Program Structure

The four-year Radiation Oncology residency follows completion of a one-year internship in Internal Medicine.

The program prepares residents for certifying examinations given by the American Board of Radiology. Residents master different treatment procedures at five clinical institutions in the Emory Healthcare System.

Learn more about the residency program at Winship in an interview with 2015-16 Chief Residents, Drs. Ronica Nanda and Trevor Lim: “What Does It Mean to Be a Resident?

Overview

PGY-1: Internship in Internal Medicine

The first year of training is a preliminary internship with the Department of Medicine. The radiation oncology interns share patient care, call, conference presentations, and clinic duties with the categorical medicine and other interns. The year is divided into twelve rotations; most will be performed at Grady Memorial Hospital, but a few rotations may be at Emory University Hospital or the Veterans' Affairs Medical Center. The year typically consists of eight months of inpatient medicine wards, one emergency medicine month, one medicine ICU month, one ambulatory medicine month, and one elective month.

PGY-2 through PGY-5

By PGY-4, residents are expected to evaluate patients, determine appropriate therapy, plan radiation fields, and complete all of the service's other clinical duties with minimal direction from attending physicians. Attending physicians still must verify treatment plans before radiation therapy is initiated. Residents will master the most difficult treatment planning options of all tumor sites by stage of disease as well as patient management issues.

Each resident must perform 10 intracavitary brachytherapy procedures and 5 interstitial brachytherapy procedures, and assist in an additional 10 intracavitary and 5 interstitial procedures. Each resident must see a minimum of 450 new patients during their entire training. They also must complete at least one manuscript suitable for publication on a clinical or basic science topic.

Our Faculty

There are 46 full-time faculty members in the Department of Radiation Oncology including 20 radiation oncologists (MD or MD/PhD) in the Clinical Division, 15 physicists (PhD) in the Division of Medical Physics and 11 cancer biologists (PhD) in the Division of Cancer Biology.

Our Hospitals and Clinics

Residents see patients or can observe treatments at the following Emory Healthcare locations:

Emory University Hospital serves as the base for the residency program. The facility at Emory gives the residents a unique exposure to neuro-oncology and pediatric radiation oncology with emphasis in stereotactic radiotherapy for central nervous system tumors. The residents also see a large number of patients with head and neck, breast, hematologic, genitourinary and gastrointestinal malignancies. Residents will gain experience in IMRT, all aspects of stereotactic radiotherapy planning, PET-CT fusion, and prostate brachytherapy. There is also the opportunity to see plaque brachytherapy for ocular melanoma. This facility performs CT simulation, which allows great precision in setup and planning of radiation treatment. Our linear accelerators at the four institutions all utilize multileaf collimators for IMRT treatment delivery. All of these linear accelerators are equipped with on-board imaging and respiratory gating capabilities. We also perform stereotactic radiosurgery at this facility using shaped-beam techniques with a linear accelerator. A PET-CT system used for treatment planning in selected patients. This facility has four linear accelerators, including two True Beam and one Novalis Tx treatment unit, as well as an HDR suite.

Emory University Hospital Midtown provides the residents with experience in treating malignancies of the breast, lung, and genitourinary system, as well as soft tissue sarcomas. The resident also will gain experience in high-dose rate intracavitary brachytherapy for lung and gynecological tumors, as well as low-dose rate interstitial prostate and low-dose rate intracavitary cervical implants. This facility has a CT simulator, two Varian linear accelerators with multileaf collimators and a high dose-rate remote afterloading unit.

Grady Memorial Hospital Edward Loughlin Radiation Oncology Center sees patients with a wide range of head and neck, lung, breast, gynecologic, genitourinary and gastrointestinal tumors. Unfortunately, patients often have advanced stages of disease, which offer a unique challenge in treatment planning and delivery. Residents also gain experience in low- and high-dose rate brachytherapy for gynecologic malignancies. This facility has a CT simulator, 2 linear accelerators with multileaf collimators, including a True Beam unit, and a high-dose rate remote afterloading unit.

Atlanta Veterans Affairs Medical Center provides the residents with experience in treating head and neck, lung and genitourinary malignancies. The facility has a CT simulator and two Varian linear accelerators with multileaf collimators.

Emory Saint Joseph's Hospital sees patients with a wide range malignancies including head and neck, breast, gynecologic and genitourinary tumors. The clinic has a CT simulator, two Varian linear accelerators with multileaf collimators, a high-dose rate remote afterloading unit and a Gamma Knife Perfexion unit. Residents can observe brachytherapy and Gamma Knife procedures at this site.

The Emory Proton Therapy Center-Winship Cancer Institute will be the first center of its kind in Georgia to offer patients access to new, ground-breaking radiation therapy. The facility, located one block from Emory University Hospital Midtown, will open in late 2018.

Rotations

Residents are assigned to an Emory facility on a rotating basis. Most clinical rotations are three months in duration.

The resident is expected to learn the presentation, evaluation, staging, radiation therapy techniques, relevant literature and clinical management of each patient encountered on the rotation. Progressive and increasing responsibilities are delegated to residents commensurate with their knowledge and experience.

Clinical research protocols are available through our affiliation with RTOG, GOG, ECOG, NSABP, POG and Brain Tumor Study Group. There are over 250 active Phase I, II, and III clinical trials at Winship Cancer Center.

Evaluation and Promotion

Residents are evaluated at the completion of each three-month rotation. At the end of each year, a composite evaluation is performed by the program director. Residents are expected to show an improvement in performance over the previous year. The Academic Committee meets in March each year to review each resident’s performance. Contracts for the following year will be offered to residents who have an overall satisfactory evaluation.

The requirements for successful completion of the residency program include preparation of at least one manuscript suitable for publication. Usually during the PGY-3 or -4 year, residents have 6 month of research in clinical radiation oncology, radiation biology, radiation physics, or some combination of these. Residents may elect rotations in other oncologic subspecialties including surgical oncology, medical oncology, pediatric medical oncology and pathology.

Examinations

Residents are expected to score above the 50th percentile on the American College of Radiology (ACR) in-service training exam. The RAPHEX examination also is administered and is optimal for PGY-4 residents preparing for the physics and radiation oncology board exam.

Chief Resident(s)

One or more of the PGY-4 residents is selected to be chief resident(s) for the next year by a vote of the Academic Committee.