Physics Medical Physics is an exciting field

[Choppy]

You'd be hard-pressed to convince me that under any circumstances in medical physics are graduate level QM, E&M, statistical mechanics, quantum field theory or classical mechanics applicable.

Something else that a lot of people only learn with time is that a field like medical physics isn't static. The technology in use now is not going to be the technology in use for the rest of one's career. We can train our new students very well in the technology we have, but no one can tell the future. The best means we have for preparing ourselves for the unknown is to hammer home the fundamentals.

Anyway, let the graduate programs decide who they think is qualified for their programs.

Yes. Let's. And while we're at it, let the senior physicists in medical physics departments decide who they think is qualified for their jobs..

 

[qball]

From dictionary.com:
phys·i·cist (fĭz'ĭ-sĭst)
n. A scientist who specializes in physics.

From AIP:
http://www.aip.org/careersvc/pify/yellow.html

From Wikipedia:
A physicist is a scientist who studies or practices physics. Physicists study a wide range of physical phenomena in many branches of physics spanning all length scales: from sub-atomic particles of which all ordinary matter is made (particle physics) to the behavior of the material Universe as a whole (cosmology).

From CAP: (requirements for professional designation as a physicist)
http://www.cap.ca/cert/req.asp

I would be glad to see some references supporting the 'qball' definition of physicist.

You just listed them. None of them say, "technician."

The CAP site is a ****ing joke, by the way. Be of good character? Hey, guess Feynman wasn't a physicist by YOUR definitions...

 

[qball]

Something else that a lot of people only learn with time is that a field like medical physics isn't static. The technology in use now is not going to be the technology in use for the rest of one's career. We can train our new students very well in the technology we have, but no one can tell the future. The best means we have for preparing ourselves for the unknown is to hammer home the fundamentals.


Yes. Let's. And while we're at it, let the senior physicists in medical physics departments decide who they think is qualified for their jobs..

I didn't say you weren't qualified, I just said you weren't a physicist. I'm sure you're an excellent "medical physicist."

 

[symbolipoint]

Would all the medical physicists reading this thread please tell your definitions of "medical physicist" and how your job conforms to the meaning/definition? I ask this after now reading the posts between Choppy and qball.

Some people seem to misinterpret the meaning of "technician". A technician might be albe to do and understand an unpredictable variety of specific things. The word, having only the most general of reliable definitions on its own, is very imprecise. I have seen job advertisements for "technician" with the stated educational qualifications fo PhD. Too, I've seen some "technician" job ads listing qualifications as "M.S. degree and 5 years experience". I really do not know how all this relates to medical physics, since I am not one, nor am I any physicist. Still, if any medical physicist is titled in his job as "Technician", he may very well have a bachelor's degree or higher. There is nothing bad about having elaborate technical skills and conceptual decision-making power while also functioning in a job as a technician. Along this line, a technician may also be either a scientist or an engineer.

 

[qball]

Would all the medical physicists reading this thread please tell your definitions of "medical physicist" and how your job conforms to the meaning/definition? I ask this after now reading the posts between Choppy and qball.

Some people seem to misinterpret the meaning of "technician". A technician might be albe to do and understand an unpredictable variety of specific things. The word, having only the most general of reliable definitions on its own, is very imprecise. I have seen job advertisements for "technician" with the stated educational qualifications fo PhD. Too, I've seen some "technician" job ads listing qualifications as "M.S. degree and 5 years experience". I really do not know how all this relates to medical physics, since I am not one, nor am I any physicist. Still, if any medical physicist is titled in his job as "Technician", he may very well have a bachelor's degree or higher. There is nothing bad about having elaborate technical skills and conceptual decision-making power while also functioning in a job as a technician. Along this line, a technician may also be either a scientist or an engineer.

I am in medical physics, and my definition of a physicist doesn't include what I do.

 

[HungryChemist]

Very interesting discussion. First of all, let's say both Choppy and qball is doing their best to represent their own personal views regarding the profession called 'medical physicist' and this is very educational and fulfilling the purpose of internet forum. So I thank you both. Hearing from Choppy, I can only guess he is up in the ladder of this medical physics community(pass the board and all, congrat!) while qball only began his carrier. Perhaps, the disagreement b/t them is only natural since they're in different stages of their carrier path.

