RADIATION ONCOLOGY
USF Health · College of Medicine

Division of Radiation Oncology

Department of Interdisciplinary Oncology

H. Lee Moffitt Cancer Center & Research Institute

at the University of South Florida (USF)

 

Residency Learning Goals and Objectives

 

Curriculum Goals by PGY Level

 

Prerequisites:

 

Satisfactory completion of PGY-1 level or greater year in an accredited United States medical, surgical, or transitional internship with competency in the ACGME mandated six general competencies.

 

  1. During this time, residents will gain a range of general medical knowledge which will serve as the foundation of their training in Radiation Oncology. 
  2. Passing score on USMLE Steps 1 and 2 or equivalent.
  3. Resident must sit for USMLE Step 3 exam in this year.  Note that results may not be available until after the PGY-2 year has begun.  Residents must have received a passing score on the USMLE Step 3 exam before completion of their PGY-2 year or they cannot advance to the PGY-3 level.
  4. Florida State training license.
  5. Fulfillment of general criteria set forth for residents at the University Of South Florida College Of Medicine.
  6. Current ECFMG certificate (FMG’s only).
  7. BLS Certification.

 

First Year Residents (PGY 2):

 

During the first month of their rotation, residents will benefit from a focused orientation which will include: basic radiation safety, multidisciplinary patient care, treatment planning, clinic structure, physics, radiobiology, simulation, port films and equipment at the primary institution. Following the one-month orientation period, eleven months will be dedicated to clinical rotations and will be weighted toward services which provide a wide spectrum of basic oncology problems. During the clinical rotations, residents will perform initial history and physical examinations, review radiographic films and pathology, and formulate treatment plans. The residents will participate in the simulation, treatment planning and dosimetry and treatment of their patients. In addition, residents will participate in follow-up examinations after treatment is completed. Residents will receive ongoing, cumulative training in medical oncology and pathology during each of their resident years of training. During each clinical rotation the residents will be supervised and instructed on a one-to-one basis by a faculty member who is responsible for both resident teaching and evaluation of resident performance during that rotation.

 

Objectives for Satisfactory Completion of PGY-2 Year:

 

Basic:

 

  1. Knowledge of procedures and policies for residents in radiation oncology training.
  2. Attendance of lecture series in clinical physics, biostatistics, and radiobiology.
  3. Passing score on USMLE Step 3 or equivalent examination in accordance with Florida State requirements.
  4. Satisfactory performance review by Program Director.
  5. BLS Certification.
  6. Successful completion of Physics and Radiation Biology didactic courses.

 

Clinical:

 

Satisfactory completion and evaluations on clinical rotations at the Moffitt Cancer Center and the James A. Haley Veterans Administration Hospital geared towards more general and basic principles of Radiation Oncology, including imaging, staging, patient work-up and multi-modality treatment approaches.

 

  1. Ability to present summaries of service patients during chart rounds or other conferences.
  2. Ability to identify basic relevant clinical data required to evaluate and manage general oncology patients.
  3. Completion of electronic log files demonstrating care of approximately 150 cases/year focused mainly on general oncologic entities.
  4. Beginning of basic understanding of quality assurance processes as they apply to radiation oncology.
 
Academic:

 

  1. Satisfactory development of presentation skills focused on general topics. 
    1. Facile in use of PowerPoint or equivalent presentation media.
    2. Ability to organize and present introductory lectures.
  2. Facile with use of medical informatics tools including departmental and hospital wide information systems.
  3. Understanding of patient rights and privacy issues as they relate to the specialty.
  4. Begin self-learning with textbook reading supplemented with classic literature and important clinical trials.
  5. Acquire basic knowledge of clinical radiotherapy physics based on satisfactory scores on internal examinations.
  6. Acquire basic knowledge of radiobiologic principles as they apply to clinical situations based on satisfactory scores on internal examinations.
  7. Presentation of resident seminar/journal club.
  8. Demonstrate beginning ability to critically evaluate and review medical literature relevant to patient care and conference discussions.

 

Second Year Residents (PGY 3):

 

The clinical rotations during the second year are intended to foster more in-depth learning by focusing on site-specific services which interact with the referral base, and other oncology and surgical specialties practice. During the second year, each resident will increase their knowledge base in Medical Oncology, Pathology and Radiology, and it is expected that residents will take an increasingly active role in diagnosis, recommending treatment, performing simulations and monitoring treatments. Residents will spend ten months on clinical rotations and two months in advanced treatment planning/applied physics at the Moffitt Cancer Center and the James A. Haley Veterans Administration Hospital. Residents will begin focused training in brachytherapy. During the clinical rotation the residents will be supervised and instructed on a one-to-one basis by a faculty member who is responsible for both resident teaching and evaluation of resident performance during that rotation.

