Successful implementation of Virtual Environment for Radiotherapy Training (VERT) in Medical Physics education: The University of Sydney's initial experience and recommendations.

This report outlines the University of Sydney's initial experience with the Virtual Environment for Radiotherapy Training (VERT) system in the Master of Medical Physics program. VERT is a commercially available system, simulating linear accelerators, patient computed tomography (CT) sets, plans and treatment delivery. It was purpose built for radiation therapy (RT) education and offers learners the opportunity to gain knowledge and skills within an interactive, risk-free environment. The integration of VERT into the RT physics module of the Master of Medical Physics program was intended to enhance student knowledge and skills relevant to the curriculum's learning objectives, and to alleviate some of the burden associated with student access to clinical equipment. Three VERT practical sessions were implemented: "RT treatment planning systems", "(CT) Anatomy for physicists" and "Linear accelerator measurements". Our experience and student evaluations were positive and demonstrated the viability of VERT for medical physics (MP) student education. We anticipate that integration of VERT into MP teaching is a valuable addition to traditional methods and can aid MP students' understanding and readiness for practice. Additional evaluations should be conducted to ascertain VERT's role in delivering efficient quantity and quality of MP education, and its potential in alleviating burdens placed on clinical departments.

The Business of Health Physics-Jobs In A Changing Market.

The health physics profession was born abruptly when once rare and precious radioactive materials became commonplace. The technological advancements that triggered an industrial complex and ended World War II demanded radiation safety on an unprecedented scale. Until then, protective measures against radiation were largely absent in laboratories. Over the subsequent decades, health physicists began protecting people and the environment in a wide range of settings including medical, research, and industrial. The use of radioactive materials and radiation-generating devices is prevalent today. Radiation doses occur continuously including during airline flights, in our homes, during medical procedures, and in energy production. Radiation is integral to numerous applications including those in medicine, dentistry, manufacturing, construction, scientific research, nuclear electric power generation, and oil and gas exploration. Activities that were once groundbreaking have now become routine and scripted. At higher doses, health effects are understood and avoided. Instruments for the detection and measurement of radiation are at times smarter than their users. Ironically, the same health physics community that has been successful in demonstrating that exposures to radiation and to radioactive materials can be effectively managed is shrinking at an increasingly rapid rate. This paper highlights the creation of past and current jobs, predicts the future opportunities in the profession, and makes recommendations necessary to protect the disappearing specialties.

A 2012 survey of the Australasian clinical medical physics and biomedical engineering workforce.

A survey of the medical physics and biomedical engineering workforce in Australia and New Zealand was carried out in 2012 following on from similar surveys in 2009 and 2006. 761 positions (equivalent to 736 equivalent full time (EFT) positions) were captured by the survey. Of these, 428 EFT were in radiation oncology physics, 63 EFT were in radiology physics, 49 EFT were in nuclear medicine physics, 150 EFT were in biomedical engineering and 46 EFT were attributed to other activities. The survey reviewed the experience profile, the salary levels and the number of vacant positions in the workforce for the different disciplines in each Australian state and in New Zealand. Analysis of the data shows the changes to the workforce over the preceding 6 years and identifies shortfalls in the workforce.

Report on the American Association of Medical Physics Undergraduate Fellowship Programs.

The American Association of Physicists in Medicine (AAPM) sponsors two summer undergraduate research programs to attract top performing undergraduate students into graduate studies in medical physics: the Summer Undergraduate Fellowship Program (SUFP) and the Minority Undergraduate Summer Experience (MUSE). Undergraduate research experience (URE) is an effective tool to encourage students to pursue graduate degrees. The SUFP and MUSE are the only medical physics URE programs. From 2001 to 2012, 148 fellowships have been awarded and a total of $608,000 has been dispersed to fellows. This paper reports on the history, participation, and status of the programs. A review of surveys of past fellows is presented. Overall, the fellows and mentors are very satisfied with the program. The efficacy of the programs is assessed by four metrics: entry into a medical physics graduate program, board certification, publications, and AAPM involvement. Sixty-five percent of past fellow respondents decided to pursue a graduate degree in medical physics as a result of their participation in the program. Seventy percent of respondents are currently involved in some educational or professional aspect of medical physics. Suggestions for future enhancements to better track and maintain contact with past fellows, expand funding sources, and potentially combine the programs are presented.