I'm also a medical physics student at an well-known CAMPEP accredited program and I did finish a lot of didactic courses work while participating research actively. So let others hear my opinions regarding what's been discussed so far by Chubby and qball.

Regarding whether or not medical physicist is real physicist. In my personal opinion I must back qball in saying that medical physicist is not physicist (in academic sense) for the reasons qball stressed so much already. Now, I'm sure there are some great physicist working as a medical physicists (or used to be great physicist either by education or their previous work), but being a medical physicist doesn't automatically mean that you are a physicist (it's not backward compatible!).

Of course, everyone's definition of being physicist is little different. But I must say, making medical physicist a subset of physicist is almost equivalent to making TV repair technician a subset of electrical engineer. Heck, I could even call a high school kid taking physics class a physicist just because he's applying laws of physics to solve his physics problem? But it really doesn't matter what the two medical physicists (I reckon one's a student yet) here say on how they should call each other. What matters is what others think of medical physicist (again personal opinion).

Let's do some thought experiment. Can you imagine a typical physics department hiring a medical physicist (let's say someone who has Ph.D. in medical physics from CAMPEP) to do any of typical physics research work that gets published in any of typical physics journals like physics reviews? I myself certainly can't. Can you imagine a typical physics department hiring a medical physicist to teach Quantum Mechanics class or even an general physics class? Again, I can't.

For all practical purpose, let's just call medical physicist a medical physicist and physicist a physicist and don't mix them up.( but if the physicians want to call us by physicist, we let them, just because physicist sounds much smarter than medical physicist).

Now, back to qball's comment about medical physicist just being "Glorious Tech". I think that was unfair call for all the medical physicists out there who strive to investigate and research to improve the clinical outcome and even advance the field of medicine as well as some of its involved engineering fields( EE, NE, and what not, but definitely not HEP). I can only infer qball meant the word for clinical physicist who is not involved in any type of research activity. But still, we should call them by clinical medical physicist.

 

[Choppy]

I still strongly disagree. A medical physicist is first and foremost a physicist.

In your thought experiment, you seem to have somehow equated "physics professor" with "physicist." I would agree that all physics professors are physicists, but I would not agree that all physicists are professors. Just because one doesn't teach quantum mechanics, doesn't mean one is not a physicist. (For the record, however, I could certainly imagine PhD graduates from the CAMPEP programs I am familiar with teaching at these levels if they chose to do so, based on having taken the same level of E&M and QM as every other PhD student in their physics departments and having passed qualifying/candidacy exams.)

Secondly, I don't understand what's practical about refusing to call yourself a physicist. If you don't want that title, then that's fine. But don't tell me that I can't use it and don't limit an ENTIRE PROFESSION because of it. Like qball, you're a student and you have limited scope of what it means to be a practicing physicist - even if you have taken some courses in a CAMPEP program.

One day, if you continue in medical physics, you're going to be working with radiation therapists and treatment planners. What makes you, as a medical physicist, different from them? The answer is your background in physics. If medical physicists ever forget that, our profession will disappear.

 

[SbF5]

It is true that we don't use differential equations or advanced E&M or quantum every day in the clinic. But they come up in research, or when you're given a problem in the clinic that the "technicians" (dosimetrists, radiation therapists, imaging technicians), engineers, trades, and physicians can't solve.

One of the problems my research group is interested in for example is combining a linear accelerator with an MRI unit. Try solving some of the RF issues that come up without any background in E&M. Or for that matter try designing any of your own equipment beyond simple phantoms. I have many days where I wish I had a stronger background in electrical engineering.

Or what if a physician asks you to perform a BED (biologically equivalent dose) calculation that accounts for aspects of tumor proliferation that aren't covered in the "standard" formulas? If you have to tell the physician that they had better call a "real" physicist, who took a differential equations class, then you're not doing your job.

Choppy; I enjoy your posts. Could you give some more detailed examples from your work where you used trainning in mathematics or physics to solve the problem (an unusual problem where the trainning was useful)? I'm curious at what level a person needs to be in these areas to really be effective in the clinic.

 

[HungryChemist]

In your thought experiment, you seem to have somehow equated "physics professor" with "physicist."

