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RADIATION ONCOLOGY TRAINING PROGRAM CURRICULUM Page 2 © 2012 RANZCR The Royal Australian and New Zealand College of Radiologists® RADIATION ONCOLOGY TRAINING PROGRAM CURRICULUM Page 2 © 2012 RANZCR. Radiation Oncology Training Program Curriculum Foreward by the Chief Censor incorporates direct clinical management of patients of CURRICULUM all ages, with a uniquely effective treatment modality. INTRODUCTION With the discovery of X-rays in the late 19th century and It is a specialty that will allow you to have meaningful the study of radioactivity by Marie Curie and colleagues interactions with patients and their families, and to be in the early 1900s, came a new era in medicine. The a key player in their overall care. realisation that some types of radiation (X-rays, electrons and gamma rays from radioactive materials) destroy Again, welcome. malignant cells, infinitely expanded our capacity to treat cancer. Over the last 100 years, the full potential of radiation in curing many cancer patients, and relieving distressing symptoms (palliation) for others, has unfolded. This stream of medicine has grown into the modern A/Prof. Sandra Turner specialty of Radiation Oncology. Chief Censor Radiation Oncology Clinicians who specialise in Radiation Oncology play an integral role in the complex multidisciplinary team management of cancer patients. Their practice is strongly underpinned by a detailed knowledge of the biological effects and physics of radiation, of pathology and anatomy as they relate to cancer and its control, and of the application of sophisticated imaging and treatment technologies. Paramount is an extensive understanding of all clinical aspects of cancer management. Radiation Oncologists are trained to be competent beyond their role as clinical and technical experts. Our Fellows are required to be excellent communicators, above all with our patients, to work in a close and collaborative fashion with radiation therapists, medical physicists, surgeons, medical oncologists, palliative care physicians and radiologists amongst others; to practice evidence-based medicine, and to take part in research and other academic pursuits, including teaching. These skills and expertise enhance the value of the specialty for the community. They are required to advocate effectively for their patients and for their profession. Welcome to this, Version 2, of our modern curriculum for training in Radiation Oncology. This document refines and updates the previous ‘new’ curriculum without changing the overall statements of the knowledge and skills required for our speciality. If you are commencing training in Radiation Oncology, you are entering an intellectually challenging and exciting career. This is a rapidly evolving specialty incorporating many varied specialised procedures and options for academic pursuits. It is highly rewarding in that it © 2012 RANZCR. Radiation Oncology Training Program Curriculum Page 3 Page 4 © 2012 RANZCR. Radiation Oncology Training Program Curriculum TABLE OF CONTENTS GOALS OF TRAINING PROGRAM CURRICULUM BACKGROUND TO CURRICULUM DEVELOPMENT 9 TRAINING PROGRAM STRUCTURE 11 • LEARNING PORTFOLIOS 11 • THE TRAINEE AND NETWORK TRAINING CENTRE(S) PARTNERSHIP 12 INTRODUCTION TO THE CanMEDS ROLES 13 • ROLE STATEMENTS 14 HOW TO USE THIS CURRICULUM DOCUMENT 15 ROLE 1: MEDICAL EXPERT 17 • RADIATION ONCOLOGY PHYSICS 21 • RADIATION AND CANCER BIOLOGY 27 • ANATOMY 32 • PATHOLOGY 35 RADIATION ONCOLOGY CENTRAL KNOWLEDGE & SKILLS SUMMARY (ROCKSS) 39 MEDICAL EXPERT SUPPLEMENT TOPICS 42 • Breast 43 • Lung and Mediastinum 47 • Head and Neck 53 • Skin 57 • Male Reproductive System 61 • Female Reproductive System 67 • Urinary Tract 73 • Gastrointestinal Tract 77 • Central Nervous System 87 • Haematology 97 • Musculoskeletal and Connective Tissue 103 • Paediatrics 109 • Endocrine 113 • Metastatic Disease 117 • Non-Malignant 121 • Clinical Oncology 123 LEARNING OPPORTUNITIES 127 ROLE 2: COMMUNICATOR 131 ROLE 3: COLLABORATOR 135 ROLE 4: MANAGER 139 ROLE 5: HEALTH ADVOCATE 143 ROLE 6: SCHOLAR 147 ROLE 7: PROFESSIONAL 151 DESCRIPTION OF ASSESSMENTS 155 GLOSSARY 161 ALPHABETICAL INDEX OF MEDICAL EXPERT SUPPLEMENTS 165 © 2012 RANZCR. Radiation Oncology Training Program Curriculum Page 5 Page 6 © 2012 RANZCR. Radiation Oncology Training Program Curriculum CURRICULUM INTRODUCTION CURRICULUM INTRODUCTION © 2012 RANZCR. Radiation Oncology Training Program Curriculum Page 7 Page 8 © 2012 RANZCR. Radiation Oncology Training Program Curriculum Goals of the Radiation Oncology Curriculum CURRICULUM INTRODUCTION This document aims to: • Articulate the knowledge, skills and attributes of a Radiation Oncologist • Provide direction to help trainees acquire the necessary competencies • Provide stimulus for potential learning opportunities and give guidance as to how to