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Residency Program in Medical PhysicsDocument Transcript
Duke University Medical Center
Department of Radiation Oncology
Residency Program in Medical Physics
A. Program Objectives and Structure
The objective of the Residency Program is to train individuals with medical physics and related education
to practice professional radiation oncology physics as well as to carry out original research in medical
physics. The program will provide comprehensive structured education and training in a clinical
environment. Residents, under the supervision of board-certified medical physicists, participate in the
clinical duties of a radiation oncology physicist. The resident trainee will be, upon completion of the
program, competent in radiation oncology physics practice and implementation of new technology, and
prepared to sit for the certification examination of the American Board of Radiology in Therapeutic
Radiological Physics. As an option, the program will help the resident pick a research project that is likely
to be completed with the residency period, to prepare the resident to be a leader in developing new
technology in medical physics.
The Residency Program is housed in the Division of Medical Physics, of Department of Radiation
Oncology, Duke University Medical Center. The department is divided into three divisions: Clinical
Radiation Oncology, Radiation Physics, and Radiation Biology.
The Program is supervised by the Director of the Radiation Physics, Fang-Fang Yin, Ph.D, and with the
oversight of the Chairman of the Department of Radiation Oncology, Christopher Willett, M.D.
The director of the Residency Program is Fang-Fang Yin, Ph.D. The Program has two associate directors
to oversee the daily operations: Shiva Das, Ph.D., who oversees the academic aspects, and Haijun Song,
Ph.D., who oversees the clinical training aspects of the Program.
The residency program enjoys a unique education resource at Duke. The department of Radiation
Oncology is one of the five sponsoring departments to the Medical Physics Graduate Program at Duke
(http://medicalphysics.duke.edu/), which admits about twenty graduate students every year. Through this
affiliation, the resident is arranged to take didactic courses in radiation therapy physics.
B. Training Content
The training essentials will be consistent with recommendations presented in AAPM Report Number 90,
“Essentials and Guidelines for Hospital-based Medical Physics Residency Training Programs”.
There are three main components to the training: didactic, clinical rotation and optional research.
B1. Didactic Curriculum
Below is the required course list. If the resident has taken equivalent courses (equivalency to be
determined by the residency program) prior to start of the residency, the resident can be exempt from
1. Radiobiolgy. Offered at Department of Radiation Oncology.
2. MP 200. Radiation physics (3 c.h.). A course covering the basics of ionizing and non-ionizing
radiation, atomic and nuclear structure, basic nuclear and atomic physics, radioactive decay,
interaction of radiation with matter, and radiation detection and dosimetry.
3. MP 220. Radiation therapy physics (3 c.h.). This introductory course has a clinical
orientation, and reviews the rationale, basic science, methods, instrumentation techniques and
applications of radiation therapy to the treatment of a wide range of human diseases. Major
radiation modalities are covered including low and high energy photon therapy, electron and
proton therapy, and low and high-dose rate brachytherapy. The clinical process of treatment,
methods of calculating dose to patient, and the role of the medical physicist in radiation
oncology clinic, are covered in detail.
4. MP 205. Anatomy and physiology for medical physicists (3 c.h.). A course focused on
medical terminology, biochemistry pertaining to MP, basic Anatomy and physiology, elementary
tumor and cancer biology, and overview of disease in general. Upon completion, the student
should: (a) understand anatomic structures, their relationships, their cross-sectional and planar
projections, and how they are modified by attenuation and artifacts in the final images; (b)
understand the physiology underlying radionuclide images, (c) understand how (a) – (b) are
modified by disease, (d) identify anatomical entities in medical images (different modalities), and
(e).identify basic disease features in medical images (e.g., Pneumothorax in chest radiographs,
microcalcoifications in mammograms).
5. MP 322. Advanced photon beam radiation therapy (3 c.h.). This course will cover the
physics and clinical application of advanced external beam photon therapies with special
emphasis on IMRT. Prerequisite: MP 220.
6. MP 210. Radiation protection (3 c.h.). Course discusses the principles of radiation protection
dealing with major forms of ionizing and non-ionizing radiation, the physics and chemistry of
radiation biology, biological effects of ionizing and non-ionizing radiations (lasers, etc.) at
cellular and tissue levels, radiation protection quantities and units, medical HP issues in clinical
environments, radiation safety regulations, and basic problem solving in radiation safety.
Courses 2-6 are offered at the Medical Physics Graduate Program at Duke.
In addition, the resident is expected to attend several seminars and give talks on current topics on a
A number of departmental and divisional conferences take place on a regular basis. Attendance at these
conferences helps the resident to develop an in-depth understanding of the clinical challenges associated
with the practice of medical physics in radiation oncology. The resident is expected to attend the weekly
departmental chart round and weekly Rauch Seminar. The resident is required to attend at least 50
percent of appropriate learning opportunities. The resident is scheduled to present his own research or a
review of published articles at Post-Doc’s Talk series approximately once every six months.