No, I didn't. I simply picked physics professor in my thought experiment because they are mostly physicist (you and I both agree to that one) As it is with any experiment, I simply chose one design over the other to test. I could have as well chose 'semi-conductor research lab looking for a physicist' which again, a person with didactic medical physics education/work background would not be (in general) a good candidate. (Now, don't go on and saying that you and others you know can definitely do semi conductor physics research, because I know, since I believe you, but I'm talking in general!)

I would agree that all physics professors are physicists, but I would not agree that all physicists are professors.

I did not said all physicists are professors. You can't disagree with me on the things that I did not claim.

Just because one doesn't teach quantum mechanics, doesn't mean one is not a physicist.

Again, I did not say that.

(For the record, however, I could certainly imagine PhD graduates from the CAMPEP programs I am familiar with teaching at these levels if they chose to do so, based on having taken the same level of E&M and QM as every other PhD student in their physics departments and having passed qualifying/candidacy exams.)

Again, let me remind you that most of existing CAMPEP program dose not require any of graduate level physics classes. Many of ABR approved physicists never had physics education at the level that is equivalent to graduate level physics degree. So, while I fully admit that you and your colleges can indeed teach physics courses at the graduate level and all, there are many fully qualified medical physicist(who are great at what they do) but who can't teach graduate level physics(myself included). And this is no way of degrading or looking down on any of the medical physicists who can't. I'm simply acknowledging that our professional training and education as a medical physicist is quiet different from that of typical physicists.

Secondly, I don't understand what's practical about refusing to call yourself a physicist.

Well, its practical because by calling different name for medical physicist, we acknowledge our training and skills are very special, and indeed unique from general physicists. For all practical purpose, this is why when radiation oncology department post their job opening to fill a clinical medical physicists they will (and should) say medical physicist wanted rather than physicists wanted. This not only eliminates some confusion to general physicists wondering about the job position, it also gives sense of special professionalism for medical physicists.

But don't tell me that I can't use it and don't limit an ENTIRE PROFESSION because of it.

Again, I did not say you CANT call yourself a physicist. Whether you're a physicist or not is not my concern. My concern was to whether or not the term medical physicist should be considered subset of physicists. And again, you make it sound like I'm against my own profession. I'm a medical physicist want to be. That is why I'm spending significant youth of my life studying the didactic courses as well as actively participating research that might bring some benefit to the clinics. I'm proud of what I'm doing. As for you're claiming that I'm limiting my profession because I want 'medical physicist' to be called 'medical physicist' is nonsense. How is calling our profession by special name is limiting? By ensuring others to acknowledge us as a very specialized professionals called 'medical physicist' we're doing ourselves a favor. This way we can keep our professionalism intact from some rogue physicists who are not properly trained in medical physics to think that he can do what we do.

Like qball, you're a student and you have limited scope of what it means to be a practicing physicist - even if you have taken some courses in a CAMPEP program.

You may be right. Maybe one day, I will go to linac to prepare for my water phantom QA and find a new particle called 'medphy-trino' and become a particle physicist.

One day, if you continue in medical physics, you're going to be working with radiation therapists and treatment planners. What makes you, as a medical physicist, different from them? The answer is your background in physics. If medical physicists ever forget that, our profession will disappear.

Wow, so all my professors and fellow collegues who doesn't have that 'physics background' you claimed to have are not different from other professions you mentioned? Medical physicist job is different from other jobs you listed above because what medical physicist 'do' is different from others. Certainly not because you know more physics than them.

 

[Choppy]

Choppy; I enjoy your posts. Could you give some more detailed examples from your work where you used trainning in mathematics or physics to solve the problem (an unusual problem where the trainning was useful)? I'm curious at what level a person needs to be in these areas to really be effective in the clinic.

Hi SbF5,

The most interesting problems are the ones that we tackle for research, or when have to introduce a new technology into the clinic. One of the first tasks I got involved in after finishing my graduate studies was developing an in-house Monte Carlo-based treatment planning and verification system. The nuts and bolts of that were largerly computer-science type stuff (like parallel computing optimization), but then I got into variance reduction and de-noising algorithms where courses like signal processing and mathematical methods helped considerably. This then served as a platform for a number of research investigations, where in some cases, even the formulation of the basic cross-sections cames into question.

