EFOMP Malaga Declaration 2023: An updated vision on Medical Physics in Europe.

In 2006, the European Federation of Organisations for Medical Physics (EFOMP) adopted the "Malaga Declaration". The declaration asserted the fundamental role of Medical Physics professionals in the radiation protection of patients, workers, general public, carers and comforters and research participants in hospitals. However, since that time the Medical Physics profession has evolved in Europe and new regulations and documentation have been issued, such as directive 2013/59/Euratom and the "European Guidelines on Medical Physics Expert" (RP174). EFOMP has published updated core-curricula and strived towards the recognition of the profession at the European level. In view of this, an update of the original Malaga Declaration was deemed necessary, to define the future vision that will guide the actions of the Federation in the years to come. This Declaration, which has been approved by the national member organizations of EFOMP in April 2023, is much broader than the original Malaga version. This is expected considering the rapid evolution of medical device technology over the last 17 years. The Radiation Protection Expert in hospital settings should be an MPE, since the latter has the highest level of radiation protection knowledge and training. Given the passion and energy that animated the debate, which led to the updating of the Malaga Declaration, we are confident that it represents a solid basis for the development of our profession in Europe which is in consonance with the aspirations of us all.

EFOMP policy statement 18: Medical physics education for the non-physics healthcare professions.

Although Medical Physics educators have historically contributed to the education of the non-physics healthcare professions, their role was not studied in a systematic manner. In 2009, EFOMP set up a group to research the issue. In their first paper, the group carried out an extensive literature review regarding physics teaching for the non-physics healthcare professions. Their second paper reported the results of a pan-European survey of physics curricula delivered to the healthcare professions and a Strengths-Weaknesses-Opportunities-Threats (SWOT) audit of the role. The group's third paper presented a strategic development model for the role, based on the SWOT data. A comprehensive curriculum development model was subsequently published, whilst plans were laid to develop the present policy statement. This policy statement presents mission and vision statements for Medical Physicists teaching non-physics users of medical devices and physical agents, best practices for teaching non-physics healthcare professionals, a stepwise process for curriculum development (content, method of delivery and assessment), and summary recommendations based on the aforementioned research studies.

CTContour: An open-source Python pipeline for automatic contouring and calculation of mean SSDE along the abdomino-pelvic region for CT images; validation on fifteen systems.

PURPOSE: Calculation of the Size Specific Dose Estimate (SSDE) requires accurate delineation of the skin boundary of patient CT slices. The AAPM recommendation for SSDE evaluation at every CT slice is too time intensive for manual contouring, prohibiting real-time or bulk processing; an automated approach is therefore desirable. Previous automated delineation studies either did not fully disclose the steps of the algorithm or did not always manage to fully isolate the patient. The purpose of this study was to develop a validated, freely available, fast, vendor-independent open-source tool to automatically and accurately contour and calculate the SSDE for the abdomino-pelvic region for entire studies in real-time, including flagging of patient-truncated images. METHODS: The Python tool, CTContour, consists of a sequence of morphological steps and scales over multiple cores for speed. Tool validation was achieved on 700 randomly selected slices from abdominal and abdomino-pelvic studies from public datasets. Contouring accuracy was assessed visually by four medical physicists using a 1-5 Likert scale (5 indicating perfect contouring). Mean SSDE values were validated via manual calculation. RESULTS: Contour accuracy validation produced a score of four of five for 98.5 % of the images. A 300 slice exam was contoured and truncation flagged in 6.3 s on a six-core laptop. CONCLUSIONS: The algorithm was accurate even for complex clinical scenarios and when artefacts were present. Fast execution makes it possible to automate the calculation of SSDE in real time. The tool has been published on GitHub under the GNU-GPLv3 license.

Early career medical physicist groups in Europe: An EFOMP survey.

