Medical Physics Residency

The two major goals of the program are to provide a broad based in-depth training which will allow the graduate to integrate successfully into a clinical system, thus assuring the continued quality of medical care received by the radiation oncology patient; and to prepare the graduate for certification by the ABR in the specialty of Therapeutic Radiological Physics.

Clinical Experience
The resident shall participate in routine clinical operations serving in either the role of a dosimetrist or physicist. The resident will be required to interact with physicians as well as technical staff and is expected to manage the patient's treatment beginning with the simulation and ending with the treatment.

Radiation Dosimetry for Patient Care
In order to accurately calculate the patient dose in a clinical environment, the resident must be able to incorporate all the uncertainties associated with the process, including simulation, machine delivery variations, and limitations of dose calculation algorithms in the treatment planning computers. Residents will:

• Receive instructions regarding the protocols for defining organs that require delineation in treatment planning systems.
• Receive instructions for the proper fusing of CT, MR, PET and other image data sets used in treatment planning.
• Assist in CT-simulation procedures to develop skills in immobilization and image data transfer to treatment planning systems.
• Demonstrate the ability to independently run clinically acceptable standard patient treatment plans using department treatment planning systems.
• Demonstrate the ability to independently run clinically acceptable segmented patient treatment plans using department treatment planning systems.
• Demonstrate the ability to independently run clinically acceptable inverse patient treatment plans with fixed-fields using department treatment planning systems.
• Demonstrate the ability to independently run clinically acceptable inverse patient treatment plans with VMAT using department treatment planning systems.
• Demonstrate the ability to independently run both LDR and HDR brachytherapy planning.
• Develop understanding of all the algorithms utilized in department treatment planning systems

Radiation Dosimetry for Radiation Protection of Staff, Patients and General Public
In order to provide protection from radiation to both the general public as well as the radiation worker, one must possess knowledge of basic radiation biology and the state and federal limits for radiation exposure. Legally required documentation includes demonstration that radiation-producing machines are calibrated according to recognized protocols from scientific agencies and that measured radiation in the working environment meets governmental standards. To achieve this, residents are expected to:

• Perform “second check” review of all types of treatment plans before first treatment
• Perform quality assurance (QA) of machines based on departmental protocols
• Perform QA of Intensity Modulated Radiotherapy (IMRT) plans
• Perform shielding design for a therapy machine vault
• Measure radiation doses in rooms housing patients implanted with radioactive material
• Read the relevant American Association of Physicists in Medicine (AAPM) Task Group (TG) reports detailed in the appropriate rotation objectives.
• Read the assigned Texas Department of State Health Services (DSHS) rules and regulations
• Give presentations on a regular basis over various TG reports or clinical projects for which they are responsible

Research Experience
The resident will be expected to participate in a clinical research project that results in either a poster presentation or an oral presentation at a meeting organized outside of the hospital system during their time at Houston Methodist.

Preparation for Board Exams
In addition to the clinical competency expected of the resident in order to successfully complete certification by the ABR, the resident will be subjected to oral exams similar in setting and scope of the ABR Part III Exam by the physics faculty after each quarter in the areas of physics they have been exposed to during that time.

Professionalism
Residents are expected to demonstrate a commitment to professional responsibilities. They shall:

• Show respect and compassion to others, including patient confidentiality
• Demonstrate integrity during interactions with others
• Follow appropriate dress codes
• Expand technical skills in response to demands of patient care

Interpersonal and Communication Abilities
Residents must acquire and demonstrate interpersonal and communication skills that result in an effective exchange of information and collaboration with physicians and departmental technical staff. Residents are expected to:

• Accurately implement physician’s prescriptions for treatment plans
• Explain variances in plans to the physician
• Accurately communicate instructions to the dosimetrists and therapists
• Deliver a departmental seminar on radiation safety
• Implement verbal or written instructions from physics faculty
• Explain technical issues to patients and families

The residency will consist of eight different modules over the course of the two-year training period. Each module will last for approximately three months. While effort will be made to present these modules in a logical progression, the program will have the flexibility to adjust the schedule to accommodate unique projects (e.g. equipment commissioning, annual tests, software implementation, etc.) and faculty availability. This will maximize both the resident’s exposure to potential onetime learning experiences in the clinic and their opportunity to directly learn from their mentors during their time at Houston Methodist.

The level of responsibility for each resident will increase as proficiency and experience is gained and then validated. First-year residents will be under direct supervision for all tasks initially with the goal of their independence continually increasing as the first year progresses. Second-year residents acquire even more responsibility as they continue to gain independence with the goal to be functioning as a junior physicist upon graduation.

