Emory_Radiation Patient Center

Mission Statement

The mission of the Residency Program in the Department of Radiation Oncology at Emory University Affiliated Hospitals is multifold: to train residents in the principles and practice of radiation oncology, including the applied principles of physics and radiobiology, treatment techniques, the radiation oncology literature, and the integration of this knowledge with surgical and medical oncology; to ensure that the residents are adequately prepared to pass their certifying examinations; to instill the importance of well-designed and -conducted clinical and basic research; to teach, by example, the importance of exhibiting the highest level of professionalism and ethics in all interactions with patients and colleagues; and to train radiation oncologists who will be leaders in our profession.

The four-year Radiation Oncology residency follows completion of a one-year internship in Internal Medicine. The program prepares residents for certifying examinations given by the American Board of Radiology.

The Radiation Oncology Residency Program was reestablished during the 1993-1994 school year at the Emory University School of Medicine. Positions are filled through the National Resident Matching Program. Applicants are accepted at the PGY-1 level and receive their first year of training with the Department of Medicine. The program consists of a one-year internship in internal medicine followed by a four-year residency in radiation oncology. Twenty residents have completed their training in the department since the program was reestablished. Of those residents, 100% have passed their board examinations and 100% have found employment, primarily in the Southeast.

The program utilizes all of the resources of the Emory University System of Healthcare. This system includes the facilities and patient bases of Emory University Hospital, The Emory Clinic, Children's Healthcare of Atlanta, Grady Memorial Hospital, Crawford W. Long Hospital and the Veterans Affairs Medical Center.

For their clinical rotations in radiation oncology, residents are assigned to one of the facilities on a rotating basis. Most clinical rotations are three months in duration. The resident is expected to learn the presentation, evaluation, staging, radiation therapy techniques, relevant literature, and clinical management of each patient encountered on the rotation. Progressive and increasing responsibilities are delegated to residents commensurate with their knowledge and experience. Clinical research protocols are available through our affiliation with RTOG, GOG, ECOG, NSABP, POG and Brain Tumor Study Group. Residents also are encouraged to enroll patients on institutional protocols.

The requirements for successful completion of the residency program include preparation of at least one manuscript suitable for publication. Usually during the PGY-3 or -4 year, residents have a six-month research rotation in clinical radiation oncology, radiation biology, radiation physics, or some combination of these. Residents may elect rotations in other oncologic subspecialties including surgical oncology, medical oncology, pediatric medical oncology and pathology.

Presently there are twenty full-time faculty members in the Department of Radiation Oncology, comprising twelve radiation oncologists in the Clinical Division, four physicists in the Division of Medical Physics, and four biologists in the Division of Cancer Biology.

The residents' educational experience comprises four institutions affiliated with Emory Healthcare. These are:

Emory Clinic/Emory University Hospital/Children's Healthcare of Atlanta

Grady Memorial Hospital Edward Loughlin Radiation Oncology Center

Crawford Long Hospital of Emory University/Emory Clinic at Crawford Long

Atlanta Veterans Affairs Medical Center

Each of these institutions provides the residents with a unique educational experience.
The Emory Clinic serves as the base for the residency program. The facility at Emory gives the residents a unique exposure to neuro-oncology and pediatric radiation oncology with emphasis in stereotactic radiotherapy for central nervous system tumors. The residents also see a large number of patients with head and neck, breast, hematologic, genitourinary and gastrointestinal malignancies. Residents will gain experience in IMRT, all aspects of stereotactic radiotherapy planning, PET-CT fusion, and prostate brachytherapy. There is also the opportunity to see plaque brachytherapy for ocular melanoma. This facility has a GE AdvantageSim simulator, which allows great precision in setup and planning of radiation treatment. There is also a Varian Acuity system for setup verification. The four Varian linear accelerators all utilize multileaf collimators. One of these linear accelerators is a new Clinac 23EX-based Trilogy system and another Clinac 23EX has on-board imaging and respiratory gating capabilities. The other two linear accelerators are a Clinac 23EX and a Clinac 600C. Stereotactic radiotherapy is performed with the BrainLAB system. Residents also may use the GliaSite for CNS brachytherapy. Novoste and Guidant systems are utilized for intravascular brachytherapy.
The Emory Clinic at Crawford Long provides the residents with experience in treating malignancies of the breast, lung, and genitourinary system, as well as soft tissue sarcomas. The resident also will gain experience in high-dose rate intracavitary brachytherapy for lung and gynecological tumors, as well as low-dose rate interstitial prostate and low-dose rate intracavitary cervical implants. This facility has a Varian Acuity simulator, one Varian linear accelerator with multileaf collimators, and a high dose-rate remote afterloading unit.

