clinical issues, Interviews, medical physics, Professionalism

A guide to explaining clinical medical physics to a non-physicist

Whether you’re a first year graduate student in medical physics, a resident, or working in the field already, you’ve probably been asked the question: “What is a medical physicist?”. In this blog post, we’ll discuss a good elevator pitch for physicists to non-physicists and give you a quick and easy breakdown of the expectations and ideas administrators and colleagues have for medical physicists. In addition, we’ll give you tips on professionalism and how to exert confidence when starting out in your career.

 Elevator pitch to a non-physicist

An elevator pitch can be used to explain your career to a non-physicist, make an impression on a potential employer, or start a conversation with potential collaborator. The elevator pitch is designed to deliver a succinct answer to the questions: “Who are you?,” “What contributions do/can you make?,” and “What are your goals?”

The goal of the pitch to a non-physicist will be mainly to explain: “What does a clinical medical physicist do?” The AAPM Virtual Pressroom has a great description of medical physicists, which can be condensed to these major points:

Medical physicists’ responsibilities include:

  • radiation safety for patients and staff through scheduled measurements and patient/staff education
  • machine standardization and reproducibility through daily, monthly, and annual testing
  • improvement of patient outcome through development of new techniques in medical imaging or radiation treatment

 Expectations of a clinical physicist

Perhaps the “elephant in the room” is that aspiring physicists don’t always have a clear idea of the expectations of a medical physicist. The potentially murky terms of  “quality control” and “quality assurance” (which are clarified here) can make explaining medical physics a non-trivial task. In this section, we’ve outlined some of the expectations of your colleagues and administrators. These expectations can help you to craft your pitch further and adequately answer follow-up questions.

The position of a medical physicist is detailed by the American College of Radiology and the role of a medical physicist in clinical practice has been defined by the AAPM  in AAPM Reports No. 38 and No. 42. Medical physicists may obtain membership as “medical staff” or  be considered “professional staff.”

General expectations of a clinical physicist include:

Administrators/supervisors Colleagues
  • provide expert consulting and implement cost-reducing strategies
  • provide protection against litigation via quality assurance programs
  • understand and observe national and state regulations
  • negotiate performance standards and costs during equipment purchase
  • perform acceptance testing, commissioning, and QC of new and existing equipment
  • quality improvement in protocols (especially imaging) to accommodate high throughput and high quality in patient care
  • prevent patient/employee overexposure through monitoring, consultation, and education

 

 

  • understand clinical workflow
  • consult with health practitioners and allied health personnel
  • maintain calibrated equipment and analyze system performance (recognize artifacts, acceptance testing)
  • organize and supervise QA/QC programs
  • organize and supervise radiation safety programs
  • be involved in development of new clinical protocols
  • coordinate and/or manage technician training in safety and new protocols
  • observe ethical standards and professional conduct
  • support and involvement in the training of other physicists

Professionalism tips

When explaining yourself to new non-physicists or interacting with well-known colleagues, it is always important to maintain the appropriate attitude, courtesy, and discretion – these aspects of conduct are termed “professionalism.” Professionalism extends to relationships between colleagues and patients, personal behavior, conflicts of interest, ethics in research, publication and education, and relationships with vendors. Modules on ethics and professionalism are available online through the AAPM and ABR.

Professionalism includes:

  1. Accountability
  2. Honor and integrity
  3. Respect for others (including patient consent and confidentiality)
  4. Excellence and continued education and commitment to the field

These components of professional conduct support the mission of quality management in clinical physics and present medical physics as a respectable profession.

Conclusion

Hopefully, this post has helped to clarify your intended role as a clinical medical physicist. Keep in mind that we are undergoing (and have undergone) highly specialized coursework and intensive training – we’ve learned a lot, and quickly! Your pitch is your chance to teach your family, friends, and non-physics acquaintances about your intended career and potential contributions.

In our next post, we will highlight crafting an elevator pitch to a potential employer and networking opportunities at the AAPM Annual Meeting!

