To solve today�fs radiotherapy problems mentioned above, the current program consists of the following five components:

1. Launching the first U.S. standard medical physics residency training program for promoting high quality medical physics profession.
2. Launching the standard medical physics graduate program for promoting high quality medical physicists development.
3. Starting a medical physics education program for clinical medical physicists, radiotherapy technologists, and radiation oncologists.
4. Establishing QA/QC programs within Juntendo University Hospitals and extending the programs to other facilities in Japan.
5. Performing high precision treatment through the advanced QA/QC procedures, state-of-the-art equipments, and a high quality R&D program.

1. Recruit two candidates (with M.S. or Ph.D. degree in physics or closely related field) for training in the U.S. at an accredited residency program in radiation oncology physics. Financial support in the form of scholarships will be needed for the duration of the training program (two years).
2. The physicists, after successful completion of clinical training, must obtain certification by the American Board of Radiology (ABR). The board certification requirements by the American Board of Radiology for a radiological physicist (or medical physicist ) are listed on their web site: http://www.theabr.org/RP_Pri_Req.htm.
   Certification requires three examinations:
   Part �h(computer-based): Anytime during training
   Part II (computer-based): After passing the Part I exam with a total of three year clinical experience
   Part III (Oral): After passing the Part II exam, in the following year.
3. The physicists after completing the training program must work for Juntendo at least for 5 years. A medical physics residency training program at Juntendo should be started for trainees with M.S. or PhD degree in physics and the curriculum drafted as soon as the trained physicist(s) is/are appointed on the department faculty staff if eligibility is confirmed by Juntendo. The requirements and guidelines for such a program are listed in the CAMPEP document.

1. Holding a Juntendo medical physics open seminar for clinical medical physicists, radiotherapy technologists, and radiation oncologists on a regular basis;
2. Establishing a medical physics education program for medical physicist candidate such as M.S. graduates in science/engineering or radiation technologists. Providing clinical traning for non-clinical medical physicists.

1. Performing research in order to establish QA/QC programs for Juntendo University Hospitals
2. In parallel with the efforts to have the physicists trained and a residency program established, it is essential that the radiation oncology program at Juntendo and its satellite clinics be upgraded to meet the international standards of practice. Guidelines to achieve these standards are listed in the �gBlue Book�h of the American College of Radiology (ACR). For example, state-of-the-art-equipment and treatment procedures must be available at the main campus and its satellites. Availability of treatment procedures such as IMRT, stereotactic radiosurgery, HDR brachytherapy and other modern treatment modalities, are a pre-requisite not only for the state-of-the-art clinical practice but also essential for accreditation of a residency program. The �gBlue Book�h guidelines also stipulate appropriate patient load per machine (e.g., not exceeding 40 patients per linac), sufficient number of physicians (e.g., one for each 200-250 patients treated annually; no more than 25-30 patients under treatment by a single physician), one physicist per 400 patients treated annually, etc. These guidelines provide equipment standards and minimum staffing requirements, without which no residency program can be established.
3. A steering committee should be formed right away to implement the steps outlined above in order to achieve the stated goal in the next five years. The membership of this committee should include: radiation oncologists, physicist(s), department manager and a representative from the administration. The Chief Radiation Oncologist should chair this committee and communicate its recommendations to the higher level of administration on a regular basis. Outside consultation regarding professional and equipment needs may be sought if needed. Because the establishment of a state-of-the-art radiation oncology program and b residency training are expensive ventures, a high degree of institutional commitment, meticulous planning and creative financing are required to achieve these goals. In addition, every effort should be made to keep the communication channels open between the interested parties in this case, the department, the administration and the equipment vendor. Timely initiation and continuation of these efforts will be the most important responsibilities of the steering committee.
4. As a result of the above steps, Juntendo will establish QA programs in the all related hospitals. This will also result in QA consulting business to domestic clinical facilities.

1. High precision radiation treatment will be provided by using advanced equipments such as Elekta Synergy.
2. QA/QC programs will be established for high precision radiotherapy.
3. R&D projects will be launched for advanced high precision treatment