The European Federation of Organisations for Medical Physics Policy Statement No. 6.1: Recommended Guidelines on National Registration Schemes for Medical Physicists

This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and 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 Radiation Protection Report No. 174, Guidelines on Medical Physics Expert and the EFOMP Policy Statement No. 12.1, Recommendations on Medical Physics Education and Training in Europe 2014, are also taken into consideration.The EFOMP National Member Organisations are encouraged to update their Medical Physics registration schemes where these exist or to develop registration schemes taking into account the present version of this EFOMP Policy Statement (Policy Statement No. 6.1“Recommended Guidelines on National Registration Schemes for Medical Physicists”).     

European Federation of Organisations for Medical Physics (EFOMP) Policy Statement 12.1: Recommendations on Medical Physics Education and Training in Europe 2014

In 2010, EFOMP issued Policy Statement No. 12: “The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations” to be applied to education and training in Medical Physics within the context of the developments in the European Higher Education Area arising from the Bologna Declaration and with a view to facilitate the free movement of Medical Physics professionals within Europe. Concurrently, new recommendations regarding qualifications frameworks were published by the European Parliament and Council which introduced new terminology and a new qualifications framework – the European Qualifications Framework (EQF) for lifelong learning. In addition, a new European directive involving the medical use of ionizing radiations and set to replace previous directives in this area was in the process of development. This has now been realized as Council Directive 2013/59/Euratom of 5 December 2013 which has repealed directive 97/43/Euratom. In this regard, a new document was developed in the context of the EC financed project "European Guidelines on the Medical Physics Expert" and published as RP174. Among other items, these guidelines refer to the mission statement, key activities, qualification framework and curricula for the specialty areas of Medical Physics relating to radiological devices and protection from ionizing radiation. These developments have made necessary an update of PS12; this policy statement provides the necessary update.     

The European Federation of Organisations for Medical Physics Policy Statement No. 10.1: Recommended Guidelines on National Schemes for Continuing Professional Development of Medical Physicists

Continuing Professional Development (CPD) is vital to the medical physics profession if it is to embrace the pace of change occurring in medical practice. As CPD is the planned acquisition of knowledge, experience and skills required for professional practice throughout one's working life it promotes excellence and protects the profession and public against incompetence. Furthermore, CPD is a recommended prerequisite of registration schemes (Caruana et al. 2014 [1]; [2]) and is implied in the Council Directive 2013/59/EURATOM (EU BSS) [3] and the International Basic Safety Standards (BSS) [4]. It is to be noted that currently not all national registration schemes require CPD to maintain the registration status necessary to practise medical physics. Such schemes should consider adopting CPD as a prerequisite for renewing registration after a set period of time.This EFOMP Policy Statement, which is an amalgamation and an update of the EFOMP Policy Statements No. 8 and No. 10, presents guidelines for the establishment of national schemes for CPD and activities that should be considered for CPD.     

Medical Physics: Forming and testing solutions to clinical problems

According to the European Federation of Organizations for Medical Physics (EFOMP) policy statement No. 13, “The rapid advance in the use of highly sophisticated equipment and procedures in the medical field increasingly depends on information and communication technology. In spite of the fact that the safety and quality of such technology is vigorously tested before it is placed on the market, it often turns out that the safety and quality is not sufficient when used under hospital working conditions. To improve safety and quality for patient and users, additional safeguards and related monitoring, as well as measures to enhance quality, are required. Furthermore a large number of accidents and incidents happen every year in hospitals and as a consequence a number of patients die or are injured. Medical Physicists are well positioned to contribute towards preventing these kinds of events”. The newest developments related to this increasingly important medical speciality were presented during the 8th European Conference of Medical Physics 2014 which was held in Athens, 11–13 September 2014 and hosted by the Hellenic Association of Medical Physicists (HAMP) in collaboration with the EFOMP and are summarized in this issue.     

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.     

