Radiation Oncology Pathway (curriculum as of Class of 2026) Introduction Sites and Personnel Goals and Objectives Description of Pathway Radiation Oncology Course Description Elective Course Descriptions Textbooks and Learning Resources Evaluations Other

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REVIEW FOR PATHWAY 2025-2026:

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Pathway Director:
Lydia Komarnicky, M.D.
e-mail: wlkasa@comcast.net

Email is the preferred method of communication.

Drexel Administrative Support for Radiation Oncology:
Heather McLaughlin
(215) 991-8518 Phone
e-mail: hgm28@drexel.edu

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When a student completes the pathway for radiation oncology, the following knowledge base and skills are expected to be achieved:

1. Basic understanding of radiation oncology.
2. Development of overall management skills for the oncologic patient, both the hospitalized sick patients, as well as ambulatory outpatients.
3. Basic understanding of the biology of cancer.
4. To develop history taking and physical examination skills.
5. Special clinical emphasis on breast , rectal, prostate, head and neck examination including direct laryngoscopy and pelvic examination.
6. Basic understanding of radiology including interpretation of chest x-rays, CT scans, ultrasound and mammograms.

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Required Courses

Emergency Medicine Subinternship
Emergency Medicine Subinternship is required by the University as a senior year course. During this course we would expect that the student will learn the principles of rapid assessment and stabilization of critically ill and injured patients; learn the initial evaluation and management of the wide range of undifferentiated patient complaints in the Emergency Department; gain skills, specialized examination technique and real-time interpretation of diagnostic studies; participate in common and more advanced procedures.

1. Take ownership of their patients and be the primary point person regarding their care.
2. Demonstrate the ability to care for patients with increasing independence while seeking help when appropriate
3. Handle the daily tasks of an intern including preparing for rounds, presenting on rounds, interprofessional knowledge and communication skills, and patient interactions, histories and physicals, note writing of all varieties, and sign-out in a proficient and efficient manner.
4. Apply their knowledge towards diagnosis and management of common acute complaints and chronic conditions, creating care plans and communicating with consultants as necessary.
5. Perform general procedures through demonstration of the necessary preparation and key issues required for the performance of procedures, including understanding patient-specific factors, indications, contraindications, risks, benefits, and alternatives. 
6. Demonstrate reliable mechanical skills in performing procedures in most situations and knows when to seek help for procedures or situations beyond the learner’s abilities.
7. Perform safe transitions of care, coordination of care, and discharge planning.

Radiation Oncology Course (must be approved by course director)

1. General introductory knowledge of the range and scope of radiation oncology.
2. Patient care in the ambulatory clinic and on hospital rounds.
3. Site specific examination, i.e. prostate, breast, ENT, bi-manual pelvic examinations.
4. General understanding of the techniques employed in radiation therapy including external beam irradiation, brachytherapy, stereotactic irradiation, and hyperbaric oxygen use. Treatment simulation, exposure to CT based 3-D treatment planning and sterotactic radiation/radiosurgery, and management of radiation oncology emergencies.
5. General interpretation of diagnostic plain x-rays, MRI and CT scan as related to radiation oncology.
6. General understanding of radiation normal tissue toxicities.
7. General understanding of some of the basic principles involved in radiation biology and physics.
8. Opportunity for original research that may lead to publication.
9. Exposure to national clinical trials.

Elective Course
Strongly Recommended Electives
The student is strongley encouraged to select at least one surgical and one non-surgical rotation from the following:

1. Surgery: general surgery, surgical oncology, otolaryngology, urology, gynecologic oncology, orthopaedics.
2. Medicine: hematology-oncology, pulmonary, ICU, gastroenterology, pathology, emergency medicine, pediatrics, geriatrics, women's health.