INTRODUCTION: Training, educating, and fostering of young professionals are key requisites for the progress of any profession. The young medical physicists (MPs) of today are the medical physics professionals and leaders of tomorrow. It is, therefore, essential that they learn to work collectively and in a coordinated manner at both national and European levels at an early stage in their career. In view of this, EFOMP is planning to create a special interest group (SIG) encompassing early career MPs from across Europe. METHODS: A survey was developed by EFOMP and circulated to all National Member Organisations (NMOs) to gather information on the status of early career groups in their respective societies and on the interest to partake in such group within the Federation. RESULTS: Of the 36 NMOs that are part of EFOMP, 32 responded to the survey. Only 9 NMOs have established early career MPs groups within their NMOs, while the remaining countries are either considering setting up young MPs groups in the future (15 NMOs) or do not show such interest (8 NMOs). Of all responders, 59% expressed interest in the creation of the EFOMP SIG, 34% remained neutral towards this issue by not answering the question and for two NMOs the SIG idea had no appeal. CONCLUSION: Most NMOs showed interest in the creation of an early career MPs group within EFOMP and offered constructive feedbacks on the roles they envisage for the group. EFOMP will use and implement this information when establishing the special interest group.

Being an excellent scientist is not enough to succeed! Soft skills for medical physicists.

PURPOSE: To provide a review of the literature and commentary regarding soft skills for Medical Physicists. METHOD: A comprehensive search in PubMed was carried out using the searchwords 'medical physics' coupled separately ('AND', both in Title) with each of the following terms: leadership, teamwork, communication, pedagog*, teach*, marketing, conflict resolution, negotiat*, qualitative research, organizational psychology. RESULTS: The total number of PubMed references was extremely low (total 6 relevant articles for all of leadership, communication, pedagog*, teach*, with the rest of the searchwords giving zero hits) which is quite disturbing. For an improved perspective, we compared the search for 'leadership AND medical physics' to 'leadership AND medical' and 'leadership AND nursing' we only had 4 hits for Medical Physics as opposed to 564 for 'leadership AND medical' and 1419 for 'leadership AND nursing'. CONCLUSIONS: It seems that Medical Physicists give an extremely low priority to soft skills as opposed to scientific skills. In a world of austerity economics and sometimes over commoditization such a situation is not only disturbing it is actually very risky for the profession. Medical Physicists must learn to provide strategic and robust leadership, be able to market their profession to all stakeholders (in particular to decision makers, other health care professions and the general public), be able to communicate their role, negotiate effectively for their profession, and boost their abilities for teambuilding and conflict resolution. The setting up of education programmes to overcome this soft skill deficit among medical physicists by national, regional and international medical physics organizations must be given priority.

Education, training and registration of Medical Physics Experts across Europe.

From its inception, EFOMP has pursued a policy to improve and coordinate education and training of medical physicists across all its participating European countries. Several EFOMP policy statements on education and training have been published and surveys have been held to get an overview of the actual situation. At the beginning of 2020 a new survey was distributed amongst the 36 National Member Organizations (NMOs), in which questions were based on recommendations published in the most recent policy statements. Thirty-three of the NMOs (91%) responded, of which 22 indicated having a National Registration Scheme (NRS) for Medical Physics Experts (MPEs) in place. Another 6 indicated considering such a scheme. Results of the questionnaire showed that there was good correspondence between education and training programmes, i.e. a division between a BSc phase, an MSc phase and a clinical phase after completion of the MSc. Differences between NRSs were primarily seen in the availability and composition of a supervising committee and in the availability of guidelines for handling professional misconduct. In addition, some differences were seen in the topics that were part of the education and training programme. The goal of a universal (registered) MPE accepted by all European countries is still far away despite the progress being made. The new procedure for approving an existing NRS, which fulfils all EFOMP criteria is seen as an important step forward. Exchange of experience, knowledge, ideas and, above all, MPE trainees between European countries is seen as the best approach to achieve this goal.

ESTABLISHING LOCAL AND NATIONAL DIAGNOSTIC AND INTERVENTIONAL CARDIOLOGY AND RADIOLOGY REFERENCE LEVELS IN A SMALL EUROPEAN STATE: THE CASE OF MALTA.

