West Penn Allegheny Health System: Education/Research: Online Resources

The Radiation Oncology Residency Program

David S. Parda, M.D., Program Director

Length of program: 4 years
Number of position(s): 4

The Radiation Oncology Residency Program is a 4 year training program during which time residents rotate on a regular schedule through disease oriented blocks. Our residents work closely with the attendings from the Department of Radiation Oncology to learn site-specific treatment planning and options, patient management, management of complications and follow-up. Increasing levels of responsibility are assigned in each postgraduate year until the Senior Resident level (PGY 5) at which time a resident will function at a level approaching that of an attending physician.

The attending mentor ensures that all residents have the opportunity for additional experience relative to each major disease site. The gynecology mentor schedules opportunities for residents to see gynecological surgical procedures such as hysterectomy and radical vulvectomy. The gastrointestinal mentor schedules residents to see organ sparing, laparoscopic, and standard surgical techniques. Residents rotate out of the department for clinical experience in hematology/oncology and pediatric radiation oncology.

Program objectives focus on AGH's three primary areas of excellence, which include:

Patient Care

Provide residents with direct patient care experience and teaching to achieve proficient, compassionate and high-quality patient care
Encourage professional interaction with medical oncologists, surgical oncologists and other related specialists throughout the duration of patient management

Education

Provide residents with training in state-of-the art radiation oncology and radiation physics education through which professional expertise can be attained
Train residents in the use of high technology radiation therapy equipment, including teletherapy, brachytherapy, 3D conformal radiotherapy, intensity modulated radiation therapy, treatment planning and total patient management

Research

Introduce residents to clinical research though participation in national multicenter protocols, design of prospective institutional protocols, and retrospective reviews of previously treated patients
Expose residents to basic science research wherein they may participate in bench work studies in laboratories of their choice

Clinical Rotations

PGY-2	One week	Radiation Physics-Introduction
	Three months	Clinical Radiation Oncology Rotation - Lung/GI/Reticuloendothelial/CNS
	Three months	Clinical Radiation Oncology Rotation - Genitourinary/CNS/Lung
	Three months	Clinical Radiation Oncology Rotation - H&N/Colorectal/Eye and Orbit
	Three months	Clinical Radiation Oncology Rotation - Gynecology/Breast/Soft Tissue and Bone/Skin/Lung
PGY-3	Three months	Clinical Radiation Oncology Rotation - Lung/GI/Reticuloendothelial/CNS
	Three months	Clinical Radiation Oncology Rotation - Genitourinary/CNS/Lung
	Three months	Clinical Radiation Oncology Rotation - H&N/Colorectal/Eye and Orbit
	Three months	Clinical Radiation Oncology Rotation - Gynecology/Breast/Soft Tissue and Bone/Skin/Lung
PGY-4	Seven months	Research Rotation
	Two months	Clinical Elective Rotation 1) Imaging or 2) Medical Oncology
	Two months	Clinical Radiation Oncology Rotation - Pediatrics (St. Jude)
	One month	Elective - Advanced Radiation Oncology/Surgical Oncology/Pathology
PGY-5	Three months	Clinical Radiation Oncology Rotation - Lung/GI/Reticuloendothelial/CNS
	Three months	Clinical Radiation Oncology Rotation - Genitourinary/CNS/Lung
	Three months	Clinical Radiation Oncology Rotation - H&N/Colorectal/Eye and Orbit
	Three months	Clinical Radiation Oncology Rotation - Gynecology/Breast/Soft Tissue and Bone/Skin/Lung

36 months in Radiation Oncology core curriculum.

12 months: Research - 8 months; Pediatrics - 2 months; Medical Oncology - 1 month; Imaging - 1 month.

Residents must be primarily involved in the care of 150-250 patients per year, a minimum of 450 patients in 3 years, with a maximum of 750 patients in 3 years.

Pediatric Radiation Oncology
The Department of Radiation Oncology at St. Jude Children's Research Hospital in Memphis, Tenn., offers an excellent two-month rotation in pediatric radiation oncology for Allegheny General Hospital radiation oncology residents at the PGY4 or 5 level. The program introduces residents to the major pediatric cancers reviewing in both clinical and didactic sessions the clinical aspects of childhood cancer.

Techniques specific to treating all common pediatric neoplasms are reviewed during the rotation with residents actively participating both in patient evaluation and treatment planning under the close supervision of the Radiation Oncology faculty. Residents also have the opportunity to monitor patients under treatment, participate in both short- and long-term follow-up, participate in national Pediatric Oncologic Protocols and attend weekly tumor boards related to leukemia, solid tumors and brain tumors. This experience is an unparalleled unique opportunity which has become a favorite of the residents.

Clinical areas of focus include childhood leukemia, tumors of the central nervous system, pediatric sarcoma (Ewing's sarcoma, rhadbomyosarcoma and other less common types of soft tissue and bone sarcomas) neuroblastoma, Wilms' tumor, Hodgkin's disease, malignant lymphoma and other less common childhood cancers.

Allegheny General Hospital assumes full financial responsibility for travel and lodging expenses.

Radiation Physics
Residents also spend a one-month clinical rotation in medical physics to gain hands-on experience with the practical aspects of treatment planning, computerized dosimetry, and machine calibration and operation. During the course of the training program, residents also are encouraged and given opportunities to participate in basic laboratory or clinical physics research.

Research
Residents are required to participate in ongoing laboratory research programs of their choice in radiobiology, cancer genetics, clinical oncology or elsewhere within the institution under direct supervision of the laboratory supervisor in each area. A mandatory nine-month rotation is set aside in PGY4 or 5 to afford this formal experience.

The goal of this effort is to introduce residents to basic laboratory techniques, methods of experimental design and implementation. Residents are responsible for carrying out at least one specific research project and for presenting the data derived at an appropriate society meeting. In addition to basic laboratory research, residents are required to participate as active members in at least one clinical research effort. This may take the form of a retrospective review of patient charts and records for publication on a specific topic or inclusion in one or more prospective research clinical trial protocols.

Internal research funds for resident education and training are available within the institution upon submission and favorable review of a project grant application. Attendings in the Department of Radiation Oncology are available to assist residents in obtaining these funds, and residents are encouraged to pursue laboratory and/or clinical research projects during their training program. By the completion of the program, authorship of at least one national presentation or publication is required.

Program Goals and Objectives
The major objective of the residency program is to produce well-trained, competent, caring and compassionate radiation oncologists who can function at a high level independently in any clinical setting and use the entire spectrum of radiotherapeutic techniques. Additionally, residents acquire experience in laboratory and clinical research, providing them with the background to pursue investigational careers.

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