The Grady Memorial Hospital, Edward Loughlin Radiation Oncology Center sees patients with a wide range of head and neck, lung, breast, gynecologic and gastrointestinal tumors. Unfortunately patients often have advanced stages of disease, which offer a unique challenge in treatment planning and delivery. Residents also gain experience in low- and high-dose rate brachytherapy for gynecologic malignancies. This facility has an Oldelft fluoroscopic simulator, two Siemens linear accelerators (one SL75 and one SL25), and a high dose-rate remote afterloading unit. Most patients get a treatment planning CT scan, and many now have a PET-CT scan.

The Atlanta Veterans Affairs Hospital provides the residents with experience in treating head and neck, lung and genitourinary malignancies. The facility has an Oldelft fluoroscopic simulator and two Varian linear accelerators with multileaf collimators. Most patients have a treatment planning CT scan.

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All residents are excused from clinical duties every Friday morning for didactic sessions held at Emory. In addition, the individual sites and attending physicians may provide lectures or informal teaching to the residents currently rotating there.

The residents’ primary clinical textbook is Principles and Practice of Radiation Oncology, Fourth Edition (Perez et al., eds). Over the course of the academic year, all sites and diseases are discussed in the didactic sessions. Each Thursday morning, one resident presents a patient’s history and physical examination, key findings on imaging, and reviews the literature on that topic. All residents are quizzed and critiqued on the epidemiology, workup, pertinent clinical findings and treatment. Most Friday mornings there is an additional resident discussion each week that complements the main clinical topic. Attending physicians serve as the moderators of these conferences. Physics and radiation biology lectures also are given each Friday morning.

A physics lecture series is given by the Division of Medical Physics and consists of one session each Friday for the entire academic year. Residents are trained in superficial and megavoltage external beam radiation therapy as well as low- and high-dose rate brachytherapy. The primary textbook is The Physics of Radiation Therapy, Third Edition, by F. M. Khan. Examinations are given at approximately two-month intervals.

There is a radiation biology lecture series given the first half of the year which is taught by faculty from the Cancer Biology and Clinical Divisions. The textbook is Radiobiology for the Radiologist, Fifth Edition, by Eric Hall.

In the second semester, residents attend a weekly graduate-level course in cancer biology at Emory University taught by the faculty of the Division of Cancer Biology. This course emphasizes the molecular and genetic aspects of the disease. There are mid-term and final examinations in this course.

The principal conferences are summarized in the table below. Residents also are encouraged to attend other departmental lectures when clinic duties permit.

Mandatory Conferences

Chart Rounds Friday 7:00 a.m. Emory

Resident Conferences Thursday; Friday 7:00 a.m.; 8:30 a.m. Emory

Journal Club Tuesday (monthly) 5:30 p.m. Emory

Morbidity & Mortality Tuesday (monthly) 7:00 p.m. Emory

Physics Friday (varies) Emory

Radiation Biology Friday (fall semester only) 10:00 a.m. Emory

Cancer Biology Friday (spring semester only) 10:00 a.m. Emory

Visiting Professors 3/year (varies) Emory

Optional Conferences

Tumor Board Monday 12:00 p.m. VAMC

ENT Monday (biweekly) 12:00 p.m. Grady

Medical Oncology Monday 1:00 p.m. VAMC

ENT Tuesday 7:00 a.m. Emory

Brain Tumors Tuesday 12:30 p.m. Emory

Sarcomas Tuesday (monthly) 5:00 p.m. Crawford Long

Med Onc Grand Rounds Wednesday 7:30 a.m. Emory

Pulmonary Wednesday 4:00 p.m. VAMC

Pediatric Tumor Board Wednesday 4:30 p.m. CHOA

Urology Thursday 7:00 a.m. Emory

Breast Thursday 5:00 p.m. Emory

Pediatric Brain Tumor Thursday (monthly) 12:30 p.m. Emory

GI Thursday 5:00 p.m. Emory

Tumor Board Thursday 12:30 p.m. Crawford Long

Pulmonary Thursday (biweekly) 12:00 p.m. Grady

Megaconference Thursday 4:00 p.m. Grady

Cutaneous Lymphoma Friday 1:00 p.m. Emory

Each resident receives $500 annually to spend on textbooks, journal subscriptions, PDA software, or other educational material. The department also pays the subscriptions for the UpToDate clinical information resource for each resident; this amount does not apply toward the book fund limit.

