Medical Physics Residency Program

Department of Radiation and Cellular Oncology

The University of Chicago
Chicago, IL 60637

Program Overview:

The Medical Physics Residency Training Program in Radiation Oncology Physics

is a clinical training program at the University of Chicago Hospitals. The training
program is based on the Guidelines for Accreditation of Medical Physics
Residency Programs as published by Commission on Accreditation of Medical
Physics Education Programs (CAMPEP). The program is directed toward
providing a 2 year program of progressive supervised clinical training for
graduates of CAMPEP accredited medical physics graduate education programs
or graduates of other programs such as the University of Chicago graduate
program in Medical Physics. Additional medical physics didactic training will be
provided to graduates of other physics-related programs.

Program Objectives

The objective of the residency program is to provide training in radiation oncology

physics in a structured clinical environment for individuals wishing to practice
professional radiation oncology physics. Residents, under the supervision of
board certified medical physicists, will participate in the routine clinical duties of a
radiation oncology physicist. At the conclusion of the program the resident will be
able to demonstrate competency in all areas of radiation oncology physics and
will be prepared to sit for the certification examination of the American Board of
Radiology in Therapeutic Radiology Physics.

Organizational Structure

The Department of Radiation Oncology at the University of Chicago is comprised

of 3 divisions: Clinical Radiation Oncology, Medical Physics, and Cancer Biology.
The department provides service to three clinical sites: University of Chicago
Hospitals in Hyde Park section of Chicago, University of Illinois/Chicago campus,
and LaGrange Memorial Hospital. Radiation Oncology staff includes: 8 Ph.D.
physics faculty, 7 clinical physics staff, 4 dosimetrists, 4 dosimetry trainees, 2
physics residents, 10 M.D. radiation oncology faculty, 10 medical residents, and
6 Ph.D. cancer biology faculty. Total external beam treatments number 165 –
180 per day. Brachytherapy procedures are performed at all sites. Patients are
routinely enrolled on national and institutional protocols.

The medical physics residency program is housed in the Division of Medical

Physics. Physics residents report to the Director of the Residency Program in
Medical Physics (Mary Martel, Ph.D.). The departmental Resident Education
Committee oversees the medical residency and physics residency programs, and
reviews the clinical training and didactic education program on an annual basis.
Dr. Martel is a member of the committee. The chair of the committee is the
medical residency Program Director (A.J. Mundt, M.D.).

The medical physics residents are hospital employees and are fully funded by
the hospital. The medical physics residents receive the same benefits, including
salary, as PGY1 and PGY2 medical residents. These benefits are stipulated in
the Graduate Medical Education manual, which is updated every year.

The residency program takes advantage of didactic education provided through

the University of Chicago Graduate School program in Medical Physics. The
physics resident audits the courses. The department also provides clinical
training for 4th year radiation therapist students from the University of Wisconsin
B.S. degree program. Several practical courses are given in radiation therapy
physics to the students, which are also attended by the physics residents. There
is a two year course in radiation therapy physics for the medical residents which
is also available to the physics residents.

History of Program Development

The Department of Radiation Oncology approved, as part of its long-term

strategic plan, the creation of a Medical Physics Residency Program in Radiation
Oncology Medical Physics, commencing July, 2000. Franca Kuchnir, Ph.D. was
the first director of the residency program and had applied for CAMPEP
accreditation of the program in March of 2000. The first two residents began
training in September, 2000, and graduated in September, 2002. Mary K. Martel,
Ph.D. is the current (and second) director of the program. The current plan is for
a 2 year Residency program with one new resident accepted per year. This will
allow for overlap and continuity in the program and add to the educational
experience.

Prior to the start of the residency program, the Division of Medical Physics has
long trained postdoctoral fellows for entry into clinical academic medical physics
positions. Dr. Kuchnir was the first postdoctoral fellow in 1971, training under the
supervision of Dr. Lester Skaggs, division director. There have been many
postdoctoral fellows since then and the majority of the fellows have achieved
ABR or ABMP certification and have academic careers in clinical departments.