References

Scope and Practice of Medical Physics. Policy No. PP17-B http://www.aapm.org/org/policies/details.asp?id=317&type=PP&current=true

AAPM Code of Ethics. Policy No. PP24-C http://www.aapm.org/org/policies/details.asp?id=329&type=PP

ABR Foundation Ethics and Professionalism Modules http://api.rsna.org/lms/org/ethics/courses/index.cfm?CFID=7433883&CFTOKEN=f6f3e328d59cc96f-AC55A203-09F1-88D2-C13F5F79E29C84F1&jsessionid=2A9974DE1EE98F4F3E719EB3BE248694.cfusion

“Medical Physics Clinical Skills Workbook for Therapy Physics.” Rosalind Franklin University of Medicine and Science, College of Health Professions. October 2012. http://www.rosalindfranklin.edu/Portals/3/Documents/Clinical_Skills_Workbook_ONLINE_VERSION__Revised_10-23-12A%5B1%5D.pdf

Quality Management in Medical Physics: General Concepts. Thomadsen, Bruce . 2004. http://www.aapm.org/meetings/amos2/pdf/26%20-4515-3485-838.pdf

Guide to Medical Physics Practice. American College of Radiology, Subcommittee of the Standards & Accreditation Committee of the Commission on Medical Physics. http://www.acr.org/Membership/Legal-Business-Practices/Group-Practice-Resources/Guide-to-Medical-Physics-Practice

AAPM Report No. 38: The role of a physicist in radiation oncology. https://www.aapm.org/pubs/reports/rpt_38.pdf

AAPM Report No. 42: The role of clinical medical physicist in diagnostic radiology. http://www.aapm.org/pubs/reports/RPT_42.pdf

Professionalism in medicine: definitions and considerations for teaching. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769526/

 

 

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clinical issues, medical physics, residencies

Interviews with Recent Medical Physics Graduates Pursuing Clinical Careers

Prospective students interested in medical physics have a variety of degree paths available, as well as areas of clinical certification, such as nuclear medicine, imaging, and therapy. To help educate and advise students interested in clinical medical physics, we have interviewed four former students and one student very close to graduation, all of whom have secured residency positions in either imaging or therapy. We’ve included a DMP, two MS, and two PhDs and asked them about the benefits of their degree path and how their degree and residency has helped them further their careers. All of the interviewees have graduated from CAMPEP-accredited programs across the country, including schools in Texas, Tennessee, Kentucky, North Carolina, and other states.

Q1. What is your educational background (i.e. DMP, MS, or PhD)?

DMP:

DMP program.

MS-therapy:

Master’s degree, therapy focus.

MS-imaging:

Master’s degree, imaging focus.

PhD-therapy:

PhD, therapy focus.

PhD-imaging:

PhD, imaging focus.

Q2. What inspired you to follow your particular area of study within the field of medical physics?

DMP:

I began developing a strong predilection for applied branches of math and physics early in my education. When I discovered  therapeutic medical physics, it seemed to me to be the perfect extreme of applied science. The field has an amazing capacity for affording  human impact, practice of the scientific process, and many, many challenges.

MS-therapy:

I chose therapeutic medical physics because of the workplace conditions, the gratification/importance, job supply, variety of duties,  and compensation (and in that order)

MS-imaging:

I knew I wanted to do Chemistry or Physics in college. I found out about medical physics at LSU and looked into it. When I realized they  got to work with all the imaging modalities, I realized this had the potential to be a great career. I was always fascinated with MRI as a kid after  having a few scans at a young age.

PhD-therapy:

A big reason I’ve pursued the therapy side of medical physics has been the clinical involvement. While it might be more reactive compared to the diagnostic side, the treatment process has always fascinated me. I enjoy the clinical responsibilities and the questions that are being asked in an effort to improve the standard of care for cancer patients.”

PhD-imaging:

As a physics undergraduate we had a seminar given by a diagnostic medical physicist on MRI. I also had a classmate that graduated before me who was studying diagnostic medical physics that helped me realize the great opportunities available in that field.

Q3. What is your current or intended career?

DMP:

Clinical Medical Physicist.

MS-therapy:

Current: therapy medical physics resident. Future: boarded clinical therapy physicist with perhaps AAPM aspirations.

MS-imaging:

My current title is Senior Radiological Physicist. My original title was just Radiological Physicist, but I was really a junior physicist.  Eventually I became the only diagnostic physicist for our healthcare organization for a little while. We recently hired someone above me  again. My intended career is to become board certified in Diagnostic and Nuclear Medicine Physics. I would like to continue to work for a  healthcare organization or university as opposed to having a consulting job.

PhD-therapy:

I’ll be finishing up my PhD work in the next couple of months and beginning a residency shortly afterward. Long term, I would like to  work at an academic center where I can find a balance of clinical responsibilities, research work, and involvement with educational activities.

PhD-imaging:

Imaging Physics Resident.

Q4. Were you interested in a residency position upon graduation? If so, what was your experience applying to residencies (and starting your residency)?

DMP:

While I was strongly interested in the additional experience that can be derived from a residency program, I was fortunate enough to be enrolled in a DMP program. This degree program allowed me to gain this experience without having to go through the residency application process.