maximise benefit from these • Demonstrate the integration and links between various areas of knowledge and their application in clinical practice • Present a framework for trainee progression through the program • Describe the assessments used across the training program • Promote regular and productive interaction between trainees and supervisors, through the use of formative in-training assessments • Indicate where learning materials and resources may be found Background to South Wales advised throughout the development process Curriculum Development and remains involved. The process of defining the scope of the modern The process culminating in the publication of the first Radiation Oncologist’s role was followed by establishing edition of this document occurred between 2004 and a framework for the shape of the new program, in parallel 2008. It involved widespread consultation between with filling out the content of the curriculum document. the Fellows of the Faculty of Radiation Oncology (“The The common core competencies evolved and continued Faculty”) of The Royal Australian and New Zealand to be refined by the CAC group during the course of the College of Radiologists (RANZCR) as well as many other project. Most members of the Faculty were involved in parties. writing and reviewing one or more sections dealing with specific tumour sites. Most topics were reviewed several In 2004, the Faculty Board advised that a comprehensive times and the final document draft was circulated widely review of the Radiation Oncology training program be for comment. undertaken. The impetus for change emanated from three areas. The main trigger was evolution of modern Since the release of the first edition in 2008, several educational and evidence-based adult-learning concepts, ongoing reviews of curriculum components have been including the increased use of formative in-training completed and feedback has been sought through the assessments. At the same time, recognition by Fellows implementation phase of the ‘new’ (now considered and trainees of the vagaries of the previous syllabus and current) curriculum. This has resulted in some, mostly assessment led to a desire to increase the objectivity and minor, changes to subject content and scope. This has clarity of all aspects of training. Furthermore, important been reflected by related in-training and summative governmental bodies in the realm of accreditation of assessments, and training tools. This 2012 version (second Medical Colleges (in particular the Australian Medical edition) contains all of these changes and updates. At the Council) were arriving at similar conclusions that were time of printing, a formal independent (external) review of reflected in requirements to all Medical Colleges. all aspects of the curriculum, including training Network operation and curriculum delivery, is in development. As the initial step, the Curriculum Advisory Committee (CAC) was convened, including many members of the The entire development and review of this curriculum Faculty significantly involved in education, as well as to date has occurred with the direct involvement of the others with an interest to become more involved. It also Education Boards - past and present - with members included trainee representatives, representatives of the listed below. The Faculty Board has retained oversight public (consumer representatives) and RANZCR secretariat of the curriculum development and subsequent updates, members, in particular the newly appointed RANZCR Head with their input and approval sought in every matter. of Education and Research. A consultant expert in post- As a subgroup of CAC and/or Education Boards, graduate medical education from the University of New © 2012 RANZCR. Radiation Oncology Training Program Curriculum Page 9 the Radiation Oncology Curriculum Editorial Teams 1 & 2 (ROCET 1 & 2), have had the task of editing, organising and formatting these documents. ROCET’s roles also included the coordination of the review process, addressing comments, advising on artwork and communicating Curriculum development issues back to the Education Board and Faculty Board. This Curriculum represents a large body of work achieved as a cooperative effort by a large number of people both within and outside The Faculty. This document will continue to be reviewed and updated in order for it to retain relevance and to meet the goals for which it was designed. Education Board Members 2006-2009 Radiation Oncology Curriculum Editorial Team 1 Members 2007-2008 A/Prof Martin Berry (Chief Censor) A/Prof Roger Allison (Dean) Dr Sandra Turner (Chair) Dr Sandra Turner Dr Matthew Seel Dr Matthew Seel Dr Mary Dwyer Dr Chakiath Jose Dr Kirsty Stuart Dr Rahul Mukherjee Ms Ally Keane Dr Tanya Holt A/Prof Graham Stevens (Chief Accreditation
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