Radiation Medicine Physics Residency

• Three Varian TrueBeam linear accelerators with Hypersight imaging, RapidArc/RapidArc Dynamic, 6 degree-of-freedom couch, real-time position management (RPM), and VisionRT surface guidance
• Accuray Radixact TomoTherapy system
• Elekta Gamma Knife Esprit with cone-beam CT and active motion tracking
• Two Siemens wide-bore CT simulators with Varian respiratory gating
• Elekta Nucletron Flexitron HDR afterloader

• Varian Eclipse cloud-based treatment planning system and ARIA record and verify
• RaySearch RayStation treatment planning system (Radixact planning)
• Varian Velocity image registration and dose accumulation system
• Radformation treatment planning software suite
• Varian Mobius3D and MobiusFx secondary dose verification and log file QA system
• Elekta Oncentra brachytherapy planning system
• Elekta GammaPlan radiosurgery planning system

During this rotation, the resident will:

• Participate in MUSC and Graduate Medical Education (GME) orientation and complete all required prerequisite training.
• Become familiar with radiation medicine equipment, clinical workflow, procedures, and operations at MUSC.
• Become acquainted with faculty, physicists, physicians, dosimetrists, and therapists.
• Become familiar with the responsibilities of the Radiation Safety Office.
• Develop didactic knowledge of regulations pertaining to radiation medicine.
• Complete required institutional and departmental safety training.

During this rotation, the resident will learn the external beam treatment planning process and treatment planning system operation, including:

• Treatment planning strategies, prescription doses, and dose limits to critical structures
• 3D conformal treatment planning and basic IMRT planning techniques
• CT simulation and simulation procedures
• Treatment planning system operation and planning techniques
• Electron and photon block fabrication
• Plan evaluation tools and dose–volume histogram analysis
• Manual and computerized monitor unit (MU) calculations
• Importing and exporting digital DICOM data
• Patient setup and image-guided radiation therapy (IGRT)
• Billing processes and physics quality check procedures

The resident will demonstrate competency in basic 3D treatment planning and plan evaluation prior to completing this rotation.

During this rotation, the resident will gain a thorough understanding of quality assurance (QA) testing and performance evaluation for:

• Physics measurement equipment
• Imaging equipment
• C-arm linear accelerators
• RadiXact treatment unit

The resident will perform routine and annual QA procedures and develop an understanding of equipment performance evaluation, tolerances, and documentation requirements. Brachytherapy and Gamma Knife® equipment are covered in separate rotations.

During this rotation, the resident will:

• Become familiar with all low and high dose rate brachytherapy procedures performed at MUSC.
• Understand fundamental brachytherapy principles and dose calculation methods.
• Calibrate brachytherapy sources.
• Perform brachytherapy treatment planning.
• Understand brachytherapy quality management program (QMP) requirements.
• Become knowledgeable about pertinent radiation safety regulations.
• Become familiar with commonly used brachytherapy references and protocols.
• Learn the fundamentals of radiopharmaceuticals.

During this rotation, the resident will:

• Gain a working knowledge of radiation detectors and scanning equipment used for linear accelerator commissioning and QA.
• Perform beam data acquisition and measurements.
• Develop an understanding of measurement techniques, detector selection, and scanning system operation.
• Begin collecting beam data for use in treatment planning system commissioning.

During this rotation, the resident will gain a thorough understanding of the process of commissioning a treatment planning system – Eclipse – for clinical use. This includes:

• Collection of beam data
• Creation of beam models
• Beam model validation and verification
• End-to-end testing and plan verification
• Documentation required for clinical implementation

During this rotation, the resident will:

• Expand knowledge of IMRT, conformal arc, and VMAT treatment planning techniques
• Become familiar with RadiXact treatment planning and optimization parameters
• Learn to compare and evaluate optimal planning techniques among IMRT, VMAT, and RadiXact for various clinical cases
• Become proficient in hypofractionated stereotactic body radiation therapy (SBRT), including 4D-CT simulation, motion management, margin definition, technique selection (3D, IMRT, conformal arc, or VMAT), and plan evaluation

During this rotation, the resident will:

• Perform QA and physics support procedures for Gamma Knife Esprit and linac-based stereotactic radiosurgery (SRS).
• Become knowledgeable in methods used to deliver total body irradiation (TBI) and demonstrate competency in performing annual QA of TBI equipment and devices.
• Become knowledgeable in methods and practical aspects of total skin electron irradiation (TSI).
• Evaluate and recommend motion management techniques for clinical patient scenarios.
• Understand the benefits and limitations of patient alignment and monitoring using real-time 3D surface imaging.
• Perform QA procedures for a 3D surface imaging system.
• Develop a basic understanding of rigid and deformable image registration algorithms and the benefits and limitations of each.
• Learn the fundamentals of proton therapy.
• Explore the unique challenges and opportunities offered by MRI-Linac.

During this rotation, the resident will become familiar with the administrative and regulatory aspects of radiation medicine physics, including:

• Structural shielding design for linear accelerators, HDR brachytherapy, Gamma Knife, and other radiation-producing equipment
• Performing a facility radiation shielding survey
• Radiation safety regulations and licensing requirements
• Professional responsibilities of the medical physicist
• Ethics and professionalism in clinical practice
• Participation in audits and accreditation processes

Resident performance and completion requirements are those in effect at the time the resident enters the program. Improvements and minor changes may be approved by the Physics Residency Committee but shall not extend the overall length of the program.