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University of California San Francisco

Residency Program Outline

Foreground Victoria Cheung

The resident rotations and the curriculum will be developed and coordinated by the CAMPEP-approved medical physics educational committee (MPEG), which will also be responsible for judging the competence of the resident in each area. The competency will be judged on the basis of CAMPEP program guidelines as well as interviews with the primary physicist in each area, interviews with the resident and performance on standardized and customized examinations.

Clinical Rotations

The Physics Residency Program consists of two years of full-time equivalent clinical training, with progressively increasing responsibilities under the supervision of qualified medical physicists. The program follows Report No 249: “Essentials and Guidelines for Clinical Medical Physics Residency Training Programs” published by the American Association of Physicists in Medicine (AAPM) in 2013 and the CAMPEP “Standards for Accreditation of Residency Educational Programs in Medical Physics”

Physics residents are immersed in the clinical environment throughout the Program. Upon completion of the program, the residents are expected to demonstrate competency in practicing fundamental clinical radiation oncology physics procedures and have a comprehensive understanding of all clinical topics in radiation oncology physics.  The residents are prepared to pass all parts of the exams of the American Board of Radiology.

The Residency Program is divided into 9 core clinical rotations each with specific objectives and competencies that must be completed by the resident. Each rotation has a primary mentor that rotates throughout the faculty. The medical physics residency steering committee (MPRSC) reviews the rotation goals and objectives annually and determines whether changes need to be made. A description of the clinical rotation schedule is provided below.

UCSF Physics Residency Rotation Schedule

  Rotation Topic Time/Mentor
  Orientation Employee Orientation, Introduction to Radiation Oncology Clinic, IT accounts, physics overview on clinical workflow, Record and verify systems, radiation protection, simulation, linac, warm-ups, MU calculations, chart checks, State and Federal regulations, professional guidelines, elements of professionalism, professional organizations, ethics, confidentiality and research on human subjects, environmental safety (HV, lead alloy) 1 month
1 Patient safety/ Patient specific measurements

Special topics (hip prosthesis, pregnant patient, pacemakers, custom patient shielding), IMRT QA principles/applications of Failure mode effects analysis (FMEA) and Root cause analysis (RCA)

In-vivo dosimetry (e.g. diodes, thermoluminescent dosimeters (TLDs), optically stimulated luminescence dosimeters (OSLDs)

Standards for exchanging and developing electronic health records

2 months
2 CT simulation & Treatment Planning

CT Simulators (including quality control, safety and compliance tests)

Treatment simulation techniques (e.g. patient positioning, immobilization)

Immobilization devices

Step-and-shoot and sliding window IMRT

Treatment planning algorithms

Monitor unit calculations/configurations (e.g. SSD setup, SAD setup, extended distance, off-axis and rotational beams)

Beam modifiers (bolus, wedges, compensators)

Tumor localization and International Commission on Radiation Units and Measurements (ICRU), target definitions [e.g. gross tumor (GTV), clinical target volume (CTV), and planning target volume (PTV)

Normal tissue anatomical contouring

2D and 3D treatment planning

IMRT/VMAT planning/optimization/QA

Site-specific treatment planning

Plan evaluation [e.g. dose-volume histogram (DVH). Conformity index, homogeneity index, biological evaluators)

Treatment records

Dose limits to sensitive structures

Clinical applications of various radiation treatments

3D external beam treatment planning workstations

Inhomogeneity correction algorithms

Total body irradiation (TBI)

Total skin electron therapy (TSET)

4 months



3 Linac & Treatment planning system commissioning

Conduct system calibration, performance evaluations, and quality control, safety and compliance tests, including vendor specifications, under the supervision of a qualified physicist

Megavoltage photons

Megavoltage electrons

Beam scanning systems

External beam dose measuring systems

Radiation detector and measurements, ADCL, Annual QA, TG51

Beam modeling and TPS commissioning

Beam data acquisition/management

Beam modeling

Treatment planning system commissioning

Validation of imported images

4 months



4 Radiation Protection and Shielding

Sealed source storage/safety/protection

Sealed source inventory/check-in/out procedures

Sealed source packaging/transportation (e.g. Title 19 CFR)

Calibration of sealed sources

Exposure and contamination surveys

Radiation signage

Definition and reporting requirements for medical events

Radiation safety of personnel during radionuclide therapy

Patient release criteria following radionuclide therapy and radiation safety for the public

Safety policies/procedures

Compliance audits

Occupational and public dose limits

National and state regulations

Radiation exposure to the public

Shielding design (primary and secondary barrier calculations)

Neutron shielding

Facility radiation surveys

Personnel dosimetry

1 month



5 Imaging

Image registration, fusion, segmentation, processing

Image-guided radiotherapy (IGRT) equipment/techniques [e.g. planar MV and KV imagers, cone beam CT, non-radiographic localization (e.g. ultrasound (US), surface camera, radiofrequency (RF) beacon tracking


DICOM standards and DICOM in radiation therapy (DICOM-RT)

PACS systems and Information acquisition from PACS/images

Quality/maintenance of imaging workstations

Evaluation of viewing conditions

1 month



6 SRS, SBRT & Motion Management

Gamma Knife & linac-based SRS

Small field planning/optimization/QA

Small field dosimetry

CyberKnife and linac-based SBRT including advanced treatment planning

Motion management techniques

Organ motion-corrected methods

Inhomogeneity correction algorithms (including Monte Carlo)

3 months



7 Brachytherapy

HDR, seed implant and IORT

Brachytherapy treatment plans and QA

Brachytherapy implants (temporary/permanent)

Brachytherapy applicators, LDR, HDR

Hyperthermia, HIFU, BSD2000

3 months



8 Proton Proton therapy technologies and clinical indications, Eye beam line, self study

1 month



9 Transition to Practice  (TTP)

Clinical Service with a physicist of the day (machine troubleshooting, weekly and Initial Chart Check)

Record and verify systems

Treatment record design/maintenance

Network integration/management

The roles of physics and information technology staff

2 months



  Elective Focus on research and clinical project, if the resident is in a good position to complete the core clinical rotations. 2 months
  Total months   24 months


Redefining Possible