WE-AB-213-01: AAPM Projects and Collaborations in Africa

WE-AB-213-02: Status of Medical Physics Collaborations, and Projects in Latin America

WE-AB-213-04: IAEA Support to Medical Physics in Africa and Latin America: Achievements and Challenges

WE-AB-213-00: Developments in International Medical Physics Collaborations in Africa and Latin America

AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO's), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: 1. Learn about the shortage of qualified Medical Physicists in Africa and Latin America. 2. Understand the reasons of this shortage. 3. Learn about the ways to improve the situation and AAPM role in this process.

WE-AB-213-03: Challenges and Opportunities

Academic program recommendations for graduate degrees in medical physics: AAPM Report No. 365 (Revision of Report No. 197).

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 America2. 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.

PACS number(s): 87.90.+y To the Editor, The American Board of Medical Physics (ABMP) wishes to share information regarding the recent adoption of a Working Agreement with the American Board of Radiology (ABR). As the Working Agreement deals with the certification of medical physicists, we believe it to be important to the clinical medical physicist. This information will be of interest to junior medical physicists, who are about to enter the process or are in the process of board certification, as well as medical physicists who hold ABMP certification. On July 9, 2001, the ABMP unanimously approved and Chairman, Larry Reinstein, Ph.D. signed the Working Agreement on behalf of the ABMP. As the Working Agreement had been previously approved by the ABR, it became effective immediately. The ABMP presented an announcement at the meeting of the Board of Directors of the American Association of Physicists in Medicine (AAPM) on July 26, 2001 in Salt Lake City, UT. The ABR also presented an announcement, and the two announcements and Working Agreement were officially received into minutes. We believe that these documents should be made readily available to all medical physicists by publication in the archival literature. The text of the ABMP announcement is as follows: ABMP Announcement of ABR-ABMP Working Agreement at AAPM Board of Directors Meeting July 26, 2001 The American Board of Medical Physics (ABMP) is pleased to announce that it has entered into a Working Agreement with the American Board of Radiology (ABR) effective July 9, 2001. This Agreement was approved unanimously by both the ABMP and ABR, and it creates an environment in which the two medical physics certification boards can work closely together for the benefit of medical physics. The ABMP believes this Agreement will unify the medical physics community and eliminate the confusion among entry-level medical physicists resulting from the two-board system. Furthermore, it will strengthen the certification process in traditional fields of medical physics by uniting the resources of both boards. Under the terms of the agreement, the ABMP will continue to exist but will no longer offer to new candidates, certification examinations in the traditional fields of medical physics (namely radiation oncology physics and diagnostic imaging physics). The ABMP will focus its future certification efforts in the non-traditional fields of medical physics, currently magnetic resonance imaging (MRI) physics and medical health physics, and in the development of subspecialty certifications, such as cardiovascular physics and neuro-irradiation physics. The ABMP will also retain its ability to rapidly expand into areas of new certification to meet changing needs in the medical physics environment. Although the ABMP will no longer participate in certification in the traditional areas for new candidates, the two boards will participate jointly in the certification of medical physicists. The composition of the certification oversight committees will be equally divided among members appointed by each board. The ABMP will recommend three voting members to be appointed to the ABR Radiological Physics Examination Committee, and the ABR will recommend an equal number of voting members for appointment to an ABMP MRI Physics Committee. The Agreement allows candidates currently engaged in the ABMP certification examination process the option of completing their examination with the ABMP or the ABR. ABMP certified diplomates may apply for, and receive, an ABR letter of certification equivalence. This letter allows them the opportunity to become members of the American College of Radiology (ACR) and to be recognized as equivalent to the ABR diplomates in all guidelines, standards, regulations, and privileges of scientific, professional, and regulatory bodies. The ABR will issue full certification and listing in the American Board of Medical Specialties to any ABMP diplomate having an ABR letter of certification equivalence and having satisfied all conditions of its future Maintenance of Certification program. The ABMP invites and expects the American Association of