It's hard to say exactly what one would "typically" encounter. Developing the kind of system I just mentioned isn't exactly typical in a smaller facility with only a few working physicists. But even these physicists could be asked to do things like develop an in-house monitor-unit calculator, or do some deformable image registration so that the oncologists can compare images from different modalities. Or they might need to figure out questions that come up when a new technology enters the clinic. Say for example, your facility is getting an X-band linac - is the RF generated by the machine the same as for an S-band - are there potential consqeuences for pacemaker patients? Or they might need to figure out why a properly calibrated well chamber consistently gives a low reading during brachytherapy seed QA.

The kinds of problems that come up clinically (especially those in smaller centres) are often discussed on medical physics list servers such as:
http://lists.wayne.edu/cgi-bin/wa?SUBED1=medphys&A=1 (global)
http://lists.wayne.edu/cgi-bin/wa?SUBED1=medphysusa&A=1 (USA)
Personally, I think students/residents should subscribe to these, but as a warning, on some days they can rather quickly fill up your inbox.

 

[SbF5]

Thanks, I'll check those out.

 

[Clancy Brown]

Hi Gang,

Thanks for the initial post Jono, the contributions has been interesting and lively to say the least. I was introduced by mistake to the exciting field of Medical Physics while searching on a topic in my current studies.

I am half way through my Electronics engineering degree with a specialization in Biomedical engineering and am hoping to further a career as a Radiation Oncology Medical Physicist (ROMP) here in Australia; for I feel this position will fulfill my interests and also to work as an engineer and a scientist. In Australia it is a long road to be an accredited ROMP, with at least MSc Medical Physics and 5 years clinic practice.

I thoroughly enjoyed the work experience tips that were posted earlier.

Is there still a skills shortage of Radiation Oncology Medical Physicist world wide?

Cheers.

 

[Choppy]

Is there still a skills shortage of Radiation Oncology Medical Physicist world wide?

There are a number of factors influencing the demand and supply of medical physicists.

First, due largely to an aging population, the number of worldwide cases of cancer is expected to increase by a factor of about 40% over the next 20 years, so if absolutely nothing else changed, one would expect the demand for all cancer-related professions to increase by a similar factor over the same period.

On top of that, radiation therapy complexity has increased drastically over the last decade. Starting in the late nineties, there was a shift towards intensity modulated radiation therapy (IMRT) treatments - where inverse planning allowed radiation dose distributions to be optimized within a given target volume. This type of treatment required substantially more work from a physics perspective: algorithm optimization, procedure definitions, plan optimizations, patient-specific QA, more machine QA, etc. which led to a small explosion in demand for medical physicists.

More recently, over the last five years or so, we're seeing a shift towards image guidance and adaptive radiation therapy. Again - more complex technology, more work for the physicists. Now when I commission a linac for example, it's not just the therapy beam, I also have to commission the imaging system as well. In the near future we're likely going to see an increase in proton therapy facilities, and possibly even MRI-guided radiation therapy, which will expand the role and responsibilities of medical physicists even further, and thus mean that more qualified medical physicists will be needed.

In North America, you're also likely to see an artificial bottleneck placed on qualified medical physicists in the coming years. By 2014, I believe, applicants for ABR certification will need to have completed a CAMPEP-accredited graduate degree and residency. To my knowledge this is specific to the ABR, but it is reasonable to expect the CCPM and other equivalent agencies across the world to follow suit. Because there are only a limited number of accredited graduate programs, the number of new qualified medical physicists will likely slow.

On the other side of the equation, right now, you have a slow economy, which effects hiring in the healthcare sector and thus medical physicists. This doesn't mean the demand isn't there.

 

[DrJD]

Just wanted to add that in my experience Medical Physicists are definitely more than just technicians.

In our rad onc department, the physicists are heavily involved in some really cool research. A lot of engineering, programming, and radiation physics. Now, are they thinking about the physics of a black hole? Of course not. But they are definitely actively engaged in physics. They are no more a technician than a Radiologist is a technician because he looks and and reads chest radiographs.

Medical physics is an amazing field!

Plus, like choppy was saying soon they will have even more responsibility. I believe they will begin to be able to charge medicare for their services as a provider.

 

[MDPhysics]

I think the discussion on this thread is great. The duties of a medical physicist are so varied depending on the route you choose to specialize and work--it's not black and white; there are a lot of shades of gray. Some "medical" physicists are purely in research--they are no where near the clinic. While others you will find work day in and day out in a clinical setting (e.g. a cancer center) where they are actively involved in treating patients. It is an amazing field that gives you a lot of options in terms of job responsibilities. IMHO, however, a medical physicist is a physicist no matter how you look at it: no matter if you're in research or clincal, physics is an integral part of your work.

