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International Medical Physics Symposium - Part 1: Making a Difference in the World: Are You Willing to Be Part?

K Cheung

A Meghzifene

J Damilakis

D Fontenla

E Lief

K Cheung1*, A Meghzifene2*, J Damilakis3*, D Fontenla4*, E Lief5*, (1) Hong Kong Sanatorium & Hospital, Happy Valley, (2) International Atomic Energy Agency, Vienna, (3) University of Crete, Crete, (4) Memorial Sloan-Kettering Cancer Center, New York, NY, (5) Marsden Medical Physics Associates, Pelham, NY

TU-E-105-1 Tuesday 2:00PM - 3:50PM Room: 105


The Symposium is jointly sponsored by IOMP and IAEA with the International Affairs Committee of AAPM. So much is happening in large part of the world particularly when it comes to medical use of radiation and assessment of radiation doses to patients in over 50 developing countries, promoting harmonization of Medical Physics practice worldwide, and comparing doses with international standards and managing doses. In recent years many papers have been published in peer reviewed journals. Several premier international organizations have produced or are preparing publications impacting on the practice of medical physics. The momentum generated creates opportunities for collaboration and cooperation between medical physicists from developing countries and with those in America and Europe. AAPM members can contribute effectively in this very stimulating area of work. You can be part of the exercise of making a difference in the world, in making patients in need of diagnostic and therapeutic procedures safer and in improving the knowledge of colleagues in developing countries.

Learning Objectives:
1. To learn about the MP practice in west Europe, in Asia, and in Latin America.
2. To learn about the MP practice in developing countries.
3. To become familiar with on-going work in over 50 developing countries in Africa, Asia, Eastern Europe and Latin America on radiation protection of patients.
4. To understand the mechanism of cooperation and collaboration.
5. To consider development of new projects.


Global Development of Medical Physics- IOMP Perspective
Kin Kin Cheung, Ph.D.
President of IOMP
Hong Kong Sanatorium & Hospital, Hong Kong

Recent large scale surveys confirm that there is a large diversity in requirements for the qualification, role and responsibilities and manpower requirement for medical physicists. This in turn can result in a corresponding diversity in the quality and standard of practice of the medical physicists in different countries and even within countries. Such conditions, which are rather unsatisfactory, may be partly due to economical reasons and partly due to the fact that medical physics is not yet fully established and recognized globally as a healthcare profession and that their important role in the clinics and hence their level of professional competence, particularly in radiation medicine is not fully realised. There is now a general trend of implementing sophisticated medical technologies and complex imaging and treatment techniques in every country. One may raise the question on whether the clinical benefits of these heavy investments will be fully realised without a corresponding improvement in medical physics service support.
IOMP has been taking several approaches to address the above issues. On the issue of professional recognition, IOMP has successfully convinced the UN International Labour Organization (ILO) to list medical physicists as professionals in the International Standard Classification of Occupations-08 (ICSO-08). This will help increasing the visibility of medical physics in national healthcare systems and help state recognition of the profession. IOMP is working to standardize the education and training requirements of medical physicists in a similar manner as other healthcare professionals by providing guidance in the form of policy statements to national member organizations on basic requirements for education and training of medical physicists working in healthcare institutions and on their role and responsibilities in medicine. The IOMP Public Relations Committee (PRC) which is chaired by Dr. Raymond Wu is working on the issue of manpower requirement of medical physics in medicine as well as on a system for global implementation of professional certification of medical physicists. The Organization is also collaborating with IAEA in preparation of complementary guidelines for member states. To further improve the recognition of the professional status of medical physicists, IOMP is mobilizing all medical physicists through their national and regional medical physics organizations to participate in a series of activities aiming to raise the awareness of the profession to members of the public, other healthcare professionals and healthcare policy makers. Amongst the initiatives is the launching of the annual event of International Day of Medical Physics starting from 2013, in which a series of scientific and educational events will be organized with global participation. IOMP is strengthening the collaborating with international professional and statutory organizations in raising the profile of the medical physics profession. The Organization is strengthening its support to NMOs in developing countries with the objective of a global development of the medical physics profession. Only with a universal recognition of the importance role of medical physicists in medicine that a high standard of practice of medical physics can realistically be developed to support clinical needs in every country.

