# Medical Physics future job outlook?

• Physics
So, I'm a quasi-junior undergraduate right now. Essentially, I was planning on transferring to NYU for physics, but over the summer I decided not to because of the crazy loans I'd be taking out, and as of right now I'm taking an Anatomy and Physiology class and Organic Chem class at a community college. Assuming I get into it, I'm planning on going to Stony Brook University to finish my undergrad, and am, right now, thinking about going into medical physics afterward. Anyway, I'm a stupid, ascurred young person and have a lot of questions.

My biggest fear is concerning the future job market. I'm guessing it'll take about 7 years from now until I graduate with possibly a PhD and do a residency, so obviously the state of the current job market doesn't mean much. Like everyone before me has said, I've heard extremely contradicting stories. My uncle, for example, is really the one who started talking to me about medical physics. He's a radiologist and knows a few at the hospital he works at and pretty much told me as a medical physicist I'll have a job and have money. But then I'm hearing horror stories about newly graduated medphysicists who can't find a job anywhere. I don't care really so much about the money, just the availability of jobs. I think I would prefer working as a clinical MP and honestly that sounds easier to get a job in than research, but does anyone have any opinions about how it's gonna look in like 7 years? I've heard a lot about the baby boomers retiring soon and everything but yea, just want to hear people's opinions.

Another fear I have is getting into the graduate programs themselves. Really, the biggest reasons I chose Stony Brook as the school that I want to go to next semester is that it's a public school and that it has its own medical physics program (CAMPEMP accredited). I was wondering if people could post their "stats", I guess, from when they applied to the grad schools (undergrad GPA, GRE scores, etc.). Also, not that it's the only one I want to go to (honestly I wouldn't mind going to any CAMPEMP accredited school), but would be going to Stony Brook for undergrad give me a better chance to get into its own grad program over someone who didn't?

Anyway, thanks to anyone that responds. You have no idea how stressed I am about all this ***. When I first got out of high school, my dream was to do research in astrophysics. hahahaha I'm such an idiot. I'm just afraid that I'll get a ridiculous amount of schooling but will end up working at McDonald's or some ***. Dassa my life.

Also, if anyone has any opinions from experience, what would you suggest I do with my 2 years of undergrad physics? Just curious.

https://www.physicsforums.com/insights/become-medical-physicist-3653-easy-steps/

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Projections are for about twice as many medical physicists as there are currently graduating from accredited programs. Many of the positions projected to open are from retirements of people like me that have been around for 30+ years. The path for most going clinical will be the DMP, which is an MS (2 years) with two years clinical training. Some will go PhD, but unless you are going to a large facility (MSKCC, MDA, etc.), it will mean little. PhDs are great, but in a practical smallish clinical setting, there isn't much more they bring to the table. The tricky part of medical physics is the serious shortage of accredited residency slots. By the time you graduate, that should resolve or there should be some temporary fix in place. Much of the supply/oversupply stuff you here about is a result of a bunch of physicist imports coming to this country and working dirt cheap. I know several that make less than my dosimetrist. The future DMP requirement to sit for ABR will kill off nearly all of that problem. I'm not sure, but I think McGill (Canada) is the only non-US accredited MP graduate program. While it doesn't pay as well for an inhouse person, you can make a good living in diagnostic MP. The push by CMS for ABR accreditation of more and more diagnostic radiology equipment (mammo, CT, MR) should boost demand in that area.

As a final note. There are MDs with PhDs, PhDs with JDs, etc. There's nothing stopping you from getting a DMP and a PhD in Astrophysics.

Choppy
No one can tell you with certainty what the job outlook for anything will be in 7 years. What medical physics has in its favour (purely from a professional point of view) is the fact that the general age of the population is increasing and that's expected to increase the incidence of cancer by about 40% over the next decade. Thus, the demand for treatment facilities and staff should follow. There are lots of plans for new cancer centres over the coming decade. In my own province (Alberta) there have been 2 larger centres for a long time, but one new centre opened last summer and two more are planned to be constructed in the near future.

Currently the economy is slow and healthcare has not been immune. So a lot of places haven't been hiring at the rate that they need to. I suspect what will happen is that once things pick up (and remember healthcare tends to lag behing everything else by about a year) there will be a lot of hiring again.

