Physics Residency – Training Requirements
The physics residency training program consists of two full years of training with a typical start date of July 1 each year. In special cases, the start date can be adjusted. In order to complete the Program, the Physics Resident must:
- Successfully complete a series of clinical physics rotations (details are discussed in a latter section) and be credentialed in all quality assurance procedures performed in our department. (Evaluations are documented for each rotation).
- Attend and pass the special training sessions and didactic courses listed below:
- Radiation Safety Exam
- Machine Operation and Safety Orientation
- Physics Didactic Course
- Radiation Biology Course
- Attend Clinical Didactic Lectures given as scheduled
- Attend/ participate in the conferences and special lectures listed below:
- New Patient Simulation Conference
- Chart Rounds QA Review Conference
- Treatment Planning Conference
- Physics/Physician Resident Seminars
- Physics Journal Club
- Physician Journal Club
- Annual Radiation Safety lecture
- Annual Fire, Chemical, Biohazard on-line training
- Prepare PowerPoint handouts for assigned topics for presentation at Physics/Physician Residents Physics Seminar
- Prepare PowerPoint Disease Site/Treatment Planning report
- Pass Year 1 Mid-Term Exam, RAPHEX Exam and Oral Exam
- Pass Year 2 RAPHEX Exam and Oral Exam
- The resident is given a certificate upon completion of the program
New physics residents are provided a two-day orientation lecture series followed by a two-week rotation in the CT-simulator and treatment planning areas at the beginning of their training.
This is followed by an intense 2-week instruction on fundamentals of treatment planning and current UC Davis Policy & Procedures (P&Ps) for treatment planning by the medical dosimetrists.
In addition, the Program Director, Associate Director and Chief Dosimetrist meet with each new resident once a week to ensure the incoming resident clearly understands the program's requirements, resident administrative procedures, conference and didactic lecture schedules, and any other pertinent information. At this meeting, the resident is made aware of program resources, including treatment machines, treatment planning facilities, dosimetry laboratories, and libraries.
During the two-year period, the physics resident will receive didactic instruction in the following areas:
- Basic Radiological Physics
- Radiation Physics Instrumentation
- Mathematics pertaining to Use and Measurement of Radioactivity
- Imaging for Planning and Localization
- External Beam Radiation Oncology Physics
- Advanced Special Procedures (e.g. TBI, TSET, IMRT, SBRT, SRS)
- Brachytherapy Physics
- Radiation Safety/Protection
- Radiation Biology
- Clinical Radiation Oncology
- Statistics (in development)
The formal Physics Course lectures are given 2 days a week 7 to 8 a.m. in the department’s Conference Room. The Physics Course utilizes the textbook by Faiz Khan, Radiation Therapy Physics, 4th Edition, published by Williams and Wilkins. It is supplemented by handouts provided by the lecturer. All lectures are posted on our share drive. Homework is assigned and reviewed at assigned sessions; mid-term and final exams (RAPHEX) are given.
The formal Radiation Biology Course is based on the 2015 ASTRO syllabus and utilizes the textbook by Eric Hall, Radiation Biology for the Radiologist, 4th Edition, published by J.P. Lippincott. It is supplemented by handouts provided by the lecturer. Physics residents must pass a final exam for this course to complete their residency training program.
The Clinical Didactic Lecture series is conducted every Monday and Wednesday morning 8:00 - 9:00 A.M. The topics are designed to essentially cover over a 2-year period the material found in the textbook by Perez and Brady, Principles and Practice of Radiation Oncology, 5th edition, published by J.P. Lippincott. A list of the lectures given is maintained by the department.
Instruction in anatomy and physiology is provided by a number of means. The physics resident is exposed to this subject matter while attending the New Patient Simulation Conference, Chart Rounds QA Conference, Treatment Planning Conference and the Clinical Didactic Lecture series. Over the two year training period, these conferences provide the resident exposure to a considerable number of patient related case management discussions involving the use of simulation images, portal images (KV and MV), CT scans, MR scans, and PET scans in which anatomical and physiological issues are discussed. In addition, we are a fully image based CT-simulation/planning clinic having no conventional simulator. The image-based virtual simulation procedure provides the physics resident with a rich experience in radiologic anatomy. In addition, the physics resident prepares at least 6 detailed reports for selected disease sites that review pertinent anatomy (critical organs at risk, target volumes including nodal regions), oncology aspects, and related technical treatment considerations (immobilization/reposition, modality/beam arrangements, doses, tolerance doses). Each report is reviewed by the Physics Residency Director and if necessary updated by the resident until final approval is obtained.
