UW-La Crosse Medical Dosimetry Program Master Competency Checklist [ student: Fenna (jm yvth site: Mayo Clinic Rochester | [Thoracic Date Evaluation Competency Performed Completed Head & Neck Primary Brain (Conformal, IMRT/VMAT) Whyajar | Nok Primary H & N (IMRT/VMAT) B\21 Ter [Lung (Conformal, IMRT/VMAT) [ Esophagus (Conformal, IMRT/VMAT) Intact Breast Tangentials Chest Wall Tangentials (bolus:non-bolus) w/Supraclay & Axilla [Abdomen | Pancreas or GE Junction (Conformal, IMRT/VMAT) ek Para-aortic or nodal irradiation (Conformal, IMRT/VMAT) Pelvis | 3 fld Pelvis with Wedges. A fid Pelvis Prostate with Nodes S18 Technique (IMRT/VMAT) ‘Anus of Vulva Conventional 3D Technique* Extremities | Limb Melanoma/Sarcoma (Conformal, IMRT/VMAT) Brachytherapy * + Interstitial 7 = onan. AAA Ae Intracavitary HOR C13] al Nee. other i Ae Craniospinal Irradiation* vofafar i2434fiaz | Palliative 2[3[al__|@fafar Kall Lymphoma (Mantle)* Sa] 21 Lo Electron Beam Plan tofu | Fusion (MR, PET, ete.) wine | NGS Re-lrradiation 4[2o[2{ wer | Stereotactic Body Radiation Therapy (SBRT)* Whisi2t | ag.Ashico Sim & Start Tx Same Day Plan 723 [Ll [Afesfer kee, ‘Optional Proton Treatment Planning © These competencies Clinical setting on actual patients if the opportunity arises. t One Brachytherapy competency must be performed in the clinic. ‘COMPETENCIES PER SEMESTER REQUIRED ‘_ACHIEVED ‘SPRING SEMESTER 5 (Mantle Lab included) [SUMMER SEMESTER | 8 (Vulva Lab included) FALL SEMESTER 10 (CSI & SBRT labs included) Onl be performed ina lab assignment, Students are encouraged to perform them in the