Available faculty members and chief resident(s) participate in
the interview process. All interviewed candidates deemed acceptable to the program are
then ranked. The rank list is entered into the NRMP match.
B. Number of Residents
The program has ACGME accreditation for a
total of 12 residents (3 per year).
C. Residency Transfers
Transfers from other Residency Programs
are accepted, if a position is available. To
determine the appropriate level of education
for transferring residents, the Program
Director must receive written verification of
prior educational experiences and a
statement regarding the performance
evaluation of the transferring resident prior
to their acceptance. A Program Director is
required to provide verification of residency
education for residents who may leave the prior to completion of their education.
12
IV. Program Curriculum
A. Format
The UCSD Residency Program curriculum strives to expose residents to all aspects of
clinical and academic radiation oncology, radiation physics and biology. The format is
designed to provide progressive participation of residents. First year (PGY-2) residents
receive an initial series of lectures introducing basic concepts in radiation oncology,
biology and dosimetry and physics. The didactic schedule consists of morning conferences,
lectures, journal clubs, and seminars. The schedule is organized around “Disease Months”
(e.g. Gynecologic Cancer, Lung Cancer, Head/Neck Cancers, etc.) (Appendix IX), during
which most conferences and lectures focus on issues related to these disease sites. The
didactic lectures and seminars are designed to provide the residents with perspectives and
opportunities for education and intellectual development, they are not meant to be
substitutes for critical, independent study. Other creative educational opportunities include
a Radiation Oncology Business Class, a Medical Spanish Class and a Job Search/Interview
Practicum. Attendance at all didactic conferences is mandatory.
B. Goals and Objectives
Specific Goals and Objectives exist for each clinical year (Appendix IV) and each clinical
rotation (Appendix V). Goals and objectives are distributed to all residents and faculty
annually and are reviewed by residents prior to their rotations. The Residency Program
requires all residents to obtain competence in the six ACGME core competencies to the
level expected of a new practitioner.
Patient Care
Patient care that is compassionate, appropriate and effective for the treatment of health
programs and the promotion of health
Medical Knowledge
Medical knowledge about established and evolving biomedical, clinical and cognitive
sciences, as well as the application of this knowledge to patient care
13
Practice-Based Learning and Improvement
Practice-based learning and improvement that involves the investigation and evaluation of
care for patients, the appraisal and assimilation of scientific evidence, and improvements in
patient care
Interpersonal and Communication Skills
Interpersonal and communication skills that result in the effective exchange of information
and collaboration with patients, their families and other health professionals
Professionalism
Professionalism as manifested through a commitment to carrying out professional
responsibilities, adherence to ethical principles, and sensitivity to patients of diverse
backgrounds
Systems-Based Practice
Systems-based practice as manifested by actions that demonstrate an awareness of and
responsiveness to the large context and system of health care, as well as the ability to call
effectively on other resources in the system to provide optimal health care.
C. Didactic Components
Monday Didactics_______________________________________
Clinical Case Conference
Monday 12 pm – 1 pm, Conference Room
One resident is assigned on a rotating basis to prepare and present a clinical case. The focus
of this conference is on specific aspects of the disease (epidemiology, anatomy, etiology,
etc.) and technical issues of its radiotherapeutic management. Expectations are based on the
year of training. Topics conform to the “Disease Month” and follow a predefined schedule.
Tuesday Didactics______________________________________
Physics Class
Tuesday 8:30-9:30, Conference Room
The conference includes didactic lectures and occasional practical demonstrations. This
conference is supervised by the Medical Physics Faculty and is a joint conference with the
Medical Physics Residents. Topics include the physics of radiation interactions, radiation
safety procedures and tests, description and calibration of radiation therapy machines,
radiation therapy does calculations, computerized treatment planning, fabrication of
treatment aids, the physics of radioactive isotopes, the safe handling of sealed and unsealed
radioactive sources, and control procedures used to determine the activity of sources.
14
Wednesday Didactics_____________________________________
Joint Clinical Case Conference
Wednesday 7:30 – 9 a.m., Conference room
One medical resident and one physics resident
are assigned on a rotating basis to prepare and
present a clinical case. The focus of the first
half hour is on the specific clinical aspects of
the disease (epidemiology, anatomy, etiology,
etc.) and will be discussed by the Radiation
Oncology Resident and the second half of the
hour will focus on technical issues of
radiotherapeutic management which will be
discussed by the Physics Resident. Expectations are based on the year of training. Topics
conform to the “Disease Month” and follow a predefined schedule.
Radiation Biology Class
Twice-Monthly, Wednesday 4 – 5 p.m.
Faculty Director: Sunil Advani, M.D.
This course exposes both Radiation Oncology and Physics Residents to a wide variety of
radiobiology topics including radiation response, cell cycle and dose rate effects. The class
is based on the textbook “Radiobiology for the Radiologist” by Eric Hall (Appendix VII).
Thursday Didactics_____________________________________
Resident Conference
Thursday 8-9 a.m., Conference Room
A rotating schedule of different formats is offered:
Clinical Didactic Lectures
Formal clinical didactic lectures based
on the current “Disease Month” will
be given by faculty specializing in that
disease site. A variety of outside
faculty are also invited.
Journal Club
The journal club is used to present
select new articles (as well as classic
reports) related to the current “Disease
Month”. Typically, 2-3 articles are
selected jointly by the Chief Resident
and Dr. Mundt.
Each article is
assigned to a particular resident to
present; however, all residents are expected to have reviewed and be ready to discuss each
article. The presenting resident should not only review the article’s contents, but also the
15
pertinent literature of the topic and provide a critique of the article. Participation and
expectations are based on the residency year of training.
Morbidity and Mortality Conference
Residents are asked to capture cases of morbidity or mortality during their clinic rotations
and to present these cases quarterly at M & M conference. Residents are expected to know
causes of the more common morbidities from radiotherapy and suggest potential strategies
for reducing this risk.
Friday Didactics_____________________________________
New Patient Rounds (“Chart Rounds”)
Friday 8-10 a.m., Conference Room
All new patients receiving radiation
therapy are presented by the treating
resident and simulation films and
plan are reviewed by the staff and
residents. Suggestions for correction
are presented. This is a confidential
quality assurance and peer review
conference. The treating resident is
expected to present each case and
describe
its
management.
Expectations are based on the year
of clinical training.
Grand Rounds
Friday 3-5 p.m. Monthly, Conference Room
This department-wide seminar features on a rotating basis the research faculty from the
Clinical and Translational Division and the Medical Physics and Technology Division
presenting their current work and updates. In addition, Visiting Professors from prestigious
institutions are invited twice yearly to present at this conference as well as spend the day
with the residents and meet with select faculty.
Other Didactic Resident Conferences
Medical Spanish Course
Monthly
Faculty: A.J. Mundt MD
Department Conference Room
All residents are provided with a free copy of Rosetta
Stone software at the beginning of residency. They
are asked to complete one level per quarter during the
16
academic year. Monthly practice sessions are held to learn and review vocabulary and
grammar appropriate to the disease month and to perform practice patient interview
sessions using basic medical Spanish.
Biostatistics Class
Six classes per year
Faculty: James Murphy MD
Department Conference Room
Residents participate in an annual biostatistics class consisting of 6 didactic lectures and
analyzing practical problems/answers (Appendix VIII). Attention is given to reviewing
concepts and statistical tests used in the clinical and basic science literature. Residents are
also exposed to medical statistics through individual conferences including monthly journal
club.
Radiation Oncology Business Class
Quarterly
Faculty: Casey Sandack MBA, Arno J. Mundt MD
Department Conference Room
This class is designed to expose the residents to the business aspects of radiation
oncology. The course is held quarterly and focuses on a variety of topics including billing
and collecting, contracting, hiring and compensation of physicians, physicists and staff,
new program startup (including equipment purchasing), and physician, physicist and staff
productivity metrics. In addition, the financial aspects of research programs and residency
training programs will be highlighted. The format is primarily lecture-based but case
studies are used throughout to provide real world, practical examples.
Anatomy for the Radiation Oncologist
Monthly
Faculty: Jona Hattangadi-Gluth MD
Department Conference Room
This class is designed to expose the residents to basic anatomy pertinent to the practice of
radiation oncology including target and normal tissue contouring. Hosted by Dr.
Hattangadi-Gluth, the monthly course reviews the anatomy of the particular disease site
based on the Disease Month.
Boards Review
Monthly
Faculty: Doug Rahn MD
Department Conference Room
Hosted by a recent residency graduate, this course is designed to familiarize the residents
with the most relevant literature and techniques in preparation for their written and oral
boards examination at the end of their residency.
17
Job Search/Interview Practicum
Three summer lectures (prior to interview season)
Faculty: A.J. Mundt MD
Department Conference Room
This practical series is designed to equip the graduating residents with the necessary skills
to identify and interview for jobs following their residency. Consisting of an introductory
lecture, the course includes critique of resumes and interview performance. The practicum
is held in the summer prior to ASTRO to help the graduating residents.
D. Clinical Components
1. Requirements
All residents must satisfy all ACGME requirements for Radiation Oncology.
i) Treatment of a minimum of 150 patients with external beam irradiation per year, for
a minimum of 450 over all clinical rotations.
The maximum allowable number of patients per year by each resident is 250. The Program
Director will ensure that these requirements are satisfied during the semi-annual resident
log review (January and July). If necessary, adjustments to the clinical rotation schedule
will be made to ensure these requirements are met. Only cases for which the resident has
performed the simulation may be counted as “treated” in a resident’s log (even if the
predominance of the patient’s treatment is during the subsequent resident’s rotation).
Additional simulations in the same patient for the same treatment site may not be counted
in the electronic log, e.g. pre- and post-chemotherapy simulations, repeat simulations for
weight loss, etc. Simulations for new treatment
sites, or substantial volume reductions requiring
a separate simulation with a different isocenter
that represents sequential, not concurrent,
treatment however, may be counted. These
definitions will be strictly adhered to in order to
avoid patient “over counting”.
ii) Treatment of a minimum of 12 pediatric
patients (of whom a minimum of nine have
solid tumors) over all clinical rotations.
A pediatric patient is defined as any patient less than 18 years of age. Again, only cases for
which the resident has performed the simulation may be counted as “treated” in a resident’s
log.
iii) Performance of a minimum of five interstitial and ten intracavitary implants.
Separate applications of an implant in a given patient may be counted separately; however,
multiple fractions of the same application may be counted only once.
18
iv) Participation in the administration of a minimum of six procedures using
radioimmunotherapy, other targeted therapeutic radiopharmaceuticals, or unsealed
sources.
The department has an agreement with Nuclear Medicine allowing radiation oncology
residents to participate in the administration of a wide variety of un-sealed sources during
their clinical years.
v) Treatment of at least 15 patients with stereotactic radiosurgery, at least 10 with
brain radiosurgery and at least 5 to other body sites.
vi) Medical Oncology
To satisfy the ACGME requirements for medical oncology, all residents must:
Attend, and document attendance at, a minimum of four hours per month of regularly
scheduled multi-disciplinary conferences during each rotation.
vii) Oncologic Pathology and Diagnostic Imaging
To satisfy the ACGME requirements for oncologic pathology and diagnostic imaging,
all residents must:
Attend, and document attendance at, a minimum of one hour per week of regularlyscheduled multi-disciplinary conferences in which oncologic pathology and diagnostic
imaging are presented and discussed.
See Appendix X for a summary of the regularly scheduled multi-disciplinary
conferences at each hospital with medical oncology, pediatric oncology, radiology, and
pathology.
19
2. Clinical Curriculum
Overview
The program provides the resident with the opportunity to gain in-depth knowledge of
clinical radiation oncology, including the indications for irradiation and special therapeutic
considerations unique to each site and stage of disease.
The residents are trained in standard radiation techniques, as well as in the use of treatment
aids and treatment planning to optimize dose distributions. In addition, residents learn the
principles of normal tissue tolerance to radiation and tumor dose-response. Residents also
gain exposure to combined modality therapy, altered fractionation schemes, pain
management, and palliative care.
Clinical Rotations
Each clinical rotation is of three months duration during which residents work one on one
with an attending physician (exceptions include the combined Dr. Kevin Murphy and Dr.
A.J. Mundt rotation and off-site rotations). The rotation schedule is determined by Chief
Resident(s) and approved by the Program Director on an annual basis.
The schedule is designed to ensure not only exposure to all clinical areas, but to allow
progressive responsibility of the resident in patient management. The rotation schedule is
distributed at the beginning of each academic year.
The clinical rotations expose
residents to the management
of brain tumors, head/neck
tumors, skin tumors, breast
cancers,
lung
cancers,
gastrointestinal
tumors,
genitourinary
cancers,
gynecologic
tumors,
lymphomas, leukemia, soft
tissue tumors, bone tumors,
and pediatric tumors.
In
addition,
residents
gain
exposure
to
the
radiotherapeutic management
of benign tumors and metastatic disease.
During specific clinical rotations, radiotherapeutic procedures are taught including
stereotactic radiosurgery, intraoperative radiation therapy, 3-dimensional conformal RT
and intensity modulated RT (IMRT) planning and delivery, image-guided RT (IGRT),
radioimmunotherapy, unsealed sources, total body irradiation (TBI) as used in stem-cell
transplantation, total skin irradiation, high- and low-dose-rate brachytherapy, hyperthermia,
kilovoltage irradiation, plaque therapy, particle therapy, and intravascular brachytherapy.
Residents also are trained in the use of external beam modalities, including megavoltage
irradiation, electron beam, simulation using conventional and/or CT simulators to localize
anatomy and computerized treatment planning. All residents personally perform technical
20
procedures, including treatment setups as well as intracavitary and interstitial placement of
radiation sources.
Follow-up of Irradiated Patients
Follow-up of irradiated patients is required on each clinical rotation, including pediatric
patients, on an inpatient or outpatient basis. This ensures that all residents have the
opportunity to learn about problems of recurrent and disseminated tumors and the late
effects (complications) of radiation therapy.
3. Resident Logs
All residents must maintain a detailed, well-organized and accurate electronic log of
patients simulated, procedures performed, procedures observed, and modalities used. These
logs are reviewed bi-annually by the Program Director (January and July). The Program
Director will ensure accuracy and verify that the case distribution meets the standards
specified. The resident logs are accessed via the ACGME website (www.acgme.org) under
the “Resident Toolbar”. Login with a password is required. Questions regarding accessing
the resident log, passwords etc. should be directed to the Residency Coordinator.
E.
Resident Investigative Project
All residents must complete a research project under faculty supervision prior to
completion of the program.
The research project may take
the form of clinical research,
medical physics, biological
laboratory research or a
retrospective analysis of data
from treated patients. These
results must be suitable for
publication in a peer-reviewed
scholarly
journal
or
presentation at a scientific
meeting. Failure to meet this
requirement may result in
withholding of certification of
successful
completion
of
radiation training. Completion
of a research project is defined as submission of an abstract to a national meeting or
submission of a manuscript for publication in a peer-reviewed medical journal. At the end
of the research year, the resident will make a formal presentation of his/her research to the
department.
F. Resident Practice Quality Improvement Project (PQI)
All residents are required to perform one practice quality improvement project during their
residency. This partially satisfies the practice based learning and improvement competency
(PBLI) and shows the ability of the resident to evaluate an aspect of his/her own practice,
21
propose and action plan for improvement and then implement this plan. The resident
presents the results of this PQI project at a
department conference.
G. Examinations
All residents are required to take the yearly
ACR in-service training examination as
well as a yearly exam in both physics and
radiobiology. Vacations during these
examinations are not permitted. Dates of
these exams can be obtained from the
Residency Program Coordinator. At the
end of each clinical rotation residents
undergo
both
written
and
oral
examinations covering the disease sites during that rotation. The purpose is to prepare the
residents for the board examinations following completion of their residency. In addition,
all residents undergo written and oral examinations following his/her 3 month rotations.
These examinations are supervised by the Chair,
Residency Program Director and Clinical
Division Director.
V. Clinical Responsibilities
A. Consultations
Each resident is responsible for seeing consults
(and re-consults) and obtaining the appropriate
clinical information, imaging, and pathologic
studies for all patients assigned to his/her
clinical service. The case is presented to the
attending physician, who will then see patient
together with the resident. A decision regarding
patient management is then made and if the patient is to be treated a “Dispo/MD Orders”
form as well as appropriate documentation and billing forms are completed. Release forms
should be obtained for pathology slides, medical records, and x-rays from the patient
whenever performed at outside hospitals. Once the consult is complete, a complete history
and physical examination must be completed by the resident within 24 hours. A summary
of the salient points of the patient’s history and disease status, as well as recommendations
and plans for treatment should be described.
B. Simulation
All simulations are scheduled with the department scheduler, Chief Therapist or designee.
All simulation requests should be accompanied by a simulation request form (disposition
form) outlining the patient’s full name, attending physician, the area to be irradiated,
patient positioning, immobilization, contrast required (and if contrast is required the most
recent creatinine documented) and whether IMRT is planned.
22
In patients undergoing CT simulation, scanning details are required including scan extent
and slice thickness. The simulation therapist must be alerted to any precautions, e.g.
positive Hepatitis-C or HIV status. For brachytherapy patients, the resident should inform
the simulation therapist what type of brachytherapy is planned (intracavitary, interstitial),
whether the patient will undergo low- or high-dose-rate brachytherapy, and whether the
patient will be an inpatient or outpatient the day of the simulation. The resident should
ensure that any scheduled simulations do not conflict with the attending faculty schedule so
that the faculty or a covering attending is present for all procedures.
C. Treatment Planning
Once the simulation is complete, the resident is responsible for delineation of the target
volume and normal tissues as necessary. In addition, the resident is responsible for
completion of the prescription specifying total dose, fractionation and special treatment
aids, and requirements. All prescriptions must be counter-signed by the supervising
attending prior to treatment.
Faculty approval of the target
volume and normal tissues must be
obtained by the resident prior to the
initiation of treatment planning. If
cerrobend or multi-leaf blocks are to be
employed, the resident should define
these blocks on the planning system and
review them with the supervising
attending prior to their fabrication.
The resident should inform the
simulator staff regarding the “start date”
for the patient, allowing sufficient time
for optimal treatment planning and quality assurance to be performed, particularly in
patients undergoing IMRT. Under the supervision of the attending, the resident should
review the planning goals and relevant constraints with the dosimetry and/or physics staff
prior to the generation of the treatment plan. The dosimetrist will then generate and present
potential treatment plans to the resident and the resident is responsible for reviewing these
plans with the attending physician. The attending physician is responsible for giving final
approval for a treatment plan to be implemented.
D. Treatment
Consent
Consent is required for all patients prior to the initiation of treatment. No patient may be
treated without a consent form in the patient’s record with the signature of the patient (or
legal guardian) and the physician obtaining consent. Consent forms can be obtained from
the medical assistant or nurse case manager. The consent may be obtained by either the
resident or attending faculty. The time necessary to obtain consent should be anticipated so
as not to delay the initiation of treatment. Therefore, patients should be asked to come to
clinic at least 15-30 minutes prior to their assigned treatment time, depending on the
23
disease and site of treatment. A new consent form is required for every new site or retreatment.
Scheduling Initial Treatment
While the resident is not responsible for scheduling of the initial treatment time on the
machine, he/she should be aware of when the patient expects to start and inform the
appropriate staff if he/she becomes aware of any changes in the treatment plan and start
date.
Initial Setups/Port Films
At the time of the initial setup, both
the resident and faculty attending
should be present. If the attending
faculty is not available, the resident
should view the setup with the
covering attending. During treatment,
port films will be obtained and
reviewed by the resident and
attending.
On-Treatment Visits (OTVs)
All patients under treatment must be
examined on a weekly basis (or twice
weekly in patients treated with twice
daily fractionation) by the resident
and attending physician. Patients who
are experiencing problems during treatment should be examined as often as necessary and
appropriate interventions performed. At the time of examination, the resident should record
the current radiation dose, as well as physical findings, side effects or problems
encountered. If a change in the treatment plan is indicated (cone-down boost, re-simulation,
etc.), the resident should schedule these with the simulation therapists and physics staff.
Advance planning is important if treatment interruptions are to be avoided. Documentation
of the weekly on-treatment visit (OTV) should be completed by the resident and attending
physician, including appropriate billing forms. Documentation of the OTV should also be
placed in the inpatient chart of all inpatients receiving radiation therapy. If treatment needs
to be interrupted, the nurse and radiation therapists should be notified personally and the
date at which treatment is expected to resume should be indicated. Appropriate
documentation of any unplanned treatment breaks should be included in the medical
record.
Brachytherapy Patients
A daily progress note should be placed in the chart of all patients admitted for
brachytherapy, informing the admitting service of potential problems, duration of
treatment, etc. The attending and the resident who performed the implant or insertion are
responsible for its removal and for “rounding” on the patient (including weekends and
holidays). The resident who performed the implant or insertion must be available
throughout the entire treatment course if problems or questions arise. If conflicts arise,
coverage must be obtained in advance. A 24 hour H/P update is required prior to any
sedation cases in the clinic. The resident assigned to the case is responsible for completing
24
this documentation. All PGY3 and above residents are required to take and pass the
on0line moderate sedation examination as well as have advanced resuscitation training
(ART).
Completion Summary
At the completion of treatment, a completion summary should be completed by the resident
with appropriate treatment details, including a brief history, site treated, total dose, fraction
size, treatment dates, number of fractions, treatment region, modality used (photons,
electrons, brachytherapy), any problems or side effects encountered (including their
severity and management) and arrangements for follow-up care. The referring physician
(and appropriate other physicians) should be clearly specified, allowing the secretarial staff
to send out copies to all appropriate clinics. Completion summaries should be completed
within 48 hours of the patient finishing. The resident is responsible for reviewing the
treatment summary and adding all appropriate information. All finalized summaries must
be signed by the attending physician.
E.
Follow-up
Residents are required to see follow-up patients during each clinical rotation. Each
attending is assigned a specific day to see follow-up patients and all patients are seen
jointly with the resident and attending. Follow-up notes should be completed within 24
hours of the patient being seen.
F.
Night and Weekend Call
The resident on-call schedule is prepared by the Chief Resident(s), Program Director and
Department Manager. All residents are included in the call schedule. Call is taken from
home for one-week durations. On-call residents are paired with a faculty member for the
on-call week. Residents are responsible for informing the Clinic Manager as soon as
possible if conflicts arise. However, the resident is personally responsible for arranging
coverage if conflicts arise. Emergency consults must be evaluated by the on-call resident
immediately following the request for consultation. The on-call attending staff should also
evaluate the patient. The on-call resident is responsible for treating all emergency patients,
as well as others who have already been started on treatment but require treatment on the
weekends or on holidays. The on-call resident should complete a history and physical on
the emergency consult and inform the appropriate attending physician who will be
ultimately managing the patient. Following discussion with the attending physician the
resident is to leave a brief note in EPIC regarding our plan for the patient.
VI.
Departmental Residency Policies
A.
Vacation
Residents are permitted 4 weeks (20 working days) of paid vacation time during each
academic year. Vacation time not used during a given academic year cannot be carried
over to the following year. It also does not accrue during a leave of absence. Residents are
requested not to take vacation during the first or last week of any rotation and no more than
1 week of vacation time during any single rotation. Additionally residents may not take
vacation during the first or last months of their residencies. Only 2 residents on clinical
25
rotations are allowed to take vacation at any one time. Attending physicians should be
given a minimum of two weeks’ notice of any vacation time. Acceptable reasons for less
notice include family or personal illness, a death in the family, or other emergencies.
Whenever possible, residents should avoid vacation time when the attending of the service
he or she is assigned to is also on vacation. All residents are required to inform the
Residency Program Coordinator of all scheduled vacations in writing a minimum of two
weeks prior to the vacation using the department written notification procedure. This
includes residents on electives and in their research year. All residents are also required to
inform the Chief Resident of all scheduled vacations a minimum of 2 weeks prior to the
vacation to ensure proper coverage has been arranged for the clinic and conferences. Senior
residents are allowed an additional maximum of 5 days in their final year for interviews
with approval of the Residency Program Director.
B.
Holidays
The following are UCSD holidays:
New Year’s (2 Days)
Martin Luther King Jr. Day
President’s Day
Cesar Chavez Day
Memorial Day
Independence Day
Labor Day
Veteran’s Day
Thanksgiving (2 Days)
Christmas (2 Days)
Unless an alternate date is designated by the President, a holiday that falls on a Saturday is
observed on the preceding Friday and a holiday that falls on a Sunday is observed on the
following Monday. A resident may observe a special or religious holiday, provided that the
work schedule permits and provided that the time off is counted as vacation or is without
pay.
C.
Professional Leave
With the approval of the Residency Director, residents may take up to five working days of
leave with pay per academic year to pursue scholarly activities pursuant to their educational
curriculum. Addition time can be obtained on a case by case basis at the discretion of the
Program Director. Time not taken may not be carried over from one academic year to the
next and will be forfeited.
D.
Sick Leave
Residents are granted up to 12 working days per year of sick leave. Sick leave that remains
unused at the end of an academic year will carry over to the following year. Sick leave is
not to be used as additional vacation.
26
E.
Family Illness and Bereavement
A resident is permitted to use not more than 30 days of sick leave in any calendar year
when required to be in attendance or to provide care because of the illness off a spouse,
parent, child, sibling, grandparent, grandchild, in-laws or step-relatives. This provision
also covers other related persons residing in the resident’s household. A resident is
permitted to use not more than five days of sick leave when his/her absence is required due
to death of a spouse, parent, child, sibling, grandparent, grandchild, in-law or step-relative.
This provision also covers other related persons residing in the resident’s household. In
addition, a resident is permitted to use not more than five days of sick leave in any calendar
year for bereavement or funeral attendance due to the death of any other person. The
resident must provide prior notice to the Residency Director as to the need for and likely
length of any such absence.
F.
Personal Leave of Absence
A resident may be granted a personal leave without pay when other leave balances have
been exhausted. See House Officer Policy Manual and Procedure Document for additional
details.
G.
Pregnancy/Childbearing
Disability Leave
A resident disabled due to pregnancy,
childbirth,
or
related
medical
conditions shall be granted a medical
leave of absence up to four months,
but not to exceed the period of verified
disability. See House Officer Policy
Manual and Procedure Document for
additional details.
H.
Paternity Leave
Paternity Leave may be granted in
accordance with the provisions of the
leave policies described including:
FMLA, Sick Leave or Vacation.
I.
Family and Medical Leave
Family and Medical Leave (FMLA) is provided for an eligible resident due to a serious
health condition, a serious health condition of the resident’s spouse, child or parent, or to
bond with the resident’s newborn, adopted or foster child in accordance with State and
Federal law. See House Officer Policy Manual and Procedure Document for additional
details.
J.
Leave for Work-Incurred Disability
27
Leave for work-incurred disability may be granted at the discretion of the Residency
Program Director. See House Officer Policy Manual and Procedure Document for
additional details.
K.
Military Leave
A resident granted temporary military leave for active-duty training or extended military
leave is entitled to receive the resident’s regular University pay for the first 30 calendar
days of such leave in any one fiscal year, provided that the resident has completed 12
months of continuous University service immediately prior to the granting of the leave. See
House Officer Policy Manual and Procedure Document for additional details.
L.
Jury Duty
A resident who is summoned and serves on jury duty shall be granted leave with pay for
the time spent on jury service and in related travel. Make-up time may be required to meet
the educational objectives and certification requirements of the training program.
M.
Ethical/Religious
No resident shall be penalized for refusing to perform medical procedures he/she feels
violates his/her religious or ethical beliefs. However, all residents must complete the
training required by the ACGME for radiation oncology before the Program Director can
certify that the resident has completed the training program.
N.
Harassment
It is the policy of the UCSD and Department of Radiation Oncology to maintain a work
environment free from prohibited forms of harassment, including sexual harassment. It is
the intention of the University to take whatever action may be needed to prevent, correct,
and, if necessary, discipline behavior which violated this policy. The full policy on Sexual
Harassment may be obtained from the Office of Sexual Harassment Prevention and Policy
or from the Office of Graduate Medical Education.
O. Licensure
Throughout the training period,
all residents must maintain a
State of California Medical
License. Copies of USMLE I-II
certificates are placed in each
resident’s permanent file. All
residents must successfully pass
the USMLE step III exam prior
to entering the PGY-5 year.
Residents must notify the
Program Director and the
Graduate Medical Education
Office in writing immediately if
28
his or her license is revoked, suspended or otherwise restricted of if an application for a
temporary or permanent license is denied. Any such revocations, suspension, restriction or
denial shall serve automatically to terminate the Residency Contract.
P.
Health Insurance Portability and Accountability Act (HIPAA)
The UCSD Hospitals are subject to state and federal privacy and security laws. All
residents must receive training about HIPAA and the privacy and security practices
of
UCSD. According to HIPAA privacy regulations, the use and disclosure of protected health
information (PHI) is prohibited. PHI refers to any information that identifies or could lead
to the identification of a patient and reveals something about the patient’s health status.
Exceptions to this regulation include:



