University of Wisconsin-La Crosse Medical Dosimetry Program Competency Check list, Competencies CANNOT be performed on datasets they must be performed on “‘real” patients student Name: YLNAN WANG Clinical Site: Beaumont Heabts ‘Competency Date | Typhon Performed | Evaluation Completed Palliative (Spine, Hip, Ribs, ete) 170 28 7 9s PECs 7 A Para-aortic or nodal irradiation (0 rm) fae li Limb Sarcoma Pelvis - GYN Lymphoma Intact Breast Tangents Chest Wall Tangents (bolus: non-bolus weighting) with S’Clav and PAB ReTreat avoiding or matching old port (any area) Lung with Boost (conformal) Abdominal IMRT (e.g. Pancreas) /y sll te Brain IMRT with MR fusion Prostate IMRT Ll | vAc 1B Prostate with nodes (MRT) ali (bee H&NIMRT Thoracic IMRT (e.g. Esophagus or Lung) Electron Beam Plan Brachytherapy Intracavitary ot Interstitial Implant Plan Other (Suggested): Plan a patient that is to be Simulated and Treated on the same day (to experience time constraints) si_| vel& ‘Whee Bazi) Please make sure you fill out the appropriate form when completing the competency.