Training Programme Description for acquiring Add-on title Veterinary
- establishing guidelines for post-graduate education and clinical experience, prerequisite to becoming acknowledged in veterinary radiation oncology
- examining and authenticating veterinarians in veterinary radiation oncology
- a sound understanding of radiation biology and physics
- safe application of radiation in clinical veterinary practice
- imaging techniques as a critical part of radiation oncology – especially for treatment plannin
- the biologic behaviour and clinical signs of various types of animal cancer
- basic understanding of other treatment modalities and their clinical application
3. Entry Requirements
4. Types of Training
4.1 Standard Training Programmes
4.2 Individual (Alternative) Programme
Education Committee prior to the start of the training programme. In an alternate programme the 15
month effective training period does not have to be consecutive, but must offer a minimum of 4
consecutive training months per year.
5. The Institute
5.1 Training Programme Director
The Programme Director of the Add-on training programme shall be responsible for the administration and continuity of the programme. The Programme Director must be a Diplomate of ECVIM-CA [Oncol] or ECVDI.
5.2 Clinical Supervision
- The add-on training can be started already before the certifying examination in medical oncology or diagnostic imaging
- No need to make extra comments on being licensed to practice in Europe, as this will be the same for the residency programmes of the two colleges.
- Length of programme may be different for the two types and must be discussed and fixed by the Education Committee in the coming year.
- Each Resident must be directly supervised when engaged in clinical activity by at least one Diplomate [Oncology] of the ECVIM-CA or by one Diplomate of ECVDI, or of one Diplomate ACVR [radiation oncology]. If the ECVIM-CA [Oncol] or ECVDI diplomate is not also an ACVR-RO diplomate this person should be de facto recognised as mentioned under 9.
The programme must provide adequate clinical and diagnostic facilities and personnel to ensure an effective educational experience for trainees. Access to an external beam radiation therapy machine in the megavoltage range, advanced diagnostic imaging and computerized radiation treatment-planning capabilities are required. These resources are not limited to those in the primary training institution; requirements can be filled by consideration of resources available at affiliating institutions.
5.4 Clinical resources
The programme must provide a sufficient volume and variety of patients for instruction. It is expected that the trainee will be exposed to a sufficient number of new cancer patients treated with ionizing radiation over the course of the training programme to provide: (1) the material necessary to expose trainees to the majority of situations likely to be encountered in the practice of radiation oncology; and (2) the opportunity for reinforcement of important radiation oncology principles. The number of cases seen may vary among training sites and also may vary depending on the species, kinds of problems, and depth of study. Emphasis should be on diversity and quality rather than quantity, although a sufficient caseload must be available. The minimal case load is about 75 cases.
5.5 Programme affiliation, multi institutional agreement
When the resources of two or more institutions are used for the clinical education of a trainee, one institution must be designated as the primary institution. Affiliating institutions are not limited to schools of veterinary medicine and may include schools of medicine or private veterinary specialty clinics. Letters of agreement, signed on behalf of the institution by the appropriate individual, must be provided from the affiliating institution.
5.6 Treatment documentation and patient follow up information
A medical record must be maintained for each case and these records must be retrievable. Medical records should include pre-treatment condition, treatment regiment, response and clinical outcome of treated patients.
6. Training Requirements and Documentation
The detailed description of the training requirements are defined in the document ‘Training requirements for the Add-On in Veterinary Radiation Oncology’.
6.1 Training period
An effective Add-on training time period of 15 months is required to complete the training programme for both the MedOnc Diplomates/Residents and the Diagnostic Imaging Diplomates/Residents.Further details of the training period are listed in the document ‘Detailed Training Requirements for the Add-On in Veterinary Radiation Oncology”.
6.2 Training content
The training period must include:
- Exposure to varieties of tumours, syndromes and conditions
- Pre-treatment evaluation of cancer patients
- Knowledge of treatment modalities as a single entity or combinations thereof
- Formulation of radiation treatment plans
- Administration of treatments
- Assessments of tumour response and normal tissue toxicities
The programme must also provide training for the following basic knowledge and/or skills:
- Biology of cancer
- Basic radiation physics
- Radiation physics applied in radiation therapy
- Radiation safety
This basic training may be acquired by attending formal national of international teaching courses, or by training offered by staff of the primary or one of the affiliating institutions or by organized selfstudy opportunities.
