Drexel University College of Medicine

Sample of Radiation Oncology Resident's evaulation process in the following competencies by year.

• PGY2
• PGY3
• PGY4
• PGY5

PGY2

Patient Care

1. Perform a comprehensive history and physical examination and appropriately stage patients according to AJCC staging system.
2. Understand the risks and benefits of various evidence-based treatment options and, prognosis based upon staging and clinical analysis.
3. Demonstrate proficiency in application of technical aspects of simulation, treatment planning and treatment delivery. Assist the attending physician in preparing the treatment prescription, simulation and treatment plan.
4. Assist the attending in recognizing acute treatment related effects and evaluate response.
5. During follow up clinics, assist the attending in recognizing chronic treatment related effects and in management of these patients after treatment.

Medical Knowledge

1. Understand the prevalence, causes, natural history, clinical presentation, histopathology of cancers as well as proper diagnosis and work-up.
2. Demonstrate knowledge of available clinical trials, review eligibility requirements for clinical trials, and recognize and identify patients who may be eligible for clinical trial accrual.
3. Understand basic concepts of brachytherapy.
4. Understand basic concepts of radiobiology.
5. Understand basic radiation physics concepts and calculations.

Practice-based Learning and Improvement

1. Apply evidence-based clinical and supportive scientific data to the management of the clinical problem and assist the attending physician with formulating a comprehensive treatment plan.
2. Use information technology to access online medical information.
3. Review pertinent literature concerning the patient and summarize it and present it at appropriate conferences.

Interpersonal and Communication Skills

1. Communicate effectively with the patient and family member to help them understand treatment options, risks and possible outcomes.
2. Create and sustain a relationship that is therapeutic for patients and supportive of their families.
3. Recognize that effective communication skills require effective listening skills as the delivery of medical care is an interactive process between medical providers and patients.

Systems-based Practice

1. Institute appropriate physician contacts to assure efficient and efficacious multidisciplinary approach to management of disease in this site.
2. Assist attending in referring patients to appropriate clinics for management of non-radiation related issues.
3. Assist attending in ordering appropriate staging and follow up exams in a prompt and timely fashion.
4. Recognize cost issues associated with proposed treatment plans and initiate activities to limit those costs where possible.

Professionalism

1. Demonstrate respect for patient age, gender, emotional state, and culture in all contacts.
2. Respect patient's dignity, autonomy and privacy.
3. Listen to patients and respect their viewpoints.
4. Present information to patients in an understandable fashion.

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PGY3

Radiation oncology residents continue development in each of the competencies addressed at the PGY2 level and additionally in those listed below.

Patient Care

1. Further refine history and physical consultation skills including ability to perform gynecological and head and neck examinations.
2. Recognize and manage acute and chronic treatment effects with guidance of the attending.
3. In follow up, begin to manage post treatment care and evaluate for recurrent/metastatic disease with appropriate diagnostic studies.
4. Upon review of current standards of care, propose alternatives for clinical or translational research in this patient population.
5. Become more proficient at brachytherapy procedures with help of attending.

Medical Knowledge

1. Develop proficiency in staging and extent of disease evaluation.
2. Recommend evidence based treatment options and discuss and compare outcomes such as local control rate, survival probability and toxicities associated with the options identified.
3. Develop basic understanding of other disciplines in oncology including chemotherapy and surgery.
4. Become comfortable with developing presentations for our own department as well as others, including journal clubs.
5. Begin developing research project to continue during residency.
6. Understand radiobiology concepts and apply to clinical radiation oncology.
7. Understand physics concepts and apply to clinical radiation oncology.

Practice-based Learning and Improvement

1. Formulate complete comprehensive cancer treatment plans with the guidance of the attending.
2. Perform simulations and develop treatment plan under the direct supervision of the attending.

Interpersonal and Communication Skills

1. Elicit and provide information to patients and their families using effective nonverbal, explanatory, questioning and writing skills.
2. Respond promptly to patients' queries and requests.
3. Develop team leadership skills to promote effective care delivery and a wholesome educational environment.

Systems-based Practice

1. Exhibit sufficient computer skills to access appropriate medical records and patient data from both department and hospital-based systems.
2. Advocate for high quality radiation oncology patient care and assist patients in dealing with system complexities.

Professionalism

1. Demonstrate a commitment to carrying out professional responsibilities and a responsiveness to the needs of patients that supersedes self-interest.

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PGY4

Radiation oncology residents continue development in each of the competencies addressed at the PGY2 and PGY3 level and additionally in those listed below.

Patient Care

1. Comprehensively evaluate patients with cancer and understand multidisciplinary aspects of patient's care.
2. Be able to perform simulation with only observation by attending.
3. Be able to perform brachytherapy procedures with little assistance from attending.

Medical Knowledge

1. For effective consultation and referral and for patient education, assess and describe common presentations of radiation interactions with antineoplastic and/or biologic agents.
2. Develop in-depth knowledge of chemotherapeutic and surgical roles in multi-disciplinary care.
3. Distinguish between important and non-important problems of each patient; prioritize and resolve issues with minimal direct action by the attending physician.
4. Understand in-depth concepts in radiobiology and apply to clinical practice.
5. Understand in-depth concepts in radiation physics, be able to perform calculations, and apply to clinical practice.

Practice-based Learning and Improvement

1. Refine practice experience through use of chart reviews, M&M and QA monitors to assess performance and management skills.
2. Where appropriate and with guidance from the mentoring faculty, review tumor site specific patient experience for outcomes analysis and submission of abstract(s) for presentation.

Interpersonal and Communication Skills

1. Develop a style of interaction with staff, attending physicians and colleagues in a manner that promotes and fosters cooperation, trust and respect.
2. Become proficient in communicating and educating medical students and junior residents in the program.

Systems-based Practice

1. Utilize services within the hospital setting or those available externally to assure patient access to quality care and management.

Professionalism

1. Demonstrate appropriate ethical activities and professional behaviors at all times.
2. Recognize challenging issues and seek appropriate guidance to resolution.

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PGY5

Radiation oncology residents continue development in each of the competencies addressed at the PGY2, 3 and 4 level and additionally in those listed below.

Patient Care

1. Independently evaluate patients and report findings to attending mentor and autonomously manage patients undergoing radiation therapy.
2. Be able to perform standard brachytherapy procedures under observation of an attending.
3. Be able to independently perform simulation, write a clear radiation prescription and devise an appropriate treatment plan with dosimetrist.

Medical Knowledge

1. Acquire an attitude consistent with life-long learning habits.
2. Demonstrate a depth of knowledge that will allow you to practice independently without direct supervision.

Practice-based Learning and Improvement

1. Formulate and execute comprehensive treatment prescriptions, plans and simulations in an independent fashion (subject to approval by the attending faculty).
2. Evaluate patient during on-treatment visits and in follow up clinic for assessment of acute or late toxicities and present and carry out a comprehensive management plan with minimal attending physician oversight.

Interpersonal and Communication Skills

1. Exemplify empathy and conscientious attention to patient/family related concerns surrounding their cancer care and management.

Systems-based Practice

1. Integrate necessary non-radiation interventions to facilitate patient care in multidisciplinary practice environment.
2. Identify system and process errors in order to improve quality of care delivery and patient safety.

Professionalism

1. Recognize and act quickly to protect patients from risk.
2. Recognize the limits of your professional competence and scope of practice.
3. Develop a level of confidence and professionalism that confers trust by your patients.

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