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Radiation Oncology Residency: The Clinical Experience

A strong clinical oncology experience is fostered by the one-on-one relationship between staff physicians and residents during their rotations. Teaching is emphasized by radiation oncology case conferences; daily multidisciplinary case conferences with the FCCC departments of surgical oncology, medical oncology, radiology and pathology; and didactic lectures given by the staff.  Overall, about 6 hours per week are dedicated to resident education.  This clinical and didactic training may be enhanced by off-site clinical elective rotations or translational research in our division of radiation physics or biology with a multitude of opportunities in world class benchtop research at the center.

The department has established a national and international reputation in the treatment of breast, prostate, gastrointestinal, lung, head and neck, and gynecologic malignancies. We are also committed to participation in national cooperative group trials sponsored by the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG), and the Gynecologic Oncology Group (GOG) (collectively, the NRG) and ECOG-ACRIN cooperative groups. Approximately 2,000 consultations and 4,000 follow-up visits are seen by FCCC staff each year. The department has approximately 120 patients under treatment each day. Patients seen in consultation or under treatment by a staff physician are evaluated initially by the resident.

Typically, residents have eight three month rotations within the department during their PGY2-3 years. The PGY-4 year is dedicated to 12 months of basic science or clinical research and administrative chief resident duties. PGY-5 residents have three months set aside for outside rotations in pediatrics and other electives.  Each year, residents take part in the clinical in-service self-assessment examination given by the American College of Radiology. A sample rotation schedule is provided:

 

Jul

Aug

Sept

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

PGY-2 GU GYN, breast Lung CNS
PGY-3 H/N Buckingham GYN, breast GI
PGY-4 Research
PGY-5 CHOP Elective H/N GU
Abbreviations: CHOP: Children's Hospital of Philadelphia; CNS: central nervous system; GI: gastrointestinal; GU: genitourinary; H/N: head and neck; PGY: post-graduate year


Residents hold daily morning conferences four days a week, 8-9 am, where various oncologic and treatment topics are discussed with attending input and feedback.  The typical tumor board schedule is provided:

Tumor Board Schedule

 
Mondays, 5 pm: Gastrointestinal Tumor Board
Tuesdays, 8 am: Lymphoma Tumor Board
Tuesdays, noon: Breast Tumor Board
Wednesdays, 8am / 4pm (alternating)   Genitourinary Tumor Board
Wednesdays, 7:30am: Thoracic Tumor Board
Thursdays, 4:30 or 5 pm: Gynecological Tumor Board
Fridays, 8 am: Head and Neck Tumor Board

Every Tuesday morning, residents actively participate in the department chart rounds. Residents attend daily one-hour clinical multidisciplinary case conferences. Current cases are reviewed and discussed with the surgical and medical oncologists, pathologists and radiologists. The radiation department holds regular journal club, morbidity/mortality and resident clinical physics conferences. Residents not on-call must be in the department from 8 a.m. until 5 p.m. Residents are on-call by long-range beeper with an attending for a one-week period approximately every eight weeks. While on-call, the resident is responsible for after-hours patient calls (first triaged by the hospital nursing coordinator) and emergency consultations and treatments.

Clinical Attending Physicians

The clinical division of our department consists of eight radiation oncologists with site-specific clinical and research responsibilities. The resident will spend one or more three-month rotations over a four-year period working on a one-to-one basis with each staff member.