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Medical Physics Residency
Physics Faculty
- Jean Pouliot, Ph.D., Chair of the Selection Committee
- Lijun Ma, Ph.D., Program Director, Member of the Selection Committee
- Josephine Chen, Ph. D.
- Cyhthia Chuang, Ph.D., Member of the Selection Committee
- Martina Descovich, Ph.D.
- Chris Diederich, Ph.D.
- Bruce Faddegon, Ph.D.
- Lynn J. Verhey, Ph.D.
Other Faculty offering instruction outside the physics area:
Others from the Dept. of Radiation Oncology who will be providing instruction to the resident:
- Clayton Akazawa, CMD
- Omar Chacon, Engineer
- Albert Chan, CMD
- Erwin Garde
- Barby Pickett, M.S., Member of the Selection Committee
Detailed outline of residency program: (see Attachment A)
Anticipated selection criteria and planned didactic instruction for individuals without a degree in medical physics: We require the physics resident to have a Ph.D. in physics or closely related field such as engineering. We will give preference to those individuals who have additional post-doctoral experience in research, teaching or applications of physics and who have demonstrated independence and productivity. We expect a commitment from the candidates to seek certification in radiotherapy physics and to pursue a medical physics career in an academic setting.
The formal instruction for the resident will include:
- The Physics of Radiation Oncology - this course is given annually to medical residents, dosimetry students and physics residents. Lectures are given by physics faculty, one hour per week from September through May. Residents are expected to show proficiency through homework problems and examinations. A physics research meeting is held each week to discuss physics work in progress in the Department. The resident will be required to attend these meetings. Additional physics topics will be presented in special lectures during the year.
- Radiation Biology - this course in given annually to medical and physics residents. Lectures are given by Drs. Fike and Murnane. Students are expected to show proficiency by homework assignments and examinations. Advanced topics in radiobiology are presented on a monthly basis during the academic year.
- Clinical - Introductory clinical radiation oncology lectures are offered during July and August for first year clinical residents. The physics resident will be expected to attend these lectures at the first opportunity. In addition, the resident is encouraged to attend morning conferences that describe new patient problems and treatment techniques.
- Related courses such as biostatistics and cellular biophysics are available through the Graduate school at UCSF. For those without knowledge of anatomy, the resident will be sent to a 1-week course in radiographic anatomy offered by the University of Texas Medical Center in San Antonio or to an equivalent course offered elsewhere.
- The clinical medical physics residency program began in September, 1993. Bruce Hill, Ph.D. was selected as our first resident and was joined by our second resident, Greg Bednarz, Ph.D. in October, 1994. We plan to continue to have three residents in our program in the future. The names of former and current clinical medical physics residents:
Bruce Hill, Ph.D. (1993-95), Greg Bednarz, Ph.D.(1994-96)
Ping Xia, Ph.D. (1995-97), Jenny Hai, Ph.D.(1996-98)
Djay Wieczorek, Ph.D. (1997-00)
*Lei Wang, Ph.D. (1999-01)
Cynthia Chuang, Ph.D. (1999-02)
*Katja Langen, Ph.D. (2001-03)
Edwardo Villareal Ph.D. (2002-04)
*Ningsheng Zhu, Ph.D. (2002-2005)
*Hong Chen Ph.D. (2003-06)
*Josephine Chen Ph.D. (2004-2007)
Martina Descovich Ph.D. (2005-2007)
Tarek Halabi, Ph.D. (2007-2009)
Andrew Hwang, Ph.D. (2007-current)
Olivier Morin Ph.D. (2008-current)
Dilini Pinnaduwage Ph.D. (2009-current)
* Denotes special 3-year combined research/physics residency program |
- The Department treats about 2500 new patients per year on 6 linear accelerators at 2 separate sites. We have an active program in IMRT-IGRT treatments, with approximately 70 patients being treated with inverse-planned IMRT each day. In addition, the Department has a very active program in HDR brachytherapy, a program in Intraoperative Radiotherapy with the Mobetron (a portable electron accelerator) and with the Intrabeam device, 2 dedicated 4D-CT scanners for treatment planning, 3DCRT treatment planning programs (both conventional and inverse systems for IMRT), Gamma Knife and Cyberknife radiosurgery, clinical and research hyperthermia programs, a clinical program to treat ocular melanomas with protons, and a range of physics research projects designed to improve dose localization in cancer patients.
