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Medical Students Rotations and Clerkships (M1, M2, M3 and M4)

Program Overview:

The radiation oncology clerkship is essentially a clinical outpatient experience at UMMC, where students participate in the workup and management of a variety of oncology patients. As an integral part of the radiation oncology team, students will have an opportunity to do physical examinations and perform procedures. They will also attend multidisciplinary tumor boards and gain an introduction to the appropriate delivery and indications of radiation therapy for cancer patients.

Program Structure:

Day 1

Meet with the medical student coordinator for general orientation and course materials. Orientation with course instructor/attending. Design a schedule for seeing patients in the clinic.

Mid-way

Meet with the course instructor/coordinator to discuss rotation.

End of rotation

Formal presentation on a topic of the student’s choice. Evaluation of course (mandatory).

Medical students will participate as part of a clinical team supervised by an attending physician. There are five basic types of patient encounters in radiation oncology:

• Consultation
• Simulation
• Treatment Delivery
• On-treatment visits (of patients undergoing a course of radiation treatment)
• Follow-up

Consultation:

• Obtain the relevant history and diagnostic workup and perform thorough physical examinations of the cancer patient (H&P).
• Present the relevant details of the H&P and workup to the attending physician.
• Review appropriate imaging and pathology.
• Discuss relevant literature so that evidence-based decision-making can occur.
• Formulate a cancer treatment plan with the attending physician.

Simulation and Treatment Planning:

• Assist in the careful design of a course of radiation treatment during patient simulation and treatment planning.
• Understand how basic anatomy and knowledge of cancer spread influences radiation planning and delivery.
• Learn the workflow process in radiation planning and the involvement of radiation therapists, dosimetrists, and physicists.

Treatment Delivery:

• Observe the delivery of radiation treatment on the treatment units (Tomotherapy, TrueBeam, Cranial/Body Radiosurgery, Brachytherapy).

Weekly On-Treatment Visits (OTV):

• Monitor patients for the acute effects of radiation treatment during weekly status check visits and the management of these effects.

Follow-ups:

• Evaluate patients for tumor response, late effects of radiation therapy, and their management.
• Answer questions to long-term quality of life and function. 

Objectives:

• Understand the central role that radiation therapy plays in the multi-disciplinary management of cancer and the basic biological principles that underlie its use.
• Learn the appropriate diagnostic evaluation, staging, and prognosis of the various major cancers (prostate, breast, gastrointestinal, lung, gynecologic, brain, head and neck, and hematologic) treated with radiation therapy.
• Grasp how basic anatomy and knowledge of cancer spread influences the delivery of radiation therapy.
• Recognize the appropriate indications for radiation therapy in the curative and palliative setting for the common cancer types.
• Become familiar with how radiation therapy can be used to improve the quality of life for cancer patients.
• Appreciate the acute and late effects that could result from treatment.
• Become acquainted with the basics of simulation, treatment planning, and delivery by working with radiation therapists, dosimetrists, and physicists.

Expectations:

• Participate in patient evaluation in ambulatory clinics. The level of student responsibility should be discussed prior to each clinic with each individual resident and attending. In general, students should expect to perform 1 complete H&P per new patient consultation for a total of 3-4/week and 3-4 H&P/week for follow-up patients. Students are encouraged to follow 1 patient/week through simulation and treatment planning and see at least 5-10 weekly on-treatment visits. All patient encounters must be supervised by a resident and/or attending. Students are urged not to advise patients and/or make treatment recommendations without the discussion or presence of a resident or attending.
• Attend teaching conferences and tumor boards.
• Formal Presentation: For those completing a 4-week elective, an oral presentation is required at the end of the rotation. The topic of this presentation is at the discretion of the student. For instance, the presentation could focus on an area of research or be based on a particularly interesting case that was seen by the student during the rotation in radiation oncology at UMMC. The focus should be on the case presentation, the cancer treatment plan including details of the radiation, and a concise review of relevant literature. It is helpful to identify an interesting case during the first 2 weeks of the rotation. The case should be discussed with the attending physician and the resident. Please notify the program director, Dr. Mundra, or the program coordinator, Andie Hand, once the topic has been chosen to schedule a conference date.

How to apply:

Medical students interested in doing a 3-4-week clinical clerkship should contact the course coordinator, Andie Hand, at 601-815-5762, or email at gme-radiationoncology@umc.edu.