Residents may attend ASTRO twice during their training with expenses reimbursed by the department. In addition, any resident who presents research at ASTRO will be reimbursed for expenses. Residents who present research at meetings of the American Radium Society or the Radiological Society of North America also will be reimbursed for expenses.

Residents receive fifteen days of personal leave for vacation and twelve days of sick leave annually. Each resident also receives five days of leave to interview for post-residency employment.

Free covered parking is available at all four radiation therapy facilities. Each resident also receives three long white coats with free laundering service at Emory.

Health insurance, term life insurance, dependent term life insurance, long-term disability insurance, and accidental death and dismemberment coverage are provided to residents at no cost. Dental and vision coverage are available to residents and dependents for minimal cost. Flexible spending accounts may be established to pay medical, dental, and dependent care expenses with pre-tax income. Retirement plans are available, but there are no employer matching contributions. Residents are eligible to purchase discounted computer hardware and software from the Emory computer store. Other optional benefits include direct deposit of paychecks, membership in the Emory Credit Union, library privileges, and membership in recreation and fitness facilities. Additional benefit information may be found at the Emory University Human Resources page: http://emory.hr.emory.edu/rtpbenplans.nsf/



The first year of training is a preliminary internship with the Department of Medicine. The radiation oncology interns share patient care, call, conference presentations, and clinic duties with the categorical medicine and other interns. The year is divided into twelve rotations; most will be performed at Grady Memorial Hospital, but a few rotations may be at Emory University Hospital or the Veterans' Affairs Medical Center. The year typically consists of eight months of inpatient medicine wards, one emergency medicine month, one medicine ICU month, one ambulatory medicine month, and one elective month.

Each intern has a longitudinal medicine clinic that is held one half-day each week for the entire year. This clinic allows the intern to gain experience managing outpatient issues over a more extended time than is possible on the scheduled rotations.



Evaluation of Patients:

Learn how to obtain a pertinent history, perform a system oriented physical exam, review pertinent radiographs, pathology and tumor markers to make patient management decisions. Learn how to present this information to attending physicians in an organized manner.

Learn and master the staging system for each cancer site and correlate each patient’s stage with treatment and prognosis.

Learn how to manage radiation oncology emergencies, such as spinal cord compression and superior vena cava syndrome.

Treatment of Patients:

Develop an awareness of all available treatment options (radiation, surgical, and medical) for patients referred to radiation oncology.

Develop competence in treatment set-ups and treatment planning of low to intermediate levels of complexity.

Learn the radiation dose tolerance of each organ so that the prescribed dose to the tumor will not exceed the tolerance of important structures in close proximity.

Develop skills in setting up appropriate radiation fields for specific stages of disease and prescribe appropriate radiation doses. The resident is expected to master the treatment set up and dose prescriptions of the patients with diagnoses within the expertise of the service's attending physician(s), and to have a good working knowledge of the same for other patients.

Develop some understanding of the psychological effects that a diagnosis of cancer has on some patients and develop a supportive resident-patient relationship.

Examinations:

The first year residents are required to take the American College of Radiology In-Service training exam. Although the scores are not used for promotion, residents are expected to score above the 50th percentile for all first year residents. The RAPHEX examination is administered to first year residents in June.

Evaluation and Promotion:

At the completion of each three-month rotation, each first year resident receives a written evaluation of his/her fund of knowledge, technical skills, professionalism, teaching skills and leadership skills. The resident must receive a satisfactory performance in the summary evaluation. At the end of the first year, a composite evaluation is performed by the program director taking into account the four quarterly evaluations. The Academic Committee meets in March of each year to discuss each resident’s evaluations for the year. Contracts for the PGY-3 year will be offered to residents who obtain an overall satisfactory evaluation.

Evaluation of Patients:

Residents are expected to refine their history, physical examination and interpretation of pertinent radiographic and pathologic information to make more advanced decisions in patient management.

Residents will exhibit more independence in the management of radiation oncology emergencies, but the attending physician must approve the resident’s treatment set-ups prior to delivering treatment.