Physicists in Medicine (AAPM) to become a sponsoring organization. In the near future, the ABMP will modify its bylaws and develop future goals to meet its new strategic direction and role as established with this Agreement. At the AAPM Board of Directors meeting during the 2001 annual meeting of the Radiological Society of North America (RSNA), the ABMP will invite the AAPM to become a sponsoring organization and will request moderate funding assistance for its new mission. The ABMP wishes to recognize the ABR physics trustees for their persistence and constructive demeanor throughout the negotiating process, which began at last year's AAPM annual meeting. We also thank the AAPM and its president, Charles Coffey, for hosting the meetings of the two Boards' representatives and for continued encouragement and support throughout the process. This Agreement is an extraordinary event in the history of medical physics. It is the sincere hope of the ABMP that the spirit of cooperation and goodwill that prevailed during these negotiations will infuse the medical physics community, so that we can all work together toward the advancement of our profession. The text of the ABR-ABMP Working Agreement is as follows: WORKING AGREEMENT AMERICAN BOARD OF RADIOLOGY and THE AMERICAN BOARD OF MEDICAL PHYSICS, INC. June 4, 2001 This agreement is effective as of this day of July, 2001 by and between the “parties” herein defined as the American Board of Radiology (ABR), a not-for-profit corporation with principal offices located at 5255 E. Williams Circle, Suite 3200, Tucson, Arizona 85711-7409 U.S.A. and The American Board of Medical Physics, Inc. (ABMP), a not-for-profit corporation with its principal office c/o Dr. Herbert Mower, Lahey Hitchcock Medical Center, 41 Mall Road, Burlington, MA 01805. WHEREAS ABR and ABMP each certify medical physicists; WHEREAS ABR and ABMP mutually agree that the process of certification of medical physicists should be defined and administered by board-certified medical physicists; WHEREAS ABR and ABMP mutually agree that having a single certification board for each field and subspecialty of medical physics will reduce confusion of medical physicists and the public; WHEREAS ABR and ABMP agree that having a single certification board for each field and subspecialty will increase efficiency of the process of certification of medical physicists; WHEREAS ABR and ABMP also agree that having a single certification board for each field and subspecialty will increase the stature of certification to individuals obtaining it; and WHEREAS ABR and ABMP mutually agree to work together from the date of this agreement forward to achieve and maintain a single certification board for each field and subspecialty of medical physics; NOW, THEREFORE, for and in consideration of the mutual covenants set forth in this agreement, it is agreed by and between the parties as follows: This agreement embodies and describes an intent of ABR and ABMP to work cooperatively to achieve shared objectives with regard to certification in medical physics. Specific terms of cooperation described in this agreement represent the initial objectives of cooperation between the parties; cooperation will continue towards the goal of continually improving the certification of medical physicists after the initial objectives have been achieved. The parties acknowledge that the spirit of cooperation evidenced in this agreement represents a long-sought goal that supports the public interest and the professional standards of medical physics. Traditional fields of medical physics include the areas of radiation therapy physics (therapeutic radiological physics), diagnostic radiology physics (diagnostic radiological physics), and nuclear medicine physics (medical nuclear physics). After the July 21, 2001 examination, the ABMP will no longer offer the Part I Written Examination for new candidates in the traditional fields of medical physics. All new candidates for certification in these areas must apply to the ABR. Candidates engaged in the ABMP certification process after the July 22, 2001 ABMP examinations may continue the ABMP certification process. Candidates engaged in the ABMP certification process, who have passed Parts I or II, may transfer into the corresponding stage of the ABR certification process. ABMP oral examination candidates who have conditioned in the one or more areas and transfer to the ABR oral examination process must take the full ABR oral examination. Non-traditional fields of medical physics include independent areas of medical physics certification other than traditional fields of medical physics. The ABR will not examine medical physicists in non-traditional fields of medical physics in which the ABMP offers certification by examination, and similarly the ABMP will not examine medical physicists in non-traditional fields of medical physics in which the ABR offers certification by examination. The ABMP presently certifies medical physicists in three non-traditional fields of medical physics: hyperthermia physics, medical health physics, and MRI physics. In