Objectives by PGY Level back to main page
Below are the general objectives of the program categorized by level of training. The objectives pertaining to the more advanced year include those of the previous year(s). For example, a PGY-3 will be expected to meet all objectives from that year as well as those from PGY-2 year. By the end of the PGY-5 year, the resident should have met all objectives.
PATIENT CARE ■ MEDICAL KNOWLEDGE ■ PRACTICE-BASED LEARNING AND IMPROVEMENT
INTERPERSONAL / COMMUNICATIONS SKILLS ■ PROFESSIONALISM ■ SYSTEMS-BASED PRACTICE
| PGY2 | PGY3 | PGY4 | PGY5 | |
| Perform and document a complete history and physical examination | ||||
| Review pertinent pathology, laboratory and diagnostic studies including imaging | ||||
| Stage a patient with cancer with reference to staging manual | ||||
| Summarize and present the patient's case to attending physician or in multi-disciplinary conferences | ||||
| Begin to discuss with patients and their families various treatment options, radiotherapy rationale, and possible side effects and complications | ||||
| Obtain informed consent for radiation therapy | ||||
| Learn the simulation process including patient position, benefits of treatment aids (markers, contrast) | ||||
| Delineate normal organs as well as gross tumor on cross-sectional imaging | ||||
| Have a basic understanding of dose, fractionation, overall treatment time | ||||
| Fill out radiation prescription in chart according to treatment plan | ||||
| Review portal images in comparison with simulation images i.e. DRRs | ||||
| Evaluate patient weekly while under treatment and manage acute toxicities | ||||
| Follow patients after treatment is completed and assess for long term toxicities | ||||
| Understand the role of palliative radiation therapy and manage patients with brain metastasis, bone metastasis, spinal cord compression and other oncological emergencies | ||||
| Begin to manage patients undergoing brachytherapy | ||||
| Accept responsibility for the care and treatment of patients assigned to a service | ||||
| Interpret pathology, laboratory, and diagnostic studies including imaging | ||||
| Begin to recommend further diagnostic testing for complete work up of the patient | ||||
| Further refine staging skills | ||||
| Begin to independently formulate a management plan for the patient | ||||
| Understand the roles of surgery and chemotherapy in the treatment of cancer | ||||
| Counsel patients and families with straightforward problems independently including treatment options, radiotherapy rationale, goal risks, benefits and side effects | ||||
| Be able to stimulate straightforward cases independently including the use of treatment aids (markers, contrast) and know external anatomical landmarks | ||||
| Be able to properly use image co-registration i.e. fusion in treatment planning and delineation of target volumes | ||||
| Understand and delineate treatment margins including CTV and PTV | ||||
| Select field arrangement, dose, fractionation, overall treatment time for 2-dimensional treatments including palliative cases | ||||
| Be able to calculate monitor units for straightforward cases | ||||
| Have a full understanding of the radiation therapy chart and be able to discuss in chart rounds | ||||
| Review simple computerized treatment plans independently and begin to understand dose-volume limitations for organs at risk | ||||
| Independently manage straightforward patients undergoing treatment at weekly treatment visits including acute toxicities | ||||
| Begin to independently assess follow-up patients for long term treatment-related toxicities and tumor recurrence | ||||
| Further refine brachytherapy skills including gynecologic, prostate, head and neck, and sarcoma patients | ||||
| Observe and participate in administration of unsealed sources | ||||
| Carry a full service of patients with efficiency and order | ||||
| Independently interpret pathology, laboratory and diagnostic studies including imaging and recommend further work-up and testing appropriately | ||||
| Independently stage a patient without reference to staging manual | ||||
| Formulate a comprehensive, multidisciplinary treatment plan for the patient | ||||
| Understand the roles of surgery and chemotherapy in the treatment of cancer including treatment related side effects and complications | ||||
| Counsel patients and families with complex problems independently including treatment options, radiotherapy rationale, goal, risks, benefits and side effects | ||||
| Simulate all cases independently including use of treatment aids | ||||
| Delineate all target volumes independently (GTV, CTV , PTV) | ||||
| Select beam arrangement, beam energy and modifiers, total dose, frationation, overall treatment time for all cased including 2-D, 3-D, and IMRT cases | ||||
| Review conformal computerized treatment plans independently and understand and implement dose-volume limitations for organs at risk; be able to modify treatment plan to achieve goal | ||||
| Be able to independently discuss and defend treatment plan for patient at chart rounds | ||||
| Independently manage more complex patients (including those undergoing chemoradiation) at weekly treatment visits and decide when patients require a treatment break or adjustment in treatment | ||||
| Independently assess follow-up patients for long term treatment-related toxicities and tumor recurrence; order appropriate testing for follow-up patients | ||||
| Perform brachytherapy procedures nearly independently including gynecologic, prostate, head and neck and sarcoma patients | ||||
| PGY2 | PGY3 | PGY4 | PGY5 | |
| Understand the anatomy, epidemiology/etiologic agents, natural history, pathology, routes of spread and initial clinical evaluation of the major disease sites | ||||
| Begin to understand basic principles of treatment for common cancers | ||||
| Begin to understand the principles of radiation physics and radiation biology | ||||