Radiotherapy physics research in the UK: challenges and proposed solutions.

In 2011, the Clinical and Translational Radiotherapy Research Working Group (CTRad) of the National Cancer Research Institute brought together UK radiotherapy physics leaders for a think tank meeting. Following a format that CTRad had previously and successfully used with clinical oncologists, 23 departments were asked to complete a pre-meeting evaluation of their radiotherapy physics research infrastructure and the strengths, weaknesses, opportunities and threats within their own centre. These departments were brought together with the CTRad Executive Group and research funders to discuss the current state of radiotherapy physics research, perceived barriers and possible solutions. In this Commentary, we summarise the submitted materials, presentations and discussions from the meeting and propose an action plan. It is clear that there are challenges in both funding and staffing of radiotherapy physics research. Programme and project funding streams sometimes struggle to cater for physics-led work, and increased representation on research funding bodies would be valuable. Career paths for academic radiotherapy physicists need to be examined and an academic training route identified within Modernising Scientific Careers; the introduction of formal job plans may allow greater protection of research time, and should be considered. Improved access to research facilities, including research linear accelerators, would enhance research activity and pass on developments to patients more quickly; research infrastructure could be benchmarked against centres in the UK and abroad. UK National Health Service departments wishing to undertake radiotherapy research, with its attendant added value for patients, need to develop a strategy with their partner higher education institution, and collaboration between departments may provide enhanced opportunities for funded research.

A 2009 survey of the Australasian clinical medical physics and biomedical engineering workforce.

A survey of the Australasian clinical medical physics and biomedical engineering workforce was carried out in 2009 following on from a similar survey in 2006. 621 positions (equivalent to 575 equivalent full time (EFT) positions) were captured by the survey. Of these 330 EFT were in radiation oncology physics, 45 EFT were in radiology physics, 42 EFT were in nuclear medicine physics, 159 EFT were in biomedical engineering and 29 EFT were attributed to other activities. The survey reviewed the experience profile, the salary levels and the number of vacant positions in the workforce for the different disciplines in each Australian state and in New Zealand. Analysis of the data shows the changes to the workforce over the preceding 3 years and identifies shortfalls in the workforce.

A grid to facilitate physics staffing justification.

Justification of clinical physics staffing levels is difficult due to the lack of direction as how to equate clinical needs with the staffing levels and competency required. When a physicist negotiates staffing requests to administration, she/he often refers to American College of Radiology staffing level suggestions, and resources such as the Abt studies. This approach is often met with questions as to how to fairly derive the time it takes to perform tasks. The result is often insufficient and/or inexperienced staff handling complex and cumbersome tasks. We undertook development of a staffing justification grid to equate the clinical needs to the quantity and quality of staffing required. The first step is using the Abt study, customized to the clinical setting, to derive time per task multiplied by the anticipated number of such tasks. Inclusion of vacation, meeting, and developmental time may be incorporated along with allocated time for education and administration. This is followed by mapping the tasks to the level of competency/experience needed. For example, in an academic setting the faculty appointment levels correlate with experience. Non-staff personnel, such as IMRT QA technicians or clerical staff, should also be part of the equation. By using the staffing justification grid, we derived strong documentation to justify a substantial budget increase. The grid also proved useful when our clinical demands changed. Justification for physics staffing can be significantly strengthened with a properly developed data-based time and work analysis. A staffing grid is presented, along with a development methodology that facilitated our justification. Though our grid is for a large academic facility, the methodology can be extended to a non-academic setting, and to a smaller scale. This grid method not only equates the clinical needs with the quantity of staffing, but can also help generate the personnel budget, based on the type of staff and personnel required. The grid is easily adaptable when changes to the clinical environment change, such as an increase in IMRT or IGRT applications.