Usually during this year, the residents spend a three-month block with two attendings in pediatric radiation oncology. The resident will master the work-up of both pediatric and brain tumors. During the other rotations, the resident is expected to master the oncologic work-up of all patients evaluated.

Treatment of Patients:

Begin to integrate the different treatment options available for oncologic patients that provide the highest potential for cure and control of tumors.

Expand competence in treatment set-up and treatment planning, including radiation treatment fields of intermediate to high level of complexity.

Expand skills in setting up appropriate radiation treatment fields for specific stages of disease and understand any variations in set-up between Emory and other academic institutions. The resident is expected to master the treatment set-up and radiation dose employed for all patients seen with the attending physicians.

Examinations:

The resident is expected to score above the 50th percentile for second year residents on the ACR in-service examination. The RAPHEX examination also is administered.

Evaluation and Promotion:

Each resident is evaluated at the completion of each three-month rotation. At the end of the second year a composite evaluation is performed by the program director with emphasis on improvement in the resident’s performance from the prior year. The Academic Committee meets in March of every year and reviews each resident’s evaluations. Contracts for the PGY-4 year will be offered to those residents who have an overall satisfactory evaluation.

Usually during this year the resident will complete a six month research rotation in clinical radiation oncology, radiation biology, radiation physics, or some combination of these. During this research rotation the resident continues to take call and attend conferences, but is excused from clinical patient-care duties. The remaining six months of the year consist of clinical rotations.

Evaluation of Patients:

Residents should refine their patient presentations to a concise encapsulation of the patient’s history, physical examination, radiographic studies and treatment plan.

Treatment of Patients:

Residents should master the most difficult treatment planning options and patient management issues.

Residents should master treatment of all tumor sites by stage of disease, and should be able to substantiate therapies with the relevant literature.

Examinations:

The resident is expected to score above the 50th percentile for all third year residents on the ACR in-service examination. The RAPHEX examination also is administered.

Chief Resident:

One of the PGY-4 residents is selected to be the chief resident for the next year by a vote of the Academic Committee.

Evaluation and Promotion:

Residents are evaluated at the completion of each three-month rotation. At the end of the third year, a composite evaluation is performed by the program director; the resident is expected to show an improvement in performance over the previous years. The Academic Committee meets in March each year to review each resident’s performance. Contracts for the PGY-5 year will be offered to residents with overall satisfactory evaluations.

Evaluation and Treatment of Patients:

Residents function more independently; they are expected to evaluate patients, determine appropriate therapy, plan radiation fields, and complete all of the service's other clinical duties with minimal direction from attending physicians. Attending physicians still must verify treatment plans before radiation therapy is initiated.

During this year residents should assess their skills and fund of knowledge, and concentrate on strengthening any deficient areas in clinical radiation oncology, radiation physics, or radiation biology.

Examinations:

The resident is expected to score above the 50th percentile for all fourth year residents on the ACR in-service examination. The RAPHEX examination also is administered.

Evaluation and Criteria for Graduation:

Residents are evaluated at the completion of each three-month rotation. The Academic Committee meets in March to review each resident’s performance. Satisfactory completion of each rotation is required.

Each resident must perform 10 intracavitary brachytherapy procedures and 5 interstitial brachytherapy procedures, and assist in an additional 10 intracavitary and 5 interstitial procedures. Each resident must see a minimum of 450 new patients during their entire training. They also must complete at least one manuscript suitable for publication on a clinical or basic science topic.

PGY-5:

Cynthia Bryant, M.D.

Medical College of Wisconsin, M.D.
University of Wisconsin, B.S. (Psychology)

Quillin Davis, M.D.

Baylor University College of Medicine, M.D., 2000
University of Houston, B.S. (Biology), 1996

Zach Fowler, M.D. (Chief Resident)

University of Maryland School of Medicine, M.D., 2000
Georgia Institute of Technology, B.EE. (Electrical Engineering), 1991

PGY-4:

Janna Andrews, M.D.

Temple University School of Medicine, M.D., 2000
Princeton University, B.A. (Molecular Biology), 1996

Adam Nowlan, M.D., M.P.H.

Emory University School of Medicine, M.D., 2001
Emory University Rollins School of Public Health, M.P.H. (Epidemiology), 1997
Bryan College, B.S. (Biology), 1993

PGY-3:

Cynthia Anderson, M.D.

