The fellow will learn the pathologic and radiographic characteristics, patterns of spread and natural history of primary and metastatic brain, skull base tumors and spinal cord tumors gaining an understanding of the anatomy of the nervous system. Attendance in the operating room for various brain/spine tumor surgeries is encouraged. Competence in the use and interpretation of diagnostic imaging and neuropathology as they pertain to the evaluation of brain/skull base/spinal cord tumors and effects after treatment as well as the appropriate management for patients with primary malignant, metastatic and benign CNS tumors. This includes familiarity with both the surgical and systemic therapy aspects of care. Competence in radiation therapy planning and delivery for neurological diseases, including use of fluoroscopic and CT simulation, MRI assisted target definitions and the use of 3D conformal radiation therapy, intensity modulated radiation therapy, stereotactic radiosurgery and stereotactic radiotherapy will be expected. From a set up perspective competence in the use of various immobilization strategies and treatment verification systems will be expected.
Fellows must become competent in understanding the appropriate applications of each treatment planning and delivery technique, with additional training in Proton Radiation Techniques and Carbon Ion Radiation Therapies with adjunct faculty from our collaborators in Japan. Fellows need to know how to define treatment targets and provide basic instructions for beam arrangements to guide dosimetric planning. S/he will become knowledgeable about the relevant medical literature, learn how to identify and critique the relevant literature and learn how to integrate it into practice. As part of this, fellows will become knowledgeable regarding treatment outcomes so that these can be discussed with the patient, family and primary care and other involved physicians. The expectation will also include familiarity with ongoing clinical research trials available to patients with these malignancies, become familiar with the incidence, presentation and management of acute and late adverse effects of radiation therapy to the nervous system.
By the end of the first year, the fellow will have mastered and refined all special techniques used in the department and will specifically focus on the use of radiation therapy in the context of CNS oncology. The fellow will thoroughly understand the role of all CNS oncological specialties, surgical or medical, and the special needs of the very young (pediatric), elderly, minority, and incarcerated patient populations. S/he will be able to manage the special needs of any patient and will understand how emotional, spiritual, or economic assistance can be offered utilizing resources within the department, The James, and broader community.
Sample Training Schedule
|Year 1||CNS Adult||CNS Pediatric||SBRT Spine / Base of Skull / Procedural||Research|
|Year 2 (Optional)||CNS Adult||CNS Pediatric||Elective / Procedural||Research|
Goals & Objectives of Training
- To learn appropriate methods and collection of data in support of a diagnosis of treatment of cancer patients with Radiation Therapy.
- To learn appropriate uses of radiation oncology therapies targeted for these diseases.
- To learn appropriate preventative measures used in the treatment of these conditions and complications of therapies.
- To learn the essentials of clinical investigation relevant to clinically-oriented questions in radiation therapy and relevant to translation of basic patient-oriented research.
- To learn to identify finding relevant to diagnosis and management of patients with cancer and as it relates to the use of radiation therapy in the management of the disease.
- To provide guidance and teaching to residents and medical students in the disease site.
- Applicants must be able to secure the appropriate visa for the appointment.
- Must be fluent in the English language.
- Must complete an application.
- Must provide current curriculum vitae indicating prior training, research and publications.
- Must provide copy of current transcript from medical or clinical training school.
- Each applicant is responsible for ensuring their application is complete.
- Applicants are responsible for ensuring that all information and supporting documents provided are authentic and accurate.
- We reserve the right to request additional information or verification of information and documents submitted. If an applicant is unable to do so, we reserve the right to withdraw consideration of the application.
- Applicants assume all costs associated with authenticating, retrieving and submitting documents and material in support of their application.