Curriculum | Tufts Medicine

Overview

In addition to rotations at Tufts Medical Center, our residents enjoy clinical rotations at two other outstanding academic institutions, Rhode Island Hospital (RIH) and the University of Massachusetts Memorial Medical Center (UMMMC), which are the principle teaching hospitals for the Warren Alpert Medical School at Brown University and the University of Massachusetts Medical School, respectively. Each of these centers has areas of academic excellence that compliment resident experience at Tufts. For example, RIH has an exceptional multidisciplinary gastrointestinal malignancy program, while UMMMC’s head and neck malignancy program is a strength of that site. All three institutions have dedicated pediatric oncology units.

Our program provides each resident with a diverse and formalized curriculum. The curriculum comprises Bone & Soft tissue, Breast, Central Nervous System (CNS/Eye), Gastrointestinal tract, Genitourinary tract, Gynecology, Head, Neck & Skin, Lung, Lymphomas/Leukemia and Pediatrics. Rotations are typically three (3) months in duration, with shorter blocks accommodating individual resident needs and interests.

Clinical training is divided into three month blocks with rotations primarily at Tufts Medical Center, Rhode Island Hospital and the University of Massachusetts Medical Center. The program is structured to foster an understanding of true multi-disciplinary clinical management.

July 2021 – June 2022 Resident rotation schedule

July	Oct	Nov	Jan	Mar	April-June
Mignano/Dipetrillo	Ko		Puthawala	Efective	Efective
Kinsella	Dipetrillo	Efective	Efective	Puthawala	Sloshansi
Efective	Efective	Dipetrillo	Kinsella		Mignano/Dipetrillo
Rava	Huber		Hepel/Wazer		Ptuhawala
Yu/Wazer	Rava		Huber		Leonard/Wazer
Dipetrillo	Hepel/Wazer		Mignano/Dipetrillo		Rava
Puthawala	Kinselia		Ko		Huber
Huber	Koffer		Sloshansi		Dipetrillo
Sioshansi	Mignano/Dipetrillo		Dipertrillo		Kinsella

Using the New Innovations Residency Management Suite, residents and faculty receive learning goals and objectives for each rotation prior to the start of the rotation. The distribution is set-up based on PGY-year level.

The primary goal of each rotation is for the resident to be able to provide the best possible care for patients from initial consultation to creation of a multidisciplinary care plan, radiation simulation and planning, management during and after therapy, and continuous follow-up. Residents will be exposed to discussions of practice-changing and informing papers as well as hands-on experience with the surgical, radiological and medical disciplines including extensive time spent with the radiation therapy team. Clinical rotations are a 1:1 apprenticeship with supervising faculty to provide experiential learning with increasing autonomy. Feedback is provided to assist residents and the program director in identifying strengths and weaknesses.

Resident case logs are reviewed by the program director and discussed with the resident twice a year during the semi-annual resident evaluation to monitor for the breadth of cases and inform scheduling for the individual resident to maximize the variety of their clinical exposure.

Board Preparation Courses

Physics

Christopher Melhus, PhD is a radiation oncologist at Tufts Medical Center.
Our Physics course, directed by TMC Chief Physicist Christopher S. Melhus, PhD, is taught by faculty and practitioners from Tufts Medical Center and the Rhode Island Hospital.

Radiobiology

Kathryn E. Huber, MD, PhD
Dr. Huber teaches “Cancer and Radiation Biology” which consists of more than 20 hours of didactic lectures. In addition, she has created “on demand” videos as supplementary study material.

Statistics

Kara L. Leonard, M.D.
Kara L. Leonard, M.D. (Rhode Island Hospital faculty) facilitates our Statistic course. Information is presented by viewing selected videos and is followed-up by a discussion of the material. Dr. Leonard is the author of “Biostatistics for Oncologists”.

Call schedule

Call is distributed among residents in 1-week blocks. Maximum call time is 1 week in a row. PGY-2 residents do not participate in the call rotation for the first two months of their residency. Call coverage extends to Tufts Medical Center, Rhode Island Hospital, and Miriam Hospital. Residents take call a total of 24 weeks over the 4 years of training. Travel reimbursement is provided for weekend call. There is NO in-house call coverage.