As for getting into an accredited program, I can tell you that it's very competative and is likely to continue to be. The only advantage of going to a school as an undergrad that you want to get into as a graduate student is perhaps the opportunity to do a senior thesis project in medical physics that will get you a good letter of reference from a professor in the program.

I have some strong disagreements with ThinkToday's statements - perhaps not in fact, but in opinion.

The path for most going clinical will be the DMP, which is an MS (2 years) with two years clinical training.
The Doctor of Medical Physics program is a program that to my knowledge only exists in one or two schools (out of 35 accredited institutions). It has its advantages, but does not have a strong research element to it, which in my personal opinion is very bad for the profession. Candidates applying for jobs with this background will be less competative than those with PhDs or even research-based MScs. The only possible advantage they will have is that they may be willing to work for less money.

Some will go PhD, but unless you are going to a large facility (MSKCC, MDA, etc.), it will mean little. PhDs are great, but in a practical smallish clinical setting, there isn't much more they bring to the table.
I disagree strongly with this statement. For a student considering his or her options, the PhD gives you a stronger background in research. There is a growing concern (as discussed at the AAPM Meeting's President's Symposium this summer) that physicists who do not perform research will slowly be replaced by more advanced radiation therapists who can perform QA and check plans.

I'm not sure, but I think McGill (Canada) is the only non-US accredited MP graduate program.
Of the 35 CAMPEP-accredited programs, 9 are Canadian.

I strongly agree that getting your undergraduate degree in a school with a graduate program is the smartest choice.

As for the DMP, put it this way. A DMP is a two year degree from a CAMPEP program with a two year CAMPEP residency. In 2012, ABR will require CAMPEP to sit for boards. In 2014, ABR will require CAMPEP residency to sit for ABR boards. The CARE Bill is coming that will require ABR certification of medical physicists (in the US). The DMP degree just gives a "special name" to the education/degree/training that will be required. I don't care for the DMP name, but the requirements still stand. In 2014 you will have four years in a CAMPEP education and residency, and you can call the degree whatever you want.

Yes, the AAPM is concerned about research, but for the most part, research doesn't pay the bills. In non-academic settings in the US, the concerns are providing quality care and staying ahead of the government cost cutting efforts. Research is overhead. Paying more for a PhD is overhead, when a "DMP" can do the same clinical work for less.

It would be naive to ever think an "advanced radiation therapist" would replace a medical physicist. CARE Bill, State licensure laws, State machine registration and RAM requirements, liability, Rad Onc input, etc., etc., would never allow it.

I stand corrected on the number of CAMPEP programs outside the US. The AAPM website was down when I first posted, so I couldn't check. I knew McGill's program had been around for years and they were an early CAMPEP program.

If you want the PhD, that's great. Best wishes.

As for the DMP, put it this way. A DMP is a two year degree from a CAMPEP program with a two year CAMPEP residency. In 2012, ABR will require CAMPEP to sit for boards. In 2014, ABR will require CAMPEP residency to sit for ABR boards. The CARE Bill is coming that will require ABR certification of medical physicists (in the US). The DMP degree just gives a "special name" to the education/degree/training that will be required. I don't care for the DMP name, but the requirements still stand. In 2014 you will have four years in a CAMPEP education and residency, and you can call the degree whatever you want.

Admittedly, I don't know a whole lot about the present state of the DMP programs, but I know back when they were being discussed as a possible solution to the residency crisis it was discussed that DMP students might be expected to pay their own way through all four years of training at rates equal or comparable to those of medical schools.

Going with the M.S. you might have to pay for two-years of school and then earn PGY-1/2 salaries during your residency ($40-55k). Going with the Ph.D. you will most likely be supported financially throughout your Ph.D. studies and then paid PGY-1/2 rates during the residency. Going with the DMP you might pay expensive tuition all four years and graduate 150k+ in debt just for graduate training. If that is still accurate then that is a point worth mentioning to aspiring medical physicists. The residency issue stands regardless of the degree being a DMP or called something different. Since the 2014 requirement for the residency must be at a CAMPEP residency program, that kills all of opportunities for the old fashion OJT route when you got paid as a "junior physicist". I doubt AAPM and ABR will reconsider, but I would have hoped they would have left open the OJT route at approved facilities (perhaps under CAMPEP's eye) for a "scope of practice" residency appropriate for the facility. e.g. If the facility only does routine, 3D, IMRT, and HDR, let the "student"/junior physicist satisfy the requirements to work/OJT in those areas under the DIRECT supervision of an ABR physicist. I think the bulk of your concern has to do with paying to learn and getting in debt. So long as there are "X" residency slots and "X" plus 100% people for them, competition will allow the host residency program to do/charge whatever they want! IMO, that is a major flaw in the system and maybe even a confict of interest. The MD residency pays the doctor, and I see no reason an MP residency should be treated differently, i.e. they should get paid. As a practical matter, unless you are going out of state and can't get a TA or RA job, which gives you in-state status at many schools, you should never have$150k+ debt.

