Residency Program in Radiation Oncology
Objectives of the program:
To provide the resident the opportunity to participate in the clinical training of DVM students in the principles and applications of radiation oncology.
To provide the resident with a thorough understanding of all aspects of radiation oncology including the following:
- Therapeutic use of ionizing radiation.
- Radiation biology and radiation physics.
- Biological behavior and response to therapy of various types of cancer in both large and small animal patients.
- Imaging techniques utilized in radiation oncology as a part of staging, treatment planning and evaluation of response to therapy.
- To prepare the resident for the Certification Examination of the American College of Veterinary Radiology in the Affiliate of Radiation Oncology.
To provide the resident with a broad overview of clinical and research priorities in veterinary radiation oncology.
The need for specific training:
New understandings of etiology and pathogenesis of cancer have emerged from laboratories, and many of the mechanisms underlying cancer in experimental animals and human patients are known or suspected to be operative in domestic animals with cancer as well. Veterinary Radiation technology is rapidly evolving and often equals the level of sophistication expected in human facilities. There are great opportunities for veterinarians with specialized training in oncology at this time in private practice, academic hospitals, and research laboratories and the current training programs are not adequately filling the available posts. The program outlined here stresses all aspects of radiation oncology including clinical patient management, but also encourages investigation into more fundamental processes in oncology. Residents are encouraged to pursue both clinical training, as well as basic research training during their residency. The clinical training program is designed to prepare the resident for a variety of opportunities in the work place, and to provide fundamental knowledge and training to assist in preparation for specialty certification.
Courses of activities:
Residents will be instructed in treatment planning and administration of radiation therapy. Residents will be given significant responsibility in these areas and will be allowed to function independently, with plans and treatment setups approved by the program director, or other radiation oncology faculty.
Residents will keep a log of patients treated. Tumor type, tumor location, tumor stage, dates of treatment, number of beams, beam configuration, and use of blocks/wedges will be archived, as well as follow up information.
Residents will be given the opportunity to present continuing education and instructional lectures to veterinary students and/or practicing veterinarians.
Image interpretation is a critical part of radiation oncology. Pretreatment images of all potential patients will be reviewed with a radiologist.Â Follow-up images made of patients having completed radiation therapy will also be reviewed with a radiologist. Residents will have the opportunity to rotate through the imaging service. A four week period in total will be devoted exclusively to training in radiology. This period will allow the resident involvement in a multitude of imaging modalities including: CT, MR, ultrasound, nuclear medicine, and radiography. During this period the resident will attend daily rounds and participate in the discussion and review of imaging studies, and attend and participate in the weekly unknown case conference provided by the radiology faculty.
Clinical management of oncology cases, including initial diagnostic plan, recognition of a variety of tumor associated syndromes and management of patients throughout treatment and in the post-treatment period is an important objective of this program. The resident will have ample opportunity to provide primary case management as well as have exposure to all of the other cases treated with radiation therapy.
Due to the nature and structure of the oncology program at the University of California the resident will have adequate exposure to and involvement in medical oncology cases. Radiation oncology residents will be instructed in the use of chemotherapy both alone and in combination with radiation therapy in the management of small and large animal cancer patients.
The following conferences will be attended regularly by trainees in radiation oncology:
Oncology morning rounds (daily): all current oncology patients including patients seen in clinics the preceding day will be discussed. The cases discussed will include both medical and radiation oncology patients. The rounds will be attended by the medical and radiation faculty and residents, as well as veterinary students currently on the rotation.
Radiation chart rounds (weekly): these rounds will be attended by the radiation oncology faculty, and the radiation and medical oncology residents. Port films will be reviewed as well as treatment set-ups and calculations.
Journal club (weekly): the journal club will be variable in terms of the participants and at times will be done in conjunction with the medical oncology and the soft tissue surgery residents and faculty.
Research environment: The close proximity and association with the University of California Davis Cancer Center Department of Radiation Oncology in Sacramento provides the opportunity to do collaborative research. Residents are required as a part of the residency training program to perform a prospective or retrospective research project. The material is presented by the resident at House Officer Seminar Day and is anticipated to lead to a publication.
Record keeping: The resident enters pertinent information into the electronic medical record for each patient visit. A separate record is kept by the radiation oncology service for each patient receiving therapy. Records of the treatment plan, set-up instructions, patient history, diagnostic tests, and acute reactions. The trainee keeps a log of patients treated through use of the patient database. Tumor type, tumor location, tumor stage, dates of treatment, number of beams, beam configuration, and use of blocks/wedges will be archived, as well as follow up information.
Out-of-hours emergency duties: Residents will share general hospital after hours/weekend emergency on a rotational basis. When on call for duties in the Radiation Oncology Service, the resident must be accessible by pager or phone and remain within a reasonable distance of the VMTH so that when contacted he or she can respond to the VMTH in person when needed. Residents will be available to perform specific oncologic procedures and assist with antineoplastic drug preparation for administration. Other duties will not be scheduled which conflict with on call duties.
