Resident Curriculum

The radiation oncology residency curriculum is designed to repeat four times over the course of residency, ensuring comprehensive coverage and mastery of material.

Core Curriculum Topics include:

• Breast Cancer:
  
  • Early Breast Cancer
  • Locally Advanced Breast Cancer
• Central Nervous System (CNS):
  
  • High-Grade Glioma
  • Low-Grade Glioma
  • Benign CNS Tumors
  • Brain Metastases
  • Pediatric CNS Tumors
• Gastrointestinal (GI) Cancer:
  
  • Esophagus
  • Gastric
  • Pancreas
  • Biliary
  • Rectal
  • Anal
  • Liver
    
• Genitourinary (GU) Cancer:
  
  • Bladder/Testicular
  • Intermediate/High-Risk Prostate Cancer
  • Active Surveillance/Low-Risk Prostate Cancer
  • Salvage Radiation Therapy
    
• Head and Neck (H&N) Cancer:
  
  • Oral Cavity
  • Larynx/Hypopharynx
  • Nasopharynx
  • Oropharynx
  • Head and Neck Skin
  • Carcinoma of Unknown Primary
  • Salivary Gland Tumors
    
• Pediatrics:
  
  • Medulloblastoma/Germinoma/Pineal Gland
  • Retinoblastoma/Optic Glioma
  • Rhabdomyosarcoma/Ewing's/Osteosarcoma
  • Germinoma/Ependymoma
  • Wilms/Neuroblastoma
    
• Thoracic Cancer:
  
  • Mesothelioma/Thymoma
  • Non-Small Cell Lung Cancer (NSCLC)
  • Small Cell Lung Cancer (SCLC)
    
• Sarcoma:
  
  • Soft Tissue Sarcoma
  • Hematologic Malignancies (HEM):
    
  • Non-Hodgkin Lymphoma
  • Hodgkin Lymphoma
  • Plasmacytoma/Multiple Myeloma
• Gynecologic (GYN) Oncology:
  
  • Cervical Cancer
  • Endometrial Cancer
    
  • Vulvar Cancer
  • Vaginal Cancer

Didactics Schedule

Weekly Didactics

• Monday to Wednesday: 8:00 AM - 9:00 AM (Protected Time for Clinical Didactics)
  
• Thursday: 8:30 AM - 9:30 AM (After NPC - Protected Time for Clinical Didactics)
  
• Friday: Full Day, Protected Time for All Residents
  
  • Physics Didactics
    
  • Radiation Biology Didactics

Clinical Didactics

• Comprehensive curriculum with a connected series (clinical oncology, radiation biology, physics), primarily focused on board preparation.
• Regular updates throughout the course of training.

Policies

• Monday-Thursday AM Didactics: All sessions between Monday and Thursday are fully protected. Residents are excused from clinical duties and should not be messaged or called during this time.
• Friday Dedicated Academic Day: Fridays are fully protected for academic activities, including didactics consolidation, board review questions, radiation biology/physics lectures, and research. Residents should not be interrupted during this time.
• Mandatory In-Person Attendance: Residents are required to attend all didactic sessions in person, except when excused for illness, vacation, or rotation at a satellite clinic. A Zoom link will be provided for attendings and residents at satellite locations, but in-person attendance is expected when possible.

Patient Coverage (8-9 AM)

Residents are required to attend educational sessions between 8-9 AM. To minimize interruptions, the following guidelines apply:

• Directing Inquiries: During this time, administrative staff should direct all questions or problems to the nursing staff instead of paging the resident.
• Seeking Attending Assistance: Nurses should first attempt to locate an attending physician in the department. If one is available, they should assist with the issue.
• Waiting Until 9 AM: If no attending is available and the problem can be safely deferred, the patient should wait until 9 AM for the resident's attention unless immediate intervention is required (e.g., acute respiratory distress, severe pain).
• Paging the Resident: If immediate intervention is necessary, the nurse will page the resident assigned to the attending of the patient. If the attending does not have a resident, the nurse should attempt to contact the attending directly. If that fails, the resident responsible for inpatient consults will be paged.
  
• Addressing Unresolved Issues: If the issue cannot be resolved over the phone, the resident must immediately visit the department.
• Routine Visits and Prescriptions: Routine matters, such as on-treatment visits or prescriptions, should be handled after 9 AM unless the patient cannot wait. Narcotic prescriptions should be handled only when necessary.

Summer Series: Attending-Led Sessions

Held annually, these sessions are attended by all residents, either in person or via a web conference. Each session is led by an attending physician and covers various cancer types.

All patients starting treatment over the prior week are presented to the faculty for review of the clinical history and radiation treatment plan. Residents are expected to present the patients of the faculty member with whom they are working. This conference occurs every Thursday morning at 7:30 am.

