The American Board of Radiology Initial Certification in Radiation Oncology: Moving Forward Through Collaboration

Radiation and Cancer Biology Educators of Radiation Oncology Residents and the Courses They Teach1

The purpose of this study was to characterize today's radiation and cancer biology educators of radiation oncology residents, and the biology courses they teach. An e-mail list of 133 presumptive resident biology educators was compiled, and they were invited to participate in a 46-item survey. Survey questions were designed to collect information about the educational and academic backgrounds of the educators, how they self-identify, characteristics of the courses they teach, the value that they assign to their teaching activities, their level of satisfaction with their courses and how they see these courses being taught in the future. Findings of this survey were compared and contrasted with prior surveys of biology educators (conducted 12 and 20 years ago, respectively), and with more recent surveys of radiation oncology residents and radiation oncology residency program directors conducted in 2018 and 2019. A total of 67 survey responses were received. Biology educators range in age, academic rank and years of teaching experience from junior (18%) to quite senior (45%). Only about 40% self-identify as radiation biologists, biophysicists or chemists, compared to 56% in 2001. The majority of the others consist of cancer biologists (15%), radiation oncologists (15%) and radiation oncology physician-scientists (16%). Educators prioritize their resident teaching as important or very important. Biology courses are widely variable in contact hours between programs and have not changed significantly over the past 20 years. About 75% of the courses are team-taught, including 15% involving multiple training programs. An average biology course consists of about 42% foundational ("classical") radiobiology, 28% clinical radiobiology and 28% cancer biology. While biology educators and radiation oncology program directors are highly satisfied with their biology courses, approximately a third of residents report being not very, or not at all, satisfied. That fewer biology educators are radiobiologists by training and their courses have remained quite variable in length and content over long periods point to the need for a consensus core curriculum for resident education in radiation and cancer biology. Both current educators and program directors also support making online teaching resources available, diversifying course instructors and consolidating biology teaching across multiple training programs.

National Cancer Institute Workshop on Artificial Intelligence in Radiation Oncology: Training the Next Generation

PURPOSE

Artificial intelligence (AI) is about to touch every aspect of radiation therapy, from consultation to treatment planning, quality assurance, therapy delivery, and outcomes modeling. There is an urgent need to train radiation oncologists and medical physicists in data science to help shepherd AI solutions into clinical practice. Poorly trained personnel may do more harm than good when attempting to apply rapidly developing and complex technologies. As the amount of AI research expands in our field, the radiation oncology community needs to discuss how to educate future generations in this area.

METHODS AND MATERIALS

The National Cancer Institute (NCI) Workshop on AI in Radiation Oncology (Shady Grove, MD, April 4-5, 2019) was the first of 2 data science workshops in radiation oncology hosted by the NCI in 2019. During this workshop, the Training and Education Working Group was formed by volunteers among the invited attendees. Its members represent radiation oncology, medical physics, radiology, computer science, industry, and the NCI.

RESULTS

In this perspective article written by members of the Training and Education Working Group, we provide and discuss action points relevant for future trainees interested in radiation oncology AI: (1) creating AI awareness and responsible conduct; (2) implementing a practical didactic curriculum; (3) creating a publicly available database of training resources; and (4) accelerating learning and funding opportunities.

CONCLUSION

Together, these action points can facilitate the translation of AI into clinical practice.

Lessons to Learn From a Successful Virtual Mock Oral Examination Pilot Experience

oronavirus (COVID-19) has caused marked impact on graduate medical education for all medical specialties. Radiation Oncology and the American Board of Radiology have also had to rapidly adapt to converting education and examinations to virtual platforms. We describe our small pilot experience in transitioning our in-person mock oral examinations to a virtual platform. Survey-based assessment revealed excellent feedback regarding ease of use and educational usefulness. Our mock oral examinations pilot experience adds to evidence that virtual mock oral examinations are an important considerationfor Radiation Oncology education and a feasible alternative to an in-person oral examination.

Radiation Oncology Initial Certification Qualification Examinations: The Resident Experience in 2019

PURPOSE

To characterize the resident experience preparing for the 2019 American Board of Radiology initial certification (IC) qualifying examinations in radiation oncology.

METHODS AND MATERIALS

The Association of Residents in Radiation Oncology distributed a survey to 360 radiation oncology residents from the 2019 and 2020 graduating classes covering topics pertinent to preparation for the medical physics (MP), radiation and cancer biology (RCB), and clinical radiation oncology (CRO) qualifying examinations.

RESULTS

The response rate was 58% (n = 210). In the 12 weeks before the MP and RCB examinations, first-time examinees studied a median of 160 hours (interquartile range, 96 to 270). Residents reported a "moderate" or "significant" negative effect on research productivity (3 [2-4]), mental health (3 [2-4]), clinical development (3 [2-4]), and family life (3 [2-4]). Half of surveyed residents (52%, n = 110) used a protected research or elective block to study while an additional 21% (n = 45) used a median of 5 (3-20) vacation days. Residents overall "agreed" (4 [2-4]) that their program's physics course was "important" for their preparation but were "neutral" (3 [2-4]) regarding the value of their program's radiobiology course. Question-based educational resources were most frequently rated as "important" study resources. Respondents "strongly" endorsed the development of a consensus radiation oncology curriculum (5 [4-5]) and "agreed" (4 [3-4]) that consolidation of the MP, RCB, and CRO qualifying examinations into a single written examination would be preferred.

CONCLUSIONS

Radiation oncology residents dedicate substantial time preparing for the IC examinations at the expense of training- and health-related outcomes. Residents report a wide range in quality of internal program didactic courses in physics and radiobiology, endorse development of a consensus radiation oncology curriculum, and prefer consolidation of the three qualifying examinations into a single written IC examination. We caution the high pass rates seen on the 2019 examinations do not obviate the need for ongoing improvement in radiation oncology graduate medical education and the board certification process.