MS-therapy:

Yes. Had on-site interviews with many academic centers, however, it was my impression that my MS degree was not competitive enough compared to PhDs. Eventually I was selected with my current residency….things have been excellent so far.

MS-imaging:

Yes, I was interested in a residency position. I interviewed for two residencies and got an invite to MD Anderson for a third. I got one of  the residencies I interviewed for. However, I decided to accept my current position. I knew a residency would have been a better educational  experience, but I was counting on having a good mentor at my first job. That was not the case and I have had to teach myself a lot and put in a  lot of effort to make sure I am going to be adequately prepared for the boards. It basically boiled down to salary and still being able to achieve  my goal of becoming board certified since I have had someone “supervising” me that is ABR certified.

PhD-therapy:

It’s been very interesting to see the development of residency programs, and more specifically their integration with the career paths  of recent graduates, over the course of my PhD work. When I first entered graduate school, I was aware of residency programs, but had no  intentions of doing one. Five years ago it was far more common for new graduates interested in clinical work to take Junior Physicist or  Assistant Professor positions right out of graduate school. Now, it is far different as all but a couple of this year’s graduates from our program,  myself included, have taken residency positions. With most of us having already passed Part 1 to the ABR’s initial certification exam, this was  more a result of the recognized benefit to getting a formal and more structured clinical training experience as well as market factors influenced  by the increasing number of residency graduates. With the ABR’s 2014 initiative now taking effect, soon all graduates interested in clinical  work will need to do residencies to obtain board certification.

The residency application process can be a lot of things, among them are stressful, fun, expensive, and fascinating. With so many more  graduates applying for residency positions (graduates still outnumber residency positions), spots have become very competitive. There are a  number of growing pains to be dealt with in the application process, and I expect that in the next couple years as the volume of applicants  remains high, a lot of those will be handled. Residencies are still relatively new to our field, and even though we’ve tried to base them  somewhat off of the physician model, there are differences in our professions that will necessitate adaptations.

PhD-imaging:

Yes. I only applied to one and was in the process of applying to another when I was accepted. It was not too difficult. The hardest part  was ensuring that I had all of the necessary information and paperwork (i.e. transcripts, reference letters, intent letter) sent in on time.

Q5. Did your program have any unique characteristics that you feel gave you a competitive advantage? How have those characteristics helped you in your career?

DMP:

My program emphasized clinical experience and complete immersion within a working clinic with highly diverse applications, in  addition to a strong academic program, that allowed me, among other things, to start developing clinical intuition, confidence, and insight that  would have taken years to develop without this opportunity. This was a unique opportunity that is often under-afforded to students and one  that I consider invaluable to my education.

MS-therapy:

My residency has as preference for clinically oriented MS physicists and takes into account an individual’s “soft skills”. In that regard, I  believe my own set of interpersonal skills helped tremendously in being selected…and in acquiring a post-residency position.

MS-imaging:

If we are talking about Duke University’s Medical Physics program, then yes I believe so. I believe the fact we had a lot of different  opportunities in different areas (research to clinical in all areas of medical physics and some of the fields that cross paths like biomedical  engineering has helped me in becoming a well-rounded physicist.I also believe the fact we were forced to learn how to code has made a big  difference. Learning to write code, scripts, etc is an invaluable tool in the work place. A lot of the people I have worked with don’t have the experience or knowledge from their graduate degrees in that area.

PhD-therapy:

There are a lot of things that my program did well in preparing me to apply to residencies. The clinical rotations gave us great exposure to the clinic. Having a basic understanding of how the clinic operates and how its problems are handled compared to the research world is very valuable. Even if a program doesn’t have formalized clinical rotations, I highly recommend that students familiarize themselves with the roles and responsibilities of all those involved in the clinic. The experience helped me to be more conversational during interviews and gave me an added sense of confidence in handling the interview questions.

PhD-imaging:

Graduating from a CAMPEP accredited institution. That ensured that I had taken all of the required courses. I had a clinical rotation with a local consulting company during the summer of my last year. I really feel that this was a big help for me.

Q6. Which degree path would you recommend to prospective students interested in the field of medical physics?

DMP:

I believe that depends a great deal on how you see yourself wanting to spend your days following your education. Different paths available to us in this career carry with them the opportunities to explore different niches within the profession that exist among the commonalities. My advice for prospective students, though, in response to this question would be to seek out professionals with a variety of backgrounds as you explore your interest in this field. Shadow them, if you can, observe their interactions with those around them, note their focuses, and ask them how their educational decisions facilitated them attaining their positions. If different aspects of the profession pique your interest above others, then this realization will go a long way to answering this question for yourself.

