Medical Physics VS Medical Dosimetry

Gypsie

Can anybody tell me the differences between a clinical medical physicist and a medical dosimetrist?

Choppy

A medical physicist has a much broader scope and higher level of responsibilities. Radiation oncology physicists commission and/or develop new equipment, new treatment approaches, and new software that comes into the clinic and further establish the protocols for using them. They are responsible for developing and maintaining quality assurance programs and calibrating linear accelerators and other equipment used in radiation therapy. They oversee the treatment planning process. They administate the treatment planning software, the simulation software, the treatment software and the network that connects them. They offer consults on complex plans, and check plans before they proceed to treatment. They often also adopt radiation safety roles. On top of all of this, they also do research. They have a background in physics, usually graduate school and a clinical residency.

A medical dosimetrist is generally responsible for individual treatment plans. They are the ones who will do most of the work designing treatment fields, optimizing plans, creating treatment charts, checking plans, consulting with physicians, etc. Some are also tasked with the initial scanning of the patients. They will usually start out as radiation therapists and go through additional training to qualify as a dosimetrist.

Mirin

I'm wondering the same thing as the OP, and this pretty much answers my question. Is medical dosimetry a good field from which work up towards medical physics? For example, if you obtained a master's in health/medical physics and started working as a dosimetrist, would you be eligible to later pursue a Ph.D in medical physics and work your way up?

Choppy

Usually, if you're trained as a medical physicist and want to do just treatment planning, you would work as a medical physicist doing treatment plans, not as a dosimetrist.

What qualifies you for the PhD in medical physics is a background in physics. So if you have an undergradaute degree in physics and then do a masters degree in medical physics, you're qualified to do a PhD in medical physics, even if you go work in a completely different field for a few years first. (Note that "qualified" is not equivalent to "competative.") Some people will, for example, go and work for a company in the field for a few years before completing their education or pursuing a residency.

What you can't do is work your way up from therapist to dosimetrist to physicist.

JHKS

To start, I worked as a physicist in a Radiation Oncology department for a university hospital for 8 years and our Med. Phys. program was a top 5. What has been said on here is MOSTLY true. You're last statement is not however. It is very possible to work from being a therapist to dosimetrist to physicist. It is a ton of work though. ALL of our dosimetrists were required to have been working/licensed radiation therapists for at least two years before beginning their dosimetry training. That being said, everyone does it differently. What makes it so hard is that you have to be trained as a therapist - most places will not want to go the route of OJT - they will want you to go to a training program and most of those want you to have been a licensed x-ray tech before attending but a back ground in physics might do the trick but you better have a good bedside manner or they'll show you the door. After all that you have to get dosimetry training which means OJT and dosimetry school and yes because of ACR guidelines this is necessary and then you'll have to work and study and go to school for medical physics. It's a tough and long route. I recommend going and talking to some people. The AAPM (American Association of Physicists in Medicine) and the AAMD (American Association of Medical Dosimetrists) are both very good about helping prospective students, have a ton of info available and you'll need to be a part of them professionally anyway. There is also ASTRO (American Society for Therapeutic Radiation Oncology) and RSNA (Radiological Society of North America). These two are monstrous organizations because they include Oncologists, Therapists, Nurses as well as Imaging professionals of all types. You can also go to a local hospital/cancer treatment center and see about talking to someone. As with any field, a practicing professional will give you a very good insight in to what you might expect. It's true there are horror stories but it's a great field to be in...and the pay is not bad either. Do a salary survey.

Some places do have another job type that has been called "super-dosimetrist". This is someone who is a trained dosimetrist but has knowledge beyond what a normal dosimetrist has. Typically they have a B.S. in physics and have studied medical physics. You can only get so far without actually going to grad school because enrollment in some courses is exclusive because it's limited...in other words...you will not see clinical time until you get to actually being a dosimetrist but becoming a dosimetrist and taking courses to get a B.S. will greatly improve your career. Dosimetry pays very well as it is.

Oh...just a note about a statement someone else made, most medical physicists have nothing to do with developing new treatment machines/modalities. They do have to commission each new piece of equipment and new software package which can be a massive task.

Choppy

You'll note I said that you can't WORK your way up.

Of course if you happen to be a therapist, go to university and study physics, get a graduate degree in medical physics, work your way through a residency, you can end up as a medical physicist. The reason I phrased it that way was because the question appeared to imply a natural working progression from dosimetrist to physicist.

Choppy

Could you explain this further? It's quite contrary to my experience.

Gruxg

I agree with JHKS.