For patient treatment, patient payment activities and hospital health care operations
Where required by law for public health and other purposes (e.g. subject to a subpoena)
Where the patient has signed an authorization form that contains a detailed explanation
of the purpose for the use or disclosure
Other exceptions include the use of a limited amount of the PHI for fundraising, the use of
PHI for research (under very particular rules), the disclosure of a limited amount of PHI
through the patient directory and the disclosure of PHI to family members (also under
particular rules). Federal and state law requires special privacy protections for certain
highly confidential information, including PHI relating to psychotherapy, HIV testing,
child abuse and neglect, etc. For further details, contact the Compliance Office.
Under HIPAA, patients have the right to:
•
•
•
•
•
•
Receive a Notice of Privacy Practices
Inspect and receive a copy of their PHI
Request an amendment to their PHI
Request disclosures of their PHI
Receive confidential communications
Complain about the UC Privacy
practices to the UC and/or Secretary of
the U.S. Department of Health and
Human Services (HHS)
HIPAA not only requires the protection of
patients’ privacy and the confidentiality of
their PHI, but also requires that UCSD
ensures the security of their PHI when it is
created, maintained and transmitted within
and outside the UCSD Hospitals. This
includes PHI maintained on laptop and
desktop computers, personal digital
assistants (PDAs) and pagers.
29
Q.
Appointment/Re-Appointment
Each appointment period is for one academic year from July 1 to June 30. Reappointment
is not automatic. It is subject to annual review and contingent upon mutual agreement,
funding availability, and satisfactory performance. Reappointment shall be recommended
by the Residency Director and approved by the Associate Dean for Graduate Medical
Education.
VII. Duty Hours and the Working Environment
A.
Resident Supervision
Supervision of residents is required in all services of the department. Supervision begins
with the house staff’s initial contact with the patient and continues through all contact the
house staff has with the patient. Supervision is complete when all documentation of the
treatment (and/or hospital stay or clinic visit) is collected for the permanent patient record.
The responsible staff physician must see all consults, re-consults, patients under treatment
and follow-ups with the resident. All aspects of treatment planning and implementation
must be supervised and approved in writing by the responsible faculty member. The
faculty member must document his or her presence for all areas of supervised work.
Patients with problems must be brought to the attention of the attending physician. The
attending physician is responsible for the daily management of all patients under his or her
care.
B.
Duty Hours
Duty hours are limited to a maximum of 80 hours
per week, averaged over a four-week period,
inclusive of all in-house call activities. Duty
hours are defined as all clinical and academic
activities related to the residency program, i.e.
patient care, administrative duties relative to
patient care, and scheduled activities such as
conferences. Duty hours do not include reading
and preparation time spent away from the duty
site. Residents must be scheduled for a minimum
of one day free of duty every week (when
averaged over four weeks). At-home call cannot
be assigned on these free days. One free day is
defined as a continuous 24-hour period free from
all clinical, educational and administrative duties.
All residents should have a minimum of 10 hours
off between shifts. All residents are also provided
with adequate time for rest and personal
activities. Duty periods of residents will not
exceed 24 hours of continuous duty in the
hospital. Residents must keep track of duty hour compliance in the web-based New
Innovations System. During the rotation, any resident who has concerns about Duty Hours
30
must contact the Residency Program Director and appropriate changes will be made to
ensure compliance.
C.
On-Call Activities
The UCSD Residency Program does not include in-house call responsibilities. All residents
are assigned on a rotating bases at-home (pager) call lasting seven days. See Section VI
“Clinical Responsibilities” sub-section “Night and Weekend Call” for further details. When
residents are called into the hospital from home, the hours spent in-house are counted
toward the 80-hour Duty Hour limit. The Program Director monitors the demands of athome call and makes scheduling adjustments as necessary to mitigate service demands
and/or fatigue.
D.
Moonlighting
Moonlighting is typically not permitted during the Residency Program unless with the
explicit knowledge of the Residency Program Director. Moonlighting hours are closely
monitored and are counted in the 80 hour/week requirement. No residents are allowed to
moonlight if doing so interferes with his/her clinical and educational responsibilities.
E.
Stress/Fatigue
All residents and faculty are educated to recognize the signs of fatigue and adopt policies to
counteract its negative potential effects. At the beginning of each academic year, all
residents and faculty must complete the on-line training session from the American
Academy of Sleep Medicine (AASM) called the S.A.F.E.R. presentation. Residents should
inform the Program Director of any issues leading to fatigue and seek assistance. At the
semi-annual meeting of individual residents and the Program Director, issues of stress and
fatigue are discussed. Changes to the rotation and/or conference schedules may be made as
needed.
F.
Substance
Abuse/Counseling
The
Department
is
committed to assist all
residents with a substance
abuse
problem
and
encourages any trainee
with such a problem to
contact the Residency
Program Director. The
Department
will
not
discipline any resident for
his/her
self-disclosure.
Self-disclosure will not,
however,
excuse
a
violation of any other
31
policy or dereliction of any duties. See House Officer Policy Manual and Procedure
Document for additional details.
VIII. Evaluations
A.
Resident
1. Rotation Evaluations
Upon completion of each clinical rotation, each resident receives a formal evaluation from
the supervising faculty (Appendix XI). These evaluations include assessment of the
ACGME competencies (patient care, medical knowledge, practice-based learning and
improvement, interpersonal and communication skills, professionalism and systems-based
practice). At the end of each rotation, the resident undergoes a written and oral examination
to assess his/her knowledge of the designated disease site. An effort is made to help
residents with any problem occurring during the rotation. Evaluations are discussed with
the resident at the completion of the rotation. Evaluations are sent to the Residency
Program Director and are made available to the Department Chair. Evaluations are
discussed at the Education Committee meeting.
2. 360° Evaluations
In addition, assessment of the resident includes quarterly 360º evaluations (Appendix XII)
by:
1.
2.
3.
4.
5.
Nurses
Radiation Therapists
Physicists/Dosimetry Staff
Medical Students (if available)
Patients
All these evaluations are maintained as part of the resident’s permanent record in the
Program Coordinator’s office and can be reviewed at any time by the resident. In addition,
these evaluations are reviewed at the semi-annual Education Committee meeting and
reviewed with the resident during his/her semi-annual meeting with the Program Director
(Appendix XIII).
Final Evaluation
The Program Director provides a final evaluation for each resident who completes the
program (Appendix XIV). This evaluation includes a review of the resident’s performance
during the entire period of education, and verifies that the resident has demonstrated
sufficient professional ability to practice competently and independently. This evaluation is
maintained as part of the permanent record by the institution.
B.
Faculty
The performance of the faculty is evaluated yearly (June) by the residents and the Program
Director (Appendix XV). The written evaluation by the residents is from the entire group
and is confidential to preserve anonymity (Appendix XVI). These evaluations include a
32
review of their teaching abilities, commitment to the educational program, clinical
knowledge, and scholarly activities. All the evaluations are discussed at the semi-annual
Education Committee Meeting and changes to the rotation schedule are made as necessary.
C.
Program
The Program as a whole is evaluated yearly by the residents, the faculty, and the Program
Director. The resident evaluation includes a review of the curriculum, didactic
conferences, etc. (Appendix XVII). These evaluations are discussed and the program is
formally evaluated at the annual Program Evaluation Committee meeting. Changes to the
program are made as necessary.
X. Disciplinary Action
Policies regarding disciplinary actions, suspension, termination, and Housestaff grievance
procedures are outlined in detail in the House Officer Policy Manual and Procedure
Document.
XI. Benefits
A. Stipends
The basic salary scales for residents are established by the University Office of the
President and available on the GME website.
At UCSD Medical Center, salaries for represented residents are collectively bargained by
UCSD and the San Diego House-Staff Association.
The first paycheck for the academic year is issued on the first day of the month of August.
Subsequent paychecks are issued on a monthly basis. Direct deposit of paychecks to San
Diego area banks is possible. Deductions for State and federal taxes as well as Medicare
are automatically made from the House Officer’s stipend. Social Security (FICA)
withholding will not be made, but in lieu of this 7.5% of the house officer’s pre-tax pay is
directed to the Safe Harbor University of California Defined Contribution Plan. These
non-voluntary contributions may be directed to one of the several managed funds or to any
one of over 100 Fidelity Investment Funds.
Each resident receives an annual housing stipend of approximately $3000; the chief
resident stipend is $600.
B.
Meetings/Travel
Attendance (including travel, hotel accommodations, meals, and registration) at one
relevant professional meeting will be supported during the residency. Additional meetings
will be supported if the resident is presenting results of his/her research in an oral
presentation at the discretion of the Residency Program Director. Travel funding may be
refused if a resident has failed to complete and submit a manuscript of research presented at
a prior meeting. Excused absence for attending a meeting should not extend beyond the
dates of the meeting and necessary travel time. Additional days will be considered vacation
33
time. Requests for attending the yearly ASTRO meeting should be submitted well in
advance (a minimum of two months). Requests for attending ASTRO will be considered
on a first-come, first-served basis, with priority given to residents presenting papers and to
senior residents scheduling interviews.
Residents should discuss planned time off with the appropriate attending on whose rotation
the meeting will occur.
C.
Away Rotations
A one month “away rotation” may be taken during the residency program, typically during
the PGY-4 year. Expenses for travel and room/board are reimbursed. Residents are
responsible for contacting the appropriate program in advance and completing all necessary
paperwork. All rotations must be approved in advance by the Residency Program Director.
D.
Books/Journals
A $300 per year allowance is provided to each resident for
professional books and/or journal subscriptions. At the
beginning of his/her first year, each resident will receive
free of charge:
• Principles and Practice of Radiation Oncology (Perez)
• IMRT: A Clinical Perspective (Mundt, Roeske)
• IGRT: A Clinical Perspective (Mundt, Roeske)
• Radiobiology for the Radiologist (Hall)
34
• Radiation Physics (Khan)
E.
Lab Coats/Scrubs
Incoming housestaff receive three lab coats at the Office of Graduate Medical Education
Orientation. The department will pay for the additional cost to have the lab coats
embroidered and laundering is performed free of charge.
F.
ID Badges
A hospital ID badge is obtained during the new resident
orientation.
G.
Parking/Transportation
Parking costs are not paid by the department. Residents
receive a discounted rate for parking negotiated by the
union; inquiries should be directed to the Office of
Graduate Medical Education.
H.
Pagers (beepers)
At the Resident Orientation, all residents are given a longrange beeper. Batteries are supplied by the department
free of charge. Each resident is responsible for his or her
pager and if lost is liable for the cost of a replacement.
I.
Email and Internet
The UC Hospitals provide all housestaff with internet access and an e-mail address that is
internet accessible. The Department of Radiation Oncology has its own server. The
35
Departmental I.T. manager, Rich Fletcher, provides all residents with email addresses and
handles all network related issues.
J.
Health and Life Insurance
Residents are eligible for enrollment in the UCSD Housestaff health, dental, vision, life and
disability insurance plans. There is no premium charge for the cost of enrollment for
him/herself, a spouse, dependent children, or a domestic same or opposite sex partner in the
health, dental, and vision plans. There is also no premium charge to the resident for
enrollment in the life or disability plans. Benefit coverage is not automatic. An enrollment
process must be followed within the timeframes established by the carriers. Following the
enrollment process, coverage is effective the date of the resident’s appointment.
Subsequently, new dependents may be enrolled provided it is within 30 days after
marriage, birth or adoption. Open enrollment for health plans (health, dental, vision and
life) occurs on an annual basis during the month of June. At that time, the housestaff will
have the opportunity to change their medical plan coverage from one carrier to another or
to enroll with a plan for the first time. See House Officer Policy Manual and Procedure
Document for additional details.
K. Malpractice Insurance
UCSD is obligated by the California Tort Claims Act to defend housestaff against any
liability or malpractice claim arising out of his/her acts or omissions within the scope of the
University duties for work completed during the training period. Professional liability
insurance coverage is maintained to meet such obligations. Exceptions to this coverage are
acts or omissions in the course of activities not within the scope of the resident’s University
duties and acts or omissions resulting from fraud, corruption, malice or criminal
negligence. See House Officer Policy Manual and Procedure Document for additional
details.
L. Recreation Facilities
UCSD offers a wide range of recreation
facilities
including
weight-training,
cardiovascular fitness, racquet-ball courts,
gymnasiums and swimming pools.
All
facilities are free of charge for residents
showing proper identification. The two main
indoor facilities are the RIMAC (Recreation,
Intra-Mural, Athletics Center) and the Main
Gym.
For a full description of facilities, refer to the
UCSD Sport Facilities website
http://sportsfac.ucsd.edu/home.html
36
M. Meal Allowance
Radiation Oncology residents do not receive a meal allowance while on call since call
taken from home.
XI.
is
Chief Resident
Each January, a Chief Resident is selected from the upcoming PGY-4 class. The Chief
Resident term extends from 7/1 to 6/30 of the following academic year. The Chief Resident
is selected by the Program Director following consultation with the faculty and Department
Chair. Qualifications include superior academic and clinical performance in the residency
program. In addition, interest and aptitude for education of junior residents are important
factors in the selection process.
Responsibilities of the Chief Resident include preparation and distribution of:
•
•
•
Clinical rotation schedule
Conference schedule with presentation assignments
On-call schedule
The final rotation, conference, and on-call schedules are reviewed and approved by the
Program Director to ensure compliance with all ACGME requirements. Together with the
Program Director, the Chief Resident is also responsible for overseeing the following
conferences, including selecting topics, dates and assigning pertinent reading:
•
•
Journal Club