For each rotation, quality assurance (QA) procedures and training will be a constant throughout the two-year training period. This includes:

• Patient-specific QA (IMRT QA, in-vivo measurements, etc.)
• Linear accelerator (therapy and imaging components) and CT simulator daily, monthly, and annual QA
• New machine and software acceptance, commissioning, and implementation (when available)

In addition, over the course of their two-year training, the resident will:

• Give 8 half-hour oral presentations to the physics group at monthly physics meetings on either relevant task group reports or clinical projects currently being conducted
  • At least four of these presentations will involve core task group reports such as TG-51, TG-142, TG-43U2, etc. These will generally be done over the first year of residency.
  • The rest will be on variable topics, which offer timely value to the physics group, or on clinical validation or research projects completed by the resident. These will generally be done over the second year of residency.
• Be provided with study materials (e.g., web-based training modules) related to questions that are encountered on exams.
• Sit for, and successfully, pass eight mock oral examinations covering the completed three-month module with the mentor physicists of that rotation asking questions simulating the ABR Part III oral exam
• Be assigned a specific clinical task or procedure for which they will be responsible for learning, implementing, and teaching across the entire hospital system. Examples include refreshing monthly QA protocols for CT and teaching and implementing new dosimetry software.
• Submit an abstract to a regional/national conference or first draft to a peer-reviewed publication over a Special Clinical Project (SCP) incorporated at the start of the second year
• Attend the following conferences/meetings when available:
  • Monthly Physics Meetings
  • Weekly Houston Methodist Hospital Radiation Oncology Peer Review Case Studies
  • Oncology Grand Rounds

Residency Program Equipment
Houston Methodist has state-of-the-art dosimetric equipment and phantoms in dedicated physics labs at each facility throughout the system. The department is outfitted with 7 Varian TrueBeams, including an STX and an Edge, 4 Varian Clinac 21iXs, 2 Halcyons, one Varian 6EX, a Gamma Knife Icon unit and 4 Philips Brilliance Big Bore CT Simulators with 4DCT capabilities and 4 Siemens Somatom CT simulators with 4DCT capabilities. Additionally, Houston Methodist has an active and diverse brachytherapy program. This includes 5 Varian HDR afterloaders for gynecological, prostate, skin, breast, and bronchus cases, two Novoste vascular brachytherapy systems, eye plaques, and LDR prostate implants.

The Medical Physics Residency will take place at the various hospitals within the Houston Methodist system. Currently there are eight facilities where the resident will work over the course of their two years in the program.

Houston Methodist Hospital
The flagship hospital of Houston Methodist, located in the Texas Medical Center

Dunn Tower, 6565 Fannin St., Houston, TX 77030
Annex, 1130 Earle St., Houston, TX 77030

• 8 ABR-certified physicists
• 3 ABR-certified radiation oncologists
• Radiation oncology residents rotate from the University of Texas Medical Branch over half of the calendar year

Houston Methodist Sugar Land Hospital
16655 Southwest Frwy., Sugar Land, TX 77479

• 2 full-time ABR certified physicists
• 1 full-time ABR certified radiation oncologist

Houston Methodist West Hospital
18500 Katy Frwy., Suite 120, Houston, TX 77094

• 1 full-time ABR certified physicist
• 1 full-time ABR certified radiation oncologist

Houston Methodist Willowbrook Hospital
13802 Centerfield Dr., #185, Houston, TX 77070

• 1 full-time ABR certified physicist
• 1 full-time ABR certified radiation oncologists

Houston Methodist The Woodlands Hospital
17201 I-45, The Woodlands, TX 77385

• 1 full-time ABR certified physicist
• 1 full-time ABR certified radiation oncologists

Houston Methodist Baytown Hospital
4401 Garth Rd., Baytown, TX 77521

• 1 full-time ABR certified physicist
• 1 full-time ABR certified radiation oncologist

Houston Methodist Clear Lake Hospital
18300 Houston Methodist Dr., Nassau Bay, TX 77058

• 1 full-time ABR certified physicist
• 1 full-time ABR certified radiation oncologist

ABOUT HOUSTON METHODIST
Houston Methodist is one of the nation’s leading health systems and academic medical centers. The health system consists of seven hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, six community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area. Houston Methodist also includes a research institute, international patient services, freestanding emergency care centers and outpatient facilities. Houston Methodist employs more than 25,000 people and experiences more than 1.3 million outpatient visits and 126,000 admissions in 2020.

ABOUT HOUSTON METHODIST HOSPITAL
Houston Methodist Hospital is recognized by U.S. News & World Report as the No. 1 hospital in Texas, one of America’s “Best Hospitals” the last 20 years and has made the publication’s distinguished Honor Roll in multiple years. Houston Methodist's primary academic affiliate is the top-ranked Weill Cornell Medicine. Houston Methodist also has affiliations with Texas A&M and the University of Houston.