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About Radiation Oncology A radiation oncologist is a physician that specializes in the use of ionizing radiation to provide therapeutic benefits to patients via external beam radiation, brachytherapy, intra-operative radiation and radiopharmaceuticals What is a radiation oncologist? A radiation oncologist uses ionizing radiation and other modalities to treat malignant and benign diseases. Radiation oncologists also may use computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasound, and positron emission tomography (PET) as additional interventions to aid in treatment planning and delivery. Radiation Oncology is distinct from other radiology specialties such as Diagnostic Radiology and Interventional Radiology as Radiation Oncology is a clinical oncology specialty. How to become a radiation oncologist? Training required is five years: one year of general clinical work, followed by four years of dedicated Radiation Oncology training. During training, resident radiation oncologists receive a comprehensive education covering clinical oncology, radiation physics, and radiation biology. During training, radiation oncologists treat both pediatric and adult patients, and perform procedures. The ACGME Residency Review Committee in Radiation Oncology oversees the education and training in Radiation Oncology. The certification process is overseen by the American Board of Radiology (ABR), which issues diplomat certificates in Radiation Oncology to successful candidates. Certification involves passing written examinations in radiation biology, medical physics and clinical radiation oncology. After successfully completion of the three components of the written examination, the trainee must pass an oral examination, which covers the full spectrum of diseases encountered in clinical Radiation Oncology. As with all other medical specialties, certification is currently time-limited, and diplomates are expected to enter a lifelong process of learning and practice improvement through a Maintenance of Certification (MOC) program. What does a radiation oncologist do? Radiation Oncology is a branch of clinical medicine devoted to the treatment of both malignant and benign disease with ionizing radiation. The radiation oncologist works with a team of nurses, radiation therapists, dosimetrists and medical physicists who are involved in the evaluation, planning, delivery and follow-up of patients treated with radiation. They also work closely with the extended clinical oncology team including surgeons, medical oncologists and ancillary services such as social workers, nutritionist, and palliative care specialists in caring holistically for patients. In its early years of development, Radiation Oncology was a subspecialty within Radiology referred to as Therapeutic Radiology. During that time, radiologists received training in both diagnostic and therapeutic radiology. Over the years, as each of these disciplines became more complex, the training and certification processes for Radiation Oncology became separate from Diagnostic Radiology. However, the board certification exams for Radiation Oncology are still administered through the American Board of Radiology (ABR). Although some radiation oncologists may choose to focus their practice on a specific disease site (particularly in academic centers), radiation oncologists are trained and certified to treat a broad spectrum of diseases utilizing various radiation modalities, with the central guiding principle of achieving maximal therapeutic gain while minimizing radiation exposure to normal tissues. Ionizing radiation includes X-ray, gamma ray and charged particles such as protons that have high enough energy to remove tightly bound electrons from atoms to create ions. Ionizing radiation can be delivered externally through external beam therapy. It can also be delivered internally using radioactive sources either through brachytherapy procedures, involves the implantation or low- or high-dose rate sources into the body, or intra-operative treatments with high-dose rate sources. Radiation can also be delivered systemically through radiopharmaceuticals that are injected intravenously. External beam radiation typically involves multiple daily treatments (called fractionation) over the course of 2 to 8 weeks. In this treatment, different radiation beam arrangements, such as 3D or intensity-modulated radiation treatment (IMRT), are used. Traditionally, external radiation was delivered using longer treatments courses (e.g. 25-33 treatments). As the ability to improve imaging at the time of treatment has improved, shorter courses of radiation have emerged (called hypofractionation). Some of the new shorter courses of radiation include stereotactic body radiation therapy (SBRT) or stereotactic ablative radiotherapy (SABR), and stereotactic radiosurgery (SRS), which are commonly delivered in 1 to 5 fractions. These techniques administer highly precise and highly potent radiation treatments with image-guided radiation therapy techniques such as cone-beam CT (CBCT) scans at the time of treatment. While most patients receive radiation with photons, there are additional types of radiation via charged particles such as protons and carbon-ions. These modalities are administered using specialized equipment and treatment machines. The goal for the use of particle therapies is to spare normal tissues, which is typically advantageous for pediatric malignancies and some patients requiring re-irradiation. Radiation Oncologists work in a multidisciplinary team alongside surgeons and medical oncologists to ensure comprehensive care for cancer patients. There is also close collaboration with primary care physicians, pathologists, diagnostic radiologists and other healthcare professionals. In the treatment of benign diseases, radiation has a long history in the management of heterotopic ossification, keloids, Dupuytren contracture, trigeminal neuralgia, arteriovenous malformations, and other benign CNS tumors. There are emerging indications for radiation in benign diseases such as cardiac ablation for arrhythmias, movement disorders (e.g. essential tremors), and osteoarthritis. For those who are interested in research, Radiation Oncology is an outstanding specialty. In addition to clinical trials, which remain an active part of most academic practices and many private community practices, many opportunities in translational and basic research are available. Radiation Oncology is an extremely rewarding field that combines hands-on clinical care, sophisticated technology in a multidisciplinary setting. Although complex cancer biology and rapidly evolving technology are an attraction for many medical students, the passion for working with cancer patients is generally a significant factor influencing the decision to enter the field. The field is particularly appealing to those who enjoy the quantitative nature of Radiation Oncology and at the same time the humanistic aspect of direct care of cancer patients.
ACRO Medical Student Membership Many membership benefits are tailored specifically for medical students to engage with the field of radiation oncology and prepare for residency. ACRO membership is free of charge for fourth year medical student members and provides a wide array of opportunities and benefits: Medical Student-Specific ACRO Benefits:
ACRO Membership: In addition to trainee-specific benefits, ACRO membership can help ease your transition from student to trainee to independent practice and provide guidance throughout your career. Below are a few of the benefits that ACRO members enjoy:
ACRODeck: ACRODeck is an introductory resource for radiation oncology residents to understand the basic principles of treating oncologic malignancies. Visit our Residents' Corner for the complete archive.
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