While on call, residents and their assigned attending assume after-hours care of all radiation oncology needs for patients at their assigned institution: phone calls, in-house consultations and arranging urgent/emergent radiation. These responsibilities teach and reinforce the essentials and basics of addressing common and important clinical situations such as managing the side effects and sequelae of radiation and treating patients with new indications for treatment, especially brain metastases, malignant spinal cord compression, malignant hemorrhage, painful metastases, and airway obstruction. Tufts Medical Center Radiation Oncology residency training program fully complies with the ACGME regulations governing resident work hours.

Efectives

Residents are encouraged to take electives in other departments (e.g. pathology, nuclear medicine, radiology, etc.) in the PGY-4 through PGY-5 years. Elective rotations are available at our Boston and Rhode Island sites in all major radiation oncology subspecialties. In addition, elective time can be spent on clinical or basic research projects.

Residents have completed electives in Radiology, Pathology, Neuroradiology, Physics and Dosimetry, Pediatric oncology, Breast, and Urology. An international elective to research the need for Radiation Oncology in India was completed by a past graduate.

Full day academics

Friday is designated as protected educational time for Radiation Oncology residents, during which residents gather at Tufts Medical Center for the day. Conferences are based on a well-developed curriculum, composed of 2 hours of clinical didactics/journal club led by residents. This is followed by 2 hours of medical physics instruction, 1 hour of radiobiology instruction, 1 hour (as designated on the schedule) of biostatistics instruction, all provided by faculty members. Tufts School of Veterinary Radiation Oncology residents as well as the Tufts University School of Medicine Oral Medicine residents join our residents during their academic day providing a unique perspective on cancer biology and management.
Multidisciplinary Subspecialty Tumor Boards and Conferences
Formal, structured, case-based tumor boards are held weekly for each disease site at each location at which time presentation of new cases and treatment plans are discussed. . Multiple disciplines including surgery, medical oncology, radiation oncology, pathology, and radiology attend and individual cases are reviewed and collectively discussed. Residents on service attend these conferences with their respective attending.

The Cancer Center Grand Rounds lecture series occurs every Friday at 8:00 am in the Wolff Auditorium and residents are strongly encouraged to attend this conference.

There is a 12 Noon conference held every Friday in the Radiation Oncology department Large Conference Room in the Proger basement and each resident is required to present at one of the Friday conferences each year. We engage visiting professors to present the remaining conferences.

Recent lecturers included:

Marcus E. Randall, MD, FACR, FASTRO
Chair and Professor, Radiation Medicine, University of Kentucky
Presentation: “Adjuvant Radiation Therapy and Chemotherapy in Endometrial Cancer: Clarity or Confusion?”

William U. Shipley, MD
Professor of Radiation Oncology, Harvard Medical School
Head, Genito-Urinary Oncology, Department of Radiation Oncology, Massachusetts General Hospital
Presentation: “Treating muscle-invading bladder cancer with organ preservation – 45 years on”

Lia M. Halasz, MD
Associate Professor, Radiation Oncology and Neurological Surgery
University of Washington School of Medicine
Presentation: “Clinician’s Guide in the new molecular era of gliomas”

Quality improvement projects

Residents and Faculty engage in Quality Improvement projects as mentors and learners. Each project is interdisciplinary and involves nursing, radiation therapists, and/or medical physics providing robust opportunity for identifying and working on areas in need of process improvement. Residents attend our bi-monthly Quality Assurance Working Group (QWAG) and quarterly Morbidity and Mortality (M&M) and QA Committee meetings where they are educated about process improvement and how to communicate with patients and regulatory agencies.

Examples of Quality Improvement projects that residents have participated in include the following:

Devised and Implemented hash-tag system for RO-ILS at Tufts Medical Center
Developed a Pacemaker/ICD policy and checklist at Tufts Medical Center
Revised documentation for the Management of Pain and Opioid Use at Tufts Medical Center
Created the “GRAY” Hand-off system