We transitioned to a Royal College of Physicians and Surgeons of Canada - Competency Based Medical Education residency training program on July 1^st, 2018. Our faculty are highly motivated to provide frequent direct observation of their clinical skills with immediate feedback. We also have several assessments including a communication skills OSCE, in-training written medical oncology examination similar to the Royal College medical oncology board examination, and our residents participate in the American Society of Clinical Oncology in-training examination during both their PGY4 and PGY5 years. This ensures that skills are being learned at the appropriate stage of training from transition to discipline (TTD) to foundations (F) to core (C) to transition to practice (TTP).

Finally, the Juravinski Cancer Centre has one of the largest clinical trials programs in the country and a very active fellowship program with opportunities for further training following residency (PGY6 and/or PGY7). McMaster University has trained many clinical research fellows over the past decade in breast cancer, lung cancer, gastrointestinal cancers, genitourinary cancers, investigational new drugs often combined with research and enrollment in the McMaster University Masters in Health Research Methodology or Masters in Education Degree Programs. Funded positions are available each year although fellows are encouraged to apply for outside sources of funding. 

Radiation Oncology is a rewarding clinical specialty that includes both hands-on, multidisciplinary clinical care of cancer patients, as well as mastery over sophisticated radiation treatment technology. It combines patient-oriented clinical skills with knowledge of the fascinating, ever-changing field of cancer biology, anatomy-based three-dimensional imaging competence, and physics-based technical radiation treatment planning skills. It demands the development of competence in general medicine and palliative care, and specifically in evidenced-based clinical oncology, requires a commitment to excellent communication and collaboration skills, and provides an inclusive, supportive, and inspiring multidisciplinary practice environment. It allows for a career focusing primarily on clinical practice, or for a highly academic career combining practice with education, research, and/or cancer control administration.

Radiation Oncology training at McMaster University is a 5-year program starting in PGY1 and takes place largely at the Juravinski Hospital and Cancer Centre (JCC) in Hamilton. Clinical experiences also occur at the Hamilton General Hospital, McMaster Children’s Hospital, and St. Joseph’s Hospital in Hamilton. Training includes general medical and surgical oncology training, training in diagnostic imaging, pathology, palliative medicine, and emergency medicine, as well as extensive training in the evaluation and management of cancers in all body sites and specific radiation treatments related to those cancers.  Training includes experience in both adult and paediatric oncology. Trainees are required to do some training in a non-teaching Cancer Centre to experience the diversity of practice that exists in this specialty, and have the opportunity to do electives in centres in Ontario, elsewhere in Canada, or beyond; our trainees have completed electives in large and small centres all across Canada, in large US cancer centres, and in Uganda, Australia, Europe and the Middle East. Residents have dedicated training in applied medical physics, radiobiology, and research methodology, and are required to complete and present a scholarly project.  There are 25 Radiation Oncologists at the JCC and a large multidisciplinary group of physicians and allied health colleagues who make the atmosphere at McMaster collegial, motivating, inclusive, and inspiring.  

The Juravinski Cancer Centre houses contemporary radiotherapy technology, including an outpatient high dose-rate brachytherapy suite, a cyberknife unit, CT and MR-simulators, an orthovoltage treatment unit, state-of-the-art linear accelerators with contemporary on-board imaging, and sophisticated treatment planning technologies.Our was the second centre in Canada to acquire a Cyberknife unit, and our recently installed Halcyon units are the first in Canada. This allows trainees to gain experience in all facets of established radiation treatment as well as evolving technologies and techniques.

Hamilton has well-developed clinical multidisciplinary teams in Gynaecologic oncology, Neuro-oncology, Head & Neck malignancies, Hepatobiliary and Gastrointestinal cancers, Breast cancers, Thoracic cancers, Haematologic Malignancies, Skin cancers, and Gentourinary cancers in addition to having one of Ontario’s few specialized Sarcoma programs, and the McMaster Children’s Hospital specialized paediatric oncology service. The Juravinski Hospital and Cancer Centre has dedicated inpatient and outpatient Palliative Care programs. Supportive care services at the Juravinski Cancer Centre include a regional genetics program with genetics counselling and testing, as well as social work, mental health,  and dietician support for patients. The JCC has an aboriginal patient navigator to service patients from the large local indigenous population living in urban Hamilton and within the region both on and off the two local First NationTerritories.  Radiation Oncologists at the JCC attend clinics at community hospitals in the region, to bring care closer to patients in their own communities, and trainees attend such clinics as well. 

