The clinical component of the program consists of nine rotations in two years and provides comprehensive training in all aspects of radiation oncology physics. For each clinical rotation the resident is closely supervised by an assigned member of the medical physics staff and ends with an oral examination. At the end of each year there is a mock ABR style exam.
External Beam Rotation I: Basic Treatment Planning
In this rotation the resident will familiarize with all basic aspects of radiotherapy simulation, 3D conformal treatment planning and treatment delivery. The resident will shadow a clinical physicist for initial physics chart check, 4DCT, weekly chart check, SBRT analysis, special physics consult and addressing machine issues. In this rotation, the resident also participates in patient specific QA and in vivo dosimetry.
External Beam Rotation II: Advanced Treatment Planning
This rotation gives an opportunity for the resident to familiarize with theoretical and practical aspects of highly conformal radiotherapy treatment planning, including IMRT, VMAT, and SRS. The resident learns about the different types of IMRT planning techniques, including forward planned segments, inverse beamlet based optimization, inverse segment optimization, intensity modulated arc therapy, RapidPlan etc.
External Beam Rotation III: Beam Data, QA & QC, Radiation Safety
In this rotation, the resident gets an opportunity to learn the theoretical and practical aspects of TPS acceptance testing and commissioning, treatment delivery machine QAs. The resident gets an understanding of treatment room design, shielding and radiation safety in the radiation oncology department. The resident will have hands on experience with a two-week treatment planning algorithm mock commissioning exercise with a mentor. The resident also learns and performs Failure Mode and Effect Analysis (FMEA), Root Cause Analysis (RCA) and associated exercises.
Rotation IV: Imaging
In this rotation the resident learns about the theoretical and practical aspects of CT, CT/PET and MR simulation and other imaging modalities. The resident gets an opportunity to participate in CT, PET/CT, CBCT and MRI monthly & annual QA. The resident will gain a better understanding of the types of image registration/fusion and the use of deformable image registration software and its limitations.
Rotation V: Brachytherapy and Special Procedures
The purpose of this rotation is to familiarize the resident with theoretical and practical aspects of brachytherapy and special procedures (TBI, SRS, SRT). The resident attends the Annual HDR radiation safety training conducted by Penn’s radiation safety office, participates in HDR clinical cases, participates in HDR commissioning or brachytherapy software upgrades, observe and perform HDR morning QA independently. The resident also participates and performs the HDR Source exchange QA under the supervision of a Qualified Medical Physicist.
External Beam Rotation VI: Gamma Knife, CyberKnife, Brachytherapy Rotation at Pennsylvania Hospital
During this rotation, the resident will work at Pennsylvania Hospital to receive training in GammaKnife, CyberKnife, and brachytherapy. The resident attends and participates in planning for GammaKnife, CyberKnife and HDR cases. The resident also attends and participates in Daily QA, Monthly QA, Annual QA for GammaKnife & CyberKnife machines under the supervision of a Qualified Medical Physicist.
Rotation VII: Clinical Practicum at the Perelman Center of Advanced Medicine
In this rotation, the resident will further increase their clinical skills by performing machine QA and patient specific QA. In this rotation, the resident gets an opportunity to participate in developmental or commissioning projects in the department. The photon team participation gives the opportunity for planning support, and involvement in clinical decisions in the department of Radiation Oncology at the Perelman Center for Advanced Medicine.
Rotation VIII: Clinical Practicum at Satellite Facility
In this rotation, the resident will rotate through a network facility to assist with medical physics duties. In this rotation the resident gets an opportunity to familiarize with any other modalities that are not available at the main center and Pennsylvania Hospital. In addition, the resident gets an opportunity to work in a small community clinical setting.
Rotation IX: Proton Rotation
The purpose of this rotation is to familiarize the resident with commissioning of both PBS and DS proton systems, treatment planning, patient immobilization strategies, stoichiometric CT calibration, as well as proton machine QA and patient specific QA. The resident attendance in the proton team room gives an opportunity to familiarize and participate in proton initial chart checks, weekly chart check, planning support, and machine support.