Educational content and didactic activities
The fellow will spend their clinical rotation on a proton radiation therapy service working closely with radiation oncology specialty board-certified attending physicians involved in the care of these patients. The attending physicians will supervise the fellow directly as they see selected in-patient consultations as well as selected new outpatient consultations in the Radiation Oncology department and the combined modality, multidisciplinary clinics. Selected follow-up patients who provide appropriate education opportunities for the fellow will also be seen. Supervision and teaching during these clinic sessions will include review of the patient presentation, discussion about patient work-up, review and discussion of pertinent imaging, discussion and formalization of a treatment plan.
The fellow will see patients weekly during their radiation therapy and be available at other times during the week to see patients experiencing treatment-related complications. Fellows will be expected to work with residents and students on the clinical service, offering guidance and teaching to the more junior trainees based upon the greater clinical experience of the fellow. Patient assignment will be based upon departmental guidelines that recognize the other demands on and responsibilities of the fellows, such as treatment planning and time for reading and study.
Treatment planning will be performed by the fellow in selected cases with direct supervision by the attending radiation oncologist and physicist. This will include discussion of the type of treatment immobilization, discussion of the appropriate CT treatment planning technique (intravenous, oral, and or intrathecal contrast, slice thickness, anatomic region and appropriate margins to be scanned), acquisition and fusion of additional tumor imaging (PET, MRI), contouring of the clinical target volumes, and in-depth review of the target volumes, target dose prescriptions, and normal tissue constraints with the attending radiation oncologist.
Didactic activities will include one-hour morning teaching conferences in the Department of Radiation Oncology, Chart Rounds, weekly Proton Rounds, Physics research presentations, monthly Proton research meetings, Radiation Oncology Journal Clubs, as well as multiple subspecialty tumor boards and teaching conferences. He/she will also have one hour weekly didactic session with the program director to review the clinical settings, cases and concepts.
Teaching can be formally divided into:
- faculty precepting, one-on-one, as patients are evaluated, planned, and treated
- conferences - fellows are expected to attend and participate in regularly scheduled teaching conferences on the assigned clinical service
- individual study - pertinent references will be provided to fellow by staff
Fellow is expected to read:
- chapter(s) in appropriate Radiation Oncology textbooks on Proton Radiation Therapy
- literature reprints of references provided to fellow by staff. These will change frequently as the literature evolves
The fellow will present on a regular basis (a case discussion of appropriate teaching cases) at the regularly scheduled department teaching conferences with attending staff radiation oncologist present to add additional instruction as indicated. Relevant conferences include resident teaching conferences, weekly proton rounds, weekly chart rounds, Radiation Oncology Journal Club, and service specific conferences.