Continuing professional development needs of Australian radiation oncology medical physicists--an analysis of applications for CPD funding.

In November 2004, the Australian federal government allocated $775,000 to individual Australian radiation oncology medical physicists (ROMPs) to access continuing professional development (CPD) activities. The funding was administered by the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM). In order to receive funding, individuals had to submit an application to ACPSEM, which assessed each application and distributed funds to successful applicants. 248 separate applications were received from 143 individuals in two rounds of applications. Information from the applications was collated and analysed, with the aim of identifying patterns that will be of use in future planning for CPD. This paper presents a summary of the information extracted from the analysis.

Analysis and practical use: the Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services--round II.

PURPOSE: The initial Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services was published in October 1995. That study measured qualified medical physicist (QMP) work associated only with routine radiation oncology procedures. In the intervening years, medical physics practice has changed dramatically. Three-dimensional treatment planning, once considered a special procedure, is the standard of care for many patient presentations. Prostate seed brachytherapy, stereotactic procedures, and intensity-modulated radiation therapy now constitute a large portion of the time medical physicists devote to clinical duties. Special procedures now dominate radiation oncology, leading to the request for an updated work and staffing study for qualified medical physicists. METHODS: The updated Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services: Round II was published in June 2003. Round II measures and reports QMP work associated with both routine and most contemporary special procedures. Additionally, staffing patterns are reported for a variety of practice settings. RESULTS: A work model is created to allow medical physicists to defend QMP work on the basis of both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The work and cost justification models may in turn be used to defend medical physicist staffing and compensation. CONCLUSION: The updated Abt study empowers medical physicists to negotiate service or employment contracts with providers on the basis of measured national QMP work force and staffing data.

Methodology for determining action levels for clean-up contaminated urban and agricultural environments.

A methodology for determining justified action levels for clean-up of contaminated environments has been elaborated based upon dose reductions and monetary costs associated with the clean-up or remedial measures. Action levels can be expressed as dose or contamination levels above which clean-up is justified and below which it is not. This paper discusses the factors needed to determine such action levels. The most important of these factors are the efficiency of the clean-up and the monetary costs of the clean-up operation. Examples of justified action levels for clean-up of urban and agricultural environments have been determined from uncertainty analyses. With selected parameter distributions for clean-up of urban and semi-urban environments, justified action levels for clean-up are found to be in the range of about 1-10 mSv y(-1). With selected parameter distributions for agricultural countermeasures, action levels for reduction of activity content in milk have been determined to be from less than 100 Bq L(-1) up to a few thousand Bq L(-1), corresponding to residual individual ingestion doses of about 0.1-0.5 mSv y(-1). The presented methodology, which can be extended to include more complex environments, can in a simple way give the decision maker an indication of when it is justified to clean a contaminated environment.

Dose and cost considerations for relocation after nuclear accidents.

The results of a comprehensive study of the dose and cost considerations for relocation after nuclear accidents are presented in this paper. These results include the quantification of the dependence of area affected by relocation on dose intervention level and source term, the countermeasures implementation cost-benefit estimate, as well as the application of cost-benefit analysis to optimize the dose intervention level for relocation. In order to explicitly consider the distribution of individual dose among the exposed population to determine the optimal dose intervention level for relocation, the concept of individual dose evaluation function has been introduced in the present work.

[The personnel needs of health physics in radiotherapy]. / Personalbedarf der Medizinischen Strahlenphysik in der Strahlentherapie.

METHODS AND RESULTS: Using a questionnaire, mean occupation time values for the different medical physics activities were derived in 1992; they formed the basis for recommendations of minimum physics staffing levels in radiotherapy. The recommended staffing levels were compared with the actual staffing levels and to other national and international recommendations.