The first year consists of three Treatment Planning Rotations (Basic, Intermediate, and Advanced), one Clinical Physics Rotation (Basic) and specific quality assurance (QA) assignments (Basic, Intermediate). Each rotation consists of (a) assigned tasks (observe/do/check/ repeat until sign-off) that are closely supervised; (b) assigned readings; and (c) feed back/evaluation. The QA assignments are done with an assigned physicist and training is geared toward becoming fully credentialed in all QA procedures on the dosimetry instrumentation, treatment machines, CT-simulator, and planning systems by the end of the first year.
The second year consists of five Clinical Physics Rotations (Elekta Linac, Tomo Brachy LDR/HDR, Gamma Knife and SBRT, Special; Areas), specific quality assurance (QA) assignments (Advanced), and an assigned special project. During the second year, the successful physics resident is given more responsibility (but always under the direct supervision of a faculty/staff physicist). The 2nd year resident is asked to be more at the front line interfacing directly with physicians, therapists, dosimetrists, clinical engineers, IS staff and working with the attending physicists. This type training should allow the physics resident to develop confidence and continue the development of the necessary skills and experience to be prepared for independent clinical physics practice by the end of the residency program.
It should also be understood that every effort is made to include the resident into acceptance testing and commissioning of any new simulation, treatment planning, treatment delivery, and localization systems implemented in the UC Davis radiation therapy clinic.
Physics residents participate in all department conferences in which the physics faculty is expected to attend. These include
- New Patient Simulation Conference
- Chart Rounds QA Review Conference
- Residents Physics Seminars
- Treatment Planning Conference
- Physics and Physician Journal Clubs
For the Residents Physics Seminars, the physics resident is assigned topics for two seminar presentations each year. The physics resident, working closely with an assigned physicist/dosimetrist advisory team, is expected to prepare a detailed PowerPoint handout on the assigned topic with a well researched bibliography that contains both "classic" papers and “state-of-the-art” references.
The Program Director, Associate Director, and the Chief Dosimetrist meet with each resident once a month to review the training assignments and the progress made. Each resident provides a written monthly report documenting accomplishments (treatment plans, QA procedures, clinic involvement, lectures and conferences attended) and listing training plans for the coming month. As training progresses, updates are given on status of procedure credentialing, assigned presentations, special project assignments, manuscript status, etc. At these meetings, the resident’s progress in their current rotation is reviewed, discussed, and if needed altered.
By the end of the first year, the Physics Resident is expected to function as a junior-physicist, with the ability to perform (with senior physicist oversight) treatment machine basic calibration and periodic QA tests, patient specific QA measurements and calculations, monitor unit and dose calculations, conventional and IMRT external beam treatment planning, brachytherapy physics procedures and planning, weekly electronic (IMPAC MOSAIQ) chart reviews including delivery and imaging for patients, and be knowledgeable of radiation safety procedures.
By the completion of the second year, the physics resident is expected to be able to demonstrate the ability to independently perform all radiation oncology physics functions, including full calibrations of treatment machines, advanced treatment planning, checks of dosimetrist planning (treatment plans, calculations, etc.), weekly electronic (IMPAC MOSAIQ) chart reviews including delivery and imaging for patients, radiation safety procedures, clinical physics consultations, and patient-related dosimetry.
Near the end of each year of their training, the resident is given an oral examination modeled after the ABMP certification exam. If the resident does not pass the exam, the resident will be placed on probation. During that period, the resident is assigned to the area(s) of demonstrated weakness. At the end of the probation period, an oral exam is again conducted. If the resident does not pass this second oral exam, the resident will be terminated from the physics Residency Program under the procedures and guidelines of the University of California, Davis.
Regular review of the Physics Residency Program requirements is the responsibility of the Physics Residency Program Committee. All clinical physics rotations and QA training essentials are reviewed once a year. If changes are needed to meet the needs of the Program, then the Physics Residency Program Director will target the appropriate faculty for that task. Modifications require approval by the Physics Residency Program Committee.