Structure and organization:
The first year of the residency program is dedicated to service in the Veterinary Medical Teaching Hospital (VMTH). Residents will have primary case responsibility, under the direct supervision of the faculty members, as and will develop an understanding of radiation physics and radiobiology concepts underlying radiation therapy and medical management of companion animals with cancer. This will include management of routine of referred patients, including both secondary and tertiary referrals. Patient case load reflects animals with cancer of all sites, allowing broad exposure to both routine, as well as unusual cancer patients. The resident will gain experiences with diagnosis and treatment of animals with cancer, utilizing the full range of capabilities in a large, well equipped, modern veterinary teaching hospital. Residents will develop skills in evaluating diagnostic images (radiographs; CT and MRI; ultrasound; nuclear medicine). Rotations are scheduled with the Small Animal Radiology Service and medical oncology or training in these departments. Residents will develop experience regarding cancer patient management with other specialists including, but not limited to, internists, medical oncologists, and surgeons. Residents will have the opportunity to develop teaching skills and will have a role as clinical instructors. This will be performed, in part, by assisting in the tutorial support of senior veterinary students and conducting clinical rounds.
During their second year, duties in the VMTH will be similar to the first year, but with increasing responsibility for developing computerized radiation treatment plans and patient management. The residents will have 4 weeks provided out-of-clinics for professional development time for research and studying, in addition to the other hospital rotations and scheduled vacation time.Â
The residents are expected to attend the annual ACVR meeting and encouraged to attend the Veterinary Cancer Society Annual Conference. A presentation of the resident's research project(s) is expected at the UC Davis Annual House Officer Seminar Day (held in the spring) in the second or third year of the residency.
Residents will have access to a shared office with individual desks and computers and will have mobile phone provided by the hospital.
Faculty participating in the program:
There are 2 faculty members participating in the program providing a 100% resident supervision. The faculty members will supervise and mentor the residents in:
All types of radiation treatments commonly accepted in all aspects of therapeutic radiology; include planning and administration of radiation for treatment of tumors in animals by teletherapy and brachytherapy;
Review patient treatment plans, and supervise current patient status including side effects and their management
Discuss and provide learning materials for gaining experience in the behavior of various types of animal cancer;
Provide an in-depth understanding of the principles of radiobiology and tumor biology;
Provide supervised, progressive responsibility for interpretation of certain imaging studies (radiographs, CT and MR);
Review medical records and patient charts and ensure that they are timely entered in the VMTH computerized medical records system.
Process of evaluation:
The Veterinary On-Line Evaluation System (VOLES) is the system through which faculty evaluates residents; residents evaluate faculty, students and the residency program; and students evaluate residents, faculty, and Clinical Services. Input for the final evaluation of resident performance will be obtained from all available faculties on the Service. Residents will be provided with an opportunity to review the evaluation and "sign off' on it before it becomes part of the resident's personnel file. Residents are evaluated by the faculty at the end of the first six months of training and at the end of each year thereafter. Continuation in the residency program is contingent on satisfactory performance during the previous evaluation period. In the event that performance is deemed to be substandard, a letter of counseling shall accompany the evaluation which notifies the resident that a deficiency has been identified. This letter will include a statement of the problem and will define required corrective measures. Residents who fail to correct deficiencies will receive a Letter of Performance and Expectation defining deficiencies, expectations, and direction to the resident regarding the specific steps he/she needs to take to remedy the deficiencies and meet expectations. The letter will state a specific timeframe to remedy deficiencies. If performance remains substandard, a Letter of Warming will be issued. Failure to improve after the Letter of Warning will result in the resident not being reappointed to the training program, or will be dismissed. Serious misconduct may result in immediate dismissal from the program.
The length of the training period will be 24 months. This training period may include training in another discipline, e.g., radiology, medical oncology but a minimum of 18 months will be devoted to clinical radiation oncology. Time will be allowed for other rotations to include but not limited to one month in radiology, two months in medical oncology, and adequate time will be allowed to do a clinical research project.
State Licensure: CA State License not required
Advanced degree during residency: Residents are not permitted to work toward an advanced degree during their residency training program.
Graduated from a college or school of veterinary medicine accredited by the AVMA; or possess a certificate issued by the Educational Commission for Foreign Veterinary Graduates (ECFVG); or are legally qualified to practice veterinary medicine in some state, province, territory, or possession of the United States, Canada, or other country. The trainee must have a DVM or equivalent degree. A one-year rotating internship or equivalent practice experience approved by the ACVR Executive Council is also required.
Have demonstrated unquestionable moral character and professional behavior.
Requirements for foreign applicants:
In addition to the minimum qualifications above, foreign graduates must also meet the following requirements.
Must be eligible for a TN (Mexico and Canada) or J-1 visa with no bars or home country requirement.
ECFVG required if graduation is not from AVMA accredited school
The University of California, Davis, and the Veterinary Medical Teaching Hospital are interested in candidates who are committed to the highest standards of scholarship and professional activities, and to the development of a campus climate that supports equality and diversity.
ALL RESIDENTS ARE STRONGLY ADVISED TO OBTAIN A CALIFORNIA LICENSE WITHIN THE FIRST YEAR OF THE RESIDENCY.
RESIDENTS MUST BE ABLE TO ARRIVE AT THE HOSPITAL WITHIN 15 MINUTES OF AN EMERGENCY CALL, THEREFORE, RESIDENTS MUST PLAN TO LIVE WITHIN 15 MILES OF THE HOSPITAL
The deadline for receipt of application materials is December 3.2012.
Applicant must be able to begin the program on August 1, 2013.