MS-therapy:

In light of current trends, I would probably recommend in the following order: DMP, PhD, and MS (and for only a few select MS programs with a history successful job placement).

MS-imaging:

There isn’t much of a choice anymore if you are looking to become board certified. You need to complete a CAMPEP Master’s and residency program (or DMP, if those programs take off). If your goal is strictly research, PhD is probably the best path.

PhD-therapy:

This is a tricky question as I would argue it depends most on the goals of the individual. While PhD graduates have been more competitive at placing in residencies (whether it is right, wrong, or how to address it is a whole separate discussion), the research training is largely unnecessary for those that want only clinical responsibilities. An MS or DMP might be a more efficient means for those students. I think it is important for prospective students to evaluate their goals and familiarize themselves with the options in order to make the most informed decision possible.

PhD-imaging:

If you want to do research or any type of academic work, I would recommend going for a PhD. If not, a MS or DMP may suffice. The advice given to me when I was finishing my undergrad was the following: ‘If you are even thinking about getting a PhD, go straight for it, don’t bother doing a Master’s and then a PhD.’ I am glad that I took that path.

Q7. If you could go back and do it all again, would you still choose the same degree path?

DMP:

Emphatically, yes.

MS-therapy:

Yes. Definitely, but I love my MS program.

MS-imaging:

Yes, the only thing I may have changed is having a dual major as an undergraduate: Physics and Computer Science or Computer Engineering. I cannot stress the importance of knowing how to code and understanding how computers work. These are tools that if you aren’t going to work in the area of medical physics could prove very useful as skills for other well-paying jobs out there.

PhD-therapy:

Without a doubt!

PhD-imaging:

Yes. I have no regrets in going for a PhD. I am also grateful to have chosen to be in a residency program. A residency was not required for me, but I am grateful for the extra training that has been given to me to further prepare me to be able to independently practice as an imaging physicist.

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clinical issues, medical physics, residencies

The Issue of Residencies

http://www.mayo.edu/mshs/careers/medical-physics

Mayo Clinic Residency Program in Medical Physics

In the recent AAPM newsletter, Dr. George Starkschall responded to two major issues that he has encountered while serving as the Chair of the Education Council. In this post, we will summarize the issues and major points made by Dr. Starkschall. These issues are specific to medical physics students who are working towards full certification by the American Board of Radiology (ABR) and want a clinical position.

Issue 1: Short-term supply of residents

“Are there going to be a sufficient number of residents to meet workforce needs after the 2014 deadline that requires candidates who wish to take the ABR exam to complete a CAMPEP-accredited residency?”

Dr. Starkschall feels that the current number of CAMPEP-approved (and pending approval) residency programs will provide enough residents to meet the minimum expected demand in both imaging and radiation therapy. In order to support more residency programs, the AAPM and RSNA have collaborated to establish residency program funding for three new programs: the University of Alabama-Birmingham, Memorial Sloan-Kettering Cancer Center, and University of Wisconsin.

Furthermore, some residency programs are incorporating private physics practices into a “hub-and-spoke” model. The residency program serves as the hub for multiple residents, providing infrastructure, any necessary classes, and possibly resident stipends. Each private practice offers one position for training and supervision of the resident in a clinical setting.

Issue 2: Surplus of medical physics graduates

“What is the AAPM doing about the mismatch between numbers of students graduating from accredited graduate programs and the number of residency positions available for these graduates?”

Dr. Starkschall explains that this issue is a nuanced one. Overall, there are simply less residency positions than there are students graduating from CAMPEP-accredited medical physics programs. Annually, more Master’s degrees are awarded than Ph.D.’s. However, residency programs are more likely to accept Ph.D. graduates than Master’s.

The AAPM and medical physics graduate programs are making a great effort to increase the number of residency positions, with an emphasis on placing Master’s students in these positions. An alternative degree path, the professional doctorate program (DMP), offers a guaranteed residency position. Several graduate schools are hoping to establish DMP programs, following in the footsteps of Vanderbilt University. These initiatives will certainly mitigate the graduate/residency mismatch in the future.

Non-clinical careers exist

In the near future, it is very unlikely that every medical physics graduate will find a clinical residency position. But, the truth is: not everyone needs a clinical residency position. Medical physicists have successful careers outside the clinical setting: in entrepreneurship, in state and national regulatory bodies, in industry, and in academia.

In our next post, we will feature short interviews from non-clinical medical physicists.

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