UW-La Crosse Medical Dosimetry Program Master Competency Checklist [ students TZN. Gimmi goth e Mays Chnic- Rochester Competency Date Evaluation Performed | Completed Head & Neck Primary Brain (Conformal, IMRT/VMAT) Primary H & N (IMRT/VMAT) [Thoracic Lung (Conformal, IMRT/VMAT) Esophagus (Conformal, IMRT/VMAT) Intact Breast Tangentials Chest Wall Tangentials (bol non-bolus) w/Supraciav & Axilla Abdomen mal, tt IMA) Para-aortic or nodal irradiation (Conformal, IMRT/VMAT) |Pelvis | 3 fld Pelvis with Wedges 4 fld Pelvis ‘Anus or Vulva Conventional 3D Technique* Prostate with Nodes SIB Technique (IMRT/VMAT) [Extremities | Limb Melanoma/Sarcoma (Conformal, IMRT/VMAT) Lilla 1 Yc Brachytherapy * + Interstitial Intracavitary HI other Craniospinal Irradiation” Palliative Re-Irradiation Lymphoma (Mantle)* EAICIES! Lo Electron Beam Plan Fusion (MR, PET, etc.) ul Stereotactic Body Radiation Therapy (SBRT)* Sim & Start Tx Same Day Plan [Optional Proton Treatment Planning ‘COMPETENCIES PER SEMESTER REQUIRED “it_ACHIEVED SPRING SEMESTER | 5 (Mantle Lab included) Q ‘SUMMER SEMESTER 8 (Vulva Lab included) al FALL SEMESTER 10 (CSI & SBRT labs included) * These competencies will be performed ina lab assignment. Students are encouraged to perform them in the clinical setting on actual patients ifthe opportunity arises. + One Brachytherapy competency must be performed in the clinic.