• Course Director: Scott Welford, Ph.D., Associate Professor, University of Miami
  
• Primary Assistant: Yami Cuervo

This course focuses on teaching the principles of molecular, cancer, and radiation biology underlying radiation oncology. It is aligned with guidelines set by the American Board of Radiology.

• Schedule: Classes are held on Fridays at 1 PM in the Radiation Oncology Library (SCCC Room 1514). Lectures are 60-90 minutes long. One midterm and one final exam (multiple-choice) will cover all topics from the course and the required textbook. The passing grade is 70%. Attendance is mandatory for PGY-2 and PGY-4 residents.
• Required Textbook:
  
  • Radiobiology for the Radiologist, 8th Edition by Hall and Giaccia, Lippincott Williams & Wilkins, 2019.
    
• Recommended Study Guides:
  
  • ASTRO Physics and Radiation Biology Study Guide
  • Basic Clinical Radiobiology, edited by Joiner and van der Kogel, 4th or 5th Edition.
  • The Basic Science of Oncology by Ian F. Tannock, Richard P. Hill, Robert G. Bristow, and Lea Harrington, 4th Edition.

Lecture Topics and Corresponding H&G Chapters:

• Introduction and Course Description / Physics and Chemistry of Radiation Absorption - Chapter 1
  
• DNA Damage and Repair - Chapter 2
• Cell Survival Curves, Mechanisms of Cell Death, and Cell Cycle - Chapters 3, 4, 25
  
• Fractionated Radiation and the Dose-Rate Effect - Chapter 5
  
• Oxygen Effect and Reoxygenation - Chapter 6
  
• LET and RBE, Protons and Hadrons - Chapters 7, 25
• The Four R’s of Radiation and Hypofractionation
• Acute Radiation Syndrome and Countermeasures - Chapters 8, 9
  
• Carcinogenesis / Hereditary Effects - Chapters 10, 11, 12
• Radiation Effects on Normal Tissue and Cataractogenesis - Chapters 13, 19, 20
• Molecular Techniques in Radiobiology - Chapter 17
• Cancer Biology - Chapter 18
• Model Tumor Systems - Chapter 21
• Time, Dose, and Fractionation - Chapter 23
• Biology and Exploitation of Tumor Hypoxia - Chapter 26
• Biology of Reactive Oxygen Species
• Targeted Agents, Chemotherapy, and Radiation - Chapter 27
• Nanoparticles in Radiation Therapy
• Immunomodulation in Cancer Therapy (and Radiotherapy)
• Hyperthermia - Chapter 28

Contact Information

Elizabeth Bossart, Ph.D., Director of Physics for Radiation Oncology Residency

The physics curriculum is designed to cover all essential topics in radiation physics, emphasizing practical applications in clinical radiation therapy.

Course Schedule

• Atomic and Nuclear Structure; Nuclear Transformations I & II
• Interaction of Radiation with Matter I (Compton, Photoelectric, Pair Production)
• Interaction of Radiation with Matter II (Attenuation Properties, HVL)
• Interaction with Matter III (Particle Interactions)
• Production of X-rays, Clinical Radiation Generators
• Dosimetry Standards and Protocols and Beam Calibration
• Radiation Beam Characteristics: Photons (Superficial Dose, Penumbra, etc.)
• Radiation Beam Characteristics: Electrons
• System of Dose Calculations (%DD, TAR, TPR, TMR, etc.)
• Dose Calculations: Practice and Electron Dose Calculations
• Summary Problem Sessions I & II
• Treatment Planning I-V
• Problem Session on Treatment Planning
• Stereotactic Radiosurgery/Radiotherapy
• Protons & Heavy Particle Therapy
• IGRT: 4DCT, Align RT, CBCT, OBI
• Dose Measurement Techniques
• QA in Radiation Therapy
• Brachytherapy I: Basics
• Brachytherapy II: Treatment Planning Applications
• Brachytherapy III: Prostate
• Brachytherapy IV: HDR
• Radiation Protection
• Radiation Shielding
• Imaging for Radiation Oncology I-V (Digital Imaging, CT, PET/PET-CT, MRI, fMRI)

Additional Notes

• The curriculum aligns with ASTRO and AAPM guidelines.
• A two-hour slot is reserved for physics topics, focusing on high-yield areas.
• Friday schedules will continue with weekly Raphex Review using ASTRO/AAPM curriculum questions.
• The curriculum is designed to repeat four times throughout residency, ensuring reinforced learning and competency in all areas.

Residents present patient cases that involved severe adverse events resulting in hospitalization, an unplanned break in treatment, discontinuation of treatment, or death. A discussion on strategies for avoiding toxicities, recognizing and managing toxicities, and analyzing and correcting any medical errors follows.

Each year the department sponsors 4 – 5 experts in Radiation Oncology from other institutions. The guest faculty member typically meets alone with the residents for 1 – 2 hours for an educational session in addition to giving a lecture to the department.