These are strongly recommended for the following reasons:

1. General Surgery and Surgical Subspecialties are recommended due to the need to have a good understanding of basic surgical and surgical subspecialty techniques as many radiation oncology patients will undergo surgery as part of their therapy and because many brachytherapy procedures are invasive and done in the operating room. It is, therefore, essential that good surgical technique and understanding of basic surgical procedures be obtained.
2. Hematology Oncology is strongly recommended as chemotherapy is a large part of cancer management. A basic understanding of the risks and benefits of chemotherapy and management of these patients is essential in radiation oncology.
3. The Medical Sub Specialists often encounter the cancer patient first and play a large part in the diagnostic work up or management of the patient. Many cancer patients require complex medical management that is important for the radiation oncologist to understand and participate in.

Recommended Electives
The other electives which are strongly recommended include:

1. Gastroenterology for basic understanding of both the normal and pathologic functions of the gastrointestinal tract. Special emphasis should be placed on the diagnosis of both upper and lower GI malignancies including their diagnosis and follow-up.
2. Urology: Prostate cancer is one of the most common malignancies treated with radiation therapy definitively today. A good understanding of prostate examination, diagnosis of cancer and follow-up management are essential. The endocrinological treatment of prostate cancer will also be studied.
3. Diagnostic radiology is important as much of radiation oncology treatment planning is based on diagnostic imaging and its interpretation. We not only read reports but must review these films and, therefore, have a basic understanding of diagnosis of pathology and identification of normal structures.
4. ENT is important as radiation oncologists are required to be able to perform a good head and neck examination including direct laryngoscopy both for on-treatment and follow-up examinations. The risk factors for development of ENT malignancies will also be studied. A good understanding of what is done at the time of oncologic ENT surgery will also be stressed.
5. Pediatrics is important as we manage both adult and pediatric malignancies. This elective would most appropriately be done at a institution outside HUH such as at St. Christopher's.
6. Pulmonology is important as lung cancer continues to be a very common form of cancer. Chest irradiation is utilized in the management of this as well as for lymphomas, esophageal carcinomas, mediastinal tumors, etc.
7. Pathology is pivotal in the radiation oncologists practice. It is important to understand how specimens are handled, processed and interpreted. One should become familiar with the cancer pathologic (as opposed to clinical) staging process involving examination of the gross specimen, as well as the microscopic details. The radiation oncologist is constantly comparing the radiographic, physical exam, and pathologic findings.

Specific student course requirements
Radiation Oncology - The elective would include learning to perform complete outpatient and inpatient consultations for oncologic patients, becoming able to present a case comprehensively, to present articles at a Journal Club, and to assist in simulations and brachytherapy procedures.

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Recommended
Essentials of Clinical Radiation Oncology, second Edition Sittenfeld, Ward, Tendulkar, Videtic. Springer Publishing

Principles and Practice of Radiation Oncology, 7th Edition, Perez CA, Brady LW, JB Lippincott Co., Philadelphia, PA 2020

Radiation Oncology Concepts: An Overview for Medical Students and Practitioners. , Purdue, Harris, Butler (this is a nice starter book but may be able to get as much information on line). For those able to rotate at Jefferson we provide this book.

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Evaluation of the Student
The student's performance in each rotation will be evaluated by supervising physicians, and residents when appropriate, using the standard Drexel University College of Medicine clinical evaluation form. Students not receiving a grade of satisfactory or higher will be counseled and provided with remediation.

Evaluation of 4th year Courses
Upon completion of each rotation, students are encouraged to complete the end-of-rotation evaluation form in DOCSS. Students have the opportunity to provide feedback on the rotation as well as on specific faculty (and residents) with whom they worked in DOCSS. All feedback is de-identified.

Evaluation of the Pathway
Students are encouraged to complete an end-of-year Pathway evaluation for the Pathway. The feedback from this evaluation will help in advising future students more effectively.

Other

Away rotation encouraged at Thomas Jefferson University Hospital. Please reach out to Dr. Komarnicky at lydia.komarnicky-kocher@jefferson.edu for assistance and advice on applying for this rotation.