I will make a plug for my site, Edit: Spam deleted you will see just how different the responsibilities are. A "medical physicist" can work in academics (at a university), in industry (for GE, Elekta, Varian, etc) or at a hospital. It really all depends on what your passion is.

 

[AtomicPile]

I think the discussion on this thread is great. The duties of a medical physicist are so varied depending on the route you choose to specialize and work--it's not black and white; there are a lot of shades of gray. Some "medical" physicists are purely in research--they are no where near the clinic. While others you will find work day in and day out in a clinical setting (e.g. a cancer center) where they are actively involved in treating patients. It is an amazing field that gives you a lot of options in terms of job responsibilities. IMHO, however, a medical physicist is a physicist no matter how you look at it: no matter if you're in research or clincal, physics is an integral part of your work.

I will make a plug for my site,Edit: spam deleted you will see just how different the responsibilities are. A "medical physicist" can work in academics (at a university), in industry (for GE, Elekta, Varian, etc) or at a hospital. It really all depends on what your passion is.

The medical physics field is oversupplied and getting worse each semester. [Edit: link deleted] is a website owned and operated by people trying to fill academic programs and maybe make a few bucks with google-adsense. Please do yourself a favor:

1. Talk to real people about this profession. Meet them in person and not through some website or e-mail group.
2. Check with your local hospital to see what professionals the hospital is genuinely hiring.

 

[Choppy]

The medical physics field is oversupplied and getting worse each semester.

Do you have some data on this, or is this just an opinion? Personally, I'm not sure I would agree, for the reasons I outlined in a previous post.

1. Talk to real people about this profession. Meet them in person and not through some website or e-mail group.

Excellent advice. While there is some value in researching any profession online, nothing beats first hand experience. If you're thinking of entering this field, I would highly suggest job shadowing.

 

[qball]

To the editors: why delete the links? I actually wanted to see what website he was talking about. Use some discretion and common sense when deciding which posts are spam and which are legitimate.

 

[AtomicPile]

Do you have some data on this, or is this just an opinion? Personally, I'm not sure I would agree, for the reasons I outlined in a previous post.Excellent advice. While there is some value in researching any profession online, nothing beats first hand experience. If you're thinking of entering this field, I would highly suggest job shadowing.

I shadowed someone who was clinical faculty at The University of Texas MD Anderson. I specifically remember the person saying that he attended my university. It turns out that person lied. The person also lied to me about medical physics job prospects. Guess what? That person still works there.

Lesson learned: Do not ask the teacher if there is a demand. Even a school like Harvard, needs someone to be their student.

---
I really like the baby boomer retiring logic that is often used to describe the pending medical physics shortage. If there is a labor shortage then the hospital will hire more therapists, dosimetrists and engineers.

Lesson 2: Do your homework and talk to people who are hiring. Find out what job titles they will be hiring in the future.
---

Then there is the 2012/2014 CAMPEP certification requirement. This is a sales and marketing scheme achieved by creating a sense of shortage and a false time constraint. That way "medical physics" will have a perceived future value that is higher and realizable in the near term.

Lesson 3: This would be similar to physicists in the 1990's being told that the faculty would be retiring soon. You can read about that story in the in the newspaper and history books. Econophysics, biophysics, medical physics, our training program wants your money and cheap labor physics!
---

Think about it very long and hard before spending you money and life on this pathway.

 

[Clancy Brown]

AtomicPile may I ask your current area of profession, I take it you are current not in a position within Medical Physics, as you seem very enthused and keen as posted.

I actually came across the profession Radiation Oncology Medical Physicist (ROMP) quite by mistake. I have done a great deal of research into the profession in the last three weeks, and am meeting my State Government's director in Radiation Oncology in the coming weeks to discuss the profession futher.

From my perspective (down under), there is a shortage of ROMPs; why would the director be so keen to meet with me and inform and show me aspects of the profession first hand. The shortage forecast is said to be so severe, that IAEA has provided a training program manual free to the public as a framework for new entrants to the profession.

I am sorry that you felt that you have been misrepresented and lead up the garden path in the past.