M & M Conference
The Chief Resident is also responsible for scheduling and coordinating the Medical Physics
Class and Radiobiology Class with the Physics and Biology faculty and selecting, inviting
and overseeing the visit of Visiting Professors each year. All potential visiting professors
must be approved by the Program Director.
XII.
Certification
Residents who plan to seek certification by the American Board of Radiology (ABR)
should consult the ABR website (www.theabr.org/) for a full description of the
requirements, fees and examination schedules. The Residency Program Coordinator will
assist all residents completing in the program in obtaining necessary documentation for
ABR certification.
37
Appendix I
Driving Directions
Rebecca and John Moores Cancer Center (La Jolla)
3855 Health Sciences Drive
San Diego CA 92103
(858) 822-6040
From Interstate-5
Exit Genesee Avenue and go east
Turn right onto Campus Point Drive and Left on Medical Center Drive
Follow the road around the Shiley Eye Center and turn left on Health Sciences Drive
Park in the lot on the right
From Interstate-805
Exit La Jolla Village Drive and go west
Turn right on Regents Road and left on Health Sciences Drive
Park in the lot on the left as you near the Cancer Center
Valet Parking is Available
Interactive Campus Map to the Cancer Center [link]
Yahoo Map [link]
Google Maps [link]
38
UCSD Radiation Oncology North County (Encinitas)
1200 Garden View Road, Suite 200
Encinitas, CA 92024
(760) 634-6661
UCSD Radiation Oncology South Bay
955 Lane Avenue
Chula Vista CA
(619) 502-7730
UCSD Radiation Oncology 4S Ranch
16918 Dove Canyon Rd
San Diego CA
39
Scripps Proton Therapy Center
9730 Summers Ridge Rd
San Diego, CA
40
Appendix II
Faculty
Chair
Arno J. Mundt, M.D. FACRO FASTRO
Professor
Vice-Chairs
Todd Pawlicki PhD FAAPM
Professor
Kevin Murphy MD
Associate Professor
Casey Sandack MBA
Division of Clinical Radiation Oncology
Parag Sanghvi, M.D.
Assistant Professor & Director
John Einck, M.D. FACRO
Professor
Ajay Sandhu, M.D.
Professor
Gina Mansy, M.D.
Associate Professor
Catheryn Yashar, M.D.
Associate Professor
David Hoopes MD
Associate Professor
Doug Rahn MD
Assistant Professor
Division of Clinical and Translational Research
Loren Mell, M.D.
Associate Professor & Director
Aladar Szalay PhD
Professor
James Urbanic MD
Associate Professor
Jona Hattangadi-Gluth, M.D.
Assistant Professor
James Murphy, M.D.
Assistant Professor
Sunil Advani MD
Assistant Professor
Utz Fischer PhD
Research Scientist
Division of Medical Physics and Technology
Todd Pawlicki, Ph.D. FAAPM
Professor & Director
Roger Rice, Ph.D.
Professor
Vitali Moiseenko, Ph.D.
Professor
Steve Sutlief PhD
Professor
Amit Majumdar, Ph.D.
Associate Professor
41
Derek Brown PhD
Associate Professor
Laura Cerviño, Ph.D.
Assistant Professor
Todd Atwood PhD
Assistant Professor
Adam Paxton PhD
Assistant Professor
Gwe-Ya Kim, Ph.D.
Assistant Professor
Kevin Moore, Ph.D.
Assistant Professor
Trent Ning, Ph.D.
Assistant Professor
Dan Scanderbeg, Ph.D.
Assistant Professor
Irena Dragojevic, Ph.D.
Assistant Professor
Jeremy Hoisak, Ph.D.
Assistant Professor
Dong Ju Choi, Ph.D.
Assistant Professor
Bongyong Song, Ph.D.
Assistant Professor
Division of Proton Therapy and Particle Research
Carl Rossi, M.D.
Professor & Director
Lei Dong, Ph.D. FAAPM
Professor
Huan Giap M.D. Ph.D.
Associate Professor
Andrew Chang M.D.
Associate Professor
Luis Perles, Ph.D.
Associate Professor
Ryan Grover M.D.
Assistant Professor
Annelise Giebeler, Ph.D.
Assistant Professor
Anthony Mascia M.S.
Instructor
Richard Lepage, M.S.
Instructor
Gary Yongbin Zhang, M.S.
Instructor
Franko Puskulich, M.S.
Instructor
Division of Veterinary Oncology
Gregory Ogilvie, DVM
Professor
David Proulx, DVM
Research Scientist
Joint Appointments
Santosh Kesari M.D. Ph.D.
Neurosciences
Clark Chen M.D. Ph.D.
Neurosurgery
42
Affiliated Faculty
Kousay Al-Korainy M.D.
Medical Oncology
Ignacio Iturbe M.D.
Medical Oncology
43
Appendix III
Departmental Publications
2010-2013
Rossi CJ. Comment on “Proton beam and prostate cancer: an evolving debate” by Anthony
Zietman. Rep Pract Oncol Radiother 2013;18:343
Salama JK, Pang H, Bogart JA, Blackstock AW, Urbanic JJ, Hogson L, Crawford J, Vokes
EE. Predictors of pulmonary toxicity in limited stage small cell lung cancer patients treated
with induction chemotherapy followed by concurrent platinum-based chemotherapy and 70
Gy daily radiotherapy: CALGB 30904. Lung Cancer 2013;82:436
Li N, Zarepisheh M, Uribe-Sanchez A, Moore K, Tian Z, Zhen X, Graves YJ, Gautier Q,
Mell L, Zhou L, Jia X, Jiang S. Automatic treatment plan re-optimization for adaptive
radiotherapy guided with the initial plan DVHs. Phys Med Biol 2013;58:8725
.
Simpson DR, Martínez ME, Gupta S, Hattangadi-Gluth J, Mell LK, Heestand G, Fanta P,
Ramamoorthy S, Le QT, Murphy JD. Racial disparity in consultation, treatment, and the
impact on survival in metastatic colorectal cancer. J Natl Cancer Inst 2013’105:1814
Thor M, Apte A, Deasy JO, Karlsdóttir À, Moiseenko V, Liu M, Muren LP. Dose/volumeresponse relations for rectal morbidity using planned and simulated motion-inclusive dose
distributions. Radiother Oncol 2013;109:388
Akers JC, Ramakrishnan V, Kim R, Skog J, Nakano I, Pingle S, Kalinina J, Hua W, Kesari
S, Mao Y, Breakefield XO, Hochberg FH, Van Meir EG, Carter BS, Chen CC. MiR-21 in
the extracellular vesicles (EVs) of cerebrospinal fluid (CSF): a platform for glioblastoma
biomarker development. PLoS One 2013;8:e78115
Duggal R, Minev B, Geissinger U, Wang H, Chen NG, Koka PS, Szalay AA.
Biotherapeutic approaches to target cancer stem cells. J Stem Cells. 2013;8(3-4):135-49.
doi: jsc.2014.8.3/4.135.
Lee LJ, Jhingran A, Kidd E, Cardenes HR, Elshaikh MA, Erickson B, Mayr NA, Moore D,
Puthawala AA, Rao GG, Small W Jr, Varia MA, Wahl AO, Wolfson AH, Yashar CM, Yuh
44
W, Gaffney DK. Acr appropriateness Criteria management of vaginal cancer. Oncology
2013;27:1166
Jaffray DA, Langen KM, Mageras G, Dawson LA, Yan D, Edd RA, Mundt AJ, Fraass B.
Safety considerations for IGRT: Executive summary. Pract Radiat Oncol. 2013;3:167-170.
Marks LB, Adams RD, Pawlicki T, Blumberg AL, Hoopes D, Brundage MD, Fraass BA.
Enhancing the role of case-oriented peer review to improve quality and safety in radiation
oncology: Executive summary. Pract Radiat Oncol. 2013;3:149-156.
Kosztyla R, Chan EK, Hsu F,
Wilson D, Ma R, Cheung A,
Zhang S, Moiseenko V, Benard F,
Nichol A High-grade glioma
radiation therapy target volumes
and patterns of failure obtained
from magnetic resonance imaging
and
18F-FDOPA
positron
emission tomography delineations
from multiple observers. Int J
Radiat
Oncol
Biol
Phys
2013;;87:1100-6
Piccioni DE, Kesari S. Clinical trials of viral therapy for malignant gliomas..
Expert Rev Anticancer Ther. 2013;11:1297-305.
Farid N, Almeida-Freitas DB, White
NS, McDonald CR, Muller KA,
Vandenberg SR, Kesari S, Dale AM.
Restriction-Spectrum
Imaging
of
Bevacizumab-Related Necrosis in a
Patient with GBM. Front Oncol.
2013;3:258
Mell LK, Carmona R, Gulaya S, Lu T,
Wu J, Saenz CC, Vaida F.
Cause-specific effects of radiotherapy
and lymphadenectomy in stage I-II
endometrial cancer: a population-based
study.
J
Natl
Cancer
Inst
2013;105:1656-66. .
Mahta A, Du Z, Borys E, Carter B, Vandenberg SR, Kesari S. 78 year old male with
dysphagia and dysarthria.
Brain Pathol 2013;23(6):705-6.
45
Mailhot Vega RB, Kim J, Bussière M, Hattangadi J, Hollander A, Michalski J, Tarbell NJ,
Yock T, MacDonald SM Cost effectiveness of proton therapy compared with photon
therapy in the management of pediatric medulloblastoma. Cancer 2013;119:4:299-307.
Tang C, Komakula S, Chan C,
Murphy JD, Jiang W, Kong C,
Lee-Enriquez N, Jensen KC,
Fischbein
NJ, Le
QT.
Radiologic assessment of
retropharyngeal
node
involvement in oropharyngeal
carcinomas stratified by HPV
status. Radiother Oncol. 2013
Nov;109:293-6.
Moiseenko V, Liu M, Loewen S, Kosztyla R, Vollans E, Lucido J, Vellani R, Popescu IA.
Monte Carlo calculation of dose distributions in oligometastatic patients planned for spine
stereotactic ablative radiotherapy. Phys Med Biol 2013;58:7107-16
Sanghangthum T, Suriyapee
S, Kim GY, Pawlicki T A
method of setting limits for
the purpose of quality
assurance. Phys Med Biol.
2013;58:7025-37.
Wang H, Chen NG, Minev BR, Zimmermann M, Aguilar RJ, Zhang Q, Sturm JB, Fend F,
Yu YA, Cappello J, Lauer UM, Szalay AA. Optical detection and virotherapy of live
metastatic tumor cells in body fluids with vaccinia strains. PLoS One. 2013 Sep 3;8:e71105
46
Webster MJ, Devic S, Vuong T, Han DY, Scanderbeg D, Choi D, Song B, Song WY.
HDR brachytherapy of rectal cancer using a novel grooved-shielding applicator design.
Med Phys. 2013;40:091704
Hiniker SM, Roux A, Murphy JD, Harris JP, Tran PT, Kapp DS, Kidd EA.
Primary squamous cell carcinoma of the vagina: prognostic factors, treatment patterns, and
outcomes. Gynecol Oncol 2013;131:380-5.
Murphy JD, Nelson LM, Chang DT, Mell LK, Le QT. Patterns of care in palliative
radiotherapy: a population-based study. J Oncol Pract. 2013;9:e220-7.
Belin LJ, Ady JW, Lewis C, Marano D, Gholami S, Mojica K, Eveno C, Longo V,
Zanzonico PB, Chen NG, Szalay AA, Fong Y. An oncolytic vaccinia virus expressing the
human sodium iodine symporter prolongs survival and facilitates SPECT/CT imaging in an
orthotopic model of malignant pleural mesothelioma. Surgery 2013;154:486-95
Expert Panel on Radiation Oncology-Gynecology, Kidd E, Moore D, Varia MA, Gaffney
DK, Elshaikh MA, Erickson B, Jhingran A, Lee LJ, Mayr NA, Puthawala AA, Rao GG,
Small W Jr, Wahl AO, Wolfson AH, Yashar CM, Yuh W, Cardenes HR. ACR
Appropriateness Criteria® management of locoregionally advanced squamous cell
carcinoma of the vulva. Am J Clin Oncol. 2013;36:415-22
Kuremsky JG, Urbanic JJ, Petty WJ, Lovato JF, Bourland JD, Tatter SB, Ellis TL,
McMullen KP, Shaw EG, Chan MD. Tumor histology predicts patterns of failure and
survival in patients with brain metastases from lung cancer treated with gamma knife
radiosurgery. Neurosurgery 2013;73:641-7
47
Zhang JP, Lee EQ, Nayak L, Doherty L, Kesari S, Muzikansky A, Norden AD, Chen H,
Wen PY, Drappatz J. Retrospective study of pemetrexed as salvage therapy for central
nervous system lymphoma. J Neurooncol 2013;115:71-7
Hong JC, Murphy JD, Wang SJ, Koong AC, Chang DT. Chemoradiotherapy before and
after surgery for locally advanced esophageal cancer: a SEER-Medicare analysis.
Ann Surg Oncol. 2013 Nov;20(12):3999-4007
Duggal R, Geissinger U, Zhang Q, Aguilar J, Chen NG, Binda E, Vescovi AL, Szalay AA
Vaccinia virus expressing bone morphogenetic protein-4 in novel glioblastoma orthotopic
models facilitates enhanced tumor regression and long-term survival. J Transl Med. 2013
Jun 24;11(1):155
Nguyen DH, Chen NG, Zhang Q, Le
HT, Aguilar RJ, Yu YA, Cappello J,
Szalay AA. Vaccinia virus-mediated
expression of human erythropoietin in
tumors enhances virotherapy and
alleviates cancer-related anemia in mice.
Mol Ther. 2013 Nov;21(11):2054-62
Buckel L, Advani SJ, Frentzen A, Zhang
Q, Yu YA, Chen NG, Ehrig K, Stritzker
J, Mundt AJ, Szalay AA. Combination
of fractionated irradiation with antiVEGF expressing vaccinia virus therapy
enhances tumor control by simultaneous
radiosensitization of tumor associated
endothelium. Int J Cancer. 2013 Dec
15;133(12):2989-99
Yan H, Zhen X, Cerviño L, Jiang SB, Jia X. Progressive cone beam CT dose control in
image-guided radiation therapy. Med Phys. 2013 Jun;40(6):06070.
McDuff SG, Taich ZJ, Lawson JD, Sanghvi P, Wong ET, Barker FG 2nd, Hochberg FH,
Loeffler JS, Warnke PC, Murphy KT, Mundt AJ, Carter BS, McDonald CR, Chen CC.
Neurocognitive assessment following whole brain radiation therapy and radiosurgery for
patients with cerebral metastases. J Neurol Neurosurg Psychiatry. 2013 Dec;84(12):138491
Salama JK, Hodgson L, Pang H, Urbanic JJ, Blackstock AW, Schild SE, Crawford J,
Bogart JA, Vokes EE; Cancer and Leukemia Group B. A pooled analysis of limited-stage
small-cell lung cancer patients treated with induction chemotherapy followed by concurrent
platinum-based chemotherapy and 70 Gy daily radiotherapy: CALGB 30904. J Thorac
Oncol. 2013 Aug;8(8):1043-9
48
Stritzker J, Szalay AA.
Single-agent combinatorial cancer therapy.
Proc Natl Acad Sci U S A. 2013 May 21;110(21):83256.
Mundt AJ, Yashar C, Mell L, Mayr N, Milosevic M.
Oncology Scan- gynecological cancers: new treatments,
old treatments, imaging, and meta-analyses. Int J Radiat
Oncol Biol Phys. 2013 Jun 1;86(2):207-10.
Weibel S, Hofmann E, Basse-Luesebrink TC, Donat U,
Seubert C, Adelfinger M, Gnamlin P, Kober C, Frentzen
A, Gentschev I, Jakob PM, Szalay AA.
Treatment of malignant effusion by oncolytic
virotherapy in an experimental subcutaneous xenograft
model of lung cancer. J Transl Med. 2013 May
1;11:106.
Kyula JN, Khan AA, Mansfield D,
Karapanagiotou EM, McLaughlin M, Roulstone
V, Zaidi S, Pencavel T, Touchefeu Y, Seth R,
Chen NG, Yu YA, Zhang Q, Melcher AA, Vile
RG, Pandha HS, Ajaz M, Szalay AA,
Harrington KJ. Synergistic cytotoxicity of
radiation and oncolytic Lister strain vaccinia in
(V600D/E)BRAF mutant melanoma depends on
JNK and TNF-α signaling.
Herbert C, Kwa W, Nakano S, James K,
Moiseenko V, Wu J, Schellenberg D, Liu M.
Stereotactic body radiotherapy: volumetric
modulated arc therapy versus 3D non-coplanar
conformal radiotherapy for the treatment of
early stage lung cancer. Technol Cancer Res
Treat. 2013 Dec;12(6):511-6.
49
Scott BJ, Kesari S. Leptomeningeal metastases in breast cancer. Am J Cancer Res. 2013
Apr 3;3(2):117-26.
Ford EC, Fong de Los Santos L, Pawlicki T, Sutlief S, Dunscombe P; American
Association of Physicists in Medicine Work Group on Prevention of Errors.
The structure of incident learning systems for radiation oncology. Int J Radiat Oncol Biol
Phys. 2013 May 1;86(1):11-2.
Kothari PD, White NS, Farid N, Chung R, Kuperman JM, Girard HM, Shankaranarayanan
A, Kesari S, McDonald CR, Dale AM. Longitudinal restriction spectrum imaging is
resistant to pseudoresponse in patients with high-grade gliomas treated with bevacizumab.
AJNR Am J Neuroradiol. 2013 Sep;34(9):1752-7.
Zeidan YH, Shultz DB, Murphy JD, An Y, Chan C, Kaplan MJ, Colevas AD, Kong C,
Chang DT, Le QT.Long-term outcomes of surgery followed by radiation therapy for minor
salivary gland carcinomas. Laryngoscope. 2013 Nov;123(11):2675-80
Ehrig K, Kilinc MO, Chen NG, Stritzker J, Buckel L, Zhang Q, Szalay AA.
Growth inhibition of different human colorectal cancer xenografts after a single
intravenous injection of oncolytic vaccinia virus GLV-1h68. J Transl Med. 2013 Mar
26;11:79
Gholami S, Chen CH, Belin LJ, Lou E, Fujisawa S, Antonacci C, Carew A, Chen NG, De
Brot M, Zanzonico PB, Szalay AA, Fong Y. Vaccinia virus GLV-1h153 is a novel agent
for detection and effective local control of positive surgical margins for breast cancer.
50
Breast Cancer Res. 2013 Mar 18;15(2):R26
Liang Y, Kim GY, Pawlicki T, Mundt AJ, Mell LK. Feasibility study on dosimetry
verification of volumetric-modulated arc therapy-based total marrow irradiation.
J Appl Clin Med Phys. 2013 Mar 4;14(2):3852.
Saria MG, Corle C, Hu J, Rudnick JD, Phuphanich S, Mrugala MM, Crew LK, Bota DA,
Dan Fu B, Kim RY, Brown T, Feely H, Brechlin J, Brown BD, Drappatz J, Wen PY, Chen
CC, Carter B, Lee JW, Kesari S. Retrospective analysis of the tolerability and activity of
lacosamide in patients with brain tumors: clinical article.
J Neurosurg. 2013 Jun;118(6):1183-7.
Gu X, Dong B, Wang J, Yordy J, Mell L, Jia X, Jiang SB. A contour-guided deformable
image registration algorithm for adaptive radiotherapy. Phys Med Biol. 2013 Mar
21;58(6):1889-901.
Weibel S, Basse-Luesebrink TC, Hess M,
Hofmann E, Seubert C, Langbein-Laugwitz J,
Gentschev I, Sturm VJ, Ye Y, Kampf T, Jakob
PM, Szalay AA. Imaging of intratumoral
inflammation during oncolytic virotherapy of
tumors by 19F-magnetic resonance imaging
(MRI). PLoS One. 2013;8(2):e56317
Yost SE, Pastorino S, Rozenzhak S, Smith EN,
Chao YS, Jiang P, Kesari S, Frazer KA,
Harismendy O. High-resolution mutational
profiling suggests the genetic validity of
glioblastoma patient-derived pre-clinical models.
PLoS One. 2013;8(2):e56185
Mahta A, Kim RY, Saad AG, Kesari S.
47-year-old man with left leg numbness.
Brain Pathol. 2013 Mar;23(2):223-4.
Chernichenko N, Linkov G, Li P, Bakst RL, Chen
CH, He S, Yu YA, Chen NG, Szalay AA, Fong Y,
Wong RJ. Oncolytic vaccinia virus therapy of
salivary gland carcinoma. JAMA Otolaryngol
Head Neck Surg. 2013 Feb;139(2):173-82.
Stritzker J, Kirscher L, Scadeng M, Deliolanis NC, Morscher S, Symvoulidis P, Schaefer
K, Zhang Q, Buckel L, Hess M, Donat U, Bradley WG, Ntziachristos V, Szalay AA.
Vaccinia virus-mediated melanin production allows MR and optoacoustic deep tissue
