Radiation Oncology Residency Training Program

The Residency Program's objectives, facilities, faculty, prerequisites and application process.

Introduction

The Radiation Oncology Residency Training Program at the 650-bed University of North Carolina Hospitals meets all the requirements of the American Board of Radiology (ABR) and is fully accredited by the American Medical Association's Accreditation Council for Graduate Medical Education (ACGME; see also UNC Healthcare's GME site). UNC Hospitals are the teaching hospitals of the UNC School of Medicine, located on the campus of the University of North Carolina at Chapel Hill.

The North Carolina Cancer Hospital is the state's major referral center for patients with cancer and has active oncology subspecialty programs in Radiation Oncology, Medical Oncology, Gynecologic Oncology, Urologic Oncology, Surgical and Breast Oncology, Thoracic Oncology, Head and Neck Cancer, Pediatric Oncology, and Neuro-Oncology. The Cancer Hospital is the clinical face of the UNC Lineberger Comprehensive Cancer Center, one of only 36 National Cancer Institute-designated comprehensive cancer centers in the United States, and nationally recognized for excellence in cutting-edge basic, clinical and translational cancer research.

Program Objectives

The Radiation Oncology Residency Training Program at UNC encompasses training in the fundamental principles of oncology, comprehensive cancer management, clinical radiation oncology, radiation treatment techniques, and research experience. The program offers didactic teaching of radiation therapy physics, dosimetry, treatment planning, radiation and cancer biology, and radiation pathology. Teaching is closely integrated with a multidisciplinary approach to state-of-the-art clinical management of cancer patients and investigative clinical research protocols.

The four-year residency program consists of a minimum of 36 months in clinical radiation oncology, electives (or equivalent) in medical oncology, surgical oncology, surgical pathology, diagnostic radiology and nuclear medicine, and radiation physics and dosimetry. In addition, a 6 month research elective supervised by a faculty preceptor is offered in areas such as radiation physics and 2- and 3-D treatment planning, molecular radiation biology, cancer biology, or specialized areas of clinical radiation oncology (IMRT, LDR/HDR brachytherapy, stereotactic radiosurgery, intraoperative radiotherapy, TBI). The Department has an ACGME-approved complement of eight residents (currently seven, with one more to be added in 2015), with two new residents accepted into the program each July.

Clinical training is provided in the standard care of common cancers as well as instruction in the management of unusual and complex oncologic problems. Over 2,200 patients are referred annually to the Department of Radiation Oncology. These include large numbers of patients with breast, gynecological, head and neck, bronchopulmonary, and lymphoreticular malignancies, along with patients with a wide range of other type of cancers. Non-oncologic conditions such as arteriovenous malformations are seen for stereotactic radiosurgery.

As residents advance through their training, they assume increasing responsibility for the evaluation and management of patient referrals, external beam and brachytherapy procedures, care of patients under treatment and follow-up care. Residents work closely with the attending radiation oncologists in all aspects of patient care and are instructed in the new areas of clinical trials, laboratory investigations, and to the development of investigational skills.

Departmental faculty have strong ties to the related disciplines of computer science, biomedical engineering, diagnostic imaging, genetics, nanotechnology, pathology and pharmacology, in addition to providing "in-house" instruction in radiation physics and radiation and cancer biology by nationally-recognized expert educators.

Facilities

The NC Cancer Hospital, first opened in 2009, houses Radiation Oncology's clinical, physics and computing, educational and administrative programs. (The Radiation and Cancer Biology Division is housed nearby in the Lineberger Comprehensive Cancer Center.)  The move to the Cancer Hospital has consolidated all clinical oncology services and professional staff in a single location, and has helped streamline operational efficiency. The move also facilitates unique education and training opportunities for our residents in the form of closer, more flexible interactions with faculty and peers in the other oncology specialties.

The 36,000 square foot Department of Radiation Oncology treats over 2,000 patients per year, and is an integral part of the UNC Lineberger Comprehensive Cancer Center. The Department has active research programs in clinical oncology, radiation and cancer biology, and medical physics, and is an acknowledged world leader in the areas of computer-aided radiotherapy treatment planning and quality assurance/human factors research aimed at continuously improving patient safety.

In addition to our main facility in Chapel Hill, we have satellite clinics in High Point and Caldwell, NC, as well as at Rex-UNC Healthcare, Raleigh, NC, a fully-owned component of UNC Radiation Oncology.  Our alliance with Rex Hospital further extends our reach with additional clinics in Wakefield, Clayton and Smithfield, NC.

The Department features the following treatment equipment and capabilities: three linear accelerators with MLC and independent jaws; a Calypso® IGRT system; a CT scanner on rails; a dedicated CT scanner for conformal treatment planning; a CyberKnife® stereotactic radiosurgery system; a TomoTherapy® system; a simulator; high and low dose rate brachytherapy equipment; and 3-D treatment planning workstations. These machines permit high energy X-ray, electron beam, and specialized radiation treatments.

A self-shielded, J.L. Shepherd Mark I irradiator is also available for radiation biology research, and serves as a campus-wide core facility for such.

Residents participate in an active brachytherapy program involving over 150 high and low dose rate radiation implant procedures annually for the treatment of gynecological, genitourinary, head and neck, esophagus, lung and other malignancies. A full array of radioactive sources for interstitial and intracavitary radiation therapy is available including iridium-192, iodine-125 and phosphorus-32.