 

[AtomicPile]

AtomicPile may I ask your current area of profession, I take it you are current not in a position within Medical Physics, as you seem very enthused and keen as posted.

I actually came across the profession Radiation Oncology Medical Physicist (ROMP) quite by mistake. I have done a great deal of research into the profession in the last three weeks, and am meeting my State Government's director in Radiation Oncology in the coming weeks to discuss the profession futher.

From my perspective (down under), there is a shortage of ROMPs; why would the director be so keen to meet with me and inform and show me aspects of the profession first hand. The shortage forecast is said to be so severe, that IAEA has provided a training program manual free to the public as a framework for new entrants to the profession.

I am sorry that you felt that you have been misrepresented and lead up the garden path in the past.

Hi Clancy Brown, where is "down under"?

Can you post the study estimating the number of ROMP's that will be needed for this worldwide shortage?

It's true that the IAEA gives away a free manual. So what does giving away a manual for free have to do with the price of rice in China? Will the IAEA serve-up a physician, equipment, facility and a little ROMP with that manual?

Let's say that I did the medical physics training, got the badge and could not find a job as a medical physicist (or any of its derivative titles).

P.S. I thought the movie Highlander was fantastic. ;)

 

[Choppy]

I’d like to clear up some misconceptions about the job market in medical physics.

(1)
To my knowledge there is no shortage of people with a background in physics trying to get into the medical physics profession. However, from an employer's point of view, when you have an opening, finding a qualified medical physicist (ie. certified by the ABR, the CCPM or equivalent) and preferably with some experience, is very difficult.

(2)
The single greatest risk factor for the most common cancers is age. As the population ages and people live longer, the demand for radiation therapy will increase. You cannot meet this demand by hiring selective occupations (as AtomicPile implied). Some hospitals may try, but this will create a workload bottleneck.

(3)
With respect to training programs wanting your money and cheap labour, I think this is incredibly misleading. Graduate programs in medical physics don't turn a profit.

 

[AtomicPile]

I’d like to clear up some misconceptions about the job market in medical physics.

(1)
To my knowledge there is no shortage of people with a background in physics trying to get into the medical physics profession.

Are those "physicists" trying to get into "medical physics" really the issue? I am guessing that this is a very common theme. A "medical physicist" is a "physicist", but a "physicist" is not a "medical physicist".

But let's phrase this in terms of a sales gimmick:

-You do not have enough education so get a bachelors (1st sale)
-You do not have enough education so get a masters in medical physics (2nd sale)
-You do not have enough education so get a Ph.D. in medical physics (3rd sale)
-Wait that is not enough, now you need to do a residency in medical physics. (4th sale)
-Guess what, a residency is not enough, because now you need ABR certification. (5th sale)
-The next line of the argument is that ABR certification means that you have met a minimum level of qualification but it does not mean you have enough experience to do your job. (6th sale)

However, from an employer's point of view, when you have an opening, finding a qualified medical physicist (ie. certified by the ABR, the CCPM or equivalent) and preferably with some experience, is very difficult.

Look at the biography of Geoff Ibbot (http://www.aapm.org/org/history/bio/2013/) Geoff Ibbot was given the title of medical physicist in 1974. Geoff received his BA in 1979. Geoff was called a "medical physicist" before he had his bachelor's degree. Geoff Ibbot is a trustee of the ABR.

So is ABR certification really that relevant or just some carrot to be dangled in front of children?

(2)
The single greatest risk factor for the most common cancers is age. As the population ages and people live longer, the demand for radiation therapy will increase. You cannot meet this demand by hiring selective occupations (as AtomicPile implied). Some hospitals may try, but this will create a workload bottleneck.

Your age argument is sound, but it lacks clarity of thought. What workload bottleneck?

(3)
With respect to training programs wanting your money and cheap labour, I think this is incredibly misleading. Graduate programs in medical physics don't turn a profit.

Help me out here...where does the money to pay the teacher's salary come from?

Lesson learned
Unless a teacher works for free, then the graduate program makes money off of its student. Shareholders may not exist, but income must be made. That fits the definition of profit.