B2. Clinical Rotation
The 24-month residency is divided into eight rotations. Each rotation covers several training topics with
multiple learning objectives. Each training topic is individually evaluated and summarized at the end of
rotation. The resident is required to turn in Rotation Reports.
Topics and Rotation of Clinical Training
Rotation Training Topics
I 1. Monthly and Daily QA of linac, simulator and CT/CT-sim
II 2. Annual quality assurance of linac, simulator and CT simulator
3. Linac acceptance and commissioning
4. Radiation output calibration of linac and orthovoltage
5. Commissioning of treatment planning system
III 6. Treatment planning: manual, computer aided 2D and 3DCRT
7. Chart checking
8. Design and fabrication of treatment aids
IV 9. IMRT: commissioning, treatment planning and QA
V 10. SRS, SRT and SBRT
VI 12. Brachytherapy LDR and GYN LDR
13. Brachytherapy HDR, QA, source calibration and procedure
VII 14. Brachytherapy prostate seed implant
15. Brachytherapy eye plaque
VIII 16.Other special procedures: TSI/TBI, commissioning and procedure, in-vivo dosimetry,
application of TLD and other dosimeters.
17. Radiation Safety
The resident will get an orientation on the rotation schedule at beginning of the residency.
One supervisor will be assigned to oversee each rotation. The supervisor will be responsible for
coordinating with other staff physicists and other staff members of the department to cover the training
topics. The supervisor will also be responsible the evaluation of the whole rotation.
To prepare the resident to implement the ever-emerging new technology in medical physics and to be a
leader in developing new technology, the program trains the resident in conducting research, as an
option, depending on the time constraint and the interest of the resident. The program will help the
resident pick a research topic that is likely to finish within the time frame of the residency and provide
necessary resource. The resident is also trained in submitting to professional society meetings and peer-
reviewed journals in medical physics.
As listed in the Table below, the Radiation Physics Division consists of 19 full-time radiation oncology
physicists, 12 with ABR or ABMP certification, 15 with a Ph.D. degree and 4 with a Master’s. Also part of
the Physics group are IT and linac engineers. Members from other areas of the department are also
involved in the running of the Program: radiation oncologists, dosimetry, hyperthermia, and radiobiology.
Table of Staff for the Medical Physics Residency Program.
Name Teaching/Training Specialty
Fang-Fang Yin, Ph.D., DABR IMRT, IGRT, new technologies
Professor of Radiation Oncology
Director, Radiation Physics Division
Shiva Das, Ph.D., DABR IMRT, functional image-guided RT (PET, SPECT),
Associate Professor beam optimization, neural network modeling,
Associate Director of MP Residency Program hyperthermia modeling
Haijun Song, Ph.D., DABR IMRT, brachytherapy, reference dosimetry, particle
Assistant Professor RT.
Associate Director of MP Residency Program
James Bowsher, Ph.D. Clinical operations
Zheng Chang, Ph.D., DABR Clinical operations
Oana Craciunescu, Ph.D., DABR IMRT, total body photon irradiation (TBI); TSI,
Assistant Professor hyperthermia, MR prognostic factors
Devon Godfrey, Ph.D. IMRT, IGRT
Wei Luo, Ph.D. IMRT, Monte Carlo modeling
Paolo Maccarini, Ph.D. Hyperthermia applicators, thermal dosimetry
Mark Oldham, Ph.D., DABMP IMRT, IGRT, optical CT and MRI dosimetry, optical
Associate Professor and thermo-acoustic imaging
Paul Stauffer, M.S., CCE, DABMP Hyperthermia applicators, thermal dosimetry
Director, Hyperthermia Program
Zhiheng Wang, Ph.D., DABR, DABMP IMRT, IGRT, SRS, SRT and SRBT, respiratory
Assistant Professor correlated treatment
Qingrong (Jackie) Wu, Ph.D., DABMP IMRT, stereotactic radiosurgery, SRS optimization
Hui Yan, Ph.D. IMRT planning, IGRT, respiratory gated RT, image
Assistant Professor fusion
Sua Yoo, PhD IGRT/IMRT
Su-Min Zhou, Ph.D., DABR Functional-image guided treatment planning and
Associate Professor verification
Ali Alkaissi, M.S. Clinical operations, quality assurance, prostate
Medical Physicist brachytherapy
Charles Curle, M.S., DABR Clinical operations, IMRT, prostate brachytherapy
Beverly Steffey, M.S., DABR Clinical operations, brachytherapy, total skin and
Medical Physicist total body irradiations
Kim Light, C.M.D., Medical dosimetry, treatment planning,
Chief Dosimetrist immobilization and patient positioning
Christopher Willet, M.D., DABR Multimodality management of gastro-intestinal
Chairman of Department of Radiation Oncology
John Kirkpatrick, M.D., DABR Head & neck and CNS tumors, SRS and highly
Assistant Professor conformal techniques
Lawrence Marks, M.D., DABR 3DCRT for breast cancer, cardiopulmonary effects
Professor of radiation therapy
Mark Dewhirst, D.V.M., Ph.D., DAVCR Radiobiology, hyperthermia, tumor microcirculation,
Professor nanocarrier delivery of drug/gene therapies
Terry Yoshizumi, Ph.D., Asso. Prof. in Radiology, radiation safety, compliance with state and federal
Director, Radiation Safety Division, Duke regulatory agencies
Jan Tabor RT administration
Debra Georgas Chief radiation therapist
Tim Eaton Engineering
Harold M Scribner Engineering
The typical financial burden of a physics resident is as follows.