Training Requirements:

Elements of Clinical Training

The training program will follow the “Essentials and Guidelines for Hospital
Based Medical Physics Residency Training Programs” as outlined in AAPM
Report #36. It is also a goal of the program for the resident to demonstrate
understanding of the topics from the study guides of the American Board of
Medical Physics and the American Board of Radiology.

Clinical Training:

The resident will work closely with faculty and staff medical physicists
responsible for clinical tasks. The resident will follow a clinical rotation schedule
with well-defined training objectives. The resident will keep a log documenting
their participation in all clinical activities. This log will be reviewed by the
supervising physicist and the program director on a weekly basis. The resident's
performance will be evaluated at the end of each rotation by use of a rotation
evaluation form. Additional reading assignments may be given to strengthen
theoretical understanding of various clinical procedures.

The Residency Training Program will commence each July and residents will
participate in a six week orientation program which includes 4 weeks of didactic
classes and 2 weeks in the clinic. This will serve to familiarize them with the
equipment, techniques, and procedures for the operation of the clinic.

Conference/Seminar Attendance:
A variety of departmental and divisional conferences take place on a regular
basis that will help the resident to develop an in-depth understanding of the
clinical problems associated with the practice of medical physics in radiation
oncology. Conferences and seminars include:

• Dosimetry and radiation safety in-services, each given on a yearly basis

• Visiting professor lectures, approximately 10 per year
• Journal club once a month with the medical residents
• Journal club once a month with the graduate students
• Clinical, Physics and Biology Faculty seminars once a month
• Chart rounds once a week
• Anatomical site-specific oncology seminars given 3 mornings per week,
with the medical residents and senior radiation oncologists
• Quality assurance meeting once a week

There are also several opportunities to attend conferences outside of the

 department:

• Radiological Society of North America annual meeting, December of every

year in Chicago. The resident will choose from the list of refresher
courses with review by the Program Director. The resident will be
expected to give a report to physics staff about highlights of the meeting.
• American Association of Physicists in Medicine Annual Meeting. The
resident may choose to go to the annual meeting, or the Summer School.
The resident will be expected to give a report to physics staff about
highlights of the meeting.
• Midwest Chapter of the AAPM meetings, on a quarterly basis.
• Other local meetings, such as the annual Varian-sponsored IMRT
symposium, Chicago Radiological Society semi-annual meetings.

Didactic Curriculum:

Residents will be expected to have completed coursework similar to that required

by the Graduate Medical Physics Program. Residents will be required to attend
courses offered by the Medical Physics program to relieve any deficiencies.
Determination of the need for additional didactic education is at the discretion of
the Resident Education Committee. Though the resident is auditing the courses,
successful completion of each course will be documented with a passing grade
for the midterm and final exams. Remedial medical physics education may also
be through a program of self-study with appropriate assessment by the Resident
Education Committee. Didactic curriculum includes:

• Summer Orientation Course 4 weeks (required for all)

• The medical physics resident who has not graduated from a program in
medical physics will be required follow the basic course sequence for the
Graduate Program in Medical Physics, University of Chicago, http://www-
radiology.uchicago.edu/gpmp/
• The Clinical Radiation Oncology Physics Course for Therapeutic
Radiology Residents (2 year course).
• Dosimetry and Treatment Planning class for radiation therapy students
(required; physics resident is teaching assistant for this course)

Requirements for program completion:

1. Demonstration of adequate medical physics education.

2. Demonstration of clinical competency in all clinical training rotations as

 documented in the rotation evaluation form and checklists completed by
the supervising medical physicist.

3. Presentation of at least two medical physics seminars or medical

dosimetry in-services.

4. Documented attendance at the majority of the required clinical and

medical physics seminars and conferences including medical physics
seminars, dosimetry and safety in-services, chart rounds, and morning
conferences.

5. Satisfactory assessment of progress as determined by means of an

annual oral examination conducted by the Residency Program Committee.

A certificate of completion is given to the resident.

Program Length

For all residents, the length of the training program is designed to be two years.
The didactic training for graduates of programs other than medical physics will be
completed in the 2 year period and not interfere with clinical training time.