- The Department of Radiation Oncology has long experience with the use of 3-dimensional treatment planning for complex treatment volumes in CNS, head/neck and elsewhere. We are one of the original members of the multi-center 3-D RTOG prostate study. We have been performing IORT cases for many years and were the first center to use a portable electron linac for IORT in the operative suite. We use the Peacock MIMiC system for delivery of dynamic intensity modulated radiotherapy. In addition, we have implemented intensity modulated radiotherapy using multiple fields shaped with conventional multileaf collimators to better shape dose distributions in 3 dimensions. We perform many special procedures such as TSE and TBI. We have large experience with our HDR remote afterloader. We have had a Gamma Knife in the Department since 1991 that we use to treat approximately 200 patients per year with stereotactic radiosurgery. We have very strong cooperation between our Department and the Departments of Pediatrics and Neurosurgery, leading to many interesting clinical research programs. We perform clinical hyperthermia and have a strong research effort in this area.
Detailed Outline of Residency Program
The resident rotations and the curriculum will be developed and coordinated by Dr. Pouliot, who will also be responsible for judging the competence of the resident in each area. The competency will be judged on the basis of interviews with the primary physicist in each area, interviews with the resident and performance on standardized and customized examinations. Didactic courses (to be described below) will be supplemented with suggested reading in areas related to each rotation. The curriculum for the physics resident, which conforms to the guidelines of AAPM report 36 is as follows:
Year I
- General radiotherapy physics - theory:
- Interactions of radiation with matter
- Treatment machines - principles of operation and beam properties
- Measurement of exposure and dose
- Calibration of photon and electron beams
- Treatment planning theory
- Dose distributions
- Radiation protection and shielding
- Radiological imaging theory
- Intensity modulation method
- Treatment equipment - practical: With Drs. Faddegon and Xia
- Calibration techniques in electron and photon beams
- Instrumentation for calibration
- Quality Assurance checks - daily, weekly, monthly, annual
- Accelerator commissioning and acceptance procedures
- Operation of automated water phantom
- Film scanning techniques
- TLD reading and quality assurance
- Electron and Photon beam properties
- Simulator quality assurance and operation
- General accelerator operation and maintenance considerations (w. Mr. DeMagri or Mr. Chacon)
- Clinical support: With Ms. Pickett and Mr. Chan Patient charts
- Hand calculation of monitor units
- Patient immobilizing devices
- Custom blocking (photon and electron)
- Tissue compensators
- Asymmetric collimation
- Multi-leaf collimator design
- Off-axis dose calculations
- In-vivo dosimetry
- Patient positioning
- Verification of position for treatment
- Portal image generation and evaluation
- Disease-specific treatment considerations
- Selection of treatment machine
- Treatment technique selection
- Simulation technique
- Treatment planning: With Ms. Pickett and Dr. Josephine Chen:
- Planning from patient contours
- CT-based treatment planning using coplanar beams only
- Fully 3-dimensional CT-based treatment planning
- Production and use of treatment aids (DRR's, Beam's eye view plots)reatment plan optimization techniques
- Radiographic anatomy
- Correlation of magnetic resonance images with CT images
- Dose algorithms (w. Dr. Smith)
- Quality Assurance considerations treatment planning ( Dr. Smith)
- Brachytherapy: With Drs. Pouliot and Ms. Pickett:
- Radionuclides
- Calibration of sources
- Leak checking
- General radiation protection
- Survey instruments
- Clinical applications
- Treatment planning for remote afterloader applications
- Source spacing
- Source position verification
- Planning and preparation of source distributions
- Remote afterloader programming and q/a procedures
- Inventory and reporting requirements
- Treatment planning and source preparation for interstitialimplants of brain tumors, ocular melanoma and prostate tumors with I-125
Year II
- Supervised clinical dosimetry with Dr. Josephine Chen
During this module, the resident will apply the knowledge learned in year 1 to assist Dr. Faddegon in dosimetry checks of the machine. The resident is expected to develop the ability to work independently in data taking and data analysis as well as to participate in the clinical implementation of new developments such as dynamic wedges and intensity modulated dose distributions.