The European Federation of Organisations for Medical Physics Policy Statement No 14: The role of the Medical Physicist in the management of safety within the magnetic resonance imaging environment: EFOMP recommendations

This European Federation of Organisations for Medical Physics (EFOMP) Policy Statement outlines the way in which a Safety Management System can be developed for MRI units. The Policy Statement can help eliminate or at least minimize accidents or incidents in the magnetic resonance environment and is recommended as a step towards harmonisation of safety of workers, patients, and the general public regarding the use of magnetic resonance imaging systems in diagnostic and interventional procedures.     

Medical physics practice and training in Ghana

Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession’s Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency’s projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana’s medical physicists in good position to practice competently and improve healthcare.     

The European Federation of Organisations for Medical Physics. Policy Statement No. 12: The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations

A recently published EFOMP's survey on the status of Education and Training in Europe, has showed the important role played by the NMOs in the organisation of the Medical Physics education and training in most countries and their efforts to fulfil EFOMP recommendations. However, despite of this, there is still a wide variety of approaches within Europe, not only in the education and training programmes but also in professional practice.There is right now some European issues that can affect not only education and training but also the future of Medical Physics as a profession: 1. the harmonisation of the architecture of the European Higher Education System, arising from the “Bologna Declaration”, for 2010, 2. the recently issued European directive: “Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications”.EFOMP is now challenged to make recommendations for education and training in Medical Physics, within the context of the current developments in the European Higher Education Area arising from “The Bologna Declaration”, and with a view to facilitate the free movement of professionals within Europe, according to the new Directive.     

The medical physics specialization system in Poland

This paper presents the situation of the profession of medical physicists in Poland. The official recognition of the profession of medical physicist in Polish legislation was in 2002. In recent years, more and more Universities which have Physics Faculties introduce a medical physics specialty. At present, there are about 15 Universities which offer such programmes. These Universities are able to graduate about 150 medical physicists per year. In 2002, the Ministry of Health introduced a programme of postgraduate specialization in medical physics along the same rules employed in the specialization of physicians in various branches of medicine. Five institutions, mostly large oncology centres, were selected as teaching institutions, based on their experience, the quality of the medical physics professionals, staffing levels, equipment availability, lecture halls, etc. The first cycle of the specialization programme started in 2006, and the first candidates completed their training at the end of 2008, and passed their official state exams in May 2009. As of January 2016, there are 196 specialized medical physicists in Poland. Another about 120 medical physicists are undergoing specialization.The system of training of medical physics professionals in Poland is well established. The principles of postgraduate training and specialization are well defined and the curriculum of the training is very demanding. The programme of specialization was revised in 2011 and is in accordance with EC and EFOMP recommendations.     

A critical assessment of the European Commission's proposals for the risk assessment and registration of chemical substances in the European Union

In May, 2003, the European Commission published detailed proposals relating to its 2001 White Paper--Strategy for a Future Chemicals Policy. The White Paper described a new registration system called the REACH (Registration, Evaluation and Authorisation of Chemicals) system, for both new and existing chemicals. Subsequently, these detailed proposals were available for an eight-week consultation period for stakeholders to voice their views and concerns. In this paper, we describe our reactions to the Commissions more-detailed proposals. These include the creation of a European Chemicals Agency to implement the REACH system in conjunction with Competent Authorities (CAs) in Member States and the Commission itself. Unfortunately, many of our concerns and suggestions, previously voiced and shared with several other key stakeholders, remain unanswered, but are as relevant as when the White Paper was published. In particular, we are concerned about the lack of a clear and coherent strategy. There is no guidance for registrants on intelligent testing to maximise the use of non-animal approaches to safety testing, based on a combination of factors for estimating exposure levels, rather than mainly on production volumes. We are also concerned about the absence of a clear programme for the development, improvement and validation of new alternative methods, in conjunction with the Commissions own unit, the European Centre for the Validation of Alternative Methods, as well as other organisations with relevant expertise and experience, including FRAME. Finally, we explain why such measures should be introduced, together with clearer guidelines for the respective roles of the Agency, the CAs and the Commission in implementing and harmonising the REACH system at the European Union and Member State levels. A series of recommendations are made, to improve the situation and to improve the risk assessment process.     

