Residents typically work directly with two attendings per three-month rotation; because many of our attending physicians are only in clinic one day a week, this allows for exposure to different perspectives of the world-renowned faculty while also permitting a good balance between education and service. The schedule is structured so that a resident is only responsible for consultations of a single attending at any given time in clinic. Attending physicians arrange weekly one-on-one teaching sessions with the resident with whom they are paired. Call occurs in weekly blocks, with approximately five calls annually, except for during research year when residents take two weeks of call.
Residents also rotate through the Ann Arbor VA Hospital once during their first year of residency, and usually at least one more time during their training as a senior resident. The VA is conveniently located one mile from the main hospital. During the senior rotation, residents travel to Providence Hospital in Novi, MI, on Mondays and Wednesdays to gain training performing prostate brachytherapy implants and planning with a University of Michigan faculty member who is a world-renowned expert in the field. Residents are reimbursed for mileage to and from Novi during this time period.
All residents making satisfactory clinical progress are able to spend their entire PGY 4 focusing on research and scholarly activities. In the interest of productivity, the residents do not have clinical responsibilities during the research year beyond the two weeks of call they take during that year, and they are not asked to prepare morning conference presentations during that year. In addition, most residents find time to engage in research in clinical years as well. The department supports residents presenting their research at conferences, and covers expenses for presenting at up to two conferences per year in addition to a generous continuing medical education account.
During PGY-1, residents spend time at another institution doing a transitional year. During this year, residents typically split their time between working on medicine floors and various electives.
Residents join our program as PGY2s. This year is spent rotating among various disease sites including breast, prostate, lung, gastrointestinal, pediatric and central nervous system, among others. PGY2s typically are assigned to work with two attendings at a time, but are never assigned to work with more than one attending on a single day (and have at least one full day without any scheduled clinics at all). New consults range from the malignancies commonly seen in the community to those uncommonly seen even at academic medical centers. No two cases are the same. You will present each case to an attending that will see the patient again with you and discuss the case. Disease sites and cases are discussed at Morning Conference on Monday and Thursday morning from 7:45 to 8:30 am. In addition, there are Physics and Radiobiology classes once per week. Wednesday mornings involve grand rounds presentations by faculty, faculty working presentations on scholarship in progress, and faculty-led practical sessions on care delivery issues relevant to the broader department community. This is known as protected time, and residents are expected to attend without clinical responsibility. The rest of the day entails developing and evaluating patient treatment plans, attending tumor boards, interacting with other providers, and problem solving any issues that come up in clinic. The expectations are high, but the attendings and senior residents are approachable, and the Program Director is supportive.
PGY-3 (i.e. second year) residents continue to expand and build on the clinical experiences of the first year and start to think about what types of research questions they will want to explore during the following year. The year is structured in much the same way as your first year in that residents rotate primarily through 2-3 month blocks working with two attendings who specialize in various disease sites. Beyond consolidating knowledge in clinic, a crucial goal for this year is to delve more deeply into the types of questions being addressed on a national and international stage by attending more research conferences. Overall, this is an exciting year of growth during residency.
The PGY 4 year is spent working closely with faculty on research projects, as well as continuing didactic education classes including Morning Conference, Treatment Planning Conference, and Resident Lecture Series. During PGY 4, residents may elect to do basic and translational research in the Radiation Oncology laboratories, to engage in substantial clinical research projects including analyses of data from prospective clinical trials and clinical trial design, and to participate in a host of opportunities to conduct health services, ethics, outcomes, and policy-related research. These research projects lead to national conference presentations, publications, and independent research grants that will form the foundation of an academic career. Additionally, collaborations are established through these projects that are vital to continued success as an independent researcher. On a typical day, residents attend a didactic class in the Radiation Oncology clinical department area at 7:30 or 7:45am. The rest of the day is spent in the relevant research area performing experiments or analyzing data, and in research meetings or conference calls with collaborators. Two weeks of the research year will be spent on call to maintain and expand clinical skills. The end of the PGY-4 year is an exciting time as many transitions take place. This is also the time that the job search begins, and a time to study for your written board exams which take place during this year. Based on all of this, the PGY-4 year is a major step toward becoming an independent clinician and researcher.
The PGY 5 year is designed to facilitate consolidation of residents’ clinical knowledge, with opportunity to create learning experiences tailored to their interests and make sure their rotations have covered all relevant sites, as they serve as the chief residents who create the schedule together with the program director. The didactic schedule is very similar to previous years, with those who passed the Physics and Radiobiology boards excused from those courses.