Program Structure

During the orientation, the resident will shadow the various groups in the department, including dosimetrists, treatment therapists, simulation therapists, oncologists, and physicists. The resident will be exposed to the treatment and planning systems in the department, and will participate in numerous discussions on clinical medical physics with the program faculty.

Mentor: Abby Besemer

The Linac Operation and Quality Assurance rotation is designed to introduce the resident to a typical “c-arm” treatment delivery system, e.g., the Varian TrueBeam platform. The resident will learn about the therapeutic beam production and shaping aspects of the system, along with the potential failure modes of the system. The resident will learn and perform national and departmental standards for periodic and post-repair quality assurance testing.

Mentors: Alison Arnold and Jordan Slagowski

During the basic treatment planning rotation, residents will learn treatment planning techniques for 2D and 3D conformal radiation therapy for a wide variety of treatment sites. Residents will also learn the physics of treatment planning and dose calculation to help further their understanding of the treatment planning process. Finally, residents will participate in CT simulation, treatment planning and plan review for UWHealth patients.

Mentors:  Dustin Jacqmin and Gemma Davies

During the Detectors and Measurement Systems rotation, residents will learn about the available devices used to measure radiation in the field of radiation oncology. The rotation will cover the functionality and application of each device. Residents will also be given the opportunity to learn about dosimeter calibrations from the University of Wisconsin Accredited Dosimetry Calibration Laboratory.

Mentor:  Jessica Miller

During the brachytherapy rotation, residents will learn the procedures, quality assurance and regulations for all brachytherapy procedures performed at the University of Wisconsin Hospital and Clinics. Residents will be able to create clinical treatment plans for high dose rate and low dose rate applications. After the completion of this rotation, the resident should have the skills and knowledge necessary to be able to create a safe, efficient and effective clinical brachytherapy program at another institution.

Mentor: Charles Wallace

During this rotation, the resident builds upon the expertise gained during the Basic Treatment Planning rotation by extending focus to IMRT, VMAT, and TomoTherapy treatment plan design. Additionally, the resident learns about IMRT QA program management, modern treatment plan optimization strategies, and updated clinical treatment planning goals and constraints.

Mentor:  Adam Bayliss and Patrick Hill

The Imaging and Image Registration rotation is focused on understanding the physics behind the imaging techniques commonly used for Radiation Oncology patients, as well as understanding the applications of these images, both during treatment planning and treatment delivery. Image acquisition, image processing, image quality, and image registration and fusion are covered for common modalities such as 2D projection images, CT, MR, Ultrasound, PET, and non-ionizing imaging techniques.

Mentor: Michael Lawless

On the stereotactic radiosurgery rotation, residents will learn about available treatment techniques used in the delivery of high dose-per-fraction, highly conformal radiation plans. Residents will also learn about appropriate procedures in the commissioning of small-field treatment techniques as well as the specifics of small-field dosimetry. Finally, residents will participate in radiosurgery planning and delivery for UWHealth patients.

Mentor: Zac Labby

On this rotation, residents will learn about the selection, implementation, utilization, and management of Treatment Planning Systems. This includes configuring machines and beam model parameter values, use of physics and planning modules, commissioning, as well as establishing and maintaining quality assurance. Residents will use measured beam data and create their own validated commissioned machine.

Mentor:  Sean Frigo

On the special procedures rotation, residents learn about total-body and total-skin irradiation techniques. These treatment techniques apply a wide range of skills learned during the residency, including detectors, measurements, treatment planning, and quality assurance. The resident learns the fundamentals of commonly employed approaches to these treatments and participates in clinical patient treatments as possible. The resident will also independently validate an aspect the current clinical program (as determined with the mentor) to gain experience with commissioning and maintaining these complex treatment programs.

Mentors:  Abby Besemer

Radiation shielding evaluation is a fundamental component of the scope of practice of clinical medical physicists. This rotation explores the latest methods for performing shielding calculations and places an emphasis on practicing these methods through a series of common radiation therapy shielding scenarios. Other facility design goals, including room layout, construction cost management, electrical/HVAC considerations, and radiation surveys will also be discussed.

Mentor:  Jennie Crosby

During the commissioning rotation, residents will learn about process of installing a new linear accelerator, including selection and performance specification, acceptance testing, and commissioning. The resident will participate in beam data acquisition measurements for a new linear accelerator. Residents will also learn about the methods used for commissioning other radiotherapy devices and will be responsible for a commissioning project of their own.

Mentors:  TBD

On the MRI in Radiation Therapy rotation, residents will learn about the characteristics of both MRI-guided radiation therapy (MRgRT) delivered via a low-field MR-linac and MRI simulation (i.e., imaging of patients in the treatment position). Major competencies will include MRI safety, quality assurance (QA), and evaluating the impact of the magnetic field on both dosimetry and image quality parameters. Imaging sequences, artifacts, and use cases will be highlighted. Residents will actively participate in the machine and patient-specific QA processes and become acquainted with MR-guided adaptive radiation therapy, including MR-only treatment planning. Specific staffing and equipment needs in these hybrid environments will be demonstrated. Overall, this rotation features state of the art equipment for cancer care and builds upon the unique strengths in MRI and MRgRT at the University of Wisconsin-Madison.

Mentor: Carri Glide-Hurst

Residents will work with the program director to create a tailored elective rotation plan based on their interests. In the past, some residents have used this rotation to provide full clinical physics support where they are assigned physicist of the day (POD), physics initial chart check (PIC), brachytherapy, and/or radiosurgery coverage duties and as an independent medical physicist. Some residents have also used this time to have dedicated time to work on a clinical development or research project. Some have also done a mix of clinical coverage and research during their elective. Recently, one resident had the unique opportunity to participate in a short away rotation at another institution to observe a GammaKnife source exchange. We hope to continue to explore the possibility of providing residents with cross-institutional training opportunities in the future.

Mentor: Abby Besemer