Residency Program in Radiation Oncology
Residency Program in Radiation Oncology
Objectives of the program:
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.
To provide the resident the opportunity to participate in the clinical training of DVM students in the principles and applications of 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. 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 attending radiation oncologist.
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 instructional rounds to veterinary students.
Image interpretation is a critical part of radiation oncology. Pretreatment images of all potential patients will be reviewed with a radiologist. Follow-up images from radiation patients 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 participate in the discussion and review of imaging studies. The resident may also attend rounds or journal club being held during their rotation.
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 Board Review (weekly): Faculty and residents rotate leading board review on medical, radiation, and basic science oncology topics.
Surgical Oncology Rounds (weekly): Rounds similar to a tumor board review include surgeons, medical oncologists, radiation oncologists, and pathologists discussing treatment recommendations for patients with recently tumor resections.
Oncology Journal Club (weekly): Oncology journal club is held weekly in conjunction with the medical oncology service participants take turns presenting articles on clinical oncology and basic cancer research.
Radiation Oncology Journal Club (intermittent): Radiation articles, both from human medical and veterinary journals, will be discussed in detail by the resident and radiation faculty.
Grand Rounds (bi-monthly): Several grand rounds patients are presented by a mix of students and residents.
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. Records of the treatment plan and set-up instructions are also recorded in the ARIA record and verify system. The trainee keeps a log of patients treated through use of the patient database.
Out-of-hours emergency duties: Currently most UC Davis residents cover approximately 1 primary emergency room shift per year, and they are available as backup doctors for the emergency room 1-3 times per month during their residency. A regular emergency room clinicians is available to residents working in the ER who have questions about workup or management of cases. There is not a formal on-call schedule for the radiation resident; however, during the weeks the resident is on the radiation service, they are generally expected to be available by phone out-of-hours for occasional client questions or questions from other clinicians in the hospital. On rare occasions, the radiation resident will return to the hospital after hours to provide euthanasia services to radiation patients
Structure and organization:
Throughout the two years, the resident will primarily dedicate their rotations to the radiation oncology service in the Veterinary Medical Teaching Hospital (VMTH). Residents will have primary case responsibility under the direct supervision of the faculty members. They will have increasing case responsibility throughout the duration of the two-year residency. Residents are primarily responsible for cases being evaluated and treated through the radiation service. Clinical duties include: performing physical exams, consulting directly with clients for new appointments and recheck visits, performance of and evaluation of various diagnostics, setting up patients for radiation planning CT scans, hand calculation of appropriate radiation cases, setup and treatment of on-going radiation cases, and management of radiation side effects.
Residents will develop an understanding of radiation physics and radiobiology concepts underlying radiation therapy and medical management of companion animals with cancer through the management of 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, MRI, ultrasound and nuclear medicine). Rotations are scheduled with the Small Animal Radiology Service and medical oncology for training in these departments. Residents will develop experience in cancer patient management by consulting with other specialists including, but not limited to, internists, neurologists, medical oncologists, and surgeons.
The residents are encouraged to attend an annual ACVR meeting and Veterinary Cancer Society Annual Conference during their residency. A presentation of the resident's research project(s) is required at the UC Davis Annual House Officer Seminar Day (held in the spring) in the second 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.
The radiation oncology resident is expected to develop their own reading and study schedule outside of their clinical duties in preparation for the ACVR radiation oncology board examination.
Faculty participating in the program:
There are three (3) faculty members participating in the program providing a 100% resident supervision. The faculty members will supervise and mentor the residents in:
- Planning and administering radiation for treatment of tumors in animals by teletherapy
- I131 treatment and delivery
- Reviewing patient treatment plans, and overseeing current patient status including side effects and their management
- Defining learning materials for expanding knowledge of the behavior of various types of animal cancer
- Developing an in-depth understanding of the principles of radiobiology and tumor biology;
- Taking progressive responsibility for all aspects of radiation cases
- Writing timely medical records and patient charts in the VMTH computerized medical records system
Process of evaluation:
UC Davis has an online evaluation system for faculty, residents, and students to evaluate each other. Input for finalized evaluations of resident performance will be obtained from all available faculty 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 Warning 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 includes 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 one month in radiology and two months in medical oncology.
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.
- TOEFL required.
- 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 5, 2016.
Applicant must be able to begin the program on August 1, 2017.