European Directive 2013/59/EURATOM requires the establishment and use of diagnostic reference levels (DRLs) for diagnostic and interventional procedures. The purpose of this study was to establish local DRLs for a major tertiary public hospital. As the hospital is the only such hospital in Malta, the same data collected for setting local DRLs can also be used for setting national DRLs, making local DRLs de facto national DRLs. A retrospective survey of cumulative kerma-area product (KAP) and fluoroscopy time data from the cardiac catheterisation laboratory and interventional radiology suites was carried out. The effect of system upgrades on cumulative KAP was also assessed. Local DRLs were set for common cardiology and interventional radiology procedures. All DRLs compare favourably with those in European literature. A Philips Allura Clarity upgrade to the cardiac catheterisation laboratories led to significant reductions in cumulative KAP (p â‰ª  0.05) for most procedures.

EFOMP policy statement 16: The role and competences of medical physicists and medical physics experts under 2013/59/EURATOM.

On 5 December 2013 the European Council promulgated Directive 2013/59/EURATOM. This Directive is important for Medical Physicists and Medical Physics Experts as it puts the profession on solid foundations and describes it more comprehensively. Much commentary regarding the role and competences has been developed in the context of the European Commission project "European Guidelines on the Medical Physics Expert" published as Radiation Protection Report RP174. The guidelines elaborate on the role and responsibilities under 2013/59/EURATOM in terms of a mission statement and competence profile in the specialty areas of Medical Physics relating to medical radiological services, namely Diagnostic and Interventional Radiology, Radiation Oncology and Nuclear Medicine. The present policy statement summarises the provisions of Directive 2013/59/EURATOM regarding the role and competences, reiterates the results of the European Guidelines on the Medical Physics Expert document relating to role and competences of the profession and provides additional commentary regarding further issues arising following the publication of the RP174 guidelines.

Maltese Radiographers' Attitudes towards Continuing Professional Development: An Initial Study Using Concept Maps.

PURPOSE: The Council for the Professions Complementary to Medicine in Malta recently published a draft document regarding the introduction of mandatory continuing professional development (CPD) for radiographers. This study explored the attitudes and motivators of Maltese radiographers prior to the implementation of mandatory CPD in order to provide the necessary information required by management to develop CPD successfully. Concept maps are used as part of a methodology to analyse qualitative data. METHODS: All radiographers working in the National Health Service were invited to complete an anonymous web-based questionnaire. RESULTS: The study showed that participants generally had a positive attitude towards CPD but were concerned about the mandatory aspect. The participants were mostly motivated by increasing professional knowledge, updating existing qualifications, and enhancing the status of the profession as a whole. Radiographers identified several difficulties with respect to CPD participation, such as lack of funding, lack of management support, and not enough local CPD opportunities. CPD participation was also negatively influenced by family commitments. CONCLUSION: The study showed that the majority of radiographers were self-motivated to engage in CPD activities, but there were some concerns. Based on these results, the authors suggest recommendations for allaying apprehension and producing the necessary conditions for a successful mandatory CPD scheme.

Curriculum for education and training of medical physicists in nuclear medicine: recommendations from the EANM Physics Committee, the EANM Dosimetry Committee and EFOMP.

PURPOSE: To provide a guideline curriculum covering theoretical and practical aspects of education and training for Medical Physicists in Nuclear Medicine within Europe. MATERIAL AND METHODS: National training programmes of Medical Physics, Radiation Physics and Nuclear Medicine physics from a range of European countries and from North America were reviewed and elements of best practice identified. An independent panel of experts was used to achieve consensus regarding the content of the curriculum. RESULTS: Guidelines have been developed for the specialist theoretical knowledge and practical experience required to practice as a Medical Physicist in Nuclear Medicine in Europe. It is assumed that the precondition for the beginning of the training is a good initial degree in Medical Physics at master level (or equivalent). The Learning Outcomes are categorised using the Knowledge, Skill and Competence approach along the lines recommended by the European Qualifications Framework. The minimum level expected in each topic in the theoretical knowledge and practical experience sections is intended to bring trainees up to the requirements expected of a Medical Physicist entering the field of Nuclear Medicine. CONCLUSIONS: This new joint EANM/EFOMP European guideline curriculum is a further step to harmonise specialist training of Medical Physicists in Nuclear Medicine within Europe. It provides a common framework for national Medical Physics societies to develop or benchmark their own curricula. The responsibility for the implementation and accreditation of these standards and guidelines resides within national training and regulatory bodies.