Residents:

Admissions

Residents will be expected to have completed a comprehensive curriculum in

Medical Physics and to have received some clinical experience during their
graduate education.
Preferred candidates must have a M.S. or Ph.D. degree in medical physics from
a CAMPEP accredited program. The next preference is for candidates having a
M.S. or Ph.D. degree in medical physics from a non-accredited program.
Candidates having a degree in physics, biophysics, radiological sciences,
engineering, or a related field with a particularly strong background in physics
may be accepted but would not be preferred. Candidates with other types of
degrees other than listed above would not be accepted.

Interested applicants are directed to our website:

http://www.radonc.uchicago.edu/typea/content/pdf/medphys_res_app.pdf

The top candidates are interviewed by phone by the program director in

February. A second round of ranking is made and the top candidates will be
invited for an on-site interview to take place during March. Applicants are notified
of the decision of the application committee on or about April 15.

Evaluation of Resident Progress:

The program director meets with the resident on a weekly basis to review the
resident’s logbook and to periodically go over rotation objectives and checklists.
At the end of each clinical rotation, the supervising faculty or staff will provide a
formal evaluation of the resident’s performance. Formal evaluation by oral
examination is made at 12 and 18 months by representative staff involved with
the resident during that year.

Staff

The Medical Physics faculty has clinical, teaching, research and development
duties. In addition, the senior faculty has administrative responsibilities. The
faculty devotes 50 - 80% of their effort to clinical operations including service,
supervision, quality assurance as well as development and implementation of
new technology. Teaching responsibilities are on a rotation or sharing basis.
There is strong collaboration between medical and physics faculty in the clinic.
While only faculty members are involved in a preceptor role, all staff members
are available and work with the trainees. The majority of the clinical faculty and
staff are certified in their respective specialty boards. Within the group, there is
professional expertise in all aspects of treatment planning, delivery,
documentation and verification of treatments as well as in depth knowledge of
the more sophisticated aspects of clinical physics such as SRS/SRT, IMRT,
video monitoring of patients under treatment, TBI, TSET, in vivo dosimetry, QA,
prostate seed implantation, dose evaluation, LDR and HDR brachytherapy. The
atmosphere is one of formal and informal teaching with medical residents,
therapists, graduate and visiting physics students frequently present in the
clinical physics quarters.

Residents will work under the direction of the faculty and staff of the Division of
Medical Physics at all 3 clinical sites. At the UC site, the ratio of physics staff to
residents is 3 to 1. Current staff includes:

Charles Pelizzari, Ph.D. Associate Professor, Division Chief

Mary K. Martel, Ph.D., Associate Professor, Clinical Chief, Residency Director
John Roeske, Ph.D., Associate Professor
Chester Reft, Ph.D., Assistant Professor
Anthony Lujan, Ph.D., Assistant Professor
Leon Myrianthopoulos, Ph.D., Assistant Professor
Danny Spelbring, Ph.D., Director Medical Information Systems
Julius Turian, MS, Clinical Physicist
Karl Farrey, MS, Clinical Physicist
Brett Smith, M.S., Clinical Physicist
Carla Rash, BS, Dosimetrist
Wells Jackson, BS, RTT, Dosimetrist
Dan Joyce, RTT, Dosimetrist
Parvathi Chiru, RTT, Dosimetrist
Simeon Bisevac, BS, Engineer
Emil Muresan, Physics Assistant

Several clinical and biology faculty members with teaching interaction with the residency
program are listed below:

Samuel Hellman, M.D., A.N. Pritzker Distinguished Service Professor

A.J. Mundt, M.D., Assoc. Professor, Teaching Faculty-Physics Residency Program
David Grdina, Ph.D., Professor-Teaching Faculty-Physics Residency Program

Clinical Services and Facilities

The department of Radiation Oncology is equipped with the latest state of the art
therapy and simulation machines, as well as with the latest technology such as
CT simulation, portal imaging, video patient monitoring, dynamic MLC, full 3-D
treatment planning for photon and electrons, SRS, IMRT, interstitial and
intercavitary LDR and HDR, intravascular brachytherapy and a superficial
therapy machine.

The department has a long standing accredited four-year medical residency

program, with three residents per year. We treat 700 to 800 patients per year at
The University of Chicago (UofC) and an equal amount in the other two locations
combined, University of Illinois at Chicago (UIC), and LaGrange Memorial
Treatment Pavilion. The University of Chicago offers an excellent educational
environment.

