The goals and objectives of the residency program are to comprehensively train and educate physicians to be skillful in the practice of radiation oncology and also to be caring and compassionate in the overall management of oncology patients. The residents should gain in-depth knowledge of clinical radiation oncology. A minimum length of 5 years of post-graduate medical education is required for Radiation Oncology. For those applicants currently in medical school, satisfactory completion of the Beaumont Hospital Transitional Year is a prerequisite. A minimum of four subsequent years will be spent in the Radiation Oncology program. During these four years, not less than 36 months will be spent in clinical radiation oncology. The remaining 12 months will be dedicated to research and/or additional clinical training. The Radiation Oncology Residency curriculum is administered by the Program Director with the collaboration of the entire clinical, physics, and radiobiology faculty, as well as the chief residents.
Transitional year (PGY-1)
The transitional year for radiation oncology residents is integrated into the radiation oncology residency match. Residents that match into our residency program are designated a transitional year spot at Beaumont Health. The transitional year is meant to provide a well-structured clinical curriculum to prepare residents for subsequent radiation oncology training. Rotations are chosen by the transitional year program director in collaboration with the radiation oncology program director. During the 12 months, rotations for radiation oncology transitional year residents include
- emergency medicine
- medical oncology
- pediatric oncology
- head & neck oncology
- urologic oncology
- general Surgery
- Acute Care Clinic (Internal Medicine)
- inpatient internal medicine
- medical Intensive care unit
- research Elective
- other electives may include: pathology, nuclear medicine
First year Radiation Oncology (PGY-2)
During the first year in Radiation Oncology, residents participate in direct patient care, from initial consultation to treatment and follow-up, under the direct supervision of attending staff. Residents rotate from one staff physician service to another, generally at three month intervals. This includes a rotation at one of our clinical sites outside of the Royal Oak campus. This insures a broad exposure to the various areas of attending staff specialization in Radiation Oncology. Integrated within the 12 months of clinical training will be required didactic lecture series in radiation biology and radiation physics, as well as participation in clinical teaching conferences and journal clubs.
During the second year of clinical training in radiation oncology, the residents continue to build on their clinical skills from the time of initial consultation to treatment and follow-up. This includes rotations at one of our other clinical sites. During rotations at clinical sites outside of Royal Oak, the resident will focus only on inpatient and outpatient consultations and perform simulations and treatment planning, without on-treatment visits or follow-up visits. This maximizes the resident experience in seeing a large variety and volume of patients. Integrated within the 12 months of clinical training will be required didactic lecture series in radiation biology and radiation physics, as well as participation in clinical teaching conferences and journal clubs.
Third year Radiation Oncology (PGY-4)
The third year of training (12 months) is dedicated to basic science research in physics or radiobiology supervised by a radiobiology and/or physics mentor, a physician mentor, as well as the Program Director and Chair of the Department, with regular meetings scheduled to review research progress. Research residents also participate in clinical research during this time. Residents participate in regular didactics during this year, which include teaching conferences, resident and guest lectures, journal clubs, physics class (if required), and radiation biology class.
Fourth year Radiation Oncology (PGY-5)
During the fourth year of training in radiation oncology, residents are placed on a six month rotation designated as the "senior service". This includes time spent at Royal Oak, as well as our Troy and/or Dearborn clinical sites. This service is designed to provide residents maximal responsibility in the work-up and management of their assigned patients. All treatment decisions and patient care on the senior service are the responsibility of the senior resident under the direction of the supervising attending physician. This experience is designed to facilitate the transition from senior resident to practicing radiation oncologist. It is unique to our institution and highly valued by the residents. Senior residents continue to participate in clinical teaching conferences and journal clubs, but are not required to attend physics or radiation biology lectures.
Radiation Oncology didactics
The Radiation Oncology training program includes core curricular didactics in clinical oncology, radiation biology, and radiation physics. There is protected didactic time scheduled throughout the four year training program. Core curriculum is taught by physicians within the department, physicists, biophysicists, radiation biologists, and guest lecturers. In addition, each resident presents two comprehensive sixty minute didactic lectures per year on topics of interest in the field of Radiation Oncology.
Clinical teaching conferences
Multiple teaching conferences are held throughout each month. These focus on each of the clinical sites in oncology, with a focus on a particular cancer during each session. Educational discussions are individualized and cover epidemiology, pathology, staging, natural history, anatomy, radiation doses and treatment planning techniques, possible treatment complications, tumor control, and survival statistics. Pertinent literature is discussed, including retrospective, prospective, and randomized studies.
Radiation Oncology conducts monthly morbidity and mortality rounds as well, where residents present pertinent cases along with a discussion of available literature on each topic. Discussions are held with residents and attending physicians.
We hold two journal clubs each month, where three articles are presented by three residents each time. Each resident is responsible for a certain number of journal club presentations per year. One of these journal clubs, “Red Club”, focuses on articles from the Red Journal (International Journal of Radiation Oncology*Biology*Physics). The second journal club meeting includes pertinent articles from other oncologic journals which focus on radiation therapy questions or outcomes.
Residents participate in a structured physics didactics course during years one, two, and three of the radiation oncology program. The physics course spans from August through February of each clinical year, with two class sessions per week. Residents are exempt from clinical responsibilities during these times. The course is taught by radiation physicists within our department, with the goal of teaching residents the core physics principles required to fully understand the field of radiation oncology while preparing them for the physics board exam. The course consists of weekly assignments to ensure residents gain an appropriate understanding of the principles, as well as a midterm and final exam at the end of the course each year.
Radiation biology didactics
Residents participate in a structured radiation biology course also during years one, two, and three of the radiation oncology program. Radiation Biology typically spans from August through March of each clinical year, with one class per week. Residents are exempt from clinical responsibilities during class time. The course is taught by radiation biologists within our department, with the goal of teaching residents the core principles of radiation biology in depth while preparing them for the radiation biology board exam. Residents participate in active lecture discussions as well as question-based reviews as part of board preparation.
During the course of training, many multidisciplinary conferences are available. We are fortunate to have guest lectures from our colleagues in all of these specialties, allowing the residents the opportunity to learn other aspects of cancer care outside of radiation oncology. These include participation by
- medical oncology
- pediatric oncology
- nuclear medicine
- gynecologic oncology
- breast surgery
- thoracic surgery
- GI/hepatobiliary/colorectal surgery
- orthopedic oncology
- surgical oncology
- pain management
- palliative care
Attendance and participation in these conferences assures that residents acquire the knowledge necessary for integration of other oncologic disciplines such as medical oncology, pediatric oncology, surgical oncology, and gynecologic oncology. Case presentations permit teaching and aid decision-making in either a prospective or retrospective fashion.