Choppy
I don't think anyone is arguing against the situation that the ABR's requirement for a CAMPEP residency is creating. For anyone seriously looking at a career in medical physics, the plan should contain an accredited residency. I agree with this completely.

ThinkToday makes some good points about the DMP program. So long as there is a demand for the program, people will be willing to pay for it.

However, unless I'm missing something about the program, making someone pay to be a resident is downright exploitation. Residents, while receiving clinical training, provide valuable services to their centres. Within a month or two of starting they are doing basic QA work. By the end of the program, they're commissioning machines, checking charts, pushing clinical and/or research projects forward. Just like any other apprenticeship, they contribute while learning.

Unfortunately, I don't see the DMP going away, but I don't think it will be the (exclusive) way of the future either.

As a practical matter, unless you are going out of state and can't get a TA or RA job, which gives you in-state status at many schools, you should never have \$150k+ debt.

Do current DMP programs offer these opportunities? I haven't paid attention to how the current programs are actually handling their DMP students financially, I'm only going by the discussions that took place when the idea of the DMP was first being thrown around. At that time it was said that DMP students would pay (not be paid) for four years of DMP work at rates comparable to that of medical schools.

If DMP tuition is the same as medical school then it seems to me that 150k in debt would not be difficult to accumulate.

If you are an in state student, you get a very big tuition break. The break is larger for public colleges and universities (in my experience).

Usually, getting a grad student RA job gets you a little pay, but mainly it usually gets you in state tuition status. I.e. cheap tuition. Generally, you work helping a PhD on a thesis project. You could be anything from a partner to a flunky. My RA position involved modifying FORTRAN Monte Carlo code and some materials work (not a flunky). TA positions can be a bit tricky. Since you'd be involved as a teaching assistant, you really need to have a handle on the equipment and material. My undergraduate TA job was as a lab assistant for the physics department. I had to help others with solid state, atomic, nuclear, etc. experiments, giving advice, preventing electrocution, preventing equipment damage, etc.

I came out of school many years ago. The DMP residency "pay or be paid" discussion is still in flux. There was a thread on the AAPM BBS that included input from people that run programs. But, as others have noted, the paint isn't dry yet on how this DMP will all look in the end. There may never be a “DMP requirement”, but the 2 year MS and 2 year residency requirement is on track to be the minimum. I have issues with the entire residency system when discussed as "school". To me, school is school and residency isn't the same as school. For example, Medical students have 4 years college, 4 years Medical "school", and residency... not residency "school". Medical School and Residency are completely separate and often at different institutions. MD Residents produce a work product and they get PAID. If the MP Resident is going to produce a work product, they should be PAID and not paying, IMO.

Write every CAMPEP residency program for information on their program, and give them your polite input. You will be able to get a feel for what is happening and what they may be thinking. If you aren't a student member of AAPM or ACR, JOIN. Send your input to AAPM and ACR. Post on the AAPM BBS.
I’m done with school, so this is your battle. You don't get to complain if you don't participate ;-)

I'm not a student, aspiring or otherwise. I am a full-time practicing clinical medical physicist.

I'm only making a point about the financials of Ph.D. / M.S. study + residency versus my understanding of DMP study. From a financial standpoint, I can't understand the desire to pursue the DMP given the other options...unless you want to be called "doctor" without paying your dues in research.

It's been pretty clearly stated the DMP is NOT a doctorate (PhD) title. It's a professional "sort of doctorate", and not a true research doctorate. Most of these programs seem to have a token amount of research, e.g. a mini-project. Here's a good link on the topic. http://www.mdphysics.com/new-abr-certification-rule/

That was my point.