Emory University School of Medicine, M.D., 2001
University of Chicago, B.A. (Political Science), 1994

Nilesh Patel, M.D.

Baylor University College of Medicine, M.D., 2002
Baylor University, B.A. (Biology), 1998

Krupali Tejura, M.D.

University of California, Los Angeles, School of Medicine, M.D., 2002
University of Southern California, B.S. (Biological Sciences and Sociology), 1997

PGY-2:

Joshua Lawson, M.D.

Emory University School of Medicine, M.D., 2003
Emory University, B.S. (Biology), 1997

Charles Perkins, M.D., Ph.D.

Emory University School of Medicine, M.D., 2003
Emory University, Ph.D. (Genetics and Molecular Biology), 1999
University of Georgia, B.S. (Genetics), 1995

Edmund Simon, M.D.

Medical College of Ohio, M.D., 2002
University of Miami, B.S. (Biomedical Engineering), 1998

PGY-1:

Mark McDonald, M.D.

Ohio State University College of Medicine, M.D., 2004
Xavier University, B.A. (English), 1999

Liza Stapleford, M.D.

Tufts University School of Medicine, M.D., 2004
University of Delaware, B.A. (Neuroscience), 1999

Natalie Xu, M.D.

Case Western Reserve University School of Medicine, M.D., 2004
Ohio State University, B.S. (Biochemistry), 2000

Tosha Balfour, M.D.
Radiotherapy Clinics of Georgia
Atlanta, GA
James Benton, M.D.
Radiotherapy Clinics of Georgia
Atlanta, GA
Mary Koshy, M.D.
Emory University
Department of Radiation Oncology
Atlanta, GA

Stuart Burri, M.D.
Southeast Radiation Oncology Group
Charlotte, NC
Michael Fallon, M.D.
Lourdes Hospital Regional Cancer Center
Binghamton, NY
Chad Levitt, M.D.
U.S. Oncology
Denver, CO

Leela Maxa, M.D.
Radiotherapy Clinics of Georgia
Atlanta, GA
John Pablo, M.D.
Savannah Oncology Center
Savannah, GA
Todd Scarbrough, M.D.
Melbourne Cancer Center
Melbourne, FL

Robin Smith, M.D.
Cancer Center at Russell Medical Center
Alexander City, AL
Terry Styles, M.D.
Cancer Center at Phoenixville Hospital
University of Pennsylvania
Phoenixville, PA
Scott Lawson, M.D.
Center for Cancer Care
San Marcos, TX

Michael Wing, M.D.
Palms West Radiation Therapy
Palms West Hospital Campus
West Palm Beach, FL
Linda Wobeck, M.D.
Piedmont Hospital
Department of Radiation Oncology
Atlanta, GA
Gary Yang, M.D.
Roswell Park Cancer Institute
Department of Radiation Medicine
Buffalo, NY

Shelley Machuta, M.D.
Saint Joseph's Hospital Center
Atlanta, GA
Suzanne Smith, M.D.
Atlanta Oncology Associates
Atlanta, GA
Natia Esiashvili, M.D.
Emory University
Department of Radiation Oncology
Atlanta, GA

Leslie Holmes, M.D.
Emory University
Department of Radiation Oncology
Atlanta, GA
William Bobo, M.D.
Southeast Radiation Oncology Group
Charlotte, NC



Applicants may apply to the residency program through the Electronic Residency Application Service (ERAS). The information that should accompany the application includes:

Curriculum vitae

Personal statement

Transcripts

Board examination scores

Three letters of recommendation

Medical schools generally mail the Dean’s letters on or after November 1st.

Interviews are conducted on two different dates in December. Interviews are by invitation, with candidates selected for interview based upon their application materials. One half of each interview day is allotted to interviews by the clinical, physics, and radiation biology faculty; applicants tour the program's four radiation therapy facilities for the remainder of the day. Applicants also have lunch with the current residents, which provides the opportunity to learn about the program in more detail and ask additional questions.

Applicants who match with Emory are required to do the PGY1 year with Emory's Department of Medicine. The department participates in the national resident matching program for the PGY1 positions.



Residency Program Director:

Karen D. Godette, M.D.
Tel: (404) 686-2391

Residency Program Coordinator:

Patrice Moua
Department of Radiation Oncology
Emory University
1365 Clifton Road, NE
Atlanta, GA 30322
Tel: (404) 778-4763
Email: patrice@radonc.emory.org