imaging and laser-induced thermotherapy of cancer. Proc Natl Acad Sci U S A. 2013 Feb
26;110(9):3316-20
51
Yan H, Wang X, Yin W, Pan T, Ahmad M, Mou X, Cerviño L, Jia X, Jiang SB Extracting
respiratory signals from thoracic cone beam CT projections. Phys Med Biol. 2013 Mar
7;58(5):1447-64. doi: 10.1088/0031-9155/58/5/1447. Epub 2013 Feb 11.
Karan T, Moiseenko V, Gill B, Horwood R, Kyle A, Minchinton AI. Radiobiological
effects of altering dose rate in filter-free photon beams. Phys Med Biol. 2013 Feb
21;58(4):1075-82.
Sanghangthum T, Suriyapee S, Srisatit S, Pawlicki T. Retrospective analysis of linear
accelerator output constancy checks using process control techniques. J Appl Clin Med
Phys. 2013 Jan 7;14(1):4032
Rossi G, Bertani C, Mari S, Marini C, Renzoni G, Ogilvie G, Magi GE. Ex vivo evaluation
of imatinib mesylate for induction of cell death on canine neoplastic mast cells with
mutations in c-Kit exon 11 via apoptosis. Vet Res Commun. 2013 Jun;37(2):101-8
Webster MJ, Devic S, Vuong T, Yup Han D, Park JC, Scanderbeg D, Lawson J, Song B,
Tyler Watkins W, Pawlicki T, Song WY. Dynamic modulated brachytherapy (DMBT) for
rectal cancer. Med Phys. 2013 Jan;40(1):011718
Taniguchi CM, Murphy JD, Eclov N, Atwood TF, Kielar KN, Christman-Skieller C, Mok
E, Xing L, Koong AC, Chang DT. Dosimetric analysis of organs at risk during expiratory
gating in stereotactic body radiation therapy for pancreatic cancer. Int J Radiat Oncol Biol
Phys. 2013 Mar 15;85(4):1090-5.
52
Hu J, Kesari S. Strategies for overcoming the
blood-brain barrier for the treatment of brain
metastases. CNS Oncol. 2013 Jan;2(1):87-98.
Jensen LG, Hasselle MD, Rose BS, Nath SK,
Hasan Y, Scanderbeg DJ, Yashar CM, Mundt
AJ, Mell LK. Outcomes for patients with
cervical cancer treated with extended-field
intensity-modulated radiation therapy and
concurrent cisplatin. Int J Gynecol Cancer.
2013 Jan;23(1):119-25
Sanghangthum T, Suriyapee S, Srisatit S,
Pawlicki T. Statistical process control analysis
for patient-specific IMRT and VMAT QA. J
Radiat Res. 2013 May;54(3):546-52.
Gentschev I, Patil SS, Adelfinger M, Weibel S, Geissinger U, Frentzen A, Chen NG, Yu
YA, Zhang Q, Ogilvie G, Szalay AA. Characterization and evaluation of a new oncolytic
vaccinia virus strain LIVP6.1.1 for canine cancer therapy. Bioengineered. 2013 MarApr;4(2):84-9.
Zakeri K, Rose BS, Gulaya S, D'Amico AV, Mell LK. Competing event risk stratification
may improve the design and efficiency of clinical trials: secondary analysis of SWOG
8794. Contemp Clin Trials. 2013 Jan;34(1):74-9.
Song S, Rudra S, Hasselle MD, Dorn PL, Mell LK, Mundt AJ, Yamada SD, Lee NK,
Hasan Y. The effect of treatment time in locally advanced cervical cancer in the era of
concurrent chemoradiotherapy. Cancer. 2013 Jan 15;119(2):325-31.
Liang Y, Bydder M, Yashar CM, Rose BS, Cornell M, Hoh CK, Lawson JD, Einck J,
Saenz C, Fanta P, Mundt AJ, Bydder GM, Mell LK. Prospective study of functional bone
marrow-sparing intensity modulated radiation therapy with concurrent chemotherapy for
pelvic malignancies. Int J Radiat Oncol Biol Phys. 2013 Feb 1;85(2):406-14.
Tang C, Fischbein NJ, Murphy JD, Chu KP, Bavan B, Dieterich S, Hara W, Kaplan MJ,
Colevas AD, Le QT. Stereotactic radiosurgery for retreatment of gross perineural invasion
in recurrent cutaneous squamous cell carcinoma of the head and neck.
Am J Clin Oncol. 2013 Jun;36(3):293-8.
53
Pan H, Rose BS, Simpson DR, Mell LK, Mundt AJ, Lawson JD. Clinical practice patterns
of lung stereotactic body radiation therapy in the United States: a secondary analysis.
Am J Clin Oncol. 2013 Jun;36(3):269-72.
Dong B, Graves YJ, Jia X, Jiang SB. Optimal surface marker locations for tumor motion
estimation in lung cancer radiotherapy. Phys Med Biol. 2012 Nov 23;57(24):8201-8215.
Haddad D, Zanzonico PB, Carlin S, Chen CH, Chen NG, Zhang Q, Yu YA, Longo V,
Mojica K, Aguilar RJ, Szalay AA, Fong Y. A vaccinia virus encoding the human sodium
iodide symporter facilitates long-term image monitoring of virotherapy and targeted
radiotherapy of pancreatic cancer. J Nucl Med. 2012 Dec;53(12):1933-42.
Reinboth J, Ascierto ML, Chen NG, Zhang Q, Yu YA, Aguilar RJ, Carretero R, Worschech
A, Zhao Y, Wang E, Marincola FM, Szalay AA. Correlates between host and viral
transcriptional program associated with different oncolytic vaccinia virus isolates. Hum
Gene Ther Methods. 2012 Oct;23(5):285-96.
Jia X, Schümann J, Paganetti H, Jiang SB. GPU-based fast Monte Carlo dose calculation
for proton therapy. Phys Med Biol. 2012 Dec 7;57(23):7783-97.
Gentschev I, Patil SS, Adelfinger M, Weibel S, Geissinger U, Frentzen A, Chen NG, Yu
YA, Zhang Q, Ogilvie G, Szalay AA. Characterization and evaluation of a new oncolytic
Vaccinia Virus strain LIVP6.1.1 for canine cancer therapy. Bioengineered. 2012 Oct
23;4(2).
Patil SS, Gentschev I, Adelfinger M, Donat U, Hess M, Weibel S, Nolte I, Frentzen A,
Szalay AA. Virotherapy of Canine Tumors with Oncolytic Vaccinia Virus GLV-1h109
Expressing an Anti-VEGF Single-Chain Antibody. PLoS One. 2012;7(10):e47472.
Zakeri K, Rose BS, Gulaya S, D'Amico AV, Mell LK. Competing event risk stratification
may improve the design and efficiency of clinical trials: Secondary analysis of SWOG
8794. Contemp Clin Trials. 2012 Oct 11;34(1):74-79.
54
Park JC, Park SH, Kim JH, Yoon SM, Song SY, Liu Z, Song B, Kauweloa K, Webster MJ,
Sandhu A, Mell LK, Jiang SB, Mundt AJ, Song WY. Organ motion during cone beam
computed tomography guided stereotactic body radiation therapy. Med Phys. 2012
Oct;39(10):6431-42.
Zhen X, Gu X, Yan H, Zhou L, Jia X, Jiang SB. CT to cone-beam
CT deformable registration with simultaneous intensity correction.
Phys Med Biol. 2012 Nov 7;57(21):6807-26.
Mell LK. Intensity modulated radiation therapy for gynecologic
malignancies: a testable hypothesis. Int J Radiat Oncol Biol Phys.
2012 Nov 1;84(3):566-8.
Pan H, Cerviño LI, Pawlicki T, Jiang SB, Alksne J, Detorie N,
Russell M, Carter BS, Murphy KT, Mundt AJ, Chen C, Lawson JD. Frameless, real-time,
surface imaging-guided radiosurgery: clinical outcomes for brain metastases.
Neurosurgery. 2012 Oct;71(4):844-51.
Jia X, Tian Z, Lou Y, Sonke JJ, Jiang SB. Four-dimensional cone beam CT reconstruction
and enhancement using a temporal nonlocal means method. Med Phys. 2012
Sep;39(9):5592-602.
Schäfer S, Weibel S, Donat U, Zhang Q, Aguilar RJ, Chen NG, Szalay AA. Vaccinia virusmediated intra-tumoral expression of matrix metalloproteinase 9 enhances oncolysis of PC3 xenograft tumors. BMC Cancer. 2012 Aug 23;12:366.
Wang H, Chen NG, Minev BR, Szalay AA. Oncolytic vaccinia virus GLV-1h68 strain
shows enhanced replication in human breast cancer stem-like cells in comparison to breast
cancer cells. J Transl Med. 2012 Aug 17;10:167
Song S, Rudra S, Hasselle MD, Dorn PL, Mell LK, Mundt AJ, Yamada SD, Lee NK,
Hasan Y. The effect of treatment time in locally advanced cervical cancer in the era of
concurrent chemoradiotherapy. Cancer. 2012 (in press)
55
Gu C, Li R, Zhang H, Fung AY, Torres C, Jiang SB, Li C. Accurate Respiration
Measurement Using DC-Coupled Continuous-Wave Radar Sensor for Motion-Adaptive
Cancer Radiotherapy. IEEE Trans Biomed Eng. 2012 Nov;59(11):3117-23.
Chen NG, Szalay AA, Buller RM, Lauer UM. Oncolytic viruses. Adv Virol.
2012;2012:320206.
Peng F, Jia X, Gu X, Epelman MA, Romeijn HE, Jiang SB. A new column-generationbased algorithm for VMAT treatment plan optimization. Phys Med Biol. 2012 Jul
21;57(14):4569-88.
Yu YA, Weibel S, Szalay AA. Real-time imaging of tumors using replication-competent
light-emitting
microorganisms.
Methods Mol Biol. 2012;872:15975.
Liang Y, Bydder M, Yashar CM,
Rose BS, Cornell M, Hoh CK,
Lawson JD, Einck J, Saenz C, Fanta
P, Mundt AJ, Bydder GM, Mell LK.
Prospective Study of Functional
Bone Marrow-Sparing Intensity
Modulated Radiation Therapy With
Concurrent Chemotherapy for Pelvic Malignancies. Int J Radiat Oncol Biol Phys 2012 (in
press)
Mell LK, Lau SK, Rose BS, Jeong JH. Reporting of cause-specific treatment effects in
cancer clinical trials with competing risks: a systematic review. Contemp Clin Trials. 2012
Sep;33(5):920-4.
Siegel CL, Andreotti RF, Cardenes HR, Brown DL, Gaffney
DK, Horowitz NS, Javitt MC, Lee SI, Mitchell DG, Moore
DH, Rao GG, Royal HD, Small W Jr, Varia MA, Yashar CM;
American College of Radiology. ACR Appropriateness
Criteria® pretreatment planning of invasive cancer of the
cervix. J Am Coll Radiol. 2012 Jun;9(6):395-402.
Gentschev I, Adelfinger M, Josupeit R, Rudolph S, Ehrig K,
Donat U, Weibel S, Chen NG, Yu YA, Zhang Q, Heisig M,
Thamm D, Stritzker J, Macneill A, Szalay AA. Preclinical
evaluation of oncolytic vaccinia virus for therapy of canine
soft tissue sarcoma. PLoS One. 2012;7(5):e37239.
56
Fowble BL, Einck JP, Kim DN, McCloskey S, Mayadev J, Yashar C, Chen SL, Hwang ES;
Athena Breast Health Network. Role of postmastectomy radiation after neoadjuvant
chemotherapy in stage II-III breast cancer. Int J Radiat Oncol Biol Phys. 2012 Jun
1;83(2):494-503.
Simpson DR, Song WY, Moiseenko V, Rose
BS, Yashar CM, Mundt AJ, Mell LK. Normal
tissue complication probability analysis of acute
gastrointestinal toxicity in cervical cancer
patients undergoing intensity modulated
radiation therapy and concurrent cisplatin. Int J
Radiat Oncol Biol Phys. 2012 May 1;83(1):e816.
Pan H, Rose BS, Simpson DR, Mell LK, Mundt
AJ, Lawson JD. Clinical Practice Patterns of
Lung Stereotactic Body Radiation Therapy in
the United States: A Secondary Analysis. Am J
Clin Oncol. 2012 (in press)
Yan H, Cervino L, Jia X, Jiang SB. A comprehensive study on the relationship between the
image quality and imaging dose in low-dose cone beam CT. Phys Med Biol. 2012 Apr
7;57(7):2063-80.
Allen AM, Pawlicki T, Dong L, Fourkal E, Buyyounouski M,
Cengel K, Plastaras J, Bucci MK, Yock TI, Bonilla L, Price R,
Harris EE, Konski AA. An evidence based review of proton
beam therapy: the report of ASTRO's emerging technology
committee. Radiother Oncol. 2012 Apr;103(1):8-11.
Park JC, Song B, Kim JS, Park SH, Kim HK, Liu Z, Suh TS,
Song WY. Fast compressed sensing-based CBCT reconstruction
using Barzilai-Borwein formulation for application to on-line
IGRT. Med Phys. 2012 Mar;39(3):1207-17.
He S, Li P, Chen CH, Bakst RL, Chernichenko N, Yu YA, Chen
N, Szalay AA, Yu Z, Fong Y, Wong RJ. Effective oncolytic vaccinia therapy for human
sarcomas. J Surg Res. 2012 Jun 15;175(2):e53-60.
Rose BS, Liang Y, Lau SK, Jensen LG, Yashar CM, Hoh CK, Mell LK. Correlation
between radiation dose to ¹⁸F-FDG-PET defined active bone marrow subregions and acute
hematologic toxicity in cervical cancer patients treated with chemoradiotherapy. Int J
Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1185-91.
Khan A, Jensen LG, Sun S, Song WY, Yashar CM, Mundt AJ, Zhang FQ, Jiang SB, Mell
LK. Optimized planning target volume for intact cervical cancer. Int J Radiat Oncol Biol
Phys. 2012 Aug 1;83(5):1500-5.
57
Beriwal S, Demanes DJ, Erickson B, Jones E, De Los Santos JF, Cormack RA, Yashar C,
Rownd JJ, Viswanathan AN; American Brachytherapy Society. American Brachytherapy
Society consensus guidelines for interstitial brachytherapy for vaginal cancer.
Brachytherapy. 2012 Jan-Feb;11(1):68-75.
Haddad D, Chen N, Zhang Q, Chen CH, Yu YA, Gonzalez L, Aguilar J, Li P, Wong J,
Szalay AA, Fong Y. A novel genetically modified oncolytic vaccinia virus in experimental
models is effective against a wide range of human cancers. Ann Surg Oncol. 2012 Jul;19
Suppl 3:S665-74
Kauweloa KI, Ruan D, Park JC, Sandhu A, Kim GY, Pawlicki T, Watkins WT, Song B,
Song WY. GateCT™ surface tracking system for respiratory signal reconstruction in 4DCT
imaging. Med Phys. 2012 Jan;39(1):492-502.
Jia X, Yan H, Gu X, Jiang SB. Fast Monte Carlo simulation for patient-specific CT/CBCT
imaging dose calculation. Phys Med Biol. 2012 Feb 7;57(3):577-90.
Patil SS, Gentschev I, Nolte I, Ogilvie G, Szalay AA. Oncolytic virotherapy in veterinary
medicine: current status and future prospects for canine patients. J Transl Med. 2012 Jan
4;10:3.
58
Pawlicki T, Chera B, Ning T, Marks LB. The
systematic application of quality measures and
process control in clinical radiation oncology. Semin
Radiat Oncol. 2012 Jan;22(1):70-6.
Wolfson AH, Varia MA, Moore D, Rao GG,
Gaffney DK, Erickson-Wittmann BA, Jhingran A,
Mayr NA, Puthawala AA, Small W Jr, Yashar CM,
Yuh W, Cardenes HR; American College of
Radiology (ACR). ACR Appropriateness Criteria®
role of adjuvant therapy in the management of early
stage cervical cancer. Gynecol Oncol. 2012
Apr;125(1):256-62.
Pan H, Alksne J, Mundt AJ, Murphy KT, Cornell M,
Kesari S, Lawson JD. Patterns of imaging failures in
glioblastoma patients treated with chemoradiation: a
retrospective study. Med Oncol. 2012;21:215-18
Gholami S, Haddad D, Chen CH, Chen NG, Zhang Q, Zanzonico PB, Szalay AA, Fong Y.
Novel therapy for anaplastic thyroid carcinoma cells using an oncolytic vaccinia virus
carrying the human sodium iodide symporter. Surgery. 2011 Dec;150(6):1040-7.
Mielgo A, Seguin L, Huang M, Camargo MF, Anand S,
Franovic A, Weis SM, Advani SJ, Murphy EA, Cheresh
DA. A MEK-independent role for CRAF in mitosis and
tumor progression. Nat Med. 2011;17:1641-5
Yashar C. Counterpoint: The device with the most dose
modulation
capacity.
Brachytherapy.
2011
Nov;10(6):436-9
Kesari S, Advani SJ, Lawson JD, Kahle KT, Ng K, Carter
B, Chen CC. DNA damage response and repair: insights
into strategies for radiation sensitization of gliomas.
Future Oncol. 2011 Nov;7(11):1335-46.
Jia X, Gu X, Graves YJ, Folkerts M, Jiang SB. GPUbased fast Monte Carlo simulation for radiotherapy dose calculation. Phys Med Biol. 2011
Nov 21;56(22):7017-31.
Ascierto ML, Worschech A, Yu Z, Adams S, Reinboth J, Chen NG, Pos Z, Roychoudhuri
R, Di Pasquale G, Bedognetti D, Uccellini L, Rossano F, Ascierto PA, Stroncek DF,
Restifo NP, Wang E, Szalay AA, Marincola FM. Permissivity of the NCI-60 cancer cell
lines to oncolytic Vaccinia Virus GLV-1h68. BMC Cancer. 2011 Oct 19;11:451.
59
Ojeda-Fournier H, Olson LK, Rochelle
M, Hodgens BD, Tong E, Yashar CM.
Accelerated partial breast irradiation
and posttreatment imaging evaluation.
Radiographics. 2011 Oct;31(6):170116.
Hess M, Stritzker J, Härtl B, Sturm JB,
Gentschev I, Szalay AA. Bacterial
glucuronidase as general marker for
oncolytic
virotherapy
or
other
biological therapies. J Transl Med.
2011 Oct 11;9:172.
Hill PJ, Stritzker J, Scadeng M,
Geissinger U, Haddad D, BasseLüsebrink TC, Gbureck U, Jakob P,
Szalay AA. Magnetic resonance
imaging of tumors colonized with
bacterial
ferritin-expressing
Escherichia
coli.
PLoS
One.
2011;6(10):e25409. Epub 2011 Oct 3.
Chen NG, Yu YA, Zhang Q, Szalay AA. Replication efficiency of oncolytic vaccinia virus
in cell cultures prognosticates the virulence and antitumor efficacy in mice. J Transl Med.
2011 Sep 27;9:164.
Jia X, Men C, Lou Y, Jiang SB. Beam orientation optimization for intensity modulated
radiation therapy using adaptive l(2,1)-minimization. Phys Med Biol. 2011 Oct
7;56(19):6205-22
Li R, Lewis JH, Jia X, Zhao T, Liu W, Wuenschel S, Lamb J,
Yang D, Low DA, Jiang SB. On a PCA-based lung motion
model. Phys Med Biol. 2011 Sep 21;56(18):6009-30..
Tian Z, Jia X, Yuan K, Pan T, Jiang SB. Low-dose CT
reconstruction
via
edge-preserving
total
variation
regularization. Phys Med Biol. 2011 Sep 21;56(18):5949-67.
Rose BS, Jeong JH, Nath SK, Lu SM, Mell LK. Populationbased study of competing mortality in head and neck cancer. J
Clin Oncol. 2011 Sep 10;29(26):3503-9.
Mahta A, Kim RY, Fanta PT, Lawson JD, Kesari S. Leptomeningeal Metastasis from
Appendiceal Adenocarcinoma: Case Report and Literature Review. J Gastrointest Cancer.
2011 (in press)
Lewis JH, Li R, Jia X, Watkins WT, Lou Y, Song WY, Jiang SB. Mitigation of motion
60
artifacts in CBCT of lung tumors based on tracked tumor motion during CBCT acquisition.
Phys Med Biol. 2011 Sep 7;56(17):5485-502.
Gentschev I, Müller M, Adelfinger M, Weibel S, Grummt F, Zimmermann M, Bitzer M,
Heisig M, Zhang Q, Yu YA, Chen NG, Stritzker J, Lauer UM, Szalay AA. Efficient
colonization and therapy of human hepatocellular carcinoma (HCC) using the oncolytic
vaccinia virus strain GLV-1h68. PLoS One. 2011;6(7):e22069.
Li R, Lewis JH, Jia X, Gu X, Folkerts M, Men C, Song WY, Jiang SB. 3D tumor
localization through real-time volumetric x-ray imaging for lung cancer radiotherapy. Med
Phys. 2011 May;38(5):2783-94.
Bhandare N, Moiseenko V, Song WY, Morris CG, Bhatti MT, Mendenhall WM. Severe
Dry Eye Syndrome After Radiotherapy for Head-and-Neck Tumors. Int J Radiat Oncol
Biol Phys. 2011 (in press)
Park JC, Park SH, Kim JS, Han Y, Cho MK, Kim HK, Liu Z, Jiang SB, Song B, Song WY.
