Location

Rush University Medical Center is located in the world-class city of Chicago. Also known as the “Second City”, Chicago is a cultural and ethnic melting pot full of energy and excitement. Chicago is a vibrant city full of art, architecture, theatre, outdoor recreation and some of the most famous museums in the country.

Rush’s main campus is located in the Illinois Medical District, one of the largest medical districts in the world. The Illinois Medical District consists of 4 of Chicago’s major medical institutions: Rush University Medical Center, The University of Illinois Medical Center, Stroger (Cook County) Hospital, and the VA Chicago Healthcare System.

General Information

Rush University Medical Center has one of the largest graduate medical education programs in the state, offering both ACGME-accredited and non-accredited training programs. Established in 1837 Rush University Medical Center has a history rich in innovation. Rush is well known throughout the country for it’s expertise in patient care, research, and teaching. This expertise has led to a number of scientific developments and clinical advancements over the years.

For example:

1968: George M. Hass, M.D. achieves a medical first by producing leukemia and malignant lymphoma by restriction of magnesium in the diet of animals. This is the first instance of a causal relation between a normal, essential dietary constituent and the development of a malignant disease.

1975: Frank R. Henderson, M.D., Former Chair, Dept., Radiation Therapy, Co-founds the Fermilab Cancer Therapy Facility (CTF) which is involved in ground- breaking clinical trials involving the use of neutrons in cancer therapy.

1982: Richard D. Penn, MD, J. A. Paice, PhD, and W. Gottschalk, MD, achieve a medical first at Rush by implanting a computerized programmable pump into the abdomen of a patient with cancer. The pump automatically delivers painkillers into the patient’s spine.

1985: Rush opens the region’s first comprehensive breast cancer center. A team of oncologists, surgeons, radiation therapists and nurses’ work together to coordinate individualized care for each patient, producing a full range of the latest and most innovative treatment options.

2002: Rush Oncologist Melody Cobleigh, M.D. leads a multi-center research initiative which identifies Herceptin as the first effective targeted therapy in Metastatic Breast Cancer when used as both a single agent and in combination with chemotherapy.

Present: Along with these medical achievements, Rush University has led the way in several clinical advancements; we are the first institution to incorporate computer controlled radiation therapy into patient treatment and Rush University Medical Center is the only test site in the world chosen to explore the use of the Perspecta Spatial 3D system to improve evaluation and planning of radiation treatments.

Faculty

The Rush Cancer Program is a leader in clinical and basic research in the prevention, detection, and treatment of cancer. Our program has been awarded the Outstanding Achievement Award by the American College of Surgeons Commission on Cancer;

“CHICAGO- Rush University Medical Center's Cancer Program has been awarded a 2005 Outstanding Achievement Award (OAA) from the American College of Surgeons Commission on Cancer. Rush is the only Chicago cancer program named on the list, and one of only two sites in Illinois. Only 39 cancer programs received the award, representing approximately nine percent of the programs surveyed. The American College of Surgeons gives the award to programs that demonstrate a "Commendation" level of compliance with seven standards including: cancer program leadership, cancer data management, clinical services, research, community outreach and quality improvement as well as a compliance rating with the other 29 standards.”

The Department of Radiation Oncology maintains its important role in cancer medicine. It has active programs in basic and clinical research integrated with the Rush Cancer Program. State-of-the-art equipment combined with strong medical physics and radiation biology sections has made Rush one of the premiere cancer treatment facilities in the region.

Radiation Oncology is staffed by board-certified Radiation Oncologists, Medical Physicists, and a Radiation Biologist.

Ross Abrams, MD Chairman Specialty: Pancreatic & GI Cancer		Katherine L. Griem, MD Associate Professor, Program Director Specialty: Breast Cancer
Thomas Zusag, MD Assistant Professor Specialty: Gynecologic & Lung Cancer		Joy Coleman, MD Instructor Specialty: CNS & Pediatric Cancers

Medical Physics & Radiation Biology

Medical Physics plays a key role in resident training. The Section of Medical Physics is responsible for the physics aspects of treatment delivery which includes; machine calibration and maintenance, treatment planning, accurate dose calculations, and delivery of treatments.

Radiation Biology explores strategies to improve radiation therapy outcomes by measuring cellular response to radiation. Residents attend a 30hr. Radiation Biology course during their training.