IAEA contribution to international harmonization of guidelines for clinical medical radiation physicists
Ahmed Meghzifene¹, Maria do Carmo Lopes², KY Cheung³, Christodoulos Constantinou⁴, Pedro Andreo⁵, Maria-Ester Brandan⁶, Maria Esperanza Castellanos⁷, Taofeeq Abdallah Ige⁸, George Henry Frey⁹

The IAEA’s Technical Cooperation Project INT/6/054 “Strengthening Medical Physics in Radiation Medicine” aims at promoting the recognition of medical physics in radiation medicine and to harmonize educational and clinical training requirements in order to achieve the required standard of patient care in radiation medicine. To achieve this project’s objective, the IAEA’ s efforts were supported by numerous stakeholders from medical physics professional societies and regional counterparts from Europe, Africa, Latin America and Asia. Within this project, the IAEA established four Working Groups (WGs) to address the issues of (i) roles and responsibilities, (ii) education & clinical training requirements, (iii) staffing requirements and (iv) raising awareness on the medical physics profession. The WG1 and WG2 drafted the guidelines on roles and responsibilities, and education & clinical training requirements for clinical medical physicists. The guidelines were compiled into a single report, aiming at providing recommendations on the minimum requirements for the academic education and clinical training necessary for a physicist to become a clinically qualified medical physicist. They include recommendations for accreditation, certification and registration, along with continuous professional development. With the purpose of establishing the grounds for substantiating the recommendation on education and clinical training requirements, the IAEA report includes first the roles and responsibilities of a clinically qualified medical physicist in radiation medicine. The goal of the IAEA report is to establish criteria that support the harmonization of education and clinical training worldwide, as well as promoting the recognition and professionalism of medical physics as a profession internationally. The IAEA report was endorsed by the International Organization for Medical Physics (IOMP) and approved for publication as an IAEA Human Health Report. The main recommendations included in the IAEA report will be presented, together with preliminary plans to support implementation, especially in low and middle income countries.
¹ IAEA, ² Portugal, IOMP, ³ Hong Kong, China, IOMP, ⁴B.O.Cyprus Oncology Centre, Cyprus, ⁵ Karolinska University Hospital, Sweden, ⁶ Mexico, ALFIM, ⁷ Colombia, ALFIM, ⁸ Nigeria, FAMPO, ⁹ USA, AAPM

Status of the Medical Physics Profession in Europe
John Damilakis, PhD
Chairman, IOMP Education & Training Committee
University of Crete, Crete, Greece

Medical Physicists in Europe are required to have (a) an advanced degree in Medical Physics (MSc or PhD), (b) a supervised, specialized clinical training in one or more areas of Medical Physics and (c) professional recognition through certification and registration. Furthermore, continuous professional development (CPD) is of vital importance for European Medical Physicists. A study shows that the entry requirements, the required postgraduate studies, the certification and registration processes and CPD schemes for Medical Physicists are far from being harmonized in Europe (EFOMP policy statements, Physica Medica, 24:3-20, 2008).
External assessment of the quality of education or training provision is always needed. Accreditation should be based upon standards. Medical Physics CPD courses must be accredited by an independent accreditation body. An accreditation body for Medical Physics courses is needed to be established in Europe. This organization will promote training and accredit programs that meet high standards.
Qualification frameworks in Europe should be referred to the European Qualifications Framework (EQF) for lifelong learning. According to the EQF, learning outcomes are expressed as inventories of knowledge, skills and competences (KSC). To facilitate harmonization of Medical Physics Experts (MPE) qualifications among the member states of the European Union, the European Commission (EC) has developed the ‘Guidelines on Medical Physics Expert’ very recently. According to these guidelines, the MPE should be independently recognized in each sub-specialty of Medical Physics. Learning outcomes for MPEs are expressed in terms of KSC. A workshop was organized in 2011 Sevilla, Spain, to discuss the status, education and training, recognition and mobility of Medical Physicists. The final draft of the ‘guidelines on MPE’ document was presented and discussed. The forthcoming document will be published in the EC radiation protection (RP) series (EC, Guidelines on medical Physics Expert, Directorate-General Energy, Luxembourg, in press).

Medical Physics Practice in Latin America: The Best of Times, The worst of Times
Doracy P. Fontenla
Chair, Latin American Affairs Sub-Committee of the AAPM International Affairs Committee
Chair, AAPM International Scientific Exchange Program
Memorial Sloan-Kettering Cancer Center, New York, USA

Introduction: Our task is to present information on the status of the Medical Physics practice in the different countries in Latin America. Because of its fundamental value, we would like to focus on the status of education and professional medical physics issues in the different countries.
Purpose: The IAEA is interested in promoting harmonization of Medical Physics practice worldwide. As a contribution, we must first learn about the diverse status of the medical physics practice, possibilities and needs in the different countries of Latin America.
Methods and Materials: The LAASC maintains a close communication with all (or most) Latin American Countries through the valuable contributions of our Latin American Liaisons and Consultants. We also rely heavily on the information and cooperation with ALFIM (The umbrella association of all Medical Physics Associations of the different countries in Latin America). This presentation is based on their contributions.
Results: There is a large diversity in the status of Medical Physics practice in the different countries of Latin America. As expected, this discrepancy is mostly due to the different economy status in Latin American countries. However, in many instances the economic deficiencies are somehow compensated by the great creativity of medical physicists in the region. A large credit must be given to the extensive work of the IAEA and IOMP in the education and practice of the profession of medical physics in different countries of Latin America.
Conclusions: LAASC always places emphasis on divulging to the Latin America medical physicists the professional and educational opportunities as well as the medical physics literature available through the AAPM website. Through the realization of ISEP workshops it has also been possible to exchange scientific information on the state of the art of the practice of medical physics, and also to divulge AAPM programs available to countries in development, such as PIP, International Affiliate, access to Medical Physics Journal and AAPM protocols, to name a few. We believe that through cooperation and work together with ALFIM, the AAPM could contribute to make a sustainable impact to the medical physics profession in Latin American Countries.
Learning objectives:
1. Understand the fundamental problems associated with the different medical physics practice levels encountered in Latin America.
2. To become familiar with on-going work in developing countries in Latin America in relation to medical physics education and professional recognition.
3. Learn how the AAPM could make a sustainable impact.