 

Objectives for Satisfactory Completion of PGY-3 Year:

 

Basic:

 

Attendance of key lecture series in clinical radiotherapy, physics, biostatistics and radiobiology with an increased role in participation and teaching.

 

  1. Ability to deliver general presentations on basic clinical topics.
  2. Satisfactory performance review by Program Director.
  3. BLS Certification.

 

Clinical:

 

  1. Ability to handle on-call emergency situations under faculty supervision.
  2. Mastery of basic clinical radiotherapy with a knowledge base commensurate with level of training.
  3. Completion of log files demonstrating care of approximately 150 cases per year focused on general and moderately complex oncologic entities.
  4. Basic experience in brachytherapy, with at least 5 to 10 observed or performed cases.
  5. Successfully complete rotations on more complex services than PGY-2 residents as demonstrated by satisfactory evaluations by faculty.
  6. Assume more responsibility on more general radiotherapy services as demonstrated by satisfactory evaluations.
  7. Demonstrate an increased understanding of technical aspects of radiotherapy by participating fully in the treatment planning processes.
  8. Basic understanding of quality assurance processes as they apply to radiation oncology.
  9. Basic understanding of brachytherapy procedures.

 

Academic:

 

  1. Demonstrate ability to self-learn by identifying and citing pertinent primary literature in common oncologic diseases.
  2. Demonstrate ability to critically evaluate and review medical literature.
  3. Presentation of resident seminars with satisfactory evaluations from resident and faculty attendees.
  4. Determine areas of interest for research project(s)
    1. Quantity of projects in accordance with departmental policy on resident research.  Begin preliminary work under faculty supervision.

Third Year Residents (PGY 4):

 

The residents will spend nine months on dedicated clinic rotations, which will include a two month Pediatric rotation at the All Children’s Hospital in St. Petersburg. The clinic rotations will be designed to increase the level of focus and intensity of the learning experience for the residents. Residents will be expected to build on the knowledge and experience of the preceding years during the first half of their training, to the point that they will have the knowledge to propose and carry out treatment of the various disease sites. During the clinical rotation, the residents will be supervised and instructed on a one-to-one basis by a faculty member who is responsible for both resident teaching and evaluation of resident performance during that rotation.

 

Residents will be required to complete a three-month elective during their third year, which will include the successful completion of a scholarly project acceptable for publication. In preparation for the elective rotation, the specific program for each individual resident will be designed and approved during their second or third year of training. A Moffitt Cancer Center faculty member will help design the program, and will mentor the resident. Residents are required to perform research and produce abstracts and manuscripts for submission to peer-reviewed journals or presentations at regional and national scientific meetings. Residents will be required to engage in an investigative project under faculty supervision.  

 

The research project will be subject to the approval of the training program director and support for attendance for at least one national meeting will be provided. Senior residents will complete any required clinical rotations or pursue specialty clinical training according to their interests.  Senior residents are expected to take on a substantial teaching and mentoring role within the training program, helping to organize and lead discussions in the various conferences. 

 

Objectives for Satisfactory Completion of PGY-4 Year:

 

Basic:

 

  1. Attend lecture series, with a further increased teaching role.
  2. Give thorough presentations on general or focused oncologic topics.
  3. Increase understanding of complex treatment planning, such as 3D conformal and IMRT techniques, complete a rotation in clinical dosimetry (may be in PGY-3 year), and gain experience in clinical brachytherapy and treatment planning. 
  4. Satisfactory performance review by Program Director.
  5. BLS Certification.

 

Clinical:

 

  1. Ability to handle on-call and/or emergent situations under faculty supervision in a more independent manner.
  2. Ability to manage general clinical situations on an independent basis.
  3. Participate in rotations with a variety of complexities, with an emphasis on problem solving and decision making; 
    1. Residents at this level should be able to assess a patient situation, determine the appropriate course of treatment and develop and implement the treatment plan, with attending supervision.
  4. Pursue elective courses in other areas of oncology.
  5. Completion of log files demonstrating care of approximately 75 cases per-year focused on moderately complex oncologic entities.
  6. Continue experience in brachytherapy, with at least 5 to 10 observed or performed.
  7. Continue to develop facility with more complicated treatments including stereotactic radiotherapy, 3D treatment planning, IMRT, and treatment planning for brachytherapy.
  8. Beginning ability to formulate valid critique of treatment and treatment plans for quality assurance purposes.
  9. Successfully complete electives in areas of interest or subspecialty training.
  10. Successfully complete pediatric rotation at the All Children’s Hospital.

