Radiation Oncology

Medical Student Elective Manual

VA Puget Sound Health Care System &

University of Washington Medical Center

1660 S. Columbian Way

Mail Stop S-111-RadOnc

Seattle, WA 98108

Tel: (206) 768-5356

Fax:(206) 768-5331

 

 

Introduction

 

Welcome to this clinical outpatient experience at the VA Puget Sound where you will be participating in the work up and management of a variety of oncology patients, attending multidisciplinary tumor boards and morning teaching rounds/didactics, and learning about appropriate delivery of radiation therapy for cancer patients.

 

Orientation

 

• Meet with Dr. Tony Quang or the Chief Resident for orientation to the department
• Please ask Rob or Corey for an updated department phone list of members of the department
• Student will be exposed to various management settings in radiation therapy

(Please refer to calendar outline below for exact times)

• New Patient Consultation
• Prostate Brachytherapy
• Status Checks
• Simulation/Radiation Therapy
• Dosimetry
• VA Tumor Board
• Chart Rounds

 

MEDICAL STUDENT CLINIC SCHEDULE

 

	Monday	Tuesday	Wednesday	Thursday	Friday
AM	Status Checks with Jean Hargrett, PA-C	New Consult with Dr. Quang & Chief Resident	Prostate Brachytherapy with Dr. Wallner	New Consult with Dr. Quang & Chief Resident	Prostate Brachytherapy with Dr. Wallner
PM	Status Checks with Jean Hargrett, PA-C	New Consult with Dr. Quang & Chief Resident	Prostate Brachytherapy with Dr. Wallner 1pm VA Tumor Board	Dosimetry 3pm Chart Rounds	Simulation/ Radiation Therapy

 

 

EXPECTATIONS

 

• Participate in patient evaluation in clinics
• The level of student responsibility should be discussed prior to each clinic with each individual resident and attending
• In general, you could be expected to perform 1 complete H&P per new patient consultation for a total of 2-4/week
• You are encouraged to follow 1 patient/ week through simulation and treatment planning and see at least 5-10 weekly status checks
• All patient encounters must be supervised by a resident and/or attending
• Please do not advise patients without the discussion or presence of a resident or attending
• Attend teaching conferences and tumor boards
• Please refer to the Clinic Schedule above for the VA Puget sound
• Please refer to the Brown Bear Calendar http://freecal.brownbearsw.com/radonc for weekly lecture/didactics/conference schedules at the UW

 

 

OBJECTIVES/Medical Knowledge

 

• Learn the appropriate diagnostic evaluation, staging and prognosis of the various major cancers (prostate, breast, colorectal, lung, GYN, CNS, head and neck, GI) treated with radiation therapy
• Learn the appropriate use of radiation therapy in the curative setting for the common cancer types
• Learn the appropriate use of radiation therapy in the palliative setting
• Understand the acute and late effects that could result from treatment
• Understand a radiation prescription
• Understand the basics of simulation, treatment planning and treatment delivery by working with radiation therapists, dosimetrists and physicists
• Understand the basic concepts of radiation biology

 

 

Patient Evaluation and Care

 

There are 5 basic types of patient encounters in Radiation Oncology: Consultation, Simulation, Treatment Delivery, Status Checks of patient undergoing a course of radiation treatment, and Follow-ups:

 

1. Consultations

• Obtain the relevant history and diagnostic workup and perform physical examinations of the cancer patient
• Present the relevant details of the H&P and workup to the attending physician (2-4/week)
• Formulate a cancer treatment plan with the attending physician

 

2. Simulation and Treatment Planning:

• Assist in the careful design of a course of radiation treatment during patient simulation and treatment planning
• Understand the workflow process in radiation planning and the involvement of radiation therapists, dosimetrists and physicists

 

3. Treatment Delivery:

• Observe the delivery of radiation treatment on the treatment units (Elekta Synergy, TomoTherapy & brachytherapy)

 

4. Weekly Status Checks:

• Evaluate patients for the acute effects of radiation treatment during weekly status check visits and the management of these effects

 

5. Follow-ups:

• Evaluate patients for tumor response, late effects of radiation therapy and their management

 

 

End of Rotation

• Mandatory Evaluation of Course by Medical Student
• VAPSHC Rad Onc DepartmentÕs Evaluation of Medical Student

 

 

Suggested References

 

Principles and Practice of Radiation Oncology, 4^th edition (Perez and Brady)

 

Technical Basis of Radiation Therapy, Practical Clinical Applications, 4^th edition (Levitt, Purdy, Perez, Vijayakumar)

 

Cancer: Principles and Practice of Oncology (DeVita, Hellman, Rosenberg)

 

Handbook of Radiation Oncology (L. Coia)

 

Prostate Cancer- A Non-surgical Perspective (Wallner)

 

Radiobiology for the Radiologist (Hall)

 

The Physics of Radiation Therapy (Khan)