exception to 4.2 the ABR may offer certification by examination in MRI physics five years after the effective date of this agreement. The ABMP will provide the ABR with equal participation in its non-traditional certification examination in MRI physics. Equal participation is defined as providing the ABR with equal representation of voting members on an ABMP committee, which is responsible to the ABMP for conducting examination for certification. The ABR members will be selected by the ABMP from nominees submitted by the ABR. The ABR will submit 2 nominees for each member to be selected by the ABMP. Subspecialty certification examinations shall require certification by the ABR or by the ABMP in a traditional or non-traditional field of medical physics. The ABMP retains the right to develop subspecialty certification examinations (e.g. in cardiovascular or neuro-irradiation physics). The ABR will not certify in subspecialties of medical physics. Medical physicists certified by the ABMP in a traditional field of medical physics will, upon written request, receive a letter of certification equivalence from the ABR stating that ABMP certification is equivalent to ABR certification in the same field. The letter of certification equivalence will be available for 5 years from the date of this agreement. The ABR acknowledges that ABMP diplomates with a letter of certification equivalence in a traditional field of medical physics should be recognized as equivalent to ABR diplomates (in the same traditional field) in all guidelines, standards, regulations, and privileges of scientific, professional, and regulatory bodies. The ABR has been informed by the American College of Radiology (ACR) that medical physicists receiving a letter of certification equivalence will be eligible for membership in the ACR on the same basis as medical physicists certified by the ABR (see Attachment A). Each medical physicist certified by the ABMP will be eligible to participate in the recertification program of the ABMP. Those ABMP diplomates who attain the ABR letter of certification equivalence after December 31, 2002 will be required to participate in the ABR's Maintenance of Certification program in order to maintain the letter of certification equivalence. Any ABMP diplomate with a letter of certification equivalence is eligible for the ABR's Maintenance of Certification program. If all conditions for maintenance of certification are satisfied, these physicists will be awarded an ABR certificate and placed in the listings of the American Board of Medical Specialties. Membership: Consistent with Article VIII, Section 5 of the ABR Bylaws, this agreement establishes that the voting members of the Radiological Physics Examination Committee shall consist of the three ABR Physics Trustees and an equal number of members from the ABMP. The ABMP members will be selected by the ABR from nominees submitted by the ABMP. The ABMP will submit 2 nominees for each member to be selected by the ABR. Parties of this agreement recognize that termination by the ABMP of certification of medical physicists in traditional fields of medical physics will cause financial hardship to the ABMP for a 3-year transition period (July 1, 2002 to June 30, 2005). The ABR agrees to provide transition compensation to the ABMP over three years for lost revenue caused by this termination of certification. Compensation shall be as follows: a first payment of $15,000 by September 30, 2002; a second payment of $15,000 by September 30, 2003; and a third and final payment of $15,000 by September 30, 2004. No other payment or compensation for any purpose shall be paid by the ABR to the ABMP. The intent of both parties is to continue to cooperate to improve the process of certification of medical physicists after the specific terms of the agreement have been satisfied. The intent of both parties is to continue to cooperate to improve the stature of certification of medical physicists. This shall include, but is not limited to, the ABR and ABMP encouraging the ACR, American College of Medical Physics (ACMP), American Association of Physicists in Medicine (AAPM) and other similar professional organizations' inclusion of ABR and ABMP medical physics certification in appropriate standards and definitions of medical physicists. The intent of both parties is to continue to cooperate to improve the unity of the process of certification of medical physicists. (The Working Agreement was signed by Robert R. Hattery, M.D., President of the American Board of Radiology on June 10, 2001 and by Lawrence E. Reinstein, PhD., Chairman of The American Board of Medical Physics, Inc. on July 9, 2001.) Medical physicists who are ABMP diplomates or are in the process of ABMP certification examination will receive a mailing that includes the material presented here as well as a Frequently Asked Questions document that will continue to evolve and will be available on the American College of Medical Physics web site (www.acmp.org). Thank you for allowing the ABMP to share this information with practicing medical physicists through the JACMP.