Other specialized treatment programs include intraoperative radiation therapy and total body irradiation for bone marrow transplantation.

Advanced treatment planning systems on computer work stations are used for all types of external beam, interstitial and intracavitary treatment plans that are routinely used in the clinical management of patients. The Department is at the forefront of research and development of sophisticated 3-D imaging and treatment planning for clinical applications, and residents routinely carry out advanced 3-D conformal treatment planning.

Radiation Oncology residents have their own work area equipped with personal computers which are part of the Department's extensive local area network. This network provides ready access to Medline, the Health Sciences Library, UNC Hospitals laboratories and the Tumor Registry, and to the internet.

Conferences

Didactic teaching courses with lectures once or twice a week are held in radiation physics and dosimetry (annually), and radiation and cancer biology (biennially). Residents participate in teaching, patient care and research in the Department, as well as attend both in-house and multidisciplinary conferences of the UNC Clinical Cancer Program. The in-house conferences include:

  1. daily morning conferences where residents make case presentations, discuss clinical treatment planning, and review simulations
  2. weekly chart rounds where current patients receiving radiotherapy are presented
  3. weekly radiation oncology clinical seminars
  4. monthly journal clubs with both resident and faculty participation
  5. monthly morbidity and mortality conferences
  6. monthly faculty research conferences
  7. less frequent conferences:  Visiting Professor lectures; oncology grand rounds; mock oral boards sessions; In-Training exam review; "best of" medical or scientific conference reports

Regular multidisciplinary conferences are held in conjunction with the Breast Oncology, Gynecologic Oncology, Medical Oncology, Surgical Oncology, Head and Neck Surgery, Pediatric Oncology, Neuro-Oncology and Gastrointestinal Oncology programs. Residents also have an opportunity to attend a variety of oncology-related lectures and symposia elsewhere on the UNC campus.

Research Programs

The Department of Radiation Oncology is actively engaged in clinical investigation programs through national cooperative research groups including the Gynecologic Oncology Group (GOG), Cancer and Acute Leukemia Group B (CALGB), National Surgical Adjuvant Breast Program (NSABP), Radiation Therapy Oncology Group (RTOG), and the Children's Cancer Study Group (CCSG).  Intramurally, faculty members are actively engaged in studies of normal tissue toxicity, radiation-drug interactions, and combination therapy with surgery and radiation.  Other areas of clinical interest include heath care outcomes research, and human factors/operations research and LEAN management principles with the ultimate goal of improving patient safety (our Department is a national leader in this area).

The Cancer Biology Division has as its emphasis the study of molecular mechanisms of radiation action, new drug discovery and characterization, and basic cancer biology.

The Physics and Computing Division develops and implements state-of-the-art imaging tools that allow radiation oncologists to better understand the various dose delivery systems and to aid in the development of newer techniques of dose delivery. The Division also has an active cancer nanotechnology program.

An additional factor that has major implications for the institutional cancer programs is the University Cancer Research Fund (UCRF). This fund, developed by the state legislature, commits an initial $25M per year, increasing to $50M per year, in support of cancer research efforts at UNC, including the development of clinical excellence in delivery of care to cancer patients and substantial research infrastructure support. A second resource is the North Carolina Translational and Clinical Sciences (NC TraCS) Institute based at UNC, part of a national consortium of medical research institutions that together offer programs and services supporting researchers through all phases of the "bench to bedside" process of translational research. Our Department benefits from both of these programs in terms of our clinical and basic research efforts that, in turn, offer additional training opportunities for our residents.

Faculty

The Departmental faculty include seventeen ABR-certified radiation oncologists (including those at our satellite facilities), ten ABR-certified radiation physicists, four radiation/cancer biologists, two faculty members devoted largely to education, and joint faculty from the Department of Computer Science. Most are actively involved in the clinical care of oncology patients, teaching and/or research. In addition to mentoring residents, faculty members are also involved in education and training programs for medical students, graduate students, radiation therapists, medical dosimetrists and practicing physicians. They have ongoing research programs, hold leadership roles in national clinical protocol development, and make regular contributions to scientific conferences at the local, regional, national and international levels.

Program Prerequisites

In order to be eligible for our radiation oncology residency training program, an applicant must:

  • Be a US citizen or hold a valid US immigration VISA that permits employment in the United States. The UNC Department of Radiation Oncology does not provide sponsorship for any type of immigration VISA.
  • Successfully complete all United States Medical Licensing Examination (USMLE) requirements or, if a foreign medical graduate, all Educational Commission for Foreign Medical Graduates (ECFMG) requirements.
  • Successfully complete a one year clinical internship in a hospital approved by the ACGME prior to entering the residency training program.

Application Process

Each year, two new residents meeting all program prerequisites are accepted. Anywhere from 30-40 applicants are selected for personal interviews. Interviews are conducted in groups of 6-8 applicants during the months of November, December and January. Having completed a prior rotation during medical school at the UNC Department of Radiation Oncology does not automatically guarantee an interview for a residency position.

Positions are offered through the National Resident Matching Program (NRMP), and applications must be submitted using the Electronic Residency Application Service (ERAS) system.

For the Fall, 2014 interview season, we have two open residency positions (start date: July 1, 2016).

Additional Information

You may obtain additional information by contacting the Program Coordinator:

Ms. Rebecca Moore

Phone: (919) 445-5203