 

Academic:

 

  1. Self-learning should focus on developing in-depth understanding of pertinent clinical, biological and technical literature.
  2. Be conversant in important clinical studies and understand their application to treatment decision-making.
  3. Presentation of resident seminar with satisfactory evaluations from resident and faculty attendees.
  4. Complete research project(s), write and submit abstract(s) and/or complete manuscript(s) for publication with faculty supervision. 
  5. Submission of publication and presentation at national meeting.

 

Fourth Year Residents (PGY 5):

 

The residents will spend nine months on dedicated clinic rotations at the Moffitt Cancer Center and the James A. Haley Veterans Administration Hospital. The clinic rotations will be designed at a high level of learning for the residents. During the clinical rotation the residents will be supervised and instructed on a one-to-one basis by a faculty member who is responsible for both resident teaching and evaluation of resident performance during that rotation. The residents will have had sufficient training and exposure to perform at an independent level and carry out treatment of any disease site. Residents should be serving as mentors to junior level residents and students, sharing experience and knowledge and assisting residents to achieve individual learning curves. Senior residents are expected to take on a substantial teaching and mentoring role within the training program, helping to organize and lead discussions in the various conferences. 

 

Residents will spend one month on a clinical investigation/molecular biology rotation and two months on an elective rotation. The specific program for each individual resident will be designed and approved during their second or third year of training. Residents will be required to continue to focus on a clinical research project during their final year of training. The faculty member assigned to mentor the resident in their research project will continue to work with the resident to help them achieve their research goals of completing the production of abstracts and manuscripts for submission to peer-reviewed journals or presentations at regional and national scientific meetings. The research program will be subject to the approval of the training program director and support for attendance for at least one national meeting will be provided. Senior residents also complete any required clinical rotations or pursue specialty clinical training according to their interests. 

 

Objectives for Satisfactory Completion of PGY-5 Year:

 

Basic:

 

  1. Attend lecture series, acting as leader or moderator along with faculty, taking an active teaching role with students and fellow residents. 
  2. Facilitate thorough presentations at a level of quality appropriate for meetings or multidisciplinary audiences.
  3. Satisfactory performance review by program director.
  4. BLS Certification.

 

Clinical:

 

1.        Ability to handle on-call situations under faculty supervision.

2.        Ability to manage moderately complex clinical situations on an independent basis.

3.        Successful completion of required clinical rotations while continuing to develop independent skills in clinical decision-making and treatment planning.

4.        Demonstrate competency to act as a general practitioner in Radiation Oncology. 

5.        Successfully complete electives in areas of interest or subspecialty training.

6.        Satisfactory performance as senior resident at the Moffitt Cancer Center and VA.

7.        Completion of log files demonstrating care of approximately 75 cases per year focused on more complex oncologic entities.

8.        Sufficient experience in the delivery of brachytherapy to assure the resident can independently plan and perform such procedures (a total accumulated experience of no fewer than five interstitial implants performed in at least five patients and ten intracavitary implants performed in at least ten patients, and assist in an additional five interstitial implants in at least five patients and ten intracavitary implants in at least ten patients during the course of training).

9.        Experience and facility with complex treatments including stereotactic radiotherapy, 3D treatment planning, IMRT and treatment planning for brachytherapy to assure the resident can independently plan and perform these procedures.

10.     Ability to formulate valid critique of treatment and treatment plans for quality assurance purposes.

 

Academic:

 

1.        Self-learning should focus on areas of interest, areas where experience may be lacking with more in depth reading on all aspects of academic oncology.

2.        Demonstrable ability to design, either in abstract or real form, clinical studies pertinent to the field.

a.        Understanding of Institutional Review Board and Human Subjects protection-related issues.

3.        Satisfactory completion of research project(s) (quantity of projects in accordance with departmental policy on resident research) sufficient to assure that the resident:

a.        Has submitted abstracts and manuscripts to peer reviews journals..

b.       Has presented research at national meetings..

Has a level of comfort with such research to assure that he/she can continue independently in the future.