6.3 Case log
An adequate case variety treated with both curative and palliative intent should be continuously monitored by means of a log-book. The case log should be a systematic collection of treated animals for which the trainee was the primary person responsible and must include:
- Patient identification
- Tumour description (type, site and information on regional or systemic metastasis)
- Treatment intent (curative, palliative) and treatment regiment (total dose, number of fractions, number of fractions per week and combinations with other treatment modalities)
- Treatment response and acute side effects
- follow-up information
During the training period a defined number of cases has to be written have to be written in detail, discussing the whole planning process, including contouring, choices for margins, calculations for possible late toxicities, and choice of treatment schedule and treatment plan. These cases have to be submitted to the Education Committee at time of application for examination.
6.4 Seminars and teaching rounds
Seminars and teaching rounds must be provided for progressive trainee participation. These rounds should be of sufficient frequency and also involve other major specialties. They should include both trainees and faculty participation on a regular basis.
Trainees should also be provided ample opportunity to present formal lectures. It is expected that each trainee will prepare and present journal clubs and lectures. Due to the short training programme a scientific abstract presentations at a national or international meeting is not mandatory but desirable.
6.6. Congress attendance
The attendance of at least one international meeting covering topics of radiation oncology is required during the 15-month training period.
6.6 Library, literature resources
The programme shall provide a sufficient variety of journals, references, and resource materials pertinent to progressive levels of education in radiation oncology and associated fields all of which should be readily accessible for trainee study.
7. Evaluation of trainees
The evaluation of trainee performance and progress must be documented and submitted to the Education Committee by an evaluation form and by copies of the verified trainee case-log.
8. Examination guidelines
Applicants to the certifying examination will be reviewed by the Education Committee to ascertain that training programme guidelines have been met and that the required training programme has been completed.
The certification examination will be administered annually by the Examination Committee and will involve detailed principles of radiation oncology. The examination can be taken only after completion of the 15 months training period and acceptance of the application.
An Examination Committee will be formed by two diplomates ECVIM-CA [Oncology] and two diplomates ECVDI, all preferably also ACVR-RO diplomates, or at least de facto recognised.
For both Dipl ECVIM-CA [Oncol] and Dipl ECVDI the exam sections General Clinical (Radiation) Oncology, General Basic Sciences and Radiation biology, Physics and Dose Calculation, and Clinical and Imaging aspects of Radiation Oncology will be required.9 The Examination Committee will come up with a proposal for format of examination, which will have to be approved by the two Colleges.
Candidates must pass the examination within eight years of completion of the residency programme. The candidate may sit the examination on four (4) occasions only.
Candidates are only allowed to use the designation [Radiation Oncology] or the title radiationoncologist if they have acquired the Diplomate status of the ECVIM-CA [Oncol] or ECVDI.
9. De facto recognition
Diplomates who will de facto acquire the add-on title veterinary radiation oncologists are:
- Those that are Diplomate ECVIM-CA [Oncol] or Diplomate ECVDI and also have the
- title Diplomate ACVR Radiation Oncology,
- Those that are Diplomate ECVIM-CA [Oncol] or Diplomate ECVDI and:
- Have at least seven years of experience in veterinary radiation oncology and
- currently active.
- Spend at least 50 per cent of his or her time in the specialty.
- Have published at least three original articles in refereed journals as first author and at least three additional articles as co-author related to oncology, excluding reviews
- and proceeding abstracts.
De facto recognition is possible up to 5 years after EBVS has provided provisional recognition. This document has been drawn up by Julia Buchholz (member Educ / Cred Com), Jane Dobson (member Educ / Cred Com), Miriam Kleiter (chair Educ / Cred Com), Federica Rossi (member Educ / Cred Com), Jimmy Saunders (ECVDI rep), Erik Teske ECVIM-CA rep).