At the start of each rotation, the rotation attending furnishes residents with crucial information and guidance to guarantee a productive and educational experience. This includes outlining the precise goals and objectives of the rotation, offering clarity on the resident's expected learning outcomes and accomplishments. The attending also addresses their expectations concerning the resident's responsibilities in patient care, ensuring that the resident comprehends their role, duties, and educational objectives.
Each year of postgraduate training is a 12-month academic year (July - June) with of five 10-week rotation blocks.
In the first year of a radiation oncology residency, the emphasis lies in establishing a basic comprehension of radiation oncology. During postgraduate year two (PGY-2), residents actively engage in the day-to-day clinical care of cancer patients, taking on an active role in managing patient cases and participating in didactic education and introductory experiences in radiation oncology. This initial year of training provides residents with various hands-on experiences, including patient care, treatment planning, and the operation of radiation therapy equipment. Residents perform patient work-ups, provide assistance in consultations, contribute to treatment planning, administer patient treatments, conduct on-treatment visits, and conduct follow-up assessments. PGY-2 residents are exposed to the full spectrum of clinical oncology cases treated at OHSU Hospital and patients within the Portland VA Hospital and Doernbecher Children's Hospital. Faculty attendings consistently supervise residents to ensure that their responsibilities align with their skill and experience levels. Residents regularly collaborate with other healthcare professionals, including medical oncologists, surgeons, radiologists, and the radiation oncology teams.
In the first year, the primary focus centers on acquiring knowledge in anatomy, pathology, staging, and epidemiology within the context of cancer care. Residents are expected to attain proficiency in conducting physical examinations and maintaining proper documentation in the official medical records' history and physical assessments.
PGY-2 residents are required to attend basic science lectures covering biology and physics, in addition to clinical lectures and tumor boards as applicable to their clinical rotations.
In the postgraduate year three (PGY-3), residents maintains a clinical focus and are expected to approach clinical problems based on prior experience, gradually assuming increased responsibilities related to patient care, decision-making, and treatment planning. During this year, PGY-3 residents actively take on greater responsibility in the day-to-day clinical care of cancer patients and become more involved in treatment planning, patient management, and the delivery of radiation therapy, with less supervision compared to the first year.
This training year marks a pivotal stage in a resident's development, as they transition from foundational learning to a more independent and specialized practice under the supervision of faculty attendings and clinical staff. Residents should demonstrate the ability to create a basic radiation volume while comprehending normal tissue and tumor anatomy, as well as understanding patterns of cancer spread.
By the end of PGY-3, residents are required to submit a research proposal for a project to be completed before completing the residency. This research can take the form of clinical studies (e.g., chart reviews) or basic science investigations. All research endeavors must receive approval from the program director and be supervised by OHSU staff. The expectation is that this research will culminate in a presentation (either a poster or a talk) at a major radiation oncology meeting (e.g., ASTRO, RSNA, ASCO) and publication in a peer-reviewed journal.
In postgraduate year four (PGY-4), residents have the opportunity to explore unique elective options actively. Residents interested in academic medicine are encouraged to take the lead in forming and participating in a research team (clinical, translational, or basic) under mentorship, thereby gaining invaluable experience and exposure. During this year, residents can request up to 12 months to commit to their research. Examples of resident research projects here and a list of resident grants and awards related to these projects here.
Residents can also choose to engage in elective rotations tailored to their interests, including brachytherapy, pediatric radiation oncology, or stereotactic radiosurgery. Additionally, residents can collaborate with the department's medical physics faculty to complete a dosimetry rotation within the department.
Furthermore, residents have the option to dedicate the majority of their time to pursuing additional degrees, certificates, or experiences, such as a Master's in Clinical Research through OHSU's Human Investigations Program, a Certificate in Human Investigations, a healthcare M.B.A., and more. We encourage residents to think creatively about supplementary experiences and training that will yield long-term benefits for their careers.
During this year, residents are also responsible for preparing for the Medical Physics for Radiation Oncology and the Radiation and Cancer Biology ABR exams, as they will have completed 24 months of residency training. Residents are provided protected time to prepare for these exams. PGY-4 residents participate in Mock Orals exams to prepare for the Oral Certifying Exam.
In postgraduate year five (PGY-5), residents prepare for graduation and independent practice, this year serves as a crucial bridge between training and autonomous clinical work. During this year, residents focus on refining their clinical skills, bolstering confidence, and gearing up for the responsibilities inherent in a radiation oncology career. PGY-5 residents take on an elevated level of clinical independence, enabling them to independently manage intricate patient cases, make informed treatment decisions, and oversee radiation therapy delivery with minimal supervision.
Residents are expected to be well-versed in established, literature-supported radiation oncology techniques and to utilize current literature and meeting information to adapt treatment approaches as new therapeutic developments emerge. Additionally, they dedicate clinical time to honing specialized procedure techniques, such as brachytherapy and radiosurgery.
In PGY-5, residents also assume the distinction of chief resident, shouldering administrative responsibilities for the program. This includes determining the didactic calendar, developing the call schedule, and providing leadership and mentorship to junior residents and medical students.
Throughout the final year, residents are required to complete research projects that were initiated during their residency. These projects often lead to presentations at major radiation oncology conferences and eventual publication in peer-reviewed journals.
During the final months of training, residents are provided with protected time to prepare for the American Board of Radiology (ABR) Clinical Qualifying Exam. PGY-5 residents also participate in Mock Orals exams to prepare for the Oral Certifying Exam.
Overall, the final year of a radiation oncology residency marks the culmination of training, enabling residents to solidify their expertise, actively contribute to research and academic pursuits, and prepare to embark on their careers as board-certified radiation oncologists.
Residents are required to participate the following academic conferences:
- Didactic lectures (Monday, Wednesday, Friday)
- Chart Rounds (Tuesday, Thursday)
- Physics didactics (alternate Fridays)
- Radiation Biology didactics (alternate Fridays)
- Tumor Board (dependent on clinical rotation)
- Multidisciplinary didactic sessions (dependent on availability)
- Clinical Informatics (annually)
- GME Quality Improvement Bootcamp (PGY-2 requirement, annually)
- Financial Principals (annually)
- Patient Safety (bi-annually)
- Morbidity and Mortality (quarterly)
- Radiation Oncology Journal Club (quarterly)
- Wellness lecture (annually)