Radiation Oncology Residency
The North Carolina Cancer Hospital, first opened in 2009, 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.
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, patient safety and healthcare engineering, and research. The program offers “in house” didactic teaching of radiation therapy physics, dosimetry, treatment planning, biostatistics, radiation and cancer biology, and radiation pathology by nationally-recognized expert educators. Intraprofessional education is also strongly emphasized, with residents interacting regularly with their fellow trainees in medical physics, radiation therapy and medical dosimetry. 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 six month research elective supervised by a faculty preceptor is offered in areas as diverse as treatment planning, molecular radiation and cancer biology, cancer nanotechnology and immunotherapy, healthcare engineering, health services research or other specialized areas of clinical radiation oncology (e.g., IMRT/IGRT, stereotactic radiosurgery, intraoperative radiotherapy, etc.). Departmental faculty also have strong ties to the related disciplines of computer science, biomedical engineering, diagnostic imaging, genetics, nanotechnology, pathology and pharmacology, facilitating additional research opportunities for residents.
Select residents with a track record of basic science and/or clinical research productivity and meeting all program requirements can apply to the ABR for acceptance into the Holman Research Pathway. Interested residents may also use their research time to earn a Master of Public Health degree from the UNC Gillings School of Global Public Health, the leading public school of public health in the United States.
The Department has an ACGME-approved complement of eight residents, 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 2,500 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.
The NC Cancer Hospital houses Radiation Oncology’s clinical, physics and computing, healthcare engineering, educational and administrative programs. (The Cancer Biology Division is housed nearby in the Lineberger Comprehensive Cancer Center.) The move to the Cancer Hospital consolidated all clinical oncology services and professional staff in a single location, and 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, cancer biology, healthcare engineering and medical physics. The Department 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 affiliate clinics in Eden and Lenoir, 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 200 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 that 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.
Didactic courses with lectures once or twice a week are held in radiation physics and dosimetry (annually), and radiation and cancer biology (every other year). The biology course is team-taught by educators at the UNC and Duke Departments of Radiation Oncology, and is attended via teleconference/webinar by medical and veterinary residents from six different training programs nationally.
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:
- daily morning conferences where residents make case presentations, discuss clinical treatment planning, and review simulations
- weekly chart rounds where current patients receiving radiotherapy are presented
- weekly radiation oncology clinical seminars
- monthly journal clubs with both resident and faculty participation
- monthly morbidity and mortality conferences
- monthly faculty research conferences
- 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.
The Department of Radiation Oncology is actively engaged in clinical studies 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, healthcare outcomes, and combination therapy with surgery and radiation. Another area of clinical interest is human factors/operations research and LEAN management principles, aimed at improving patient safety. Our Department is a national leader in this area, and the only training program in the US to have a dedicated Division of Healthcare Engineering (see below).
The Division of Cancer Biology has as its emphasis the study of molecular mechanisms of radiation action, new drug discovery and characterization, and basic cancer biology. The Division also has an active cancer nanotechnology program.
The Division of Physics and Computing 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 of Healthcare Engineering has a broad focus, studying the impact of transformational leadership, LEAN-based management practices, design of physical spaces and processes, and cognitive/behavioral factors on workers’ ability to perform their jobs well, with the ultimate goal of improving efficiency, reliability, safety and quality of radiation therapy treatment.
An additional factor that has major implications for the institutional cancer programs is the University Cancer Research Fund (UCRF). This fund, created 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.
The Departmental faculty include twenty one ABR-certified radiation oncologists (including those at our affiliate clinics), twelve ABR-certified medical physicists, four radiation/cancer biologists, two faculty members devoted largely to education, three faculty members involved in LEAN management and human factors research, 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 radiation oncology and medical physics residents, faculty members are also involved in education and training programs for medical students, graduate students and postdoctoral fellows, radiation therapists and medical dosimetrists. 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.
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. Please note that per UNC Health Care policy, applicants who require a Visa to work in the United States must have a J-1 Visa. H1-B Visas are not sponsored.
- 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.
Each year, two new residents meeting all program prerequisites are accepted, from a pool of 30-40 applicants chosen for personal interviews. Interviews are conducted in groups of 10-12 applicants typically during the month of December (although interview dates in November and January might also be available). 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.
For the Fall, 2019 interview season, we will have two open residency positions (start date: July 1, 2021).
Living in Chapel Hill, NC
The Research Triangle – home to approximately 2 million people (about 60,000 in Chapel Hill) – is a region of the central North Carolina Piedmont bounded by the cities of Raleigh and Durham, and the town of Chapel Hill. Three Tier 1 research universities (University of North Carolina at Chapel Hill, Duke University in Durham and North Carolina State University in Raleigh) are located in the Triangle area, plus Research Triangle Park, one of the largest high-tech research and development hubs in the world, comprised of some 200 companies, including GlaxoSmithKline, Biogen Idec, Syngenta, United Therapeutics, Cisco, Bayer CropScience, the U.S. EPA, NIH’s National Institute of Environmental Health Sciences (NIEHS; the only NIH institute/center outside of the DC metro area), and the original research institute that launched Research Triangle Park, RTI International.
The Triangle, considered one of the best places to live in the US, prides itself on its vibrant food scene, a spirited arts culture and music scene, a passionate and rivalry-rich sports scene, and a strong community for young professionals. North Carolina‘s climate varies from the Atlantic coast in the east to the Appalachian Mountain range in the west, however most of the state boasts a humid subtropical climate, conducive to myriad outdoor activities during most of the year. On average, Chapel Hill summers range from the upper 60s to the mid 90s; fall sees upper 40s to the upper 70s; winter ranges from mid 20s to the low 50s; and spring sees mid 50s to upper 70s. Average annual rainfall is about 46 inches, and average annual snowfall about 5 inches.
Chapel Hill-Carrboro City Schools (CHCCS) is one of two public school systems in Orange County, NC, and serves some 12,000 students, operating three high schools, four middle schools, eleven elementary schools, a school for young people being treated at UNC Hospitals, and an alternative high school. CHCCS employs over 250 nationally certified teachers, and is consistently ranked at or near the top of school districts in North Carolina in test performance, graduation rates and SAT/ACT scores. It is also among the highest in per-pupil funding.
You may obtain additional information by contacting the Program Coordinator:
Ms. Rebecca Moore
Phone: (984) 974-8418