Ultra-fast digital tomosynthesis reconstruction using general-purpose GPU programming
for image-guided radiation therapy. Technol Cancer Res Treat. 2011 Aug;10(4):295-306.
Wang JZ, Pawlicki T, Rice R, Mundt
AJ, Sandhu A, Lawson J, Murphy
KT. Intensity-modulated radiosurgery
with rapidarc for multiple brain
metastases and comparison with
static approach. Med Dosim. 2011 (in
press)
Nath SK, Sandhu AP, Jensen L, Kim
D, Bharne A, Nobiensky PD, Lawson
JD, Fuster MM, Bazhenova L, Song
WY, Mundt AJ. Frameless imageguided stereotactic body radiation
therapy for lung tumors with 4dimensional computed tomography or
4-dimensional positron emission
tomography/ computed tomography.
Clin
Lung
Cancer.
2011
May;12(3):180-6.
Moiseenko V, Song WY, Mell LK, Bhandare N. A comparison of dose-response
characteristics of four NTCP models using outcomes of radiation-induced optic neuropathy
and retinopathy. Radiat Oncol. 2011 Jun 6;6:61.
Lawson JD, Sicklick JK, Fanta PT. Gastric cancer. Curr Probl Cancer. 2011 MayJun;35(3):97-127.
61
Jia X, Dong B, Lou Y, Jiang SB. GPU-based iterative cone-beam CT reconstruction using
tight frame regularization. Phys Med Biol. 2011 Jul 7;56(13):3787-807
Cerviño LI, Du J, Jiang SB. MRI-guided tumor tracking in lung cancer radiotherapy. Phys
Med Biol. 2011 Jul 7;56(13):3773-85
Jia X, Lou Y, Lewis J, Li R, Gu X, Men C, Song WY, Jiang SB. GPU-based fast low-dose
cone beam CT reconstruction via total variation. J Xray Sci Technol. 2011;19(2):139-54.
Gu X, Jelen U, Li J, Jia X, Jiang SB. A GPU-based finite-size pencil beam algorithm with
3D-density correction for radiotherapy dose calculation. Phys Med Biol. 2011 Jun
7;56(11):3337-50.
Advani SJ, Markert JM, Sood
RF, Samuel S, Gillespie GY,
Shao
MY,
Roizman
B,
Weichselbaum RR. Increased
oncolytic efficacy for high-grade
gliomas by optimal integration
of ionizing radiation into the
replicative cycle of HSV-1. Gene
Ther. 2011 Nov;18(11):1098102.
Devisetty K, Wong SJ, Mell LK.
How does TPF improve survival
over PF? Lancet Oncol. 2011
May;12(5):419-20
Tian Z, Jia X, Dong B, Lou Y,
Jiang SB. Low-dose 4DCT
reconstruction via temporal
nonlocal means. Med Phys. 2011 Mar;38(3):1359-65.
Lu SM, Scanderbeg DJ, Barna P, Yashar W, Yashar C. Evaluation of two intracavitary
high-dose-rate brachytherapy devices for irradiating additional and irregularly shaped
volumes of breast tissue. Med Dosim. 2011 (in press)
Haddad D, Chen NG, Zhang Q, Chen CH, Yu YA, Gonzalez L, Carpenter SG, Carson J,
Au J, Mittra A, Gonen M, Zanzonico PB, Fong Y, Szalay AA. Insertion of the human
sodium iodide symporter to facilitate deep tissue imaging does not alter oncolytic or
replication capability of a novel vaccinia virus. J Transl Med. 2011 Mar 31;9:36.
62
Park JC, Park SH, Kim JH, Yoon SM, Kim SS, Kim JS, Liu Z, Watkins T, Song WY.
Four-dimensional cone-beam computed tomography and digital tomosynthesis
reconstructions using respiratory signals extracted from transcutaneously inserted metal
markers for liver SBRT. Med Phys. 2011 Feb;38(2):1028-36.
Nath SK, Sandhu AP, Kim D,
Bharne A, Nobiensky PD, Lawson
JD, Fuster M, Bazhenova L, Song
WY, Mundt AJ. Locoregional and
distant failure following imageguided stereotactic body radiation
for early-stage primary lung cancer.
Radiother
Oncol.
2011
Apr;99(1):12-7.
Pan H, Simpson DR, Mell LK,
Mundt AJ, Lawson JD. A survey of
stereotactic body radiotherapy use
in the United States. Cancer. 2011
Oct 1;117(19):4566-72.
Weibel S, Raab V, Yu YA, Worschech A, Wang E, Marincola FM, Szalay AA. Viralmediated oncolysis is the most critical factor in the late-phase of the tumor regression
process upon vaccinia virus infection. BMC Cancer. 2011 Feb 14;11:68.
Gu X, Jia X, Jiang SB. GPU-based fast gamma index calculation. Phys Med Biol. 2011
Mar 7;56(5):1431-41
Hofmann E, Grummt F, Szalay AA. Vaccinia virus GLV-1h237 carrying a Walker A motif
mutation of mouse Cdc6 protein enhances human breast tumor therapy in mouse
xenografts. Int J Oncol. 2011 Mar;38(3):871-8.
Haripotepornkul NH, Nath SK, Scanderbeg D, Saenz C, Yashar CM. Evaluation of intraand inter-fraction movement of the cervix during intensity modulated radiation therapy.
63
Radiother Oncol. 2011 Mar;98(3):347-51
Gaffney DK, Erickson-Wittmann BA, Jhingran A, Mayr NA, Puthawala AA, Moore D,
Rao GG, Small W Jr, Varia MA, Wolfson AH, Yashar CM, Yuh W, Cardenes HR. ACR
Appropriateness Criteria® on Advanced Cervical Cancer Expert Panel on Radiation
Oncology-Gynecology. Int J Radiat Oncol Biol Phys. 2011 Nov 1;81(3):609-14.
Nath SK, Sandhu AP, Sethi RA, Jensen LG, Rosario MD, Kane CJ, Parsons JK, Millard
FE, Jiang SB, Rice RK, Pawlicki T, Mundt AJ. Target localization and toxicity in doseescalated prostate radiotherapy with image-guided approach using daily planar kilovoltage
imaging. Technol Cancer Res Treat. 2011 Feb;10(1):31-7.
Men C, Romeijn HE, Jia X, Jiang SB. Ultrafast treatment plan optimization for volumetric
modulated arc therapy (VMAT). Med Phys. 2010 Nov;37(11):5787-91.
Scanderbeg DJ, Alksne JF, Lawson JD, Murphy KT. Novel use of the contura for high dose
rate cranial brachytherapy. Med Dosim. 2011 Winter;36(4):344-6.
Yashar C, Mahmood U. Strut-adjusted volume implant: a targeted radiation treatment in
breast cancer. Future Oncol. 2010 Dec;6(12):1813-6.
Young GS, Macklin EA, Setayesh K, Lawson JD, Wen PY, Norden AD, Drappatz J, Kesari
S. Longitudinal MRI evidence for decreased survival among periventricular glioblastoma. J
Neurooncol. 2011 Aug;104(1):261-9.
Tyagi N, Lewis JH, Yashar CM, Vo D, Jiang SB, Mundt AJ, Mell LK. Daily online cone
beam computed tomography to assess interfractional motion in patients with intact cervical
cancer. Int J Radiat Oncol Biol Phys. 2011 May 1;80(1):273-80
Song WY, Huh SN, Liang Y, White G, Nichols RC, Watkins WT, Mundt AJ, Mell LK.
Dosimetric comparison study between intensity modulated radiation therapy and threedimensional conformal proton therapy for pelvic bone marrow sparing in the treatment of
cervical cancer. J Appl Clin Med Phys. 2010 Aug 15;11(4):3255.
64
Nath SK, Carmona R, Rose BS, Simpson DR,
Russell M, Lawson JD, Mundt AJ, Murphy KT.
Observed magnetic resonance imaging changes in
pediatric patients treated with stereotactic
radiosurgery for intracranial tumors. Childs Nerv
Syst. 2011 Mar;27(3):399-406
Song W, Huh SJ, Liang Y, White G, Nichols RC,
Watkins WT, Mundt AJ, Mell LK. Dosimetric
comparison study between intensity modulated
radiation therapy and three-dimensional conformal
radiotherapy for pelvic bone marrow sparing in the
treatment of cervical cancer. J Appl Clin Med Phys
2010;11:3255-9
Adams RD, Marks LB, Pawlicki T, Hayman J,
Church J. The new radiation therapy clinical
practice: the emerging role of clinical peer review for radiation therapists and dosimetrists.
Med Dosim 2010;35:320-3
Nath SK, Carmona R, Rose BS, Simpson DR, Russell M, Lawson JD, Mundt AJ, Murphy
KT. Observed magnetic resonance imaging changes in pediatric patients treated with
stereotactic radiosurgery. Childs Nervous Syst 2010 (in press)
Li R, Jia X, Lewis JH, Gu X, Folkerts Men C, Jiang SB. Single projection based volumetric
image reconstruction and 3D tumor localization in real time for lung cancer radiotherapy.
Med Image Comput Assist Interv 2010:13:449-56
Seubert CM, Stritzker J, Hess M, Donat U, Sturm JB, Chen N,
Hof JM, Krewer B, Tietze LF, Gentschev I, Szalay AA. Enhanced
tumor therapy using vaccinia virus strain GLV-1h66 in
combination with a beta-galactosidase activated analog of
duocarmycin SA. Cancer Gene Ther 2010 (in press)
Mell LK, Jeong JH, et al. Predictors of competing mortality in
early breast cancer. Cancer 2010;116:5365
Hasselle MD, Rose BS, Kochanski JD, Nath SK, Bafana R,
Yashar CM, Hasan Y, Roeske JC, Mundt AJ, Mell LK. Clinical outcomes of intensitymodulated pelvic radiation therapy for carcinoma of the cervix. Int J Radiat Oncol Biol
Phys 2011;80:1436-45
Mell LK, Jeong JH. Pitfalls of using competing primary end points in the presence of
competing risks. J Clin Oncol 2010;28:4297-9
Sandhu AP. Pitfalls of retrospective and non-randomized comparison of treatment
modalities. J Clin Oncol 2010;28:520
65
Men C, Jia X, Jiang SB. GPU-based ultra-fast
direct aperture optimization for online adaptive
radiation therapy. Phys Med Biol 2010:55:4309-19
Yashar C, Scanderbeg D, et al. Initial clinical
experience with the Strut-Adjusted Volume Impalnt
(SAVI) breast brachytherapy device for accelerated
partial breast irradiation: first 100 patients with
more than 1 year of follow-up. Int J Radiat Oncol
Biol Phys 2011;80:765-70
Watkins WT, Li R, Lewis J, Park JC, Sandhu A,
Jiang SB, Song WY. Patient-specific motion
artifacts in 4DCT. Med Phys 2010;37:2855-61
Li R, Jia X, Lewis JH, Gu X, Folkerts M, Men C, Jiang SB. Real-time volumetric image
reconstruction and 3D tumor localization based on a single x-ray projection image guided
radiotherapy. Med Phys 2010;37:2822-8
Gentschev I, Ehrig K, Donat U, Hess M, Rudolf S, Chen N, Yu YA, Zhang Q, Szalay AA.
Significant growth inhibition of canine mammary carcinoma xenografts followed treatment
with oncolytic Vaccinia virus 1h68. J Oncol 2010;2919;736907
Wang JZ, Rice R, Pawlicki T, Mundt AJ, Sandhu A, Lawson J, Murphy KT. Evaluation of
patient setup uncertainty of optical guided frameless system for intracranial stereotactic
radiosurgery. J Appl Clin Med Phys 2010;11:3181
Simpson DR, Lawson JD, Nath SK, Rose BS, Mundt AJ, Mell LK. A survey of imageguided radiation therapy use in the United States. Cancer 2010;116:3953-60
Ahmad E, Sandhu AP, Fuster MM, Messer K, Pu M, Nobiensky P, Bazhenova L, Seagren
S. Hypofractionated radiotherapy as definitive treatment of stage I non-small cell lung
cancer in older patients. Am J Clin Oncol 2010 (in press)
Stritzker J, Weibel S, Seubert C, Gotz A, Sazalay AA. Enterobacterial tumor colonization
in mice depends on bacterial metabolism and macrophages but is independent of motility.
Int J Med Microbiol 2010 (in press)
Quon H, Yorn SS, Garg MK, Lawson J, et al. ACR Appropriateness criteria: local-regional
therapy for resectable oropharyngeal squamous cell carcinoma. Curr Prob Cancer
2010;34:175-92
66
Lim K, Small W, Portelance L,
Creutzberg C, Mundt A, Mell
LK, Mayr N, Viswanathan A,
Erickson B, De Los Santos J,
Gaffney D, Yashar CM et al.
Consensus guidelines for
delineation of clinical target
volume
for
intensitymodulated pelvic radiotherapy
in the treatment of intact
cervical cancer. Int J Radiat
Oncol Biol Phys 2011;79:34855
Liang Y, Messer K, Rose BS,
Lewis JH, Jiang SB, Yashar
CM, Mundt AJ, Mell LK. Impact of bone marrow radiation dose on acute hematologic
toxicity in cervical cancer: principal components analysis on high dimensional data. Int J
Radiat Oncol Biol Phys 2010;78:912-6
Jia X, Gu X, Sempau J, Choi D, Majumdar A, Jiang SB. Development of a GPU-based
Monte Carlo calculation code for coupled electron-photon transport. Phys Med Biol
2010:55:3077-86
Jia X, Lou Y, Li R, Song WY, Jiang SB. GPU_based fast cone beam CT reconstruction
from undersampled and noisy projection data. Med Phys 2010:37:1757-60
Nichols MM, Mell LK, et al. Outcomes in black patients with early breast cancer treated
with breast conservation therapy. Int J Radiat Oncol Biol Phys 2010 (in press)
Rose BS, Aydogan B, Liang
Y, Yeginer M, Yashar CM,
Mundt AJ, Roeske JC, Mell
LK.
Normal
tissue
complication
probability
modeling
of
acute
hematologic
toxicity
in
cervical
cancer
patients
undergoing
chemoradioterhapy. Int J
Radiat Oncol Biol Phys
2011;79:800-807
Lewis JH, Li R, Watkins WT,
Lawson JD, Segars WP,
Cervino LI, Song WY, Jiang
SB. Markerless lung tumor
tracking
and
trajectory
reconstruction using rotational cone-beam projections. Phys Med Biol 2010;55:2505-22
67
Gentschev I, Donat U, Hofmann E, Chen N, Yu YA, Szalay AA. Regression of human
prostate tumors and metastases in nude mice following treatment with recombinant
vaccinia virus GLV-1h68. J Biomed Biotechnol 2010;2010:489759
Cervino LI, Jiang Y, Sandhu A, Jiang SB. Tumor motion prediction
with the diaphragm as a surrogate: a feasibility study. Phys Med Biol
2010;55:N221-6
Stapleford LJ, Lawson JD, et al. Evaluation of automatic atlas-based
lymph node segmentation for head and neck cancer. Int J Radiat
Oncol Biol Phys 2010;77:959-66
Cervino LI, Pawlicki T, Lawson JD, Jiang SB. Frameless and maskless cranial stereotactic
radiosurgery: a feasibility study. Phys Med Biol 2010;55:1863-73
Eskander RM Scanderbeg D, Saenz CC, Brown M, Yashar CM. Comparison of computed
tomography and magnetic resonance imaging incervical cancer brachytherapy target
contouring. Int J Gynecol Cancer 2010;21:47-53
Nath S, Lawson JD, Simpson D, Wang JZ, Mundt AJ,
Muprhy KT. Single-isocenter frameless intensity
modulated stereotactic radiosurgery for simultaneous
treatment of multiple metastases: clinical experience.
Int J Radiat Oncol Biol Phys 2010;78:91-7
Mell LK, Dignam JJ, Salama JK, et al. Predictors of
competing mortality in advanced head and neck
cancer. J Clin Oncol 2010;28:15-20
Nath SK, Lawson JD, Wang JZ, Mundt AJ, Murphy
KT.
Optically-guided
frameless
linac-based
radiosurgery for brain metastases: clinical experience.
J Neurooncol 2010;97:67-72
Nath SK, Sandhu AP, Rose BS, Parsons JK, Mundt AJ. Toxicity analysis of postoperative
image-guided intensity-modulated radiotherapy for prostate cancer. Int J Radait Oncol Biol
Phys 2010 (in press)
Wang JZ, Rice R, Mundt A, Sandhu A, Murphy KT. Image-guided stereotactic spine
radiosurgery on a conventional linear accelerator. Med Dosim 2010;35:53-62
Gu X, Pan H, Liang Y, Choi D, Majumdar A, Jiang SB. Implementation and evaluation of
various demons deformable image registration algorithims on a GPU platform. Phys Med
Biol 2010;55:207-1
68
Appendix IV
Goals and Objectives
By Residency Year
First Year (PGY-2)
Patient Care
 To obtain complete and accurate general histories and physicals in patients with gynecologic
cancers, gastrointestinal tumors, genitourinary cancers and head and neck cancers;
 To demonstrate the ability to be able to develop appropriate treatment plans for patients with
in patients with gynecologic, gastrointestinal tumors, genitourinary cancers and head and neck
cancers;
 To understand current practices in patients with gynecologic, gastrointestinal tumors,
genitourinary cancers and head and neck cancers;
 To simulate and design external beam fields correctly in patients with gynecologic cancers,
gastrointestinal tumors, genitourinary cancers and head and neck cancers;
 To develop and execute appropriate follow-up care in patients with gynecologic cancers,
gastrointestinal tumors, genitourinary cancers and head and neck cancers;
 To understand the importance of brachytherapy in the treatment of gynecologic, genitourinary
and some head and neck cancers;
 To perform brachytherapy under direct attending supervision on patients with gynecologic,
genitourinary and head and neck cancers.
Medical Knowledge
 To understand the general process of radiation oncology including consultation, informed
consent, planning, treatment delivery, quality assurance and follow-up;
 To demonstrate a basic understanding of the physical and biologic principles underlying
radiation oncology;
 To be able to perform basic dose calculations and understand the impact of fractionation, time
and dose factors;
 To demonstrate an understanding of the natural history, workup, treatment options,
radiotherapeutic management and outcome of patients with gynecologic cancers,
gastrointestinal tumors, genitourinary cancers and head and neck cancers;
 To demonstrate up-to-date medical knowledge in patients with gynecologic cancers,
gastrointestinal tumors, genitourinary cancers and head and neck cancers;
 To understand the rationale for various therapies in patients with gynecologic cancers,
gastrointestinal tumors, genitourinary cancers and head and neck cancers;
Practice-Based Learning and Improvement
 To demonstrate willingness to seek feedback from others regarding care of his/her patients;
 To begin to identify cases or morbidity and mortality in patients on the service and discuss the
potential causes with the attending physician. All residents
 To compile cases of morbidity and mortality to perform PBLI analysis at the end of rotation
and for presentation at department M&M conference.
 To be able to access medical information from various sources (including on-line) pertinent to
the care of his/her patients with gynecologic cancers, gastrointestinal tumors, genitourinary
cancers and head and neck cancers.
 To critique research evidence for applicability in the care of his/her patients with gynecologic
cancers, gastrointestinal tumors, genitourinary cancers and head and neck cancers;
Systems-Based Practice
69