- Special techniques with Dr. Faddegon
The resident will learn the physics of special procedures including: superficial x-ray treatment for skin lesions, IORT (intra-operative radiation therapy with electrons). The clinical applications of these techniques as well as the special dosimetric considerations will be covered. - Stereotactic radiosurgery with Drs. Lijun Ma, Martina Descovich and Cynthia Chuang
The resident will learn the clinical indications for single fraction radiosurgery, the techniques for diagnostic localization of targets using combinations of MRI, CT and angiographic projections (for both tumors and arterial-venous malformations), for treatment planning, documentation and implementation of treatments using the Gamma Knife. The installation of the Cyberknife will permit the resident to learn methods of stereotactic radiosurgery and radiotherapy using the linac.
- Intensity modulated radiotherapy with Dr. Josephine Chen
The resident will learn the principles of inverse treatment planning, the advantages and disadvantages of different methods of IMRT beam delivery, will assist with preparation and interpretation of treatment plans for verification dosimetry and for patients with tumors in a variety of locations. Stop-and-shoot as well as Peacock MIMiC and dynamic MLC beam delivery methods will be investigated.
- Clinical physics research in radiotherapy with Dr. Jean Pouliot
The resident will have the opportunity to participate in the clinical implementation of new techniques in radiotherapy such as: computerized image comparison for evaluation of patient position using portal images, the use of multiple multileaf collimator patterns to produce 3-dimensionally conformal dose distributions, and the design of new treatment techniques such as intensity modulation which can improve the ratio of tumor dose to normal tissue dose. In addition, the resident will learn about the use of other modalities such as neutrons, protons and heavy ions through assigned readings and discussions. The resident will also participate in the planning and treatment of ocular melanoma patients with protons at the U.C. Davis cyclotron. This module will provide the background for clinical physics research in radiotherapy.
- Clinical and experimental hyperthermia with Dr. Diederich
The resident will participate in a comprehensive hyperthermia program involving both research and development "state of the art" hyperthermia technologies, as well as ongoing clinical treatments with a wide assortment of modern equipment. The residents will assist in clinical hyperthermia treatments and learn required quality assurance procedures for ultrasound and microwave devices. In addition, the resident will learn about techniques for temperature monitoring, treatment planning, and radiobiological considerations of heat and radiation.
- Radiobiology with Dr. Murnane
Through lectures and reading assignments, the resident will learn the basics of radiobiology. This will include cellular response to deposited energy, mammalian cell radiosensitivity, modifiers to cellular radiosensitivity, repair mechanisms, dose-rate effects, solid tumor systems, linear energy transfer, relative biological effectiveness, cell and tissue kinetics, dependence of biological response on time, dose, fractionation and volume of tissue irradiated, response of tissues to heat (hyperthermia), acute and late effects after irradiation, and tissue-specific descriptions of radiation effects.
- Clinical topics with Dr. David Larson, PhD, MD
Through lectures and reading assignments plus discussions with physicians, the resident will learn the basics of clinical presentations of malignancies, sites of anatomical spread, modes of metastases, extent of disease, potential complications of disease and of treatment, indications for radiation therapy and for combined surgery and/or chemotherapy, as well as basic radiographic anatomy. In addition to daily clinical conferences and lectures, the resident will be expected to attend a special set of clinical lectures by the medical faculty offered during July and August.
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