Resident Offices, Classrooms, and Conference Rooms

The Division of Medical Physics is located in the Department of Radiation

Oncology, on the same floor as administration and other offices, and one floor
above the main clinic. The physics residents have an office carrel in the
housestaff/medical residents’ room, on the same floor as the clinic. Secretarial
support is provided by Division administrative support staff. Residents are
provided with a personal computer and access to the institutional intranet.
Graduate courses, medical resident conferences and other meetings are given in
the department’s conference room, located on the first floor of the department.

Clinical Facilities, Laboratories, and Shops

The clinical facilities at the University of Chicago, University of Illinois and

LaGrange Memorial Hospital are available to the training program. At The
University of Chicago Center for Advanced Medicine we have three Varian
Clinacs 2100 EX accelerators equipped with dynamic MLCs, EPIDs and a patient
information system (VARIS). This equipment is available for physics use on
weekends and evenings. Accessories for SRS, SRT, TBI, TSET, custom patient
immobilization and a home-developed video system for fast and accurate patient
repositioning and monitoring of patient motion are in use. We have an
aggressive program of IMRT. The department is equipped with two CT based
simulators and AcQsim (with Voxel-Q software), block cutting and mold room.
We have a well-established LDR brachytherapy program and intravascular
brachytherapy. Treatment planning tools consist of full 3-D capabilities for
photons and electrons (PLUNC, from the University of North Carolina), IMRT
(CORVUS, from NOMOS), SRS/SRT for circular and shaped beams (XKNIFE
and XPLAN from Radionics). We have multiple treatment planning stations so
that training can be done in parallel with clinical service.
At the University of Illinois Outpatient Care Center (opened October 1999) there
is similar equipment: two Varian Clinac 2100 EX with MLCs, EPIDs and VARIS,
Ximatron conventional simulator and AcQsim simulators, block/mold room, LDR
brachytherapy program and intravascular brachytherapy. In addition there is a
superficial machine (Oldelft Therapax-150) and a recently acquired HDR unit
(Varisource). Availability of the machines for physics use is on evenings and
weekends. Treatment planning tools are comparable to those at UC: PLUNC for
photons and electrons, SRS/SRT for circular fields (STP from FISHER) and
Eclipse/Helios for IMRT. There are multiple treatment planning stations. The
UIC facility was modeled after UC.

LaGrange Memorial Hospital has a Varian Clinac 2100 CD, Varian 4/100,
Ximatron conventional simulator, GE CT with simulation software, Varis, and
PLUNC treatment planning system. There is also intravascular brachytherapy.

Dosimetry laboratories are available to the program at The University of Chicago,

the University of Illinois and LaGrange Memorial Hospital. We have capabilities
and expertise in state of the art dosimetry techniques such as standard and
specialized ion chambers, diodes for photon, electron and stereotactic beams, a
diamond detector, TLD annealing ovens and automated TLD readers, state of
the art film densitometer, water tank dosimetry system, a 25 linear diode array for
dosimetry of dynamic MLC, three humanoid phantoms for TLD and film
dosimetry, an IMRT and a CT phantom and a large supply of tissue, bone and
lung equivalent plastic slabs

Libraries:
The department has reference and repeat copies of textbooks available to the
residents. Up-to-date collections of the journals relevant to Radiation Oncology
and Medical Physics are also maintained in the department. In addition the
residents have privileges at the University of Chicago library system which
contains one of the most complete medical library collections. There is online
access to Medline and electronic journals.
Summary

A major strength of this program is that it resides in a mature academic

environment where residents have good access to clinical training (treating 1500
patients per year) and didactic education (medical residency program and a
graduate program in medical physics). Good relationships exist among staff
members, facilitating the integration of the resident into the clinical routine.
Specialization among the staff permits in-depth training in the clinical and physics
aspects of both routine and special procedures. Abundant training and
educational opportunities exist including resident teaching opportunities. Didactic
programs are available for all aspects of medical physics. A vast variety of
medical physics subjects are covered in the department’s dosimetry in-services
and seminars.