 

[Choppy]

But let's phrase this in terms of a sales gimmick:
-You do not have enough education so get a bachelors (1st sale)
-You do not have enough education so get a masters in medical physics (2nd sale)
-You do not have enough education so get a Ph.D. in medical physics (3rd sale)
-Wait that is not enough, now you need to do a residency in medical physics. (4th sale)
-Guess what, a residency is not enough, because now you need ABR certification. (5th sale)
-The next line of the argument is that ABR certification means that you have met a minimum level of qualification but it does not mean you have enough experience to do your job. (6th sale)

Alright, so at what point would you argue someone has sufficient training and experience to work independently as a medical physicist? Keep in mind that the people that make this decision have to balance it against the potential for lawsuits from cohorts of patients potentially over or underdosed, not to mention a moral obligation to provide an acceptable standard of care.

From a cost-effectiveness point of view, graduate programs don't bring enough money into the department to offset the cost of the program. If they did, you would see all sorts of small graduate programs popping up at smaller independent centres. But they only exist in larger institutions capable of absobring these costs.

Further, from the point of view of someone potentially going through the process, you have to keep in mind that as a graduate student you receive a stipend. It's not a lot. But it covers the cost of tuition and modest living. Beyond that, as resident, you're getting paid a reasonable salary. So even if you want to believe this process is some sort of a cash grab, the student/resident gets both money and an education out of it.

Look at the biography of Geoff Ibbot (http://www.aapm.org/org/history/bio/2013/) Geoff Ibbot was given the title of medical physicist in 1974. Geoff received his BA in 1979. Geoff was called a "medical physicist" before he had his bachelor's degree. Geoff Ibbot is a trustee of the ABR.

So is ABR certification really that relevant or just some carrot to be dangled in front of children?

The first airplane was built in 1903 by a pair of bicycle mechanics. Are the regulations of the aeronautical engineering industry really all that relevant?

Your age argument is sound, but it lacks clarity of thought. What workload bottleneck?

Let's put it this way - say you're in the business of building houses and you need to expand, so you hire more carpenters, bricklayers, electricians, and roofers, but you keep the same number of plumbers. The plumbers will keep the construction at the same pace as always because the plumbers won't be able to work any faster (or if they do, you'll end up with shotty plumbing, which will lead to lawsuits, and lost business). This is a workload bottleneck.

Medical physicists play a critical role in the clinical operations of a radiation therapy department. They can't be replaced by dosimetrists, therapists, or technicians.

Help me out here...where does the money to pay the teacher's salary come from?

In my department, the medical physicists are given adjuct appointments within the department of physics at the local university, but we get paid the same whether we teach or not.

 

[AtomicPile]

Alright, so at what point would you argue someone has sufficient training and experience to work independently as a medical physicist? ...

The point is that there is an over supply of medical physicists. Which is why the qualifications for the job keep rising.

Also, I am very concerned about someone lobbying for "medical physics" in a physics forum who make this statement:

To my knowledge there is no shortage of people with a background in physics trying to get into the medical physics profession.

 

[Heresy]

AtomicPile is just bitter =/

 

[Choppy]

The point is that there is an over supply of medical physicists. Which is why the qualifications for the job keep rising.

Again - do you have any data on this?

One study I'm aware of suggested a need for approximately 200 new medical physicists (in radiation oncology) per year to meet the projected demand in 2020. [Mills et al. Med. Phys. 36 2769 (2009)] Granted it is a single study, but the number isn't unreasonable - even if you assign it some rather large error bars. The number of people passing the board exams every year, ABR and CCPM combined, is in the ballpark of 100. This is without any program accreditation prerequisites (they haven't come into effect yet).

So, even if that study overestimates the need by a factor of 2, the profession would be just breaking even - hardly a saturated market.

As I've mentioned before, healthcare is effected by a slow economy just like all other industries. The hiring will likely be slow for a while, but this doesn't mean that the demand has disappeared, or that there is a conspiracy to raise the qualifications to artificially inflate the value of the currently employed physicists.

 

[AtomicPile]

Again - do you have any data on this?

The conference abstract that you cite undercounts the existing workforce by defining and using the phrase "qualified medical physicist". Under this definition neither an MS graduate, Ph.D. graduate, postdoctoral fellow, nor a residency graduate is considered a "qualified medical physicist" even though the graduate is in the employment pipeline. Furthermore a hospital can legally operate without employing a "qualified medical physicist" or for that matter a "medical physicist".