The academic Department of Oncology includes the clinical Radiation Oncology, Medical Oncology, Malignant Haematology and Surgical Oncology faculty, as well as non-clinical faculty in epidemiology and statistics. The Department of Oncology is very productive and collaborative with respect clinical oncology research output, and faculty provide education, support, supervision and mentorship to trainees in research methods and the development and completion of scholarly projects. Depending on research interests, other resources to support scholarship include the Supportive Cancer Care Research Unit (SCCRU), McMaster’s Department of Health Research Methods, Evidence and Impact (HEI), the McMaster Education Research, Innovation and Theory (MERIT) Program and the Centre for Health Economics and Policy Analysis (CHEPA).  We are a full member of the Radiation Therapy Oncology Group (RTOG), an affiliate member of the Children’s Oncology Group (COG), an active participant in National Cancer Institute of Canada - Clinical Trials Group (NCIC-CTG) and are home to the Ontario Clinical Oncology Group (OCOG) and the Escarpment Cancer Research Institute (ECRI).  The JCC has a large Clinical Trials Department, participating in intergroup trials, industry trials, and in-house trials.

Residents are required to provide regular Radiation Oncology educational seminars to the inpatient Internal Medicine Housestaff, and to present at regular Journal Club meetings, Morbidity and Mortality Rounds, Clinical/pathology Conferences, and Multidisciplinary Case Conferences. Many trainees also commit to longitudinal clinical skills teaching to undergraduate MD students, and there are ad hoc opportunities to participate in education to undergraduate elective students. The collaborative atmosphere of the program results in frequent teaching of junior residents by senior trainees, both formally and informally. Many residents have identified opportunities for innovative educational initiatives, which have been adopted into the formal program.  

Trainees in this program share a dedicated large, comfortable, bright space with ample computer resources for access to clinical and educational information, and radiation treatment planning technology. Residents are financially supported to attend one Canadian Association of Radiation Oncology (CARO) annual scientific meeting and one American Society of Radiation Oncology (ASTRO) meeting during training, plus any North American meetings at which the trainee presents research. Trainees are also supported to attend the national "prep course" in PGY3, PGY4 and PGY5 to prepare for the Royal College exam, and the London "contouring boot camp" once during training. Recommended physics and radiobiology texts are provided, as well as access to e-anatomy. Wednesday afternoons are protected for education, which includes a weekly JCC-wide rounds followed by the academic half-day on a variety of relevant topics.  Radiation physics is taught in a protected 2-week "basics" course in the fall followed by longitudinal sessions throughout the academic year, in the PGY2 and PGY3 years. A physics "review" week for senior residents is given annually. Radiobiology is taught through the U of T annual Radiobiology Course, in PGY2 and PGY4. An annual in-house written exam and semi-annual OSCE in PGY3, 4, and 5 help prepare senior residents for the Royal College fellowship exam, and dedicated one-on-one mock oral exams are given by faculty in the months leading up to the fellowship exam. Residents participate in and lead regular Journal Club meetings, and JCC-wide Morbidity and Mortality Rounds. Most importantly, resident work one-on-one with Radiation Oncologists throughout the PGY2-PGY5 years, acquiring the skills and knowledge required for a successful career in Radiation Oncology.

The Division of Radiation Oncology is a collegial, diverse, and inclusive group of 25 Radiation Oncologists who welcome our trainees into the specialty and support them educationally and personally through training. Residents each have a faculty mentor available for personal or professional support and additional mentoring relationships develop organically through training. The Program Director’s door is always open, physically and virtually. McMaster’s Postgraduate Medical Education office has confidential support services for residents and access to a variety of supports to meet the needs of trainees. Most importantly, the resident group in the Radiation Oncology program creates a welcoming and mutually supportive training environment, supported by the program and the faculty to hold team-building and social events to ensure all residents thrive.

Transition to Discipline (PGY1)

Trainees will spend the first 8 weeks of training in the Radiation Oncology Department in various clinical, treatment planning and delivery, and orientation environments.

Foundations (PGY1)

Trainees will spend the remainder of the PGY1 year in Foundational training, including 12 weeks in General Internal Medicine and 4 weeks in each of Thoracic Surgical Oncology, Gynaecology Surgical Oncology, Emergency Medicine, inpatient and outpatient Palliative Care, Diagnostic Imaging, Neuro-Oncology, and inpatient Oncology.

Core (PGY2-midPGY5):

Trainees will spend most of this stage of training working one-on-one with JCC Radiation Oncologists, gaining knowledge, experience and skill in each disease site plus paediatric radiation oncology. There will also be protected time for focusing on learning the technical aspects of radiotherapy, applied radiation physics, and radiobiology, protected time for scholarly work, and dedicated clinical experiences in Medical Oncology, Malignant Haematology, Community Radiation Oncology, and clinical electives outside of the JCC.

Transition to Practice (latter PGY5):

This stage of training will comprise longitudinal clinical experience, practice management, completion of scholarly work, and the development of independent decision-making and treatment planning, to prepare for fellowship or independent practice.