• Rent for housing and utilities $1200/month
• Food $300/month
• Books $200/semester
The pay scale and benefits is tied to that for a M.D. resident in our department. The current pay scale is
$45k - $55k yearly. The fringe benefits are that of standard for a full-time salaried employee at the Duke
University Medical Center, which includes Social Security, Medicare, health insurance for employee and
dependents, paid time off, sick leave, etc. The department will reimburse the resident for attending
professional meetings once a year during the course of the residency.
The Radiation Oncology Department is equipped with 5 modern linear accelerators with both photon and
• 1 Novalis Tx
o dual-energy full feature Varian Trilogy (MV PV, OBI kV CBCT, Gating)
o High Definition MLC (2.5 mm leaf) and high dose rate beam for SRS and SRBT.
o 6 electron energy beams
• 2 dual-energy full feature Varian Trilogy linacs, with 5 electron energy beams
• 1 dual-energy Varian 21EX linac, with MLC, MV PV and 5 electron energy beams
• 1 Varian 600EX single-energy linac with MV Portal Imager.
• 2 scanners: 1 conventional GE CT and 1 GE Light Speed 4 slice 4D CT
• a conventional simulator
• 1.5-tesla Infinity Echospeed MRI scanner (GE Signa/General Electric Medical Systems) with
SR120 gradients (hardware), LINUX based EXCITE 11.0 M4 (software), a torso 4-Coil Phased
Array, and cardiac imaging capabilities.
• Varian Eclipse Treatment Planning System and ARIA information system.
• iPlan treatment planning.
• GammaMed HDR mobile unit.
• Ortho-voltage superficial treatment unit.
• TBI and TSI treatment setups.
• One set of Cs-137 LDR capsule sources
• PLUNC treatment planning system for research applications
• Four hyperthermia therapy units. One system for deep seated tumors of the breast and
extremities operates inside the GE 1.5 T magnet for simultaneous MRI temperature monitoring
for real-time control of heating.
o BSD Model 500 Superficial Microwave Hyperthermia System for breast and chest-wall
o BSD Model 2000 Annular Phased Array RF Deep Hyperthermia System for deep pelvis
o Duke 140-MHz RF Deep Hyperthermia for deep breast and extremity tumors
o GE 1.5T MR for integrated temperature monitoring and heat treatment control
C4. Clinical Resources
The Department of Radiation Oncology is responsible for providing clinical services at seven institutions:
Duke University Medical Center, the Durham Veterans Administration Medical Center, Durham Regional
Hospital, Duke Health Raleigh Hospital, Maria Parham Hospital, and Granville Medical Center.
The Department of Radiation Oncology holds a series of weekly and monthly rounds Grand Rounds are
held in Radiation Oncology in which a variety of in-house and guest lecturers give presentations. Several
times a year, distinguished radiation physicists and radiobiologists from other institutions are invited to
give Grand Rounds presentations.
Each week, the Radiation Physics Division alternately conducts research meetings and staff meetings.
Clinical issues in medical physics are addressed during the staff meetings.
Radiation Physics also conducts a weekly meeting to discuss recent journal articles or to provide a forum
for post-doctoral fellows and graduate students to present their research. The Duke University Medical
Physics Degree Program holds weekly seminars throughout the fall and spring semesters.
Each year, Duke University and nearby University of North Carolina—Chapel Hill hold joint medical
physics classes for radiation oncology residents. Medical physics residents will be encouraged to attend
these classes. In April 2007, Duke hosted the first North Carolina IMRT/IGRT Symposium. Eastern
Carolina University will host this conference in the year 2008, and in following years it will be hosted by
University of North Carolina and Wake Forest University Medical Center. This conference is a unique
format for radiation oncology clinicians across the state to learn about new technology applications.