Both Medical Physics and Radiation Biology have active research projects underway. As a resident you will have the opportunity to participate in research initiatives offered by both sections.

Equipment

The department is also equipped with state-of-the-art treatment technology which include:

• TomoTherapy Image Guided Radiation Therapy
• Intensity-Modulated Radiation Therapy
• Three-Dimensional Conformal Radiotherapy
• High and Low Dose Rate Brachytherapy
• Stereotactic Radiosurgery
• Total Skin Electron Irradiation
• Total body Irradiation
• Endovascular Brachytherapy

Program Overview

Our ACGME accredited residency program in Radiation Oncology is a four year post graduate training program. The program combines both didactic and clinical instruction in oncology patient care, medical physics, and radiation biology. The program curriculum is designed to allow residents progressive participation in their training which increases with the successful completion of each academic year.

Throughout training, residents are required to meet six core competencies outlined by the ACGME:

Patient Care – Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Medical Knowledge – Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate sciences and the application of this knowledge to patient care.

Practice-Based Learning and Improvement – Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.

Interpersonal and Communication Skills – Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patient families, and professional associates.

Professionalism – Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principals, and sensitivity to a diverse patient population.

System-Based Practice – Residents must demonstrate an awareness of and responsiveness to the larger context and system of healthcare and the ability to effectively call on system resources to provide care that is of optimal value.

Goals & Objectives

First-year Objectives (Cognitive):

• Basic principles of cancer care and oncology.
  
• Natural history and pattern of spread of cancer by type.
  
• Basic principles of radiation therapy.
  
• Basic principles of radiation physics.
  
• Differing approach to the curative and palliative patient.
  
• The prescription: ability to effectively communicate to the technical staffs the details of treatment delivery.
  
• Comprehension of 2-D computerized treatment planning.
  
• The linear accelerator and it’s role in radiation therapy.
  
• The difference between photon and electron beams.
  
• Prescribing drugs relevant to the cancer population.
  
• Evaluating acute toxicities of radiation treatment and their management.
  
• Knowledge of newer innovative technologies in radiotherapy, e.g. phototherapy and immunotherapy.
  
• Reading and analyzing the literature critically.
  
• The sources for information, both textbooks, computer availability and means of finding appropriate references.
  
• The major oncologic journals and their strengths and weaknesses.
  
• Developing analytic and research skills for presentations on an oncology subject.
  
• Ethical problems that arise in cancer treatment and the means available to resolve them.
  
• Combined modality treatment approach.
  
• Knowledge of support groups available for cancer patients.
  

First Year Objective (Skills):

• Successful interaction with other services especially medical oncology, surgery, and pediatrics.
• Gynecological, rectal, head and neck examination, from the oncologist's prospective.
• Examination of lymph node regions.
• Ability to select appropriate, acceptable individual treatment plan.
• Translation of radiographic findings onto simulation films.
• Comparison of portal and simulation films, basic anatomy and radiographic correlation.
• Radiation safety procedures.
• Ability to catheterize the bladder, insert rectal tubes, vaginal markers.
• Emergency whole brain and spinal set-ups.
• Drawing of blocks for both simple and complex fields including, breast, lymphoma, head and neck, pelvic malignancies.
• Perform and document on-treatment visits.
• Manage treatment-related side effects.
• Check set-up on machine.
• Present information for informed consent.
• Interact as part of the team, including nurses, social workers, dieticians, etc.
• Perform follow-up examination; learn to distinguish recurrences from normal late tissue reactions.
• Evaluate recurrences.
• Learn to diagnose and manage late radiation therapy complications

Second-Year Objectives (Cognitive):

• The resident should be able to make a critical evaluation of clinical studies in regard to their design, statistics, and the validity of their conclusion.
• Familiarity with alternative forms of cancer treatment, including surgery and chemotherapy, as well as the benefits and toxicities of combined modality treatment.
• Critical appreciation of the limitations and value of diagnostic studies (pathology and imaging) related to cancer management.
• Evaluation, presentation, work-up, simulation and treatment of a range of common tumors.
• Presentation of a lecture in a more mature fashion to a larger group.
• Carry a full service of patients with efficiency and order.
• Present and defend cases at tumor boards.
• Critical analysis of articles at journal club.
• Continue to expand knowledge of radiotherapy via textbooks, attending teaching and journal review.