Status of Medical Physics in Asia Pacific Region
Kin Yin Cheung, Ph.D.
President of IOMP
Hong Kong Sanatorium & Hospital, Hong Kong

According to a large scale surveys conducted in year 2011 by an ad hoc medical physics working group, the Asia and Pacific region has about 3864 radiation oncology medical physicists. This is a significant increase from about 2410 found in a 2008 survey. The number of imaging medical physicists in the region is rather uncertain as the two surveys did not cover specifically medical physicists engaged in imaging physics work. It is estimated that about 10% of the medical physicists in AFOMP are engaged in imaging work. This number is expected to increase as imaging physics is gaining momentum due to increasing application of imaging techniques in radiation therapy. Despite of the significant increase in the number of medical physicists in radiation oncology over the past three years, the mean ratio of the number of radiation oncology medical physicist to MV treatment machine in the region remained basically unchanged due to a corresponding increase in the number of treatment machines in the region. The regional mean ratio was 1.04 in 2008 against 1.14 in 2011. The national ratio varied significantly between countries from 0.64 in a developing country to 2.13 in a developed country. The survey data indicated that there were much shortage in both radiotherapy treatment equipment and medical physicists in the developing countries in the region.
According to a large scale global survey conducted by IAEA during late 2009 to early 2010 on education, training and professional development of medical physicists, most of the countries in the region demanded a master degree as the entry requirement for the medical physics profession. However, formal clinical training was available in only 9 countries with duration of training varied between 1 to 4 years. Four of these countries adapted the IAEA clinical training programs in radiation oncology physics and imaging physics. In countries where formal clinical trainings were not available, informal on the job trainings were given to newly appointed medical physicists. National systems for professional certification of medical physicist were established in countries where formal clinical trainings are available. Voluntary CPD systems were also established in these countries. The survey data indicated a large variation in the clinical training and professional development of medical physicists in the region. Such degree of disparity in qualification and competency is considered as unsatisfactory and can have negative impact on the standard of practice and professional status of medical physicists. External audit of training and professional certification systems is considered by some countries as useful in improving the professional status of certified medical physicists and also in getting supports for training resources. Medical physicists in the region are looking into standardization of training and professional competence and are exploring the possibility of achieving this through independent accreditation. With this objective, six medical physics organizations in the region have become chartered members of the International Medical Physicist Certification Board (IMPCB) and are enthusiastically working to have their national certification systems accredited by IMPCB or other accreditation bodies.

AAPM Website Development for International Information Exchange
Eugene Lief, PhD
Chairman, AAPM International Affairs Committee
Marsden Medical Physics Associates, Pelham, NY, USA

Rapidly growing international collaboration in Medical Physics leads to increasing globalization of our profession. To facilitate the information exchange necessary for the further development of international ties in Medical Physics, AAPM International Affairs Committee (IAC) plans significant expansion of its information webpages. The material that we plan to add includes:
-links to our sister societies abroad,
-regulations and work methodologies in other countries to be used as a reference,
-training programs in Medical Physics,
-schedules of refresher courses in other countries,
-licensing issues overseas,
-possible avenues in international collaboration
-exchange programs
-online educational materials,
-personal contact information etc.
We see the informational aspect of our work as a global task and propose formation of International Information Subcommittee. If approved, the subcommittee will have its first meeting in August 2013. The Subcommittee will establish working relations with other IAC subcommittees as well as with International Medical Physics Organizations and our sister societies in other countries. The result of this work will be a systematic collection of international information and placing it in the form of links to AAPM website. This task will be handled more efficiently with the help of other physicists and members of international community. We are soliciting comments, new ideas and new information that could be included on the website.
This lecture will provide an overview of the plan for development of international information exchange and information that is going to be included. We will be providing our contact information and soliciting help from the participants. We are interested in new suggestions and possibly other information sources that could be suggested by the colleagues.
Learning Objectives:
1. Understand the future trends in globalization of Medical Physics profession.
2. Learn about AAPM International Affairs Committee (IAC) efforts to help this globalization.
3. Find out about the types of information that is going to be included in the IAC webpages.
4. Be prepared to collaborate on the web site development.

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