Developements of new treatment machines or techniques usually takes place in technology companies and some reference hospitals (a few in the world). It needs multidisciplinary teams formed by engineers, IT specialists, applied non-medical physicist, and yes, some medical physicist too. But the percentage of medical physicist involved in new developements is tiny. The vast majority of medical physicist work in commissioning and quality assurance of technology/software developed by others.

Choppy

JHKS said that most medical physicists have NOTHING TO DO with developing new treatment machines/modalities.

I agree that most medical physicists aren't building new linear accelerators in spare vaults in their hospitals. But that doesn't mean they do nothing but commissiong and QA.

Many have ongoing relationships with the companies that are doing these things, doing field testing or beta testing, or identifying and reporting on errors. Outside of any formal agreements medical physicists will also work to characterise the performance parameters of various devices, write software or develop ways to extend the use of conventional technologies beyond their intended use, or run simulations to investigate the possible consequences of adopting new technologies or treatment modalities.

Even the clinical physicist who measures and publishes clinically relevant data on the radiological characteristics of a new type of treatment couch is contributing to the development of that technology.

This being said, I came from a centre where medical physicists were leading multidisciplinary teams to develop a new type of treatment machine.

I'm not necessarily disagreeing with JHKS either. But I am an experienced medical physicist and that statement is quite contrary to my experience.

Diaby2AFC

So it's basically pointless to try to get into a dosimetry program without a radiation therapy background?

ThinkToday

This is an old post and not current. There are other threads discussing this. Short version: go to www.medicaldosimetry.org You will find 3 certified programs for a BS in medical dosimetry: Thomas Jefferson (Philly), CARTI (Little Rock), and MDACC (Houston). Call them for the details of what you would need. Given the length of their programs, it would appear they expect you to handle the base core requirements before hand.

jennykeith

This is so NOT true.

Therapists are trained in house to be dosimetrists. Until recently this was STANDARD. And then the therapist goes on to take their cmd exam and become certified. Maybe takes some additional courses. Only recently have dosimetry programs popped up.

Also, dosimetrists with a background in physics become medical physicists. It's considered a way to get your foot in the door when you don't have an MS in medical physics, but just physics. You work a few years as a dosimetrist then become a junior medical physicist, then a physicist. I've seen it happen many times. You just have to educate yourself.

However, to be an ABR certified medical physicist, you now have to have a residency. But some institutions, especially private, for-profit companies, will hire non-ABR physicists. And you can still work as a physicist to gain experience then go through a residency later to take your boards.

Choppy

Your experience is quite different than mine. In all 3 of the centres that I've worked at, dosimetrists have all started out as therapists who were then trained in dosimetry. I've never seen someone simply accepted into a dosimetrist position because they have a physics background. Nor have I ever seen a jump from dosimetrist to junior physicist. In today's environment such a jump seems improbable to me - not impossible, mind you - but improbable. (Years ago things were very different. There was a time where you could get a medical physics position with a bachelor's degree.) But now there are lots of accredited graduates to chose from. So this is not a career path I would advise a student/recent grad to count on.

By 2014 you will need to have both come through an accredited graduate program and an accredited residency. So for someone looking at starting the process now, it's not just a case of learn as you go and get into the residency when you can. You have to get through the right set of hoops if you want ABR certification.

ThinkToday

In the old days, this was the usual case. There have been dosimetry programs around for years (just not JRCERT), although they didn't require getting a BS. Programs such as http://www.arcphysics.net/ . These programs were geared towards RTR and RTTs to train at a more intense level than the old OJT method.

Like Choppy indicated, I've never seen this in 30 plus years, so your experience is much different than mine. In my experience, Medical Physics in the US has always required a graduate school path. However, graduate school (at least in the 70s/80s) could have been in physics, health physics, biology, etc. (related science). The technology in those days was pretty simple. There weren't any calculations used that couldn't be done by hand with a calculator, ruler, and compass, and techniques were pretty simple. I have seen RTRs and RTTs progress to become Medical Physicists, but only after leaving work and going to graduate school for a Medical Physics degree. In the old days, a Junior Physicist was just a new graduate or sometimes referred to an uncertified medical physicist.

In the US, reimbursements are being more and more tied to accreditation and accreditations are requiring certified staff. Even if you've seen that path work that you mentioned before, it no longer exists to become a Qualified Medical Physicist (QMP). I do know a few companies that will hire a non-ABR physicist very cheaply and have them under the supervision of an ABR certified physicist that would check up on them every week or so. They will usually require ABR certification in 3 years, so the lack of proper education, residency, etc. will eventually catch up with them.