Although brachytherapy is the most conformal method of radiation treatment delivery and has been shown to produce best cancer control outcomes in many disease sites, its use has been in decline in many parts of the world. While financial and logistic considerations may be partly responsible for this decline, failure to train the next generation in brachytherapy techniques has been identified as a significant factor. In Canada, radiation oncology residency training is being transitioned to Competence by Design, where specific competencies including those around brachytherapy need to be taught by the programs and achieved by the residents. The Royal College of Physicians and Surgeons of Canada have also developed an Area of Focused Competence Diploma in Brachytherapy, which can be awarded to physicians successfully completing an accredited brachytherapy training fellowship, or to those in practice through a different route. Specific competency Milestones need to be achieved. Our expectation is that these initiatives will standardize brachytherapy training, improve quality of treatment delivery and further facilitate clinical use of brachytherapy.
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