Medical Dosimetry Graduate Certificate Program

IU Graduate School &

The Department of Radiation Oncology
IU Simon Cancer Center

All students accepted into the Medical Dosimetry Graduate

Certificate Program will have completed:

Bachelors degree, (Radiation Therapy preferred but not required),

maintaining a GPA of 3.5 or higher.
Certification through the ARRT as a Radiation Therapist
Pre-Requisite Courses:
College Algebra and Trigonometry or Pre-Calculus
Cross-Sectional Anatomy
Radiation and Cancer Biology

Twelve Month
Course of Study

Concepts for Preparation and Planning in Medical Dosimetry I 3 credit hours

Concepts for Preparation and Planning in Medical Dosimetry II 2 credit hours

Medical Physics for Radiation Oncology I 1 credit hour

Medical Physics for Radiation Oncology II 2 credit hours

Clinical Oncology and Dosimetric Considerations 1 credit hour

Independent Study / Research in Radiation Oncology 2 credit hours

Clinical Practicum I Introduction to General Dosimetry 2 credit hours

Clinical Practicum II Intermediate Planning for Medical Dosimetry 4 credit hours
Clinical Practicum III Advanced Topics in Medical Dosimetry 8 credit hours
Clinical Practicum IV Assessment Challenges in Medical Dosimetry 4 credit hours
 Curriculum Overview

Concepts for Preparation and Planning in Medical Dosimetry I

This course is an introduction for the skills and technologies needed to pursue a career in
medical dosimetry. It is designed for the student who has already completed a program in
Radiation Therapy Technology and provides background information on both the professional
and technological side. Both didactic lectures and hands on lab computer activities are included.

Professional Relations and Responsibilities

Ethical Conduct & Code of Ethics for AAMD, MDCB
Professional / Legal Perspective / Malpractice
Scope of Practice for Medical Dosimetry
Introduction to the E Portfolio

External Beam Monitor Unit Calculations

Dosimetric Quantities
Photon and Electron Monitor Unit Calculations
Central Axis and Off Axis Dose Calculation
Manual Correction for Inhomogeneity

Math Topical Review with Dosimetric Applications

Geometric and Trigonometric Applications to Dosimetry
Logarithmic Applications

Imaging Modalities
Overview of Imaging Modalities
CT Simulation Considerations
Immobilization / Reproducibility
Motion Management, Artifacts
Set Up and Positioning Strategies

Imaging / Cross-Sectional Anatomy Review

Target Volume Definitions ICRU Defined
Contouring / Segmentation of Organs at Risk (RTOG Contouring Guidelines)

Cancer Patient Management

Signs and Symptoms
Cancer Treatment Modalities
Cancer Management

Computer Technology and Networking

Definitions
Data Transfer
Networking Technologies / PACS / DICOM

Introduction to Basic Planning

Conventional SSD and SAD Techniques for Photons
Introduction to Planning with Electrons
Concepts for Preparation and Planning in Medical Dosimetry II

Designed to give the student a thorough understanding of treatment planning

considerations for the patient, the course addresses conventional planning techniques as well as
newer technologies. Both didactic lectures and supervised planning lab experience is included.

3-D Treatment Planning

ICRU Reports 50, 62
Nomenclature for Targets
Reference Point & Normalization
Virtual Simulation
3D Conformal Planning
Plan Evaluation

Electron Beam Planning

ICRU Report 71

Inverse Planning IMRT and VMAT

ICRU Report 83
Segmentation Considerations
Choosing the Beam Arrangement
IMRT Optimization, Constraints, Priorities
Plan Evaluation

SBRT Planning
Meeting Protocol Requirements
Segmentation Considerations
Treatment Planning and Plan Evaluation

Brachytherapy Planning
Gynecological Brachytherapy
Prostate Brachytherapy
Brachytherapy Manual Calculations

EMR Technology The Electronic Medical Record

Requirements / Documentation
Billing Requirements
Clinical Oncology and Dosimetric Considerations

The course consists of a series of site specific oncology lectures given by radiation
oncologist lecturers. After completing this course, the medical dosimetrist should be able to
participate in the discussion about optimal treatment planning for specific anatomical sites and
offer helpful suggestions when asked.

Cancers of the Head and Neck

Cancers of the Central Nervous System
Cancers of the Gastrointestinal Tract esopho-gastric, pancreas, liver, rectum, anal
Cancers of the Genitourinary Tract - prostate, bladder, testis
Gynecologic Malignancy cervix, uterine, vulvar, vaginal, ovarian
Lymphoma
Cancers of the Skin melanoma, non-melanoma, mycosis fungoides
Breast Cancer
Pediatric Malignancies
Extremity Soft Tissue Sarcomas
Benign Malignancies
Metastatic Disease

Discussions include:
Anatomy, Pathology, Physiology, Lymphatic Drainage
Site Specific Treatment Planning
Dose Calculation Considerations
Critical Organs and Dose Limiting Factors
Positioning and Immobilization
Age Specific Considerations
Medical Physics for Radiation Oncology I

Medical Physics I covers nuclear physics, production of X-rays, and ionizing radiation. The
course provides the basis for the field of medical physics and the production of radiation.

Review of Math and Physics Concepts Calculations

Structure of Matter Nuclear Transformations

Production of X-rays Clinical Radiation Generators

Interactions of Ionizing Radiation

Medical Physics for Radiation Oncology II

Medical Physics II addresses the physics considerations for measurement of absorbed

dose, dose distributions, dosimetric calculations, treatment planning for photons, electrons and
brachytherapy, other advanced technologies and quality assurance from the physicist point of
view.

