Your Donations in Action: Sierra Silverwood, MD

In many low- and middle-income countries (LMICs), access to high-quality cancer care is limited by a lack of training in advanced radiation therapy techniques such as intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). These techniques enable precise radiation delivery while minimizing damage to healthy tissue, improving outcomes and reducing side effects.

To help address this gap, Rayos Contra Cancer, a non-profit dedicated to improving global radiotherapy care, developed a large-scale, fully remote IMRT/VMAT training curriculum for medical physicists practicing in English-speaking LMICs. The 15-week program, conducted in 2022, combined structured didactic instruction with hands-on treatment planning exercises.

Participants’ treatment-planning competency and changes in their confidence and knowledge were assessed pre- and post-course.

For her 2024 RSNA Research Medical Student Grant project, "A Longitudinal Assessment of Remote IMRT/VMAT Training Curriculum in Low- and Middle-Income Countries,” Sierra Silverwood, MD, incoming radiation oncology resident at Memorial Sloan Kettering Cancer Center in New York, and colleagues evaluated the long-term impact of the training by reassessing participants two years after course completion.

The project included treatment planning exercises, knowledge assessments and confidence surveys. The researchers found that objective treatment planning quality improved significantly after training and continued to improve at the two-year follow-up. Gains in knowledge and self-reported confidence were also sustained over time.

“These findings are notable because most prior global radiation oncology education programs have evaluated only short-term outcomes,” Dr. Silverwood said.

The durable gains seen in treatment-planning quality, knowledge and confidence—along with the potential for knowledge sharing within institutions—highlight how structured virtual training programs can build sustainable radiation oncology workforce capacity in resource-constrained settings.

“Overall, this work supports scalable, virtual education as a strategy to strengthen global radiotherapy capacity and reduce disparities in access to advanced cancer treatment,” Dr. Silverwood said.

The study has also been accepted for publication in the International Journal of Radiation Oncology, Biology, Physics.

Dr. Silverwood credits the R&E Foundation grant with providing protected time to focus on the project and deepen her engagement in global radiation oncology education research.

“This experience helped shape my interests at the intersection of radiation oncology, global health and scalable education initiatives,” Dr. Silverwood said. “Furthermore, it strengthened my commitment to developing innovative training strategies that improve equitable access to advanced radiotherapy as I begin residency in radiation oncology.”

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