Curriculum
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The core curriculum is
comprised of the clinical curriculum as well as the didactic
curriculum. The clinical curriculum is comprised of approximately 41 months
of clinical rotations with the remaining devoted to research, dosimetry and
medical physics. The didactic curriculum is comprised of mandatory
conferences, lectures, and tumor boards. The majority of the curriculum will
be dedicated to treatment of cancer patients with external beam
radiation therapy and brachytherapy, but will also include topics such as intraoperative radiation therapy, radioimmunotherapy, unsealed sources,
hyperthermia, kilovoltage irradiation, plaque therapy, particle therapy,
benign disease and others topics that may be developed.
CLINICAL
The clinical curriculum includes clinical experience with lymphomas and leukemias; gastrointestinal, gynecologic, genitourinary, breast, soft tissue and bone, skin, head and neck, lung, pediatric, central nervous system tumors, and treatment of benign diseases for which radiation is utilized. The residents will learn indications for irradiation and special therapeutic considerations unique to each site and stage of disease including the use of combined modality therapy, altered fractionation, including stereotactic radiotherapy, brachytherapy, pain management and palliative care.
The faculty will ensure that the resident personally performs technical procedures, including treatment setups as well as intracavitary and interstitial placement of radiation sources.
Follow-up of the irradiated patients by the resident, including pediatric patients, on an inpatient or outpatient basis is a required part of resident training to ensure that residents have the opportunity to learn about the problems of recurrent and disseminated tumors and of late aftereffects and complications of radiation therapy.
Clinical Rotations
There are 6 clinical services within the primary and integrated institutions ( Loyola University Medical Center and Hines VA Hospital). Rotation on these services is mandatory and is generally in 3 month blocks. Rotations will be scheduled in such a way to provide adequate educational experience in different disease sites and radiation therapy techniques. The resident will maintain a one-to-one teaching relationship with his/her attending on that service. There are 2 additional required rotations at participating sites (see External Rotations ). Additionally there are 2 electives: Dosimetry/Medical Physics and Research. Participation in these electives is not mandatory and at the discretion of the program director can be withheld if there is failure to be promoted to next level of training or multiple unsatisfactory evaluations. The ACGME required electives including medical oncology, oncologic pathology, and diagnostic imaging are fulfilled by documented participation in multidisciplinary conferences where medical oncology management, imaging, and pathology are shown and discussed.*
A typical 4-year schedule is shown. In general, the residents rotate through the clinical services twice through their residency. The one-month spent in dosimetry/physics will be in lieu of 1month spent on one of the clinical service rotations.
REQUIRED
1. Head and Neck
9 months 2. CNS/Lymphoma/Pediatrics 6 months 3. Lung/Gastrointestinal 6 months 4. Genitourinary 6 months 5. Breast/Gynecologic 6 months 6. Hines VA 6 months 7. Pediatrics (St. Jude Children's) 1 month 8. Gynecologic/Brachytherapy (Stroger Cook County) 2 months ELECTIVES 9. Dosimetry/Physics 1 month 10. Reseach 6 months 11. Medical Oncology * * 12. Pathology * * TOTAL REQUIREMENT 48 MONTHS * If resident is found to be deficient in attendance of multidisciplinary conferences, they will be required to rotate on one or more of these rotations. External Rotations
To complement the resident experience, pediatric oncology rotation and gynecologic oncology rotations have been established at St. Jude Children’s Research Hospital in Memphis, TN, and Stroger Hospital of Cook County in Chicago, IL, respectively. Both are mandatory for all residents and usually take place during the PGY-4 or -5 year. These institutions have a status of affiliated institutions for the purpose of residency training.
Pediatrics: A one-month pediatric oncology rotation at St. Jude Children’s Research Hospital is mandatory for residents. The resident must be at least a PGY-3. Residents are expected to follow standard policies and procedures already in existence in that institution.
Gynecological Oncology: A rotation at Stroger Hospital of Cook County is mandatory for residents to increase their gynecological oncology experience, particularly with respect to brachytherapy. Residents will rotate with the attending physician who is in charge of the gynecological oncology patients undergoing radiation therapy at Stroger Hospital. Due to the organization of that clinic and the fact that staff is not there every day of the week, the residents will spend Tuesdays and Wednesdays at Stroger clinic and when brachytherapy implants are held. Residents will also remove implants on whatever day they are scheduled. It is not intended that residents participate in treatment of patients other than those with a gynecological malignancy. On days when residents are not in Stroger Hospital, they will rotate with the faculty member without an assigned resident at Loyola/Hines.
Dosimetry/Medical Physics Elective
During the PGY-3 year, the resident will spend one month on the clinical dosimetry and medical physics service. The resident will be supervised by the Chief of Physics. The intent of this rotation will be for the resident to become intimately familiar with standard planning techniques: 2-D, 3-D, IMRT, brachytherapy, stereotactic radiation therapy. The resident will be introduced to dosimetry and the RTP workstations (Xio) and will be required to participate in the planning of a variety of “standard” cases. Additionally the resident will also participate in the QA of radiation therapy equipment as it applies to clinical practice. This will also serve as an opportunity for the resident to identify a potential research project and mentor.
Research Elective
The ACGME requires that an investigative project be completed under faculty supervision. To facilitate this, residents will have a 6 month elective dedicated to research. This will generally be scheduled in the PGY-4 year and completion of the statistics course is a prerequisite. A component of the research should be Hines VA-based. The project(s) must be formalized and a one page proposal must be presented to the program director at least 1 month in advance of the rotation. Failure to do so may result in postponement/cancellation of the elective. This proposal should identify the faculty mentor, the objective of the project, proposed methods i.e. retrospective review versus prospective data collection, and statistical methods which will be used to analyze data. If patient charts are to be reviewed, the project must by reviewed and approved by the IRB. Once the project is approved and begun, the mentor and resident should meet monthly to review progress. The mentor will be responsible for formally evaluating the resident at the 6 week, 3 month, 18 week, and 6 month time periods. Should there be no or minimal progress, the resident may be required to defer the remainder of the research elective and begin clinical rotation. The elective will conclude with a 30 minute presentation to the faculty/residents. Ideally the resident will present his/her research at a regional/national meeting and will write a corresponding manuscript.