To understand the various professionals within the department (therapists, nurses, dosimetrists,
physicists, social workers etc.) and their responsibilities in the care of his/her patients and
work effectively with these individuals using the care of patients;
To understand the various disciplines in oncology and how they work in a team approach to
provide the best care to patients with gynecologic cancers, gastrointestinal tumors,
genitourinary cancers and head and neck cancers.
To understand referral to hospice and how this can be beneficial to the care of our end-stage
patients.
To provide care in a number of healthcare systems such as the VA, Kaiser Permanente, UCSD
and multiple HMO’s and how the organizations work in different ways to provide the best care
to their patients.
Professionalism
 To demonstrate the ability to recognize limits of abilities and asks for help when it is needed;
 To respond to each patient’s unique needs and be sensitive to issues relating to patient culture,
age, gender, and disabilities
 To demonstrate the ability to take responsibility for his/her actions and admit mistakes;
 To learn to prioritize multiple demands on your time to put the patient’s needs above your
own.
Interpersonal and Communication Skills
 To be able to accurately provide informed consent to patients with gynecologic cancers,
gastrointestinal tumors, genitourinary cancers and head and neck cancers;
 To accurately and succinctly present a new patient to the attending physician including all
pertinent information
 To demonstrate care and concern with his/her patients;
 To be able to provide reassurance in patients and their families;
 To demonstrate courtesy and consideration to consultants, therapists and other team members;
 To provide timely updates;
 To complete medically records thoroughly and in a timely fashion;
 To accurately articulate the treatment plan of his/her patients with gynecologic cancer,
gastrointestinal tumors, genitourinary cancers and head and neck cancers presented at chart
(new patient) rounds;
Second Year (PGY-3)
Patient Care
 To obtain complete and accurate general histories and physicals in patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To demonstrate the ability develop appropriate treatment plans for patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To understand current practices in patients with CNS tumors, lymphoma/leukemia, lung
cancers and breast cancers;
 To simulate and design external beam fields correctly in patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To develop and execute appropriate follow-up care in patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To demonstrate the ability to consider input from the multi-disciplinary team;
 To be able to coordinate follow-up care with other health care providers;
 To demonstrate the ability to perform brachytherapy in patients with breast and other disease
sites under direct attending supervision;
70
Medical Knowledge
 To demonstrate an increased understanding of the process of radiation oncology including
consultation, informed consent, planning, treatment delivery, quality assurance and follow-up;
 To initiate the develop of treatment plans (including target and normal tissue delineation)
while requiring progressively less need for correction;
 To demonstrate an understanding of the natural history, workup, treatment options,
radiotherapeutic management and outcome of patients with CNS tumors, lymphoma/leukemia,
lung cancers and breast cancers;
 To understand the rationale for various therapies in patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To have a basic understanding of the early and late normal tissue effects from radiation,
chemotherapy and combined treatment approaches;
Practice-Based Learning and Improvement
 To perform extra reading when needed
 To identify cases of morbidity and mortality in one’s own practice and suggest approaches to
avoid these problems in future patients.
 To identify 3 patients at the end of the rotation for whom a change in treatment plan or
approach could have resulted in a better outcome.
 To be able to access medical information from various sources (including on-line) pertinent to
the care of his/her patients with CNS tumors, lymphoma/leukemia, lung cancers and breast
cancers;
 To demonstrate up-to-date medical knowledge in patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To critique research evidence for applicability in the care of his/her patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
Systems-Based Practice
 To understand the various professionals outside the department and their responsibilities in the
care of his/her patients and work effectively with these individuals in the care of patients;
 To effectively work with other providers in providing complete and integrated care;
 To understand the importance of appropriate referrals to community resources including
referrals to hospice when appropriate;
 To follow accepted patient care pathways;
Professionalism
 To demonstrate the ability to put patient needs above his/her own interests;
 To recognize and address ethical dilemmas and other conflicts of interest;
 To effectively maintain patient confidentiality;
Interpersonal and Communication Skills
 To be able to accurately provide informed consent to patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers;
 To effectively utilize non-technical language when speaking with patients and their families;
 To establish rapport with patients and their families;
 To encourage questions and checks for understanding when communicating with patients and
their families;
 To accurately articulate the treatment plan of his/her patients with CNS tumors,
lymphoma/leukemia, lung cancers and breast cancers at new patient (chart) rounds.
71
Third Year (PGY-4)
Patient Care
 To obtain complete and accurate general histories and physicals in patients with sarcomas,
pediatric malignancies, gynecologic cancers and those with metastatic disease requiring
palliation.
 To demonstrate the ability to be able to develop appropriate treatment plans for patients with
sarcomas, pediatric malignancies, gynecologic cancers and those with metastatic disease
requiring palliation.
 To understand current practices in patients with sarcomas, pediatric malignancies, gynecologic
cancers and those with metastatic disease requiring palliation.
 To independently simulate and design external beam fields correctly in patients with sarcomas,
pediatric malignancies, gynecologic cancers and those with metastatic disease requiring
palliation.
 To develop and execute appropriate follow-up care in patients with sarcomas, pediatric
malignancies, gynecologic cancers and those with metastatic disease requiring palliation.
 To demonstrate the ability to perform interstitial brachytherapy in a variety of disease sites and
to perform appropriate therapy with unsealed sources;
 To respond quickly and appropriately to unexpected follow-up events;
Medical Knowledge
 To provide complete and accurate instructions to the technical staff regarding patient
immobilization, simulation, treatment planning and delivery and monitor these processes with
little need for correction;
 To develop treatment plans (including target and normal tissue delineation) with little need for
correction;
 To demonstrate familiarity and understanding of the use of special radiotherapy procedures
including interstitial brachytherapy and unsealed sources;
 To demonstrate an understanding of the natural history, workup, treatment options,
radiotherapeutic management and outcome of patients with sarcomas, pediatric malignancies,
gynecologic cancers and those with metastatic disease requiring palliation.
 To understand the rationale for various therapies in patients with sarcomas, pediatric
malignancies, gynecologic cancers and those with metastatic disease requiring palliation.
 To have a thorough understanding of the early and late normal tissue effects from radiation,
chemotherapy and combined treatment approaches;
Practice-Based Learning and Improvement
 To maintain accurate logs of his/her patients and their outcomes to review and track his/her
practice;
 To demonstrate the ability to change practice behaviors in response to self-assessment and
feedback from others;
 To identify cases of morbidity and mortality during the rotation and understand the causes.
These cases will be presented and department M&M conference.
 To be able to access medical information from various sources (including on-line) pertinent to
the care of his/her patients with sarcomas, pediatric malignancies, gynecologic cancers and
those with metastatic disease requiring palliation.
 To demonstrate up-to-date medical knowledge in patients with sarcomas, pediatric
malignancies, gynecologic cancers and those with metastatic disease requiring palliation.
 To critique research evidence for applicability in the care of his/her patients with sarcomas,
pediatric malignancies, gynecologic cancers and those with metastatic disease requiring
palliation.
72
Systems-Based Practice
 To make appropriate referrals to community resources;
 To resolve differences in treatment recommendations;
 To consider costs and benefits of tests and treatments;
 To understand billing codes in radiation oncology and their appropriate usage;
Professionalism
 To exercise authority accorded by position and/or experience;
 To demonstrate the ability to provide equitable care regardless of patient culture or
socioeconomic status;
Interpersonal and Communication Skills
 To be able to accurately provide informed consent to patients with sarcomas, pediatric
malignancies, gynecologic cancers and those with metastatic disease requiring palliation.
 To demonstrate the ability to effectively manage difficult patient and family situations;
 To involve patients and family in decision-making;
 To accurately articulate the treatment plan of his/her patients with sarcomas, pediatric
malignancies, gynecologic cancers and those with metastatic disease requiring palliation
presented at chart (new patient) rounds
Fourth Year (PGY-5)
Patient Care
 To be able to obtain complete and accurate general histories and physicals in all patients
undergoing definitive and palliative RT;
 To demonstrate the ability to be able to develop appropriate treatment plans in all patients
undergoing definitive and palliative RT with minimal attending input;
 To understand current practices in all patients undergoing definitive and palliative RT;
 To be able to simulate and design external beam fields correctly in all patients undergoing
definitive and palliative RT with minimal attending input.
 To develop and execute appropriate follow-up care in all patients undergoing definitive and
palliative RT;
 To be able to perform interstitial or intracavitary brachytherapy on a cancer patient under
direct supervision with minimal attending assistance.
Medical Knowledge
 To demonstrate a thorough understanding of all major oncologic specialties (surgical, medical
and radiotherapeutic) and their role in the treatment of the oncology patient;
 To demonstrate an understanding of the natural history, workup, treatment options,
radiotherapeutic management and outcome of all major cancer sites;
 To demonstrate knowledge of all special radiotherapy procedures;
Practice-Based Learning and Improvement
 To demonstrate understanding of the importance of reviewing ones own practice and to
compare his/her patient outcomes to accepted guidelines and national or peer data;
 To apply new skills or knowledge to patient care;
 To understand the importance of continual improvement in ones practice;
Systems-based Practice
 To understand the importance of coordinating care of all patients within the greater health care
system;
 To understand the importance of being cost-conscious in the care of his/her patients;
73
Professionalism
 To demonstrate a high-level of responsibility, integrity and ethics;
 To be a model to junior residents
Interpersonal and Communication Skills
 To be able to accurately provide informed consent to all patients undergoing definitive and
palliative RT;
 To be an effective educator and counselor to his/her patients;
 To be an effective team-player in the care of ones patients;
 To accurately articulate the treatment plan of all patients undergoing definitive and palliative
RT;
74
Appendix V
Goals and Objectives
Example Clinical Rotations
Gynecologic Radiation Oncology – PGY 1 Goals and Objectives
During this rotation, the resident is expected to gain an understanding of the principles of radiation
oncology in the treatment of patients with gynecologic malignancies.
Patient Care

