Radiation Oncology
Dr. Lisa Barbera, Division Head
Kelsey Knock, Administrative Assistant
The Faculty of Medicine, University of Calgary, in conjunction with the Tom Baker Cancer Centre, provides a fully accredited, residency training program in Radiation Oncology. The program functions within a dynamic teaching environment in the Department of Oncology, as there are training programs offered in the oncology disciplines as well as medical physics.
Over 4600 new patients are seen for outpatient consultation in Radiation Oncology clinics annually. The majority of inpatient consults and admissions occur on the oncology wards, Units 46 and 47, at the Foothills Medical Centre.
As of Fall 2020, the Division of Radiation Oncology at the Tom Baker Cancer Centre presently consists of 23 radiation oncologists. There are nine linear accelerators, one conventional simulator, two CT simulators, and an orthovoltage unit. We have capabilities for Stereotactic Radiosurgery (SRS), three dimensional conformal radiotherapy (3DCRT), intensity modulated radiotherapy (IMRT), and volumetric arc radiotherapy (VMAT) utilizing Varian Eclipse planning, as well as gynecologic, breast and prostate brachytherapy.
The Division has the latest technology and one of the best equipped facilities in the country. The catchment area and patient numbers ensure that residents will see the entire spectrum of tumours. The Tom Baker Cancer Centre is expected to be replaced by the Calgary Cancer Centre in 2023. It is located on Foothills Hospital campus and will be the largest cancer centre in Canada. Please visit the following webpage for more info on the Calgary Cancer Centre: https://www.albertahealthservices.ca/info/page15399.aspx. A virtual tour of the new facility is available.
The Division also actively participates in national and international cooperative clinical trials groups including NRG (formerly RTOG), NCIC, COG and NSABP.
Program Highlights
Our Radiation Oncology Residency Training Program at the University of Calgary was established in 2002 and has enrolled 30 trainees to date. The program currently accepts one trainee per year through the Canadian Resident Matching Service (CaRMS). Our program provides 2 preceptors to 1 trainee 8-week rotations through the majority of core Radiation Oncology training that provides excellent clinical exposure. The final training year incorporates a year-long rotation with two preceptors, along with single preceptor 8-week rotations, to provide a longitudinal clinic experience of managing patients from start to finish and includes follow-up care to emulate post-training practice. Formal academic half-day teaching with a 2-year curriculum, a dedicated medical physics training course in PGY1/2, and advanced treatment planning course in PGY3/4 provides a suitable didactic learning environment. Our program also incorporates a CanMEDs lecture series to individually address these competencies through a structured learning approach. Our residents are competitive for research awards and have excellent funding support for education courses and to attend conferences throughout training.
Overview
The Radiation Oncology Residency Training Program at the University of Calgary transitioned to competency-based medical education (CBME) in July 2019 with all trainees entering the program after this date affiliated with a new training program initiative. This initiative, called Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process. Residency training is divided into four stages that follow the CBD guidelines outlined by the Royal College of Physicians and Surgeons of Canada. There is an established didactic teaching program covering core radiation oncology topics and includes necessary basic oncologic knowledge in radiation physics, radiobiology, treatment planning, and clinical physics.
Program Outline
The overall goal of the program is to provide a training environment that ensures residents acquire the knowledge and skills to function as independent radiation oncologists. At the completion of training, a resident will have demonstrated competence in the CanMEDS domains as described in the Objectives of Training for Radiation Oncology (http://rcpsc.medical.org/residency/) and fulfil all CBD requirements. The training program is structured to meet the requirements of training as set out by the Royal College.
Transition to Discipline
One month orientation in Radiation Oncology.
Foundations
The Foundations stage of training consists of 11 months of four-to-eight week rotations in general internal medicine, general surgery, neurology, respiratory medicine, infectious disease medicine, otolaryngology medical, emergency medicine, gynecologic oncology, pediatric oncology, medical oncology, palliative care, and diagnostic radiology.
Core
The Core stage of training consists of 36-44 months of radiation oncology rotations, including up to 6 blocks of electives/research blocks. Residents are encouraged to pursue elective opportunities at other training centres. During this time, residents take first call for Radiation Oncology services. Radiation physics and radiobiology will be taught weekly during protected time for academic half days, in addition to Radiation Oncology teaching. Towards the end of the Core stage, an 8-week clinical physics and treatment planning rotation is undertaken. A mandatory rural/community-based Radiation Oncology rotation for a minimum of 4 weeks is also performed as well as one four-week rotation each in Medical Oncology and Pediatric Oncology. Training experiences in Pathology will be supplemented by interactive web-based education resources and didactic teaching. In addition, scholarly projects are initiated.
The Royal College examination is undertaken at the end of the Core stage, typically in the latter half of PGY-4 or early part of PGY-5.
Transition to Practice
The final stage of training now incorporates a formal period of time, typically 3-9 months, for Transition to Practice training. The chief objective is to emulate independent practice, but in a supervised learning environment. The training stage follows the Royal College examination to permit trainee focus on clinical practice with increased responsibilities. The structure for Transition to Practice includes professional development and personal wellness planning, assessing and managing patients at a consultant level, managing day-to-day aspects of practice, and mandatory completion of at least one scholarly project prior to graduation.
Research
Residents are expected to complete at least one clinical or basic science research project during their training. Research can be conducted in Radiation Oncology or on a collaborative basis with other oncology specialties, or with clinical physics, or with a basic science investigator at the Southern Alberta Cancer Research Institute.
Travel and Conference Funding
Residents are funded to participate in the National Radiobiology Review course in Toronto, ON, Anatomy and Radiology Contouring course in London, ON, and the Royal College examination preparatory course typically held in Montreal, QC, Ottawa, ON, London, ON, or here in Calgary, AB. In addition, conference funding to attend one or two North American meetings per year is available for residents who present their research work.
Teaching
The didactic basic physics course runs from September to April every two years and taken in either the first or second year of residency training, while an 8-week treatment planning course is held in the third year of training. Academic half-day occurs weekly on a Tuesday or Friday afternoon from September through August. Several combined oncology teaching sessions are held annually covering topics common to all training programs (e.g. research methods, molecular biology, introduction to other oncology specialties, etc.).
Multidisciplinary tumour board conferences and quality assurance rounds for all tumour sites are held weekly. Residents participate in a journal club administered by staff.
Training Sites
- University of Calgary
- Tom Baker Cancer Centre
- Foothills Medical Centre
- Peter Lougheed Centre
- Rockyview General Hospital
- Alberta Children’s Hospital
- Jack Ady Cancer Centre in Lethbridge, AB
- Central Alberta Cancer Centre in Red Deer, AB
Radiation Oncology Fellowship Program
Our Radiation Oncology Fellowship Program accepts one to three fellows per year. Clinical and research activities focus on brachytherapy, stereotactic body radiation therapy (SBRT), head and neck oncology, patient reported outcomes, and/or health services research, but other areas of specialization can be accommodated based on the successful candidate’s interest.
Fellowships are one-year in duration, and provide an opportunity to gain clinical expertise, research and publication productivity. The Division of Radiation Oncology has close collaborations with the Arnie Charbonneau Cancer Institute for candidates interested in translational research activities.