Second Year Objective (Skills):

• The residents are expected to develop skills in the following areas:
• Further sophistication of all technical skills introduced during year one.
• Brachytherapy: gynecologic breast, head and neck.
• Ability to pre-plan and present a plan for simulation.
• Learn the technical nuances of the more difficult set-ups: e.g. 3-field breast, mantle-para-arotic match, cranio-spinal, other junction fields, thyroid

Third-and Fourth-Year Objectives (Cognitive):

• The third-year residents should demonstrate
• The synthesis of two years of intensive training.
• In-depth understanding of dosimetry and the finer points of treatment planning.
• Ability to handle independence and responsibility in work-up, treatment planning and simulation.
• Clinical and/or laboratory projects.
• Ability to interact and help more junior residents.
• Attend and participate as junior attending in conferences, learning to articulate and defend an option or opinion.
• Familiarity with the likelihood of the long-term potential toxicity of radiation related to dose and volume.
• A strong working knowledge of all the options, as well as their risks and benefits, in the management of common malignancies, with emphasis on the use of radiation therapy.
• Further knowledge in physics and radiobiology, directed by their performance on the national in-training board exams.
• Clear career goals.

Third and Fourth-Year Objectives (Skills):

• Further refinement of skills acquired during years one and two.
• Present to the patient’s a comprehensive recommendation including indications for radiation treatment, alternative therapies, risk/benefit analysis and if the patient wished to be treated, to take informed consent.
• Run simulation with attending as “back-up” only.
• Assume greater responsibility for administering a course of radiotherapy, including determining does prescription, managing side effects and deciding when patients need to go on break and resume treatment.
• Perform brachytherapy with attending as “observation” only.
• Assume greater independence in follow-up evaluations.
• Assume greater independence in resolution of social/ethical problems.
• Work effectively with ancillary support services.

Clinical Conferences

Resident Morning Conference – Meets twice weekly
Residents have the opportunity to share and experience knowledge with each other. Residents are assigned research topics on specific conditions or areas of interest by the Chief Resident. They then present lectures on assigned topic and have peer discussions.

Chart Rounds – Meets once a week
Quality assurance conference involving all clinical staff. The treating resident presents his/her case and describes treatment options and management.

Physics Class – Meets once weekly
Didactic lectures and laboratory demonstrations of radiation safety procedures, calibration of radiation therapy machines, and the construction of treatment aids.

Statistics Conference – Varies
The didactic component covers the clinical and basic science literature with regard to biostatistics and practical problems/answers. Attention is given to reviewing concepts and statistical tests used in the clinical and basic science literature.

Radiobiology Conference – Varies
A series of didactic lectures covering all aspects of radiation effects on normal and neo-plastic tissues, as well as the fundamental biology of the causes, prevention, and treatment of cancer.

Journal Club – Monthly
The Journal Club is used to present select new articles to all residents. Residents are assigned articles by the Chief Resident. They are expected to research and present the article at Journal Club where an open discussion will follow each presentation.

Rotations

Call Schedule

Work Environment

Application Process

The Radiation Oncology Department is a participant in E.R.A.S. (Electronic Residency Application System) and will soon be accepting applications through this system for the upcoming academic year. Because of the large volume of applicants, we will not be able to interview all that apply. You must submit a complete application to be considered for an interview.

Here in the Department of Radiation Oncology, we seek to recruit outstanding individuals, who are enthusiastic, hard working, and possess a sound fund of basic science and clinical knowledge. We consider our residents to be an asset to this department and we take pride in their training and education. Prior graduates of this program have performed successfully on both written and oral examinations of the American Board of Radiology and have gone on to obtain desirable academic positions and private practice opportunities throughout the country.

In summary, we feel that the rich clinical and academic reserve at Rush University Medical Center allows excellent standards of education at our center. It is our goal to train our residents to become excellent Radiation Oncologists.

Application Requirements

• Dean’s letter
• Medical school transcripts
• USMLE Scores, minimum step 1 score of 225
• Three (3) letters of recommendation
• ECFMG Certification (foreign medical school graduates)

If you have any questions or would like to obtain more detailed information about the Radiation Oncology residency program please refer to our Residency Program Manual or contact our Residency Coordinator:

Molly Stasko
Residency Coordinator - Dept of Radiation Oncology
Woman's Board Center for Radiation Therapy
Rush University Medical Center
500 S. Paulina, Ground Floor Atrium, Rm 013
Chicago, IL 60612
Ph: (312) 942-7774
Fax: (312) 563-2857