Exploring Medical Physics: A Guide for Prospective Graduate Students

[the potato one]

I have just changed my major to physics (and math minor). I'm still not sure what field I will want to study in grad school, but I am most interested in: medical physics and radiology, astrophysics, particle physics, and nuclear physics. Currently, medicine and radiology holds the most interest for me, but I have a few questions about the field:

What classes do graduate schools offering medical physics require, besides the usual physics and math courses?
Will I need to take the MCAT in addition to the general GRE and physics GRE?
What is the difference between getting a master's in health/medical physics and getting a bachelor's in radiology?
For those in the field: Do you enjoy it? Is there anything else I should be considering?
Any other questions, comments, and concerns are greatly appreciated.

Thanks in advance guys!

 

[Choppy]

What classes do graduate schools offering medical physics require, besides the usual physics and math courses?

Most medical physics programs require a bachelor's degree in physics or equivalent and that will usually cover the physics and math that you need (including a mathematical methods for physicists course, senior E&M, an intro quantum course, statistical mechanics, etc.). Just about everything else is optional. Some courses that I would recommend (in no particular order):
- senior laboratory course
- nuclear physics course
- signal or image processing course
- senior computational or numerical methods course
- 1st year biology
- 1st year chemistry and maybe organic chemistry
- anatomy and physiology
- an introduction to medical physics course
Again, these courses aren't mandatory as medical physics students tend to pick up what they need as they go, but having a solid foundation in these subject can certainly give you a leg up on the competition and allow you to concentrate your energy in graduate school in other areas.

Will I need to take the MCAT in addition to the general GRE and physics GRE?

No MCAT. I'm not sure all medical physics programs require the physics GRE either. This will vary by program.

What is the difference between getting a master's in health/medical physics and getting a bachelor's in radiology?

This one is hard to answer because I don't know what a bachelor's degree in radiology is. A radiologist is a medical doctor who specializes in reviewing radiographic images (and other imaging modalities like MRI). An x-ray technologist (which these days will often have a bachelor's degree) is someone who specializes in performing the actual imaging - so that would be the person who set the patient up and operates the scanner. A radiation therapist is someone who specializes in setting up patients to deliver therapeutic radiation - usually for the treatment of cancer.

A master's degree in medical physics is usually a professional graduate program that is the minimum education necessary to work as a medical physicist. The work a medical physicist does depends on the area of specialization: radiation oncology, diagnostic imaging, MRI, or nuclear medicine. In radiation oncology, for example the medical physicist is responsible for the proper operation of the linear accelerators used to deliver the radiation: commissioning, calibration, quality assurance, as well as the implementation and development of new procedures, administration of the networks that run the machines. They play a role in developing treatment plans, often giving input in difficult planning cases or checking to make sure that a plan will deliver what it's intended to deliver. On top of this many of them will do some kind of research. Health physics usually means radiation protection work.

For those in the field: Do you enjoy it? Is there anything else I should be considering?

Absolutely I enjoy it! On the "pro" side, you've got a professional job that can really make a difference in people's lives, new challenges every day. On the "con" side, there certainly are easier careers. My day rarely ends at 5:00 pm and at times the job can be extremely stressful. Often the stress comes because you're the guy responsible for getting something new or something broken to work as it's supposed to within a limited timeframe. And quite often you're in a position to act as a mediator between different disciplines including: physicians, radiation therapists, IT, service engineers, and managers. Career-wise the field is competitive too. Completing a graduate program in medical physics does not necessarily guarantee you a job in the field, although just about all graduates from the programs I've been involved with are working in the field.

 

[the potato one]

Thanks for giving such a detailed and thoughtful response!

I have another question that was brought up to me by a friend: Given the current research into using nanotechnology to deliver a more focused and controlled dose of treatment, will radiation oncology and nuclear medicine remain a viable career option over the next couple of decades?

 

[Choppy]

That's a good question.

There's always a possibility that a magic cure for cancer could be discovered tomorrow, but the same is true in just about any specialized field - a new technology could come along that could render the field obsolete. But this has an extremely low probability in the field of medical physics and radiation oncology.

1. Some of the new nanotechnology-based drugs are allowing us to introduce a delivery system that can specifically target cancer cells with unprecidented accuracy. But you still have a lot of problems, even with targeted drugs that are toxic to cancer cells. Those drugs eventually have to collect somewhere - so you're often limited by toxicites induced in organs like the liver, kidneys, bladder etc.
2. The research "machines" in the pharmaceutical industry have been chasing cancer drugs for years. We're talking billions upon billions of dollars going directly into research, and absolutely brilliant people spending careers studying these things. And while progress is being made, it seems a fairly safe bet that the answer is not going to be a simple one.
3. Cancer is a broad term for many (on the order of 100) different diseases that have similar characteristics. A cure for one is highly unlikely to be a cure for all.
4. From a healthcare perspective: drugs are expensive, radiation is cheap.
5. We're starting to see how radiation can be used as a "substitute" for surgery. One example is in early stage lung cancer where the convential treatment is surgery. But many patients are not candidates for surgery. In those situations there has been a lot of interest in a technique called stereotatic (ablative) body radiation therapy or SBRT(SABR). And we're finding that SBRT has outcomes that are on par with surgery and now there is a lot of interest in directing more patients in this direction as SBRT has fewer complications.
6. Radiation already does a very good job at curing many cancers. So any new development that comes along will (a) have to be significantly better than what's already being done and/or (b) be more socio-economically viable. See point 4.
7. Even if you have a miracle cure for cancer, you still have to detect it. You do this using imaging technologies supported by medical physicists.
8. The single most significant predictor for the incidence of cancer is age, and populations are getting older. Growth in cancer occurance has followed predictions very well in the past.

On top of all of this, one point I like to emphasize to students is that a medical physicist should first and foremost be a physicist (although not all graduate programs in medical physics seem to be set up this way). The reason I say this, it that by developing a strong foundation in physics and developing a skill set that includes problem solving abilities, programming skills, IT and networking skills, electronics and machining skills, proficiency in writing and technical communications, etc. you're in a strong position to retool if ever necessary.

 

[the potato one]

Okay, that's something to think about. I'll definitely be talking about this with my academic adviser in the next couple of weeks. Thanks so much for your help! :D