Review of true tales of medical physics: Insights into a life‐saving specialty, edited by Jacob Van Dyk

IAEA Support to Medical Physics in Nuclear Medicine

BackgroundMedical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics.ConclusionsPublished recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral responsibility to effectively transpose Basic Safety Standards into national legislation in order to ensure high quality and safety in patient healthcare.

<sec><p indent="0mm">This paper aims to outline the current status, major development directions, and challenges faced in the field of global medical physics, with a focus on education, certification, and technology. Based on the organizational structure of the International Organization for Medical Physics (IOMP), the paper explores the different characteristics and challenges of medical physics development in Europe, the Asia-Pacific region, and Africa from a regional perspective. These regions represent different stages of global medical physics development and highlight the importance of regional-based international cooperation in advancing medical physics. While these regions face unique issues, they also share the common goal of improving medical practices through the advancement of medical physics. </sec><sec> In countries with matured medical physics development, the United States, the United Kingdom, and Japan are representative. The United States trains highly specialized medical physicists through rigorous education systems, clinical residency programs, and certification processes, ensuring the safety and precision of clinical practice. The integration of research and clinical applications in the United States enables the country to remain at the forefront of technological innovations in medical physics. The United Kingdom has played an important role in the development of radiotherapy technology. Despite challenges such as equipment and human resource shortages, it is actively expanding training programs to meet healthcare demands. Moreover, the United Kingdom has focused on making radiotherapy treatments more efficient and accessible, adapting to evolving patient needs and technological advancements. Japan demonstrates a leadership role in technology within the Asia region, vigorously promoting certification systems and establishing professional status. Japan’s commitment to integrating cutting-edge technology with clinical practice has placed it in a leadership position, particularly in the fields of diagnostic imaging and charged particle radiation therapy. </sec><sec> As a rapidly developing country, China has made significant progress in the field of medical physics. It is actively enhancing the medical physics education system, strengthening international cooperation, advancing discipline construction, and accelerating talent cultivation. China’s investment in research and development, as well as its emphasis on cross-disciplinary collaboration, has fueled rapid advancements in the field. Although there is still ample room for improvement in educational standardization and resource allocation, China is continuously narrowing the gap through reform and innovation. The country is also making strides in developing its advanced medical technologies and is increasingly becoming a key player in the global medical physics landscape. </sec><sec> By comparing the practical experiences of different regions and countries, this paper aims to deepen the understanding of the global development trends and future challenges in medical physics, emphasizing the importance of international collaboration and knowledge sharing. The study underscores how each region’s unique challenges—whether economic, technological, or educational—can be addressed through collaborative initiatives that foster mutual learning and advancement. By optimizing educational resources, promoting advanced technology, and enhancing standardization, countries can accelerate the narrowing of development gaps, collectively meet the growing global demand for high-quality healthcare services, and promote the sustainable development of medical physics. Such efforts will ensure that medical physics continues to evolve in line with the needs of an increasingly interconnected and globalized healthcare environment. </sec>

Medical physics graduate programs should adjust enrollment to achieve equilibrium between graduates and residents

The questionnaire survey was conducted in 2020 to investigate the working conditions of qualified medical physicists in Japan. We developed a web-based system for administering the questionnaire and surveyed 1,228 qualified medical physicists. The number of received responses was 405. We summarized the results of the survey by job category. The obtained results showed that most of the people working as certified medical physicists met the following conditions: (1) position of healthcare occupation, (2) direct supervisor is a medical doctor or a medical physicist, (3) licensed or passed an examination for a Class I Radiation Protection Supervisor, (4) without the license of professional radiotherapy technologist, (5) master's or doctor's degree, (6) being assigned to the section that is different from the radiological technologist section. The average annual salary was approximately 600,000 yen higher for those employed as medical physicists than for those employed as radiotherapy technologists. The percentage of work performed by a certified medical physicist in radiation therapy greatly varies depending on whether the physicist is dedicated to treatment planning and equipment quality control. Alternatively, the proportion of the true duties of medical physicists in charge of radiation therapy, as considered by qualified medical physicists in radiation therapy, was the same regardless of whether they were working full-time or not. The results of this survey updated the working status of certified medical physicists in Japan. We will continue to conduct the survey periodically and update the information to contribute to the improvement of the working conditions of medical physicists and policy recommendations.

The Abt study of medical physicist work values for radiationoncology physics services, Round III is completed and was published in May of 2008. It supersedes the Abt II study of 2003. The 2008 Abt study measured qualified medical physicist (QMP) work associated with routine radiationoncology procedures as well as some special procedures. In the intervening years between Abt II and Abt III, medical physics practice has changed. Image‐guidedradiation therapy and image‐guidedstereotactic radiosurgery along with respiratory gating are emerging radiationoncology technologies. High dose rate afterloading brachytherapy is an important special procedure with a significant component of medical physicist work. These procedures emphasized the need for an updated work and staffing study for qualified medical physicists. As before, a work model was created to allow the medical physicist to defend QMP work based on both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiationoncology physics services. Additionally, staffing patterns were surveyed and reported for a variety of practice settings. The work and cost justification models may in turn be used to defend medical physicist staffing and compensation. The Abt study round III was designed to empower the medical physicist to negotiate a service or employment contract with providers based on measured national QMP work force and staffing data. EducationalObjectives: 1. Understand the information documented in the Abt studies. 2. Understand what new information was provided in the Abt III study. 3. Understand how to use the Abt studies to justify medical physicist work and staffing