A critical assessment of the European Commission's proposals for the risk assessment and registration of chemical substances in the European Union

In May, 2003, the European Commission published detailed proposals relating to its 2001 White Paper - Strategy for a Future Chemicals Policy. The White Paper described a new registration system called the REACH (Registration, Evaluation and Authorisation of Chemicals) system, for both new and existing chemicals. Subsequently, these detailed proposals were available for an eight-week consultation period for stakeholders to voice their views and concerns. In this paper, we describe our reactions to the Commission's more-detailed proposals. These include the creation of a European Chemicals Agency to implement the REACH system in conjunction with Competent Authorities (CAs) in Member States and the Commission itself. Unfortunately, many of our concerns and suggestions, previously voiced and shared with several other key stakeholders, remain unanswered, but are as relevant as when the White Paper was published. In particular, we are concerned about the lack of a clear and coherent strategy. There is no guidance for registrants on intelligent testing to maximise the use of non-animal approaches to safety testing, based on a combination of factors for estimating exposure levels, rather than mainly on production volumes. We are also concerned about the absence of a clear programme for the development, improvement and validation of new alternative methods, in conjunction with the Commission's own unit, the European Centre for the Validation of Alternative Methods, as well as other organisations with relevant expertise and experience, including FRAME. Finally, we explain why such measures should be introduced, together with clearer guidelines for the respective roles of the Agency, the CAs and the Commission in implementing and harmonising the REACH system at the European Union and Member State levels. A series of recommendations are made, to improve the situation and to improve the risk assessment process.     

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.     

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.     

The use of the Internet training course modality in the field of tissue banking: the International Atomic Energy Agency (IAEA)/National University of Singapore (NUS) experience

The International Atomic Energy Agency (IAEA) promoted and supported an important training program for the training of tissue bank operators and medical doctors within its radiation and tissue banking program. The purpose of the program was to train an increase number of tissue bank operators and medical doctors in Asia and the Pacific, Latin America and Eastern Europe, that were working or were associated to a number of tissue banks established in these regions under the IAEA program during the 1980s, 1990s and 2000s. The National University of Singapore Tissue Bank was designated, in 1996, as the Regional Training Centre (RTC) for Asia and the Pacific region and later on, in 2002, as the International Training Centre (ITC) for the whole IAEA program. The National Atomic Energy Commission of Argentina and the Faculty of Medicine of the University of Buenos Aires were also designated, in 1999, as the Regional Training Centre for the Latin American region. The objective of the ITC was to train tissue banks operators and medical doctors from all over the world and the RTCs to train tissue bank operators and medical doctors mainly from the Asia and the Pacific and the Latin American regions. Since 1997, training of tissue bank operators and medical doctors were carried out using the modality of distance training courses. However, due to its limitation, this type of courses was transformed, in 2002, in an Internet training course modality, with the purpose to increase not only the number of participants but, at the same time to reduce, as much as possible, the costs associated with the organisation of these courses. Since November 1997, the number of training courses carried out in the RTCs established under the IAEA program was 14, eight of them under the Internet training course modality. The total number of students registered in these courses was 261 and the total number of students graduated was 166 for a rate of approval of 63.6%. The National University of Singapore and the Faculty of Medicine from the University of Buenos Aires are the academic institutions that provide the certificate/diploma to the graduated students.     

The nature of the membrane sites controlling anion permeability of human red blood cells as determined by studies with disulfonic stilbene derivatives

