Residency Training Program
Roy H. Decker, MD, PhD
Department of Therapeutic Radiology
Yale University School of Medicine
Description of the Program
During the first year of the program, residents generally rotate through the radiation oncology services at the parent institution, Yale-New Haven Hospital. The trainee is introduced to the principles of basic physics and radiobiology through a weekly lecture series in each subject. The didactic courses in physics and radiobiology are repeated every year, and trainees continue to attend these courses throughout their residency training. Residents are also introduced to the clinical application of physics, treatment planning and dosimetry through hands-on activities and one-on-one teaching sessions in conjunction with the treatment planning-dosimetry staff. Throughout the first year of training, the resident performs new patient consultations, gathers experience in the technical aspects of radiation therapy, and subsequently follows patients through the treatment course and post-treatment follow-up under the close supervision of the attending physician. Residents generally spend 3 months with a designated “Attending Team” that generally includes two attending physicians who specialize in different areas. The resident will rotate throughout the year with various Attending Teams. Hence, trainees are exposed to all clinical subspecialties of radiation oncology.
Residents are involved with simulations and special procedures, including but not limited to: 3D-conformal radiotherapy, intensity modulated radiation therapy (IMRT), computed tomography (CT) and conventional simulation, stereotactic radiosurgery/Gamma-Knife radiosurgery, intraoperative brachytherapy, high dose rate remote afterloading brachytherapy, total body irradiation (TBI), total skin electron beam radiotherapy and interstitial/intracavitary treatment throughout their training. During the second, third and fourth years, the resident has increasing responsibility for patient care and treatment planning. The Yale Children's Hospital is part of the Yale-New Haven Hospital, which provides a broad experience in all adult and pediatric malignancies. Trainees also become familiar with various aspects of clinical and translational investigation, through participation in the clinical care and design of treatment for patients enrolled in such investigational studies. The Yale-New Haven Hospital radiation oncology training program provides residents with all of the requirements for successful completion of the training program, and eligibility for the American Board of Radiology (ABR) examination.
Additional Lawrence and Memorial Cancer Center in Waterford (approximately 50 minutes from Yale) provide experience in general radiation oncology in a community hospital setting. This network of facilities provides all residents with a broad base of clinical experience in radiation oncology. Both facilities are directed and staffed by Yale University radiation oncology faculty who rotate between one of these facilities and Yale-New Haven Hospital. This provides the resident with the unique opportunity to participate in a more general practice environment, but with the educational benefits of working side by side a Yale University attending. All Yale University attending staff members either see patients on a regular basis or provide coverage at these hospital-based departments and hence, the resident has a unique opportunity to work with a variety of different attending physicians during these respective rotations. Lawrence and Memorial Cancer Center is staffed by physics and dosimetry personnel, who are also full time Yale-New Haven Hospital staff members. Residents actively participate in multidisciplinary tumor board activities at these hospitals in conjunction with the Yale attending staff member. Both hospital departments have fully integrated dosimetry and treatment planning sections, state of the art linear accelerators, and offer prostate brachytherapy. IMRT for prostate, head and neck, and other sites is available at Lawrence and Memorial Cancer Center.
Throughout the four-year residency program, there are numerous teaching conferences scheduled on a weekly basis. These include a lecture series in physics, basic radiobiology with molecular biology, and a clinical lecture series. Residents also have 4 morning teaching sessions per week that consist of a combination of didactic and interactive teaching that includes incorporation of current and significant literature in oncology. Through weekly radiation oncology conference, chart rounds, brachytherapy conference, weekly case presentation, and the Yale Comprehensive Cancer Center's grand rounds, the trainee is exposed to all clinical aspects of radiation oncology and general oncology.
In addition to the departmental conferences, there are a number of multidisciplinary tumor boards in which the residents participate on a regular basis. These weekly multidisciplinary conferences include head and neck, gynecologic, pediatric, GI, GU, breast, thoracic, lymphoma, neurologic, and other oncology based tumor boards. Multidisciplinary clinics in breast and thoracic oncology for example, are also available and attended by residents. A didactic lecture series and periodic departmental-sponsored visiting professorships provide additional training in clinical radiotherapy, physics and radiobiology. For trainees who are interested, the Yale Comprehensive Cancer Center, the Yale University School of Medicine and Yale University offer additional educational opportunities in all aspects of medicine. Residents also have full access to a wealth of information from the Harvey Cushing/John Hay Library of the Yale University School of Medicine, which is located across the street from the radiation oncology department. Residents are provided with an annual stipend that can be used for educational materials, textbooks, and meetings. Research endeavors are very strongly encouraged, and presentation of this work by the trainee at national meetings is highly supported.