Learn to perform an accurate history and physical examination of a gynecology patient
including a complete pelvic examination.

Develop skills to accurately (and in patient appropriate language) explain the treatment
options to and obtain informed consent from patients with gynecologic cancers.

Learn to develop a treatment plan for patients with gynecologic cancer after discussing case
with the attending.

Under attending direct supervision simulate a gynecology patients receiving external beam
irradiation and request appropriate treatment aids and positioning.

Under attending supervision delineate treatment fields (conventional planning) and
target/normal tissues (3D and IMRT planning) in patients with gynecologic cancers.

Learn to critically evaluate potential treatment plans in gynecologic oncology patients.

Monitor and manage side effects of gynecology patients undergoing external beam
irradiation.

After discussion with attending, select the appropriate type of brachytherapy approach and
modality (LDR vs. HDR) (intracavitary vs. interstitial) in a patient undergoing brachytherapy.

Perform intracavitary procedures under the supervision of the attending.

Simulate a patient receiving intracavitary brachytherapy.

Critically evaluate potential treatment plans in intracavitary brachytherapy patients.

Monitor and manage side effects of intracavitary brachytherapy.

Perform at least 5 intracavitary brachytherapy procedures under attending supervision during
first year rotation.

Evaluate gynecology patients in follow-up regarding side effects and disease recurrence
learning the signs and symptoms of both toxicity and recurrent disease.
Medical Knowledge

Begin to develop a detailed knowledge of pelvic anatomy both grossly and on sectional
imaging.

Perform required reqding on the epidemiology and etiology of gynecologic cancers

Learn the common presenting signs and symptoms of gynecologic cancers.

Be able to order the necessary workup and appropriate diagnostic studies (x-rays, laboratory
tests, etc.) of patients with gynecologic malignancies after discussion with attending
physician.

Know the staging of gynecologic malignancies

Be able to discuss the standard treatment approaches used in gynecologic cancers

Learn the role of radiotherapy in the treatment of gynecologic cancer

Be able to discuss the outcome of major gynecologic cancers by stage and treatment

Learn the common treatment sequelae (and their management) following surgery,
chemotherapy and radiotherapy in these patients and how they differ with 3D conformal vs.
IMRT.
75





Know possible indications for intracavitary brachytherapy in the treatment of gynecologic
cancers and types of intracavitary approaches (tandem and ovoids etc.) used
Learn the differences between low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy
and their respective uses.
Know the types of radioactive sources used in LDR and HDR brachytherapy
Know the potential complications of intracavitary brachytherapy and their management
To show knowledge acquired during the rotation by passing a practical examination at the
completion.
Practice Based Learning and Improvement

To perform extra reading of gynecologic-oncology materials when needed

To be able to access medical information from various sources (including on-line) pertinent
to the care of his/her patients with gynecologic cancers

To demonstrate up-to-date medical knowledge in patients with gynecologic cancers

To critique research evidence for applicability in the care of his/her patients with gynecologic
cancers

To demonstrate practice based learning by identifying three patients during his/her rotation
for which a difference in treatment could have possibility produced a better outcome.

To identify cases of morbidity during the rotation for presentation and M & M conference
and be familiar with causes of morbidity and ways to reduce it.
Systems-Based Practice

Learn to work as part of a treatment team with other physicians, nurses, therapists,
dosimetrists, physicists and others and understand the role of each team member.

To understand the various professionals outside the department and their responsibilities in
the care of his/her patients and work effectively with these individuals in the care of patients.

To learn the differences in EMR systems and how to access those systems at UCSD, Kaiser
and VA systems.

To begin to learn how differences in economics of various Health Care Systems may produce
differences in work-up, staging and treatment of patients.

To follow accepted patient care pathways (NCCN, ACS, etc)

To begin to understand the cost/benefit relationships associated with various treatment
approaches used in the management of gynecologic cancers.
Professionalism

To demonstrate the ability to put patient needs above his/her own interests

To maintain respectful interactions at all times with patients, clinic staff and colleagues both
within our Department and in other Departments.

To begin to learn how to manage a busy clinic schedule and and multiple demands on his/her
time without compromising patient care.

To recognize and address ethical dilemmas and other conflicts of interest

To effectively maintain patient confidentiality

To respect patient privacy and be respectful of patients’ concerns and cultures during physical
examinations

To use a chaperone for all gynecologic examinations
Interpersonal and Communication Skills

Learn to accurately and concisely present a patient case to the attending physician including
all pertinent positives and negatives without extraneous information.

To be able to accurately provide informed consent to patients with gynecologic cancers under
attending guidance.
76





To effectively utilize non-technical language when speaking with patients and their families
To establish rapport with patients and their families
To encourage questions and checks for understanding when communicating with patients and
their families
To begin to learn how to accurately articulate the treatment plan of his/her patients with
gynecologic cancers presented at chart (new patient) rounds
To communicate effectively with medical oncologists and gynecologic oncologists regarding
the care of shared patients
Lymphoma/Leukemia – PGY3 Goals and Objectives
During this rotation, the resident is expected to gain a more advanced understanding of and
increased independence in caring for patients with lymphoma/leukemia/myeloma.
Patient Care

Independently perform an accurate history and physical of the lymphoma patient and
understand how this may differ from the history and physical done for other malignancies.

Accurately (and in patient appropriate language) learn to explain the treatment options to and
obtain informed consent from patients with lymphoma.

Independently formulate a plan to simulate patients with lymphoma, leukemia or myeloma
who will receive external beam irradiation and request appropriate treatment aids and
positioning.

Demonstrate knowledge of and be able to explain the set up of patients for Total Body
Irradiation (TBI) and the physics of assuring appropriate dose to target tissues.

Delineate appropriate treatment fields (conventional planning).

Be able to delineate accurate target volumes including GTV, CTV and PTV as well as normal
tissues for patients receiving 3D conformal or IMRT treatment with minimal attending input.

Demonstrate knowledge of critical structures and tolerance doses in patients with lymphoma.

Demonstrate an understanding of how external radiation is sequenced with systemic therapy
in patients with hematologic malignancies.

Critically evaluate potential treatment plans for patients with lymphoma. Should be able to
choose the appropriate plan to present to attending.

Demonstrate increased independence in monitoring and managing side effects in these
patients undergoing external beam irradiation or TBI.

Demonstrate independence in evaluating lymphoma/leukemia patients in follow-up regarding
side effects and disease recurrence
Medical Knowledge

Know the epidemiology and etiology of lymphoma/leukemia/myeloma.

Demonostrate an understanding of anatomy of the lymphatic system and patterns of spread of
various hematologic malignancies.

Know the signs and symptoms of lymphoma/leukemia/myeloma.

Be able to explain the appropriate work-up and diagnostic studies (x-rays, laboratory tests,
etc.) of patients with hematologic malignancies.

Be able to describe the staging and prognostic systems for hematologic malignancies.

Have a comprehensive understanding of the pathology of hematologic malignancies.

Know the standard treatment approaches used in the treatment of
lymphoma/leukemia/myeloma.

Be able to describe the role of radiotherapy in the treatment of lymphoma/leukemia/myeloma
based on evidence.

Understand the role of TBI in stem cell/bone marrow transplant.
77




Be able to discuss the outcome of lymphoma/leukemia/myeloma by prognostic group or
stage.
Understand the treatment sequelae (and their management) following chemotherapy and
radiotherapy in these patients including TBI patients.
Demonstrate the ability to teach junior residents about patients with hematologic
malignancies at clinical case conferences.
To successfully pass a practical examination of patient care and medical knowledge geared
toward level of training at the completion of the rotation.
Practice-Based Learning and Improvement

To maintain accurate logs of his/her patients and their outcomes to review and track his/her
practice

To demonstrate the ability to change practice behaviors in response to self-assessment and the
feedback from others.

To identify three patients at the end of the rotation for whom a change in treatment may have
resulted in a better outcome.

To identify cases of morbidity in his/her own practice and be able to discuss data regarding
causes of this morbidity and ways to prevent it.

To be able to access medical information from various sources (including on-line) pertinent
to the care of his/her patients with lymphoma/leukemia/myeloma.

To develop up-to-date medical knowledge in patients with hematologic malignancies and be
able to apply this knowledge to his/her own practice.

To critique research evidence for applicability in the care of his/her patients.
Systems-Based Practice

To work as part of a team of providers caring for the patient including physicians, nurses,
therapists, dosimetrists and others and take a leadership role on this team.

To make appropriate referrals to community resources

To continue to learn how differences in economics of various healthcare systems such as
UCSD, VA and Kaiser influence the care and treatment of patients and how to navigate these
differences.

To resolve differences in treatment recommendations.

To consider costs and benefits of tests and treatments.

To begin to understand billing codes in radiation oncology and their appropriate usage.

Demonstrate ability to navigate the EMR at various healthcare systems from which the
patients are coming and how to adequately obtain important medical information in each
system.
Professionalism

To exercise authority accorded by position and/or experience.

To put the patient’s needs above his/her own needs.

To demonstrate the ability to provide equitable care regardless of patient culture or
socioeconomic status.

To be respectful of patient’s discomfort with an uncomfortable physical exam.

Demonstrate ability to provide uncompromised care to a these patients despite multiple other
demands on his/her time.

Be a role model and be identified by junior residents as one they can go to for
questions/advice.
Interpersonal and Communication Skills
78





To be able to clearly and accurately provide informed consent to patients with hematologic
malignancies in understandable language.
To demonstrate the ability to effectively manage difficult patient and family situations
To involve patients and family in decision-making when appropriate.
To accurately articulate the treatment plan of his/her patients with hematologic malignancies
presented at chart (new patient) rounds and at tumor boards.
To effectively communicate with medical oncologists and the BMT team.
Pediatric Radiation Oncology – PGY4 Goals and Objectives
Patient Care

Independently perform an accurate history and physical examination of a pediatric patient
including a thorough physical examination.

Be able to independently formulate a treatment plan for your pediatric patients and
thoroughly discuss this with the attending physician.

Accurately (and in patient appropriate language) explain the treatment options to and obtain
informed consent from the parents of patients with pediatric cancers.

Independently simulate a pediatric cancer patient receiving external beam irradiation and
request appropriate treatment aids and positioning.

Be able to determine if the pediatric patients will require anesthesia utilizing information
from your examination and the treatment team.

Be able to delineate treatment fields and target/normal tissues in patients with pediatric
diseases treated with external beam irradiation with minimal attending input.

Be able to describe standard radiotherapy techniques and when to incorporate IMRT in the
treatment of patients with pediatric malignancies.

Be able to critically evaluate potential treatment plans in pediatric cancer patients.

Monitor and independently manage side effects of pediatric patients undergoing external
beam irradiation with minimal attending input.

Demonstrate an advanced familiarity with normal tissue tolerances in pediatric patients.

Be able to accurately identify various morbidities and patient toxicities from radiation therapy
by seeing patients in follow-up clinic.
Medical Knowledge

Develop a more advanced understanding of the epidemiology and etiology of pediatric
malignancies including possible risk factors for the disease.

Demonstrate knowledge of surgical techniques for treatment of pediatric cancers.

Be able to describe the anatomy of the region of treatment when appropriate to radiation
treatment fields in a pediatric patient.

Be able to stage pediatric cancers appropriately.

Know the standard treatment approaches used in pediatric cancer patients.

Be familiar with anesthesia techniques and risks thereof in patients with pediatric
malignancies.

Be able to independently make evidence-based recommendations on the use of and extent of
radiotherapy for a particular patient’s clinical situation.

Be familiar with the outcome of pediatric patients by disease and stage.

Be able to accurately describe known treatment sequelae (and their management) following
surgery, chemotherapy and radiotherapy in pediatric cancer patients.

Successfully pass a practical examination of medical knowledge given at the completion of
the rotation geared toward level of training.
Practice-Based Learning and Improvement
79





Demonstrate willingness to seek feedback from faculty and ancillary staff regarding care of
his/her patients with pediatric disease.
Be able to access medical information from multiple sources (including on-line) pertinent to
the care of his/her patients and use that information to improve his/her care.
Demonstrate ability to evaluate his/her own practice and identify areas for improvement
including selecting three patients from the pediatrics rotation for whom a different treatment
or treatment approach may have resulted in a superior outcome and discuss these cases with
your attending.
Demonstrate up-to-date medical knowledge in patients with pediatric cancers and apply that
knowledge to their treatment.
Be able to critically evaluate studies and their usefulness to the care of clinical patients
including a critique of statistical methods, treatment given and conclusions drawn in the
study.
Systems-Based Practice

To maintain accurate logs of his/her patients and their outcomes to review and track his/her
practice

To act as a team leader for the care of his/her patients.

To know the various professionals within the department (radiation therapists, nurses,
dosimetrists, physicists, social workers, etc) and understand their responsibilities in the care
of his/her patients with GI cancer and work effectively with these individuals in the care of
these patients.

To work effectively with a multidisciplinary team of providers (like the Peds Oncology team
at Childrens) to make decisions regarding care for these patients and to effectively deliver
that care in a coordinated fashion.

To be aware of system resources and effectively advocate for patients and their parents in
identifying and finding those resources.

Be familiar with the cost-effectiveness of various resources in the care and treatment of
Pediatric cancer patients and how this may influence treatment in the various healthcare
systems in which we work.

Be familiar with the patient-safety and quality-assurance methods in use in our clinic and in
the UCSD system and how they apply to patients with pediatric tumors.

Demonstrate an advanced familiarity with multiple medical systems including those at
Kaiser, Childrens and UCSD as well as their individual EMR systems.
Professionalism

To demonstrate the ability to recognize limits of abilities and ask for help when it is needed.

To respond to each patient’s unique needs and be sensitive to issues relating to patient
culture, age, gender and disabilities.

To demonstrate the ability to take responsibility for his/her actions and admit mistakes

To deliver compassionate care and take the necessary time with patients even when there are
other demands on his/her time.

To respect the privacy of patients and with pediatric cancers and their parents.

To demonstrate ability to incorporate the parents, when appropriate, in the treatment of
children with cancer.

To demonstrate care and concern with his/her pediatrics patients.

