Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research,education, and quality control

Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine.     

Towards an updated ESTRO-EFOMP core curriculum for education and training of medical physics experts in radiotherapy – A survey of current education and training practice in Europe

PurposeESTRO-EFOMP intend to update the core curriculum (CC) for education and training of medical physicists in radiotherapy in line with the European Commission (EC) guidelines on Medical Physics Experts (MPE), the CanMEDS methodology and recent developments in radiotherapy. As input, a survey of the current structure of radiotherapy MPE national training schemes (NTS) in Europe was carried out.MethodsA 35-question survey was sent to all European medical physics national societies (NS) with a focus on existence of an NTS, its format and duration, required entry-level education, and financial support for trainees.ResultsTwenty-six of 36 NS responded. Twenty had an NTS. Minimum required pre-training education varied from BSc in physics or related sciences (5/2) to MSc in medical physics, physics or related sciences (6/5/2) with 50–210 ECTS in fundamental physics and mathematics. The training period varied from 1 to 5 years (median 3 years with 50% dedicated to radiotherapy). The ratio of time spent on university lectures versus hospital training was most commonly 25%/75%. In 14 of 20 countries with an NTS, a research project was mandatory. Residents were paid in 17 of 20 countries. The recognition was mostly obtained by examination. Medical physics is recognised as a healthcare profession in 19 of 26 countries.ConclusionsThe NTS entrance level, duration and curriculum showed significant variations. This survey serves to inform the design of the updated CC to define a realistic minimum training level for safe and effective practice aiming at further harmonization in line with EC guidelines.     

The European Federation of Organisations for Medical Physics. Policy Statement No. 7.1: The roles,responsibilities and status of the medical physicist including the criteria for the staffing levels in a Medical Physics Department approved by EFOMP Council on 5th February 2016

This EFOMP Policy Statement is an amalgamation and an update of the EFOMP Policy Statements No. 2, 4 and 7. It presents guidelines for the roles, responsibilities and status of the medical physicist together with recommended minimum staffing levels. These recommendations take into account the ever-increasing demands for competence, patient safety, specialisation and cost effectiveness of modern healthcare services, the requirements of the European Union Council Directive 2013/59/Euratom laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation, the European Commission’s Radiation Protection Report No. 174: “Guidelines on medical physics expert”, as well as the relevant publications of the International Atomic Energy Agency. The provided recommendations on minimum staffing levels are in very good agreement with those provided by both the European Commission and the International Atomic Energy Agency.     

医学人文在医学微生物学教学中的应用

在讲授医学微生物学知识的同时,对医学生进行医学人文教育,将有助于培养德才兼备的医学人才。本文提出了在医学微生物学课程中可融入人文教育的几项知识点,希望对该课程的医学人文教育有所启示。     

医学微生物学讨论式教学的意义

医学微生物学是医学基础课,为了提高教学质量,通过讨论式的微生物学教学方式,启发培养学生的多向思维能力、创新能力和开拓精神,拉近学生与现代生命科学发展的距离,使微生物学课程的学习成为对微生物学探索的开始,采用讨论微生物学新进展的教学方式,探索最合适的培养高素质人才的有效途径。     

SBRT for prostate cancer: Challenges and features from a physicist prospective

Emerging data are showing the safety and the efficacy of Stereotactic Body Radiation Therapy (SBRT) in prostate cancer management. In this context, the medical physicists are regularly involved to review the appropriateness of the adopted technology and to proactively study new solutions. From the physics point of view there are two major challenges in prostate SBRT: (1) mitigation of geometrical uncertainty and (2) generation of highly conformal dose distributions that maximally spare the OARs. Geometrical uncertainties have to be limited as much as possible in order to avoid the use of large PTV margins. Furthermore, advanced planning and delivery techniques are needed to generate maximally conformal dose distributions. In this non-systematic review the technology and the physics aspects of SBRT for prostate cancer were analyzed. In details, the aims were: (i) to describe the rationale of reducing the number of fractions (i.e. increasing the dose per fraction), (ii) to analyze the features to be accounted for performing an extreme hypo-fractionation scheme (>6–7 Gy), and (iii) to describe technological solutions for treating in a safe way. The analysis of outcomes, toxicities, and other clinical aspects are not object of the present evaluation.     

概念图在医学微生物学教学中的应用

概念图已成为各种教育背景下的学习工具,通过概念图可以构建学生的知识结构、促进学生批判性思维的发展和对知识的理解。本文初步探讨了概念图在医学微生物学教学准备、教学实施及教学评价等方面的有效应用。     

当前医患矛盾对医学生德育教育的影响与对策

当前我国医患关系呈现为整体和谐、局部矛盾尖锐的态势,局部矛盾体现在暴力伤医事件频频发生。在缓解局部矛盾的过程中,医学生作为青年学生,面对恶性暴力事件带来的冲击时心理生理都会受到很大影响。同时,医学生作为未来医生又直接关系到未来医患关系的构建,因此,如何在当前特殊形势下避免医患矛盾给医学生带来不良影响,加强医学生德育教育的有效性,成为医学生德育教育的重点和难点。本文通过分析医患矛盾成因,对医学生德育教育的影响以及对策来探讨和研究,希望为构建和谐医患关系和医学生德育教育方面提供新的解决思路。     

中美模拟医学教育差异之浅析

随着社会的进步,直接以患者为对象的传统临床实习教学模式面临着严峻考验。计算机技术费飞速发展,为模拟医学教学带来了划时代的进步,使医学教育进入现代医学模拟教学时代。随着现代科技及医疗环境及教学理念的进步,模拟医学教育近年来发展较快。现代模拟教学方式被认为是一种提高患者安全的有效临床教学方法,其教学活动可重复、无风险、可控制且灵活多样。我国这方面也取得了一定发展并具备了一些特点。但是由于整个医学教学氛围、教学习惯、教育体系、考核体系、评估体系的差异,导致和美国存在比较大的差异。如何结合我国的教学现状并配合医学界教学改革进程,探索具有中国特色的模拟训练方案对提高我国医学教学质量及最大可能的保障患者安全具有重要意义。     

对医学生开展艾滋病教育课程的实践

艾滋病教育课程在大学的开设面临重要性和紧迫性,由于专业的特殊性,在医学院校开展艾滋病教育课程更显意义重大。该文论述了对医学生开展艾滋病教育课程的几点实践体会。