| Begin to understand acute and chronic effects of radiation therapy | ||||
| Begin to understand normal tissue tolerance i.e. TD 5/5 to radiation therapy | ||||
| Begin to understand basic principles of dose specification, dose prescription, field design, and field geometry | ||||
| Begin to understand SSD and isocentric technique, single field, AP/PA field and basics of stereotactic radiation therapy and brachytherapy | ||||
| Understand rationale behind selection of a treatment modality | ||||
| Begin to understand clinical evidence to support treatment modality including results from landmark clinical trials | ||||
| Further refine understanding of principles of treatment for all cancers of major disease sites | ||||
| Continue to understand principles of radiation physics and radiation biology | ||||
| Further refine understanding of acute and chronic effects of and normal tissue tolerance to radiation therapy | ||||
| Understand follow-up evaluation of cancer patients | ||||
| Further refine knowledge of principles of dose specification, dose prescription, field design, and field geometry including dose homoeneity | ||||
| Further refine knowledge of radiation therapy techniques including 3 field, 4 field, oblique field, stereotactic therapy, 3-D conformal radiation therapy | ||||
| Understand treatment results and outcomes of therapy (radiation therapy, surgery, or chemotherapy) with respect to the major disease sites | ||||
| Understand patterns of failure with respect to the major disease sites | ||||
| Understand more advanced radiation therapy techniques such as 4-field breast, mantle/para-aortic field match, craniospinal irradiation, other junctioned fields, optimal beam arrangement, stereotactic radiation therapy, intesity-modulated radiation therapy (IMRT) and brachytherapy | ||||
| Understand in detail the principles of clinical oncology with respect to the major disease sites in preparation for the ABR clinical radiation oncology exam | ||||
| Understand in detail the principles of radiation physics and radiation biology in preparation for the ABR physics and radiobiology exam | ||||
| PGY2 | PGY3 | PGY4 | PGY5 | |
| Begin to identify sources for information including textbooks, journals, on-line resources | ||||
| Using above sources, begin to locate, appraise and assimilate evidence from scientific studies to improve patient care | ||||
| Critically read and analyze relevant literature during participation in morning conferences and journal clubs | ||||
| Incorporate formative evaluation feedback into daily practice | ||||
| Learn basic principles of statistics and evidence-based medicine | ||||
| Start and maintain ACGME web-based patient log | ||||
| Critically evaluate clinical studies with regards to methods, design, statistics and validity of conclusion and use to improve patient care | ||||
| Continue to critically read and analyze relevant literature during participation in morning conferences and journal clubs | ||||
| Continue to learn principles of statistics including its limitations | ||||
| Develop and execute an investigative project suitable for publication under faculty supervision as a means of developing practice improvements | ||||
| Participate in the education of co-residents, medical students, nurses, therapists or other staff | ||||
| PGY2 | PGY3 | PGY4 | PGY5 | |
| Write a radiation therapy prescription to effectively communicate the details of treatment delivery to the therapy staff | ||||
| Use the EMR i.e. EPIC and IMPAC to effectively communicate details of the patient visit, patient assessment and treatment plan | ||||
| Use personal and electronic communication (EPIC/IMPAC) to communicate with other staff i.e. nurses, therapists, dosimetrists, physicists with regards to patient care | ||||
| Understand that a radiation oncologists works as an integral part of a team to effectively care for patients alongside physician colleagues, co-residents, nurses, therapists, dosimetrists, physicists, administrative and secretarial staff, social workers, dieticians, etc. | ||||
| Involve the patient and patient's family in decisions regarding care using clear communication and empathetic behavior with respect to emotional needsd, intellectual capacity, and ethnic/racial backgrounds | ||||
| Develop a relationship with the patient as a health care provider that begins at consultation an continues through simulation, treatment and follow-up | ||||
| Demonstrate the ability to communicate and coordinate care between disciplines i.e. medical oncology, surgery, general medicine | ||||
| Understand the importance of a neat and complete radiation oncology chart and be able to defend in chart rounds | ||||
| Learn to communicate directly and personally with referring physicians/disciplines | ||||
| PGY2 | PGY3 | PGY4 | PGY5 | |
| Demonstrate compassion, integrity, and respect for patients, families, medical colleagues, and staff | ||||
| Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, national origin, disabilities and sexual orientation | ||||
| Respect patient confidentiality and autonomy | ||||
| Demonstrate the ability to comply with medical records and charting requirements specific to rotations | ||||
| Demonstrate a commitment to learning the fundamentals of radiation oncology by attending lectures and clinic, keeping up with assigned readings and demonstrating accountability to patients, society and the profession | ||||
| PGY2 | PGY3 | PGY4 | PGY5 | |
| Practice cost-effective health care that does not compromise the quality of care | ||||
| Advocate for quality patient care and assist patients in dealing with system complexities | ||||
| Understand that the practice of radiation oncology is an interdependent part of the health care system and society at large | ||||
| Consider how your practice affects other healthcare professionals and the hospital system | ||||
| Know what resources are available for patient care, within or outside the institution and make referrals as appropriate |