Measurement of Ionizing Radiation Quality of X-Ray Beams

Measurement of Absorbed Dose Dose Distribution and Scatter Analysis

System of Dosimetric Calculations Isodose Distributions

Patient Data, Corrections, Setup Field Considerations

Electron Beam Therapy Brachytherapy

Quality Assurance 3D Conformal / IMRT Planning

Total Body Irradiation Monte Carlo Introduction

Stereotactic Radiosurgery Proton Planning

Independent Study / Research in Radiation Oncology

This course is comprised of two separate components, both of which highlight the
students ability to work independently as well as oral and written communication skills.

Each student prepares treatment plans requiring advanced planning skills and the ability
to interpret the physicians written instructions or a clinical protocol for assigned site-specific
data sets. All aspects of the planning processes are critiqued by members of the
physics/dosimetry staff in an open discussion peer review format where they are judged on
contouring skills, plan optimization, following ICRU guidelines, protocols, oral communication
skills, critical thinking skills, and time management.

In addition, each student works independently on a research project, preparing both a

written research paper and a power point presentation on a treatment planning topic of their
choice. The paper is written in a format consistent with the AAMD/CIVCO student writing
competition guidelines published on the AAMD website page. The students may choose to
submit their work to the AAMD Student Writing Competition or as a Poster Session at the AAMD
Meeting.

Examples of Advanced Planning Cases:

3D Intact Breast Compensation Methods

3D Techniques for Chestwall & Nodal Volumes
IMRT Techniques for Chestwall & Nodal Volumes
IMRT Head/Neck with SIB Technique
IMRT Prostate Multiple Phase Technique
3D SIB Technique for the Pancreas Protocol
Sarcoma of an Extremity Planning Methods
3D Planning for the Partial Brain
IMRT Planning for the Partial Brain
IMRT Pelvis for Anal or Vulvar planning
SBRT Planning for the Lung-Liver-Spine
Whole Brain with Hippocampal Sparing
Introduction to Proton Planning
Clinical Practicum I General Dosimetry Introduction

This clinical experience provides the student with a general overview of clinical activities.
The student will use the clinic time to apply new skills learned in the didactic course RAON D601
and will have access to an education data base to practice their skills. They will also observe /
assist one of the clinical dosimetrists with activities such as importing images, registrations and
normal tissue contouring. All students are assigned to IU Health University Hospital for this
rotation and will be expected to meet established competency requirements.

Competency List Summer Session

Electronic Medical Record and Chart Management

Overview of CT / Simulation Requirements for Dosimetry

Monitor Unit Calculations

Acquiring / Importing Images from the CT Simulator

Acquiring / Importing Images from PACS for PET, MR, Diagnostic CT, Other

Registration of Images Rigid Registration and Deformable Registration

Using Eclipse Contouring Tools

Creating a Single Field SSD Plan

Creating 3D Whole Cranium Plan

Creating a 3D Coplanar Plan

Clinical Practicum II Intermediate Planning for Medical Dosimetry

Clinical rotations at various clinical sites provide a broad experience in 2D, 3D and IMRT
planning as well as experience with brachytherapy planning and physics quality assurance tasks.
Demonstration of clinical competency is required. Clinical rotation consists of 360 contact
hours.

Required Competency List Fall Semester

CT Simulation Requirements

Block Fabrication for Electrons

Fabrication of Custom Bolus

3DCRT Treatment Planning for:

3D/3DCRT Thorax Coplanar Lung, Esophagus
Tangent Breast Field in Field, E compensators
Lumpectomy Boost
3DCRT Non-Coplanar
Electron Treatment Planning

IMRT Treatment Planning

Head and Neck
Pancreas
Prostate

VMAT Treatment Planning

Head and Neck
Prostate

SBRT Treatment Planning

Lung
Liver

Introduction to Brachytherapy
Low Dose Rate GYN Treatment Plan

Physics Quality Assurance of the Treatment Chart

Education Conference / Webinars / Workshops

Clinical Practicum III Advanced Topics in Medical Dosimetry

This clinical rotation allows the student to participate in and demonstrate competency
for advanced technologies, including IMRT, VMAT, SBRT and Brachytherapy. The student will
also become familiar with the quality assurance procedures for the linear accelerators, IMRT QA,
and brachytherapy. The rotation includes 540 clinical contact hours.

Required Competency List Spring Semester

3D Treatment Planning
3DCRT Any Anatomic Site
3D Post Mastectomy & Nodal
3D Electron Planning

IMRT Planning
Prostate
Head and Neck
Chest Wall & Nodal Volumes
Quality Assurance of the Plan

V-MAT Planning
Any anatomical Site
Quality Assurance of the Plan

SBRT Planning
Lung, Liver, Spine, Pancreas, Kidney, Bone Met
Cone Beam CT verification Process

SRS Gamma Knife

Observations / Planning Techniques for Gamma Knife

Brachytherapy
HDR QA, Planning, Treatment Delivery

Physics Quality Assurance

Electron Cutout Measurement
Daily Morning QA
Monthly Verification Linear Accelerator
IMRT QA
Clinical Practicum IV Assessment Challenges in Medical Dosimetry

The final clinical experience allows the student to spend time at one or more approved
clinical sites. Students will perform competencies that review the skills learned during the year.

Required Competency Checklist:

Prone Breast Simulation and Treatment Planning

Inverse Treatment Planning

SBRT Treatment Planning & Plan Evaluation Techniques

HDR Brachytherapy

IMRT QA Procedure

Required Professional Development:

Life Long Learning Demonstrated by:

Volunteer Activities at Annual AAMD Meeting
Attendance at Student Gathering AAMD Meeting
Attendance at minimum of 3 Workshop Sessions for Treatment Planning
Attendance at minimum of 2 Workshop Sessions for Professional Development