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: Pes fron lei NYMY ks See ‘Competency Evaluator’s Date Clinical Sit of [Intact Breast Tangentials | [Breast or Chest wall withs’clav and PAB «| UL tof tiig Limb Sarcoma nA Fi Prostate Se conformal)* A fas GE Sn menial Ce ee oe EO » Set ee 0 Fier [interstitial Implant Plan | 12) ly The competencies with the asterisk can be done on either an IMRT plah OR a conformal plan. Please ‘make sure you fil out the appropriate form when completing the competency. 4