Summary The disulfonic acid stilbene derivative SITS reported to be covalently bonded to the membrane of the red blood cell, was found to be largely reversibly bound. Reversal of its specific inhibitory effect on anion permeability was attained by washing the cells with buffer containing albumin. The small fraction of covalently bonded SITS could be increased by prolonging the time of exposure of the cells or by multiple exposures. A series of other disulfonic stilbene derivatives was synthesized. All of them specifically inhibited anion permeability whether or not they are capable of forming covalent bonds. Their inhibitory effectiveness, however, varied over a 5,000-fold range, allowing certain conclusions to be made concerning the chemical architecture of the binding site. Certain of the compounds were almost entirely covalently bonded. One of them was labeled with¹²⁵I and used to determine to which membrane proteins the compound is bound. Over 90% was found in a protein band on acrylamide gels of 95,000 mol wt. The most effective compound against sulfate permeability was equally effective against chloride permeability, producing a maximum inhibition of over 95%. The residual anion fluxes respond differently to pH and temperature than do the fluxes of unmodified cells.This paper is based on work performed in part under contract with the U.S. Atomic Energy Commission at the University of Rochester Atomic Energy Project (Report No. UR 3490-199) and in part by the Medical Research Council of Canada, Grant No. MA-4665. Z. I. Cabantchik was the recipient of an International Atomic Energy Agency (Vienna) Fellowship.     

Female medical physicists: The results of a survey carried out by the International Organization for Medical Physics

IntroductionThe gender composition of the existing medical physicist (MP) workforce around the world is basically unknown. The International Organization for Medical Physics (IOMP) performed a survey in order to investigate the number of MPs in countries around the world and the percentage of women MPs compared to total number of MPs.Materials and methodsA simple online questionnaire prepared as a Google Forms survey asking the country, the total number of MPs, the number of female MPs and finally the gender of the person providing the data was sent in mid-March 2013 to six regional member organizations of IOMP, as well as contact points in many member countries.ResultsSixty-six countries responded to the survey by mid-July 2013. Fifty two percent of those who filled the form were females, the rest males. The total number of MPs was 17,024, of which 28% were female (4807). The median values of percentages of females were 21% in the USA, 47% in Europe, 35% in Asia, 33% in Africa and 24% in Latin America.ConclusionThis is the first international survey that investigates the number and percentage of female MPs around the world. There are European countries that are far away from the target set by European Commission (40%) whereas in countries in the Middle East and Asia, female MPs actually outnumber males. This study is the first step in a more in-depth study that needs to be taken in near future.     

The European federation of organisations for medical physics policy statement no. 15: Recommended guidelines on the role of the medical physicist within the hospital governance board

This EFOMP Policy Statement presents an outline on hospital governance and encourages the participation of the Medical Physicist in the hospital governance. It also emphasises how essential it is for Medical Physicists to engage in their hospital's governing board's committees for the overall good of the patient.     

An international survey of tissue banking, a preliminary report

International Atomic Energy Agency is currently carrying out a survey on the tissue banking activities from the tissue banking organisations worldwide. The purpose of the survey is to establish regional and global overview of the current tissue banking activities and practices in order to assist the International Atomic Energy Agency to provide further guidance about the use of radiation technology to sterilise tissues as well as to promote better collaboration between the regional tissue banking associations. The survey is an on-going exercise and the preliminary data is presented here. This exercise is not completed and the authors urge the remaining tissue banks to participate in the survey.     

The European federation of organisations for medical physics policy statement No. 13: Recommended guidelines on the development of safety and quality management systems for medical physics departments

This EFOMP Policy Statement outlines the way in which a Safety and Quality Management System can be developed for Medical Physics Departments. The Policy Statement can help Medical Physicists to eliminate or at least minimize accidents or incidences due to improper use or application of medical technology on one hand and on the other to guarantee a safe, effective and efficient usage of new highly complicated and sophisticated technologies and procedures.     

Cardiovascular effects after low-dose exposure and radiotherapy: what research is needed?

The authors of this report met at the Head Quarter of the International Atomic Energy Agency (IAEA) in Vienna, Austria, on 2–4 July 2012, for intensive discussions of an abundance of original publications on new epidemiological studies on cardiovascular effects after low-dose exposure and radiotherapy and radiobiological experiments as well as several comprehensive reviews that were published since the previous meeting by experts sponsored by the IAEA in June 2006. The data necessitated a re-evaluation of the situation with special emphasis on the consequences current experimental and clinical data may have for clinical oncology/radiotherapy and radiobiological research. The authors jointly arrived at the conclusions and recommendations presented here.