The objective of our program
To offer a comprehensive education in clinical radiation oncology, treatment planning, radiation physics, and radiobiology, preparing graduates for a career in academic medicine and the ability to provide outstanding patient care as practicing radiation oncologists. This training program exposes residents to a large volume and variety of cancer patients including those with pediatric, gastrointestinal, gynecologic, genitourinary tract, reticuloendothelial system, upper respiratory tract (including the head, neck, and lung), breast (both primary and metastatic), central nervous system, skin, bone, and soft tissue tumors. It provides the resident with experiences in short and long-term follow up of irradiated patients mainly on an outpatient basis. This program emphasizes a multi-modality approach to the management of cancer patients. This approach involves a close personal working relationship between the attending physician and resident as well as intensive interaction with other oncologic specialties. There will be numerous opportunities for radiation oncology residents to interact with specialists in medical oncology, neuron-oncology, surgery and surgical specialties as well as physicians in diagnostic radiology, nuclear medicine, pathology, clinical laboratory medicine, and physicians active in tumor registries
Residents participate in many cooperative group trials and multicenter clinical trials including those of the Radiation Therapy Oncology Group (RTOG), the Southwest Oncology Group (SWOG), the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Lung Cancer Study Group (LCSG), the Pediatric Oncology Group (POG), the Collaborative Ocular Melanoma Study (COMS), and the New Advances on Brain Tumor Therapy (NABTT).
The radiation physics and biology faculty of the division are active in research with laboratories at the Medical School, the Cancer Therapy & Research Center (CTRC), and University Hospital. Residents are encouraged to collaborate with basic science researchers within the division. A unique facility at the Medical School allows study of the biological effects of non-ionizing radiation. Primary areas of research are hyperthermia, genetic toxicology, computerized treatment planning, and drug-radiation interactions in the laboratory. Clinical research opportunities are available in Intensity Modulated Radiotherapy and Radiosurgery (IMRT and IMRS) as well as 3D CT-Guided Interventional Brachy-therapy and intravascular Brachy-therapy.
Residents are required to formally participate in at least one research project during their years of training. Research may be clinical or in some aspect of physics or radiobiology. Residents are encouraged to present results at national meetings and to seek publication in refereed journals. Residents are also encouraged to compete for grant support—including American Cancer Society funds and institutional grants available to junior investigators.
The arrangement whereby private practice and University physicians work side-by-side in a radiation therapy facility is truly unique and a plus for the resident’s education. The private practice radiation oncologists at the CTRC provide formal lectures and informal consultation to the resident physicians. Observation and experience in those aspects of the practice of radiation oncology unique to a private setting are readily available to residents. Elective rotations with the private practitioners are encouraged. Since the CTRC is a shared facility, resources are pooled to provide a state-of-the-art center and a range of equipment that is exceeded by few other programs. This unique arrangement permits residents to have access to high energy accelerators for photon and electron therapy, two spiral CT virtual simulators, virtual simulation workstations, 3D-CRT, a remote afterloading brachytherapy unit, and intensity modulated radiotherapy planning and delivery systems.
During the 48-month program, residents are required to dedicate 36 months to clinical radiation oncology. Under the close direction of the physician faculty, the resident physician assumes increasing clinical responsibility. The program is designed to prepare residents for a career in academic radiation oncology. Residents will be trained to design an appropriate and complete diagnostic and staging workup. The resident will also learn to plan and execute a therapeutic radiation course. These skills require the ability to clinically and radiographically localize a tumor. With radiation physics and technological support, radiation portals are designed to deliver a curative radiation dose to the tumor while at the same time protecting critical normal structures from toxic radiation doses.
Residents are also trained to provide appropriate and close follow up care of patients after therapy is completed. During their months of clinical radiation oncology training, residents are trained in external beam and brachytherapy methods of planning and radiation treatment delivery to include intensity modulated radiosurgery (IMRS), extra-cranial IMRS, PET/CT fusion treatment planning and hyperthermia techniques as well as the latest conformal radiation techniques. The latest hardware and software for IMRT and IMRS are available along with 3D conformal planning delivery with MLC. CT-guided brachytherapy using a stereotactic arm correlated to the CT scanner is available to deliver radioactive seeds to targets in an outpatient setting. All residents will learn about proper clinical trial design and execution. Residents are expected to be active in the recruitment and management of patients on institutional and national cooperative group clinical research trials.
Six months of elective time are available to the residents. Residents are required to rotate in pathology, medical oncology and pediatric oncology if they have not previously had postgraduate training in these specialties. They are also encouraged to elect time in imaging modalities such as CT, MRI, and nuclear medicine. An understanding and appreciation of these modalities is essential to localize and target the tumor for a radiation dose. Electives in brachytherapy and private practice radiation therapy are also encouraged.
Patients are primarily referred through University Hospital and the Audie L. Murphy V.A. Hospital. Regular clinics are conducted at these two primary teaching hospitals. Privately insured patients make up about thirty percent of the practice, Medicare/Medicaid patients comprise approximately fifty percent, with the remainder funded through various other sources. In addition, our faculty have privileges at Santa Rosa Children’s Hospital, the largest pediatric hospital in South Texas. Through this association and the weekly pediatric tumor board, the residents will participate in the management of pediatric oncology cases.
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