To act as a mentor to junior residents in the department.
Interpersonal and Communication Skills

To be able to communicate recommendations, side effects and risks in an understandable way
to pediatric patients and their parents.
80







To be able to accurately provide informed consent to patients with pediatric cancers and their
parents.
To be able to provide reassurance to patients and their families
To demonstrate courtesy and consideration to consultants, therapists and other team members
To provide timely updates.
To be able to present patients including the plan of care in a clear and succinct manner to
attending physicians in clinic and at patient conferences in our department and outside.
To be able to demonstrate competency and knowledge in the field by teaching junior
residents in pediatric cancers at clinical case conference.
To communicate effectively with the Peds-oncology team as Co-physician in the patients
with Pediatric malignancies.
Research Year – PGY5 – Goals and Objectives
Patient Care
 To understand current practices in all patients undergoing definitive and palliative RT by
attendance at didactic conferences.
 To be able to simulate and design external beam fields correctly in all patients undergoing
definitive and palliative RT with minimal attending input during on-call situations.
 To learn how knowledge learned in research endeavors can benefit patients.
Medical Knowledge
 To demonstrate a thorough understanding of all major oncologic specialties (surgical, medical
and radiotherapeutic) and their role in the treatment of the oncology patient.
 To demonstrate an understanding of the natural history, workup, treatment options,
radiotherapeutic management and outcome of all major cancer sites.
 To demonstrate knowledge of all special radiotherapy procedures.
 To use research experience to advance medical knowledge.
 To advance his/her knowledge of statistics by applying it to research projects.
 To use the significant medical knowledge that he/she has learned to guide research endeavors.
Practice-Based Learning and Improvement
 To participate in quarterly Morbidity and Mortality conference and learn the various causes in
our patients.
 To understand the importance of continual improvement in ones practice;
Systems-based Practice
 To develop an advanced understanding of the team approach to medicine during on-call
hospital situations.
 To understand the importance of being cost-conscious in the care of his/her patients;
Professionalism
 To demonstrate a high-level of responsibility, integrity and ethics in the clinic and research
setting.
 To be a role-model to junior residents
 To be mentor to junior residents in helping to guide them in the selection of their own research
projects.
 To take a lead in department didactic conferences.
81
Interpersonal and Communication Skills
 To be able to accurately provide informed consent to all patients undergoing definitive and
palliative RT while on call.
 To be an effective team-player in the clinic and the laboratory or other research environment.
 To effectively articulate the importance of their research program, and research in general, to
residents and faculty.
 To learn the skills necessary to give an effective presentation at department and
regional/national meetings.
82
Appendix VI
Medical Physics Class 2014-2015
Lecture
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
Faculty
Scanderbeg
Manger
Manger
Moore
Moore
Moiseenko
Moiseenko
Dragojevic
Dragojevic
Cerviño
Cerviño
Cerviño
Cerviño
Atwood
Atwood
Paxton
Paxton
Atwood
Atwood
Kim
Kim
Scanderbeg
Scanderbeg
Brown
Brown
Hoisak
Hoisak
Ning
Ning
Pawlicki
Pawlicki
Sutlief
Sutlief
Ning
Kim
Moore
Kim
Moiseenko
Moiseenko
Sutlief
Title
Radiation Safety/Structure of Matter
Nuclear Transformations 1
Nuclear Transformations 2
Interactions of Ionizing Radiation 1
Interactions of Ionizing Radiation 2
Clinical Radiation Generators 1
Clinical Radiation Generators 2
Production of X-rays 1
Production of X-rays 2
Radiation Measurements; ion chambers 1
Radiation Measurements; ion chambers 2
Quality of X-ray Beams; absorbed dose 1
Quality of X-ray Beams; absorbed dose 2
Dose Distribution, Scatter Analysis 1
Dose Distribution, Scatter Analysis 2
Dosimetric Calculation, PDD, TMR 1
Dosimetric Calculation, PDD. TMR 2
Treatment Planning, Isodose Distributions 1
Treatment Planning, Isodose Distributions 2
Treatment Planning, Data, Correction 1
Treatment Planning, Data, Correction 2
Brachytherapy 1
Brachytherapy 2
Brachytherapy 3
Brachytherapy 4
Electron Beam 1
Electron Beam 2
Radiation Protection 1
Radiation Protection 2
Quality Assurance 1
Quality Assurance 2
3DCRT 1
3DCRT 2
SRS, TBI, Tomotherapy 1
SRS, TBI, Tomotherapy 2
IMRT/IGRT 1
IMRT/IGRT 2
TCP, NTCP, EUD, Radiobiology 1
TCP, NTCP, EUD, Radiobiology 2
Proton Physics
83
Appendix VII
Radiobiology Class
Lecture 1
Faculty: Advani
Overview of Radiobiology/Cancer Biology and its Relation to Clinical Radiotherapy
Lecture 2
Faculty: Advani
Chapters 1-2 Hall Text
Radiation absorption & DNA damage and repair
Lecture 3
Faculty: Advani
Chapters 3-4 Hall Text
Cell survival curves & Radiosensitivity and cell cycle
Lecture 4
Faculty: Advani
Chapters 5 Hall Text
Fractionated Radiation and dose-rate effects
Lecture 5
Faculty: Advani
Chapters 6-7 Hall Text
Oxygen effect, reoxygenation & LET, RBE
Lecture 6
Faculty: Advani
Chapters 8-9 Hall Text
Acute radiation syndrome & Radioprotectors
Lecture 7
Faculty: Advani
Chapters 10 Hall Text
Radiation carcinogensis & Hereditary effects
Lecture 8
Faculty: Advani
Chapters 11 Hall Text
Hereditary effects of radiation
Lecture 9
Faculty: Advani
Chapters 12-13 Hall Text
Effects on embryo and fetus & Radiation cataractogensis
Lecture 10
Faculty: Advani
Chapters 14-15 Hall Text
Radiologic terrorism & Molecular imaging
Lecture 11
Faculty: Advani
84
Chapters 16 Hall Text
Doses and Risks in Diagnostic Radiology/Nuclear Medicine
Lecture 12
Faculty: Advani
Chapters 17 Hall Text
Radiation protection
Lecture 13
Faculty: Advani
Chapters 18 Hall Text
Cancer Biology
Lecture 14
Faculty: Advani
Chapters 19-20 Hall Text
Dose-response relationships for model normal tissues & clinical responses of normal tissues,
Lecture 15
Faculty: Advani
Chapters 21-22 Hall Text
Model tumor systems & Cell, tissue, tumor kinetics
Lecture 16
Faculty: Advani
Chapters 23-24 Hall Text
Time, dose, and fractionation in radiotherapy & Retreatment after radiotherapy
Lecture 17
Faculty: Advani
Chapters 25, 28 Hall Text
Alternative Radiation Modalities & Hyperthermia
Lecture 18
Faculty: Advani
Chapters 26 Hall Text
The biology and exploitation of tumor hypoxia
Lecture 19
Faculty: Advani
Chapters 27 Hall Text
Chemotherapy agents from the perspective of the radiation biologist
Lecture 20
Faculty: Advani
Radiobiology Review & Exam
85
Appendix VIII
Biostatistics Class
Lecture 1: The basics
Terminology, structure of data, and why this matters.
Lecture 2: Construct a “Table 1”
T-tests, Chi-squared tests, and non-parametric equivalents.
Lecture 3: Create a “dose-response curve”
Linear regression, logistic regression, and TCP/NTCP modeling.
Lecture 4: Simple survival statistics
Time-to-event analysis, Kaplan-Meier plots, and cumulative incidence analysis.
Lecture 5: Complex survival statistics
Cox-regression, and Fine-Gray regression models.
Lecture 6: Design a clinical trial
Alpha, beta, statistical power, and sample size.
86
Appendix IX
“Disease Months”
Month
July
August
September
October
November
December
January
February
March
April
May
June
Disease
Introduction/Emergencies
Genitourinary
Soft Tissue/Bone/Benign
Central Nervous System
Gynecology
Metastatic/Palliative
Breast
Pediatrics
Leukemia/Lymphoma
Gastrointestinal
Head/Neck
Lung
87
Appendix X
Multidisciplinary Conferences
Monday
UCSD Breast
Kaiser Breast
UCSD Soft Tissue/Bone
7:45-9 am
12:30-1:30 pm
5-6 pm
Weekly
Weekly
Monthly
Tuesday
UCSD Gynecology
UCSD GI
Rady Childrens CNS
Encinitas Breast
Scripps Chula Vista General
VA Pulmonary
VA General
UCSD Liver
Pomerado Breast
7:30-8:30 am
12-1 pm
12-1 pm
12-1 pm
12-1 pm
3-4 pm
4-5 pm
4-5 pm
5-6 pm
Bi-Weekly
Weekly
Bi-Weekly
Weekly
Weekly
Weekly
Weekly
Weekly
Bi-Weekly
Wednesday
Rady Childrens Body
Sharp Chula Vista General
12-1 pm
12:30-1:30 pm
Bi-Weekly
Weekly
Thursday
UCSD Head/Neck
5-7 pm
Weekly
Friday
UCSD GU
UCSD Neuro-Oncology
UCSD Lung
UCSD Leukemia/Lymphoma
Kaiser Head/Neck
Kaiser General
11-12 am
11-1 pm
12-1 pm
12-1 pm
12:30-1:30
12:30-1:30
Bi-Weekly
Weekly
Weekly
Weekly
Bi-Weekly
Weekly
88
Appendix XI
Quarterly Resident Evaluation by Attending
Overall Evaluation
Unsatisfactory = several behaviors performed poorly or missed (ratings, 1,2 or 3)
Satisfactory = most behaviors performed acceptably (ratings, 4, 5 or 6)
Superior = all behaviors performed very well (ratings, 7, 8 or 9)
Patient Care
1) Information Gathering
Obtains complete and accurate patient histories
Performs thorough and appropriate physical exams
Obtains enough information to include or exclude likely significant problems
Unsatisfactory
1
2
Satisfactory
3
4
5
6
Superior
Unable to Evaluate
7 8 9
2) Treatment Planning
Develops appropriate plans for specific diagnoses
Reflects good understanding of current practices
Considers input from the multidisciplinary team
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
3) Treatment Preparation
Simulates patients correctly
Designs external beam fields correctly
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
4) Treatment Implementation
Oversees therapy (external RT and brachytherapy) effectively and appropriately
Able to perform intracavitary/interstitial brachytherapy and unsealed sources
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
7 8 9
Unable to Evaluate
89
5) Patient Follow-up
Plans and executes appropriate follow-up care
Coordinates care with other health care providers
Responds quickly and appropriately to unexpected follow-up
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Medical Knowledge
6) Analytic Thinking
Uses effective problem solving
Demonstrates sound clinical judgment
Applies analytic approaches to clinical situations
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Practice-based Learning and Improvement
8) Practice Review
Uses a systematic approach such as a log or chart review to track own practice
Compares own outcomes to accepted guidelines and national or peer data
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
9) Ongoing Learning
Seeks feedback from others
Does extra reading when needed
Accesses medical information on-line to support his/her education and to manage patients
Demonstrates up-to-date medical knowledge
Critiques research evidence for applicability to patient care
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
7 8 9
Unable to Evaluate
90
10) Improvement
Changes practice behaviors in response to feedback from others and review of own
practice
Applies new skills or knowledge to patient care
Unsatisfactory
1
2
Satisfactory
3
4
5
6
Superior
Unable to Evaluate
7 8 9
Systems-based Practice
11) Care Coordination
Works effectively with other provides to provide complete and integrated care
Resolves differences in treatment recommendations
Reconciles contradictory advice
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
12) Cost-Conscious Care
Considers costs and benefits of tests and treatments
Follows accepted patient care pathways
Uses appropriate billing codes
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
13) Coordination with System
Assures patient awareness of, and advocates for patient access to, available care options
Makes appropriate referrals to community resources
Understands different healthcare delivery systems and medical practices
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Professionalism
14) Responsibility
Accepts responsibility willingly
Follows through on tasks carefully and thoroughly
91
Is dependable and industrious
Responds to requests in a helpful and prompt manner
Unsatisfactory
Satisfactory
Superior
1
4
7
2
3
5
6
8
Unable to Evaluate
9
15) Scope of Practice
Recognizes limits of abilities
Asks for help when it is needed
Refers patients when it is appropriate
Exercises authority accorded by position and/or experience
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
16) Patient Needs
Responds to each patient's unique needs and characteristics by being sensitive to issues
related to patient
culture, age, gender, and disabilities
Provides equitable care regardless of patient culture or socioeconomic status
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
17) Integrity/Ethics
Takes responsibility for actions
Admits mistakes
Puts patient needs above own interests
Recognizes and addresses ethical dilemmas and conflicts of interest
Maintains patient confidentiality
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Interpersonal and Communication Skills
18) Relationship-Building
Establishes rapport with patients and their families
Demonstrates care and concern
92
Is respectful and considerate
Provides reassurance
Manages difficult patient/family situations
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
19) Patient Education/Counseling
Explains risks, side effects and benefits of treatment, limitations and outcomes
Uses non-technical language
Encourages questions and checks for understanding
Involves patient/family in decision-making
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
20) Team Interaction
Demonstrates courtesy and consideration to consultants, therapists and other team
members
Provides timely updates
Invites others to share their knowledge and opinions
Negotiates and compromises when disagreements occur
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
21) Medical Records
Completes timely, thorough and legible medical records including well-documented
physical examinations, complete discussion of treatment plan with adequate discussion of lab,
pathology and radiologic findings
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
22) How can the resident improve his/her abilities in the areas above?
93
Appendix XII
360° Evaluations
Staff Evaluation of Radiation Oncology Resident
Please rank the resident's performance for each category. Any marks in the "Needs Improvement"
categories should be accompanied by written explanations; also feel free to include any positive
comments. Your evaluation will be kept anonymous. Thank you for your time and assistance.
PATIENT CARE
Obtains relevant information from patients
Unsatisfactory
1
2
Satisfactory
3
4
5
Superior
6
Unable to Evaluate
7 8 9
Obtains relevant information from referring clinicians
Unsatisfactory
1
2
Satisfactory
3
4
5
Superior
6
Unable to Evaluate
7 8 9
Attempts to make patient comfortable during the exam
Unsatisfactory
1
2
Satisfactory
3
4
5
Superior
6
Unable to Evaluate
7 8 9
Demonstrates continued improvement in performing exams
Unsatisfactory
1
2
Satisfactory
3
4
5
Superior
6
Unable to Evaluate
7 8 9
Makes an effort to minimize patient radiation dose
Unsatisfactory
1
2
Satisfactory
3
4
5
Superior
6
Unable to Evaluate
7 8 9
Comments
INTERPERSONAL SKILLS
Communicates effectively with patient
Unsatisfactory
Satisfactory
1
2
3
4
5
6
Superior
7
8
9
Unable to Evaluate
94
Demonstrates skill in obtaining informed consent (effectively explaining risks, benefits,
alternatives, and possible complications)
Unsatisfactory
1
2
Satisfactory
3
4
5
6
Superior
Unable to Evaluate
7 8 9
Communicates effectively with technologists
Unsatisfactory
1
2
Satisfactory
3
4
5
6
Superior
Unable to Evaluate
7 8 9
Communicates effectively with other physicians and staff
Unsatisfactory
1
2
Satisfactory
3
4
5
6
Superior
Unable to Evaluate
7 8 9
Comments
PROFESSIONALISM
Punctuality: is on time (aside from AM and noon conference)
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Availability: Is available all day
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Appearance: always presents a professional appearance
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Confidentiality: always protects patient confidentiality
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Altruism: places interests of patients/others above own self
Unsatisfactory
Satisfactory
Superior
Unable to Evaluate
95
1
2
3
4
5
6
7 8 9
Compassion: understanding/respectful of patients, patient families, etc
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Discrimination: does not discriminate against patients on the basis of religion, gender, or ethnicity
Unsatisfactory
1
2
3
Satisfactory
4
5
6
Superior
Unable to Evaluate
7 8 9
Comments
Overall assessment
Excellent Good Satisfactory
Comments
Needs
Improvement
Needs Significant
Improvement
N/A
96
Appendix XIII
Program Director Semi-Annual Resident Evaluation
Overall Evaluation (based on individual rotation evaluations including 360° evaluations)
Unsatisfactory = several behaviors performed poorly or missed (ratings, 1,2 or 3)
Satisfactory = most behaviors performed acceptably (ratings, 4, 5 or 6)
Superior = all behaviors performed very well (ratings, 7, 8 or 9)
Patient Care
Comment and Suggestions for Improvements:
Unable
Unsatisfactory Satisfactory Superior
to
Evaluate
1
2
3
4 5 6 7 8 9
Comments
Medical Knowledge
Comments and Suggestions for Improvements:
Unable
Unsatisfactory Satisfactory Superior
to
Evaluate
1
2
3
4 5 6 7 8 9
Comments
Practice-based Learning and Improvement
Unsatisfactory Satisfactory Superior
Comments and Suggestions for Improvements:
1
Comments
2
3
4
5
6
7 8 9
Unable
to
Evaluate
97
Systems based practice
Unsatisfactory Satisfactory Superior
Comments and Suggestions for Improvements:
1
2
3
4
5
6
Unable
to
Evaluate
7 8 9
Comments
Professionalism
Comments and Suggestions for Improvements:
Unable
Unsatisfactory Satisfactory Superior
to
Evaluate
1
2
3
4 5 6 7 8 9
Comments
Interpersonal and Communication Skills
Unsatisfactory Satisfactory Superior
Comments and Suggestions for Improvements:
1
Comments
2
3
4
5
6
7 8 9
Unable
to
Evaluate
98
Appendix XIV
Final Summative Resident Evaluation
Overall Evaluation (based on individual rotation evaluations during entire residency)
Any Unsatisfactory score requires explanation in comments section
Patient Care
Unsatisfactory Satisfactory Superior
Medical Knowledge
Unsatisfactory Satisfactory Superior
Practice based learning
Unsatisfactory Satisfactory Superior
Systems based practice
Unsatisfactory Satisfactory Superior
Professionalism
Unsatisfactory Satisfactory Superior
Interpersonal and Communication Skills
Unsatisfactory Satisfactory Superior
Comments:
Program's Decision:
Pass Fail
My signature below represents my attestation that the above resident has demonstrated sufficient
competence in all the above areas to enter practice without direct supervision.
Program Director
Resident
99
Appendix XV
Annual Program Director Evaluation of Faculty
Completed by Residency Program Director
On each faculty member involved with Resident Teaching
Clinical Teaching Ability:
Commitment to Educational Program:
Clinical Knowledge:
Professionalism:
Scholarly Activities:
100
Appendix XVI
Annual Faculty Evaluation
Please comment on your experience with the attending physicians you worked with over the last
year.
Medical Knowledge
1) Demonstrates extensive clinical knowledge of subject matter
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
2) Contributes high quality lectures and conferences
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
Practice-based Learning and Improvement
3) Consistently provides teaching outside of formal lectures
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
4) Committed to enhancing the Educational Program
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
Professionalism
5) Demonstrates professionalism and a strong work ethic
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
Practice-based Learning and Improvement
6) Encourages the participation in scholarly activities
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
101
Appendix XVII
Year-End Program Evaluation by Resident
Please comment on your experience with the residency program over the last year
Education
Overall program
philosophy in
encouraging
mastering of the
core
competencies
Poor Fair Average Good Excellent
Unable to Evaluate
Overall
curriculum
Poor Fair Average Good Excellent
Unable to Evaluate
Rotations/
Electives
Poor Fair Average Good Excellent Unable to Evaluate
Rounds
(educational vs.
work)
Poor Fair Average Good Excellent
Unable to Evaluate
Conference
quality
Poor Fair Average Good Excellent
Unable to Evaluate
Access to
educational
materials
Poor Fair Average Good Excellent
Unable to Evaluate
Preparation for
Board
Certification
Poor
Fair
Average
Good
Excellent
Unable to Evaluate
Good
Excellent
Unable to Evaluate
Attending Physicians / Teaching Faculty
Number of fulltime vs. part-time
Poor
Fair
Average
Research vs.
teaching
responsibilities
Poor Fair Average Good Excellent
Unable to Evaluate
Clinical vs.
Poor Fair Average Good Excellent
Unable to Evaluate
102
teaching skills
Availability and
approachability
Poor Fair Average Good Excellent
Unable to Evaluate
Representatives
for all
subspecialties
Poor Fair Average Good Excellent
Unable to Evaluate
Instruction in
patient education
and counseling
Poor Fair Average Good Excellent
Unable to Evaluate
Average number
of patients
Poor Fair Average Good Excellent
Unable to Evaluate
Level of
Supervision by
Attendings
Poor Fair Average Good Excellent
Unable to Evaluate
Call Schedule
Poor Fair Average Good Excellent
Unable to Evaluate
Teaching/
Conference
Responsibility
Poor Fair Average Good Excellent
Unable to Evaluate
"Scut" Work
Poor
Clinic
Responsibilities
Poor Fair Average Good Excellent
Work Load
OVERALL
Program Strengths
Fair
Average
Good
Excellent
Unable to Evaluate
Unable to Evaluate
103
Program Weaknesses
Recommendations for Improvement