Residency Program in Medical Physics


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Residency Program in Medical Physics

  1. 1. Duke University Medical Center Department of Radiation Oncology March, 2008 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 (, 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 such courses. 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
  2. 2. 2 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 regular basis. 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
  3. 3. 3 V 10. SRS, SRT and SBRT 11. IGRT 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. B3. Research 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. C. Resources C1. Staff 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 Professor of Radiation Oncology Director, Radiation Physics Division IMRT, IGRT, new technologies Shiva Das, Ph.D., DABR Associate Professor Associate Director of MP Residency Program IMRT, functional image-guided RT (PET, SPECT), beam optimization, neural network modeling, hyperthermia modeling Haijun Song, Ph.D., DABR Assistant Professor Associate Director of MP Residency Program IMRT, brachytherapy, reference dosimetry, particle RT. James Bowsher, Ph.D. Assistant Professor Clinical operations Zheng Chang, Ph.D., DABR Assistant Professor Clinical operations Oana Craciunescu, Ph.D., DABR Assistant Professor IMRT, total body photon irradiation (TBI); TSI, hyperthermia, MR prognostic factors Devon Godfrey, Ph.D. Assistant Professor IMRT, IGRT Wei Luo, Ph.D. Associate IMRT, Monte Carlo modeling
  4. 4. 4 Paolo Maccarini, Ph.D. Assistant Professor Hyperthermia applicators, thermal dosimetry Mark Oldham, Ph.D., DABMP Associate Professor IMRT, IGRT, optical CT and MRI dosimetry, optical and thermo-acoustic imaging Paul Stauffer, M.S., CCE, DABMP Professor Director, Hyperthermia Program Hyperthermia applicators, thermal dosimetry Zhiheng Wang, Ph.D., DABR, DABMP Assistant Professor IMRT, IGRT, SRS, SRT and SRBT, respiratory correlated treatment Qingrong (Jackie) Wu, Ph.D., DABMP Assistant Professor IMRT, stereotactic radiosurgery, SRS optimization Hui Yan, Ph.D. Assistant Professor IMRT planning, IGRT, respiratory gated RT, image fusion Sua Yoo, PhD Assistant Professor IGRT/IMRT Su-Min Zhou, Ph.D., DABR Associate Professor Functional-image guided treatment planning and verification Ali Alkaissi, M.S. Medical Physicist Clinical operations, quality assurance, prostate brachytherapy Charles Curle, M.S., DABR Medical Physicist Clinical operations, IMRT, prostate brachytherapy Beverly Steffey, M.S., DABR Medical Physicist Clinical operations, brachytherapy, total skin and total body irradiations Kim Light, C.M.D., Chief Dosimetrist Medical dosimetry, treatment planning, immobilization and patient positioning Christopher Willet, M.D., DABR Professor Chairman of Department of Radiation Oncology Multimodality management of gastro-intestinal cancer John Kirkpatrick, M.D., DABR Assistant Professor Head & neck and CNS tumors, SRS and highly conformal techniques Lawrence Marks, M.D., DABR Professor 3DCRT for breast cancer, cardiopulmonary effects of radiation therapy Mark Dewhirst, D.V.M., Ph.D., DAVCR Professor Radiobiology, hyperthermia, tumor microcirculation, nanocarrier delivery of drug/gene therapies Terry Yoshizumi, Ph.D., Asso. Prof. in Radiology, Director, Radiation Safety Division, Duke radiation safety, compliance with state and federal regulatory agencies Jan Tabor RT administration Debra Georgas Chief radiation therapist Tim Eaton Engineering Harold M Scribner Engineering C2. Finances 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. C3. Equipment
  5. 5. 5 The Radiation Oncology Department is equipped with 5 modern linear accelerators with both photon and electron capabilities • 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 treatments o BSD Model 2000 Annular Phased Array RF Deep Hyperthermia System for deep pelvis treatments 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. C5. Conferences 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.