The "conference abstract" which is not considered "peer reviewed" is by M Mills(1), J Thornewill(2), and R Esterhay(2)
[(1) University of Louisville James Graham Brown Cancer Center, Louisville, KY, (2) University of Louisville School of Public Health, Louisville, KY]

I try to encourage people to get out there and talk to real people in their community.

Michael Mills, Ph.D., MSMPH, FAAPM
Radiation Oncology Dept.
James Graham Brown Cancer Center
529 S Jackson St
Louisville , KY 40202
work phone: 502-561-2700
email: mdmill03@gwise.louisville.edu
CV http://browncancercenter.org/CancerResearchers/tabid/85/Default.aspx?id=1617

Michael Mills has a Masters in Public Health from the Univ. of Louisville School of Public Health and he shares a history with his co-authors. Michael has worked at The University of Texas M.D. Anderson Cancer Center and has worked with many other academic faculty (e.g. MG Herman, KR Hogstrom, MT Gillin, PR Almond) who are trying to lengthen the training period for their respective academic programs. In 1993 PR Almond started a residency program at Univ. of Louisville, KY.

Call up Michael Mills, pretend you are a "qualified medical physicist" and ask him for a job.

 

[AtomicPile]

AtomicPile is just bitter =/

Oh, c'mon, "global warming" was an honest mistake...we just need more "medical physicists" to study the problem. ;)

 

[qball]

First of all, I would like to clarify a few points.

A "medical physicist" is a "physicist", but a "physicist" is not a "medical physicist".

Wrong, wrong, wrong! Medical physicists do not study physics, and physicists do not study "medical physics." Radiation oncology physics was old 50 years ago. No one studies it any more. What they study now is the incorporation of new imaging technology into rad. onc., or better ways to calculate dose. Both use known physics. On the imaging side, the physics is also not new. What's different is the way it's applied. Physicists certainly don't care about any of these things.

Second, the field of medical physics is not just limited to radiation oncology. You only need ABR certification if you're doing some kind of clinical work. For pure research it is not necessary.

It is my suspicion that the new requirements for 2012/2014 are designed to prevent physics Ph.d's from entering the field directly. Currently there is no restriction and someone with a Ph.d. in any relevant field can do a residency and enter the field of medical physics. According to the AAPM's Bruce Gerbi (http://chapter.aapm.org/nccaapm/Gerbi_Bruce.pdf ) 54% of all medical physicists are trained on the job. While this probably sufficient (let's face it, this ISN'T rocket science) it seems that the current medical physics community doesn't believe the field is insular enough.

Additionally, there is talk about instituting PDMP programs in medical physics. This obviously won't affect the current students, but future students (post-2014) will have to deal with it. This essentially a Ph.d. program you have to pay for, like med. school. The only good thing that could come out of this is that paying students can demand excellence in teaching that the rest of us can only pray for. Also, it seems counter-intuitive to claim that the need for medical physicists is rising but propose to solve this by increasing the number of programs students have to pay to attend. Would this really increase the quality of medical physicists if any Johnny Richdaddy can pay to get into a program and become a medical physicist?

Anyone in this profession needs to seriously question the direction the field is moving, especially in the US (AAPM). Anyone thinking of getting into the field needs to find a way to get an honest assessment of what the field is like from someone they trust, by reading these forums, or through whatever means they have available.

 

[AtomicPile]

Radiation oncology physics was old 50 years ago... On the imaging side, the physics is also not new.

Agreed that there is no new basic science.

Second, the field of medical physics is not just limited to radiation oncology. You only need ABR certification if you're doing some kind of clinical work. For pure research it is not necessary.

The AAPM, ACMP, ASTRO and ACR are trying to train everyone within the healthcare community to expect ABR certification. In addition they are loading academics into national and international advisory boards.

The nasty part of this is that if enough people subscribe to the practice, then it becomes the standard of care. This then trickles down into law.

This is what is so horrible about the "qualified medical physicist" definition; the definition is constantly being altered so that it translates into a certification "ponzi scheme" that produces more people than job slots.

54% of all medical physicists are trained on the job.

Be wary of posts encouraging people to go to school and train for this. Gerbi is part of the same subset of people who share the same slides to lobby for a residency. One of the key flaws is that their statistics do not cite a valid unbiased study. The real cure is to call some hospitals/clinics and get the real facts.

The only good thing that could come out of this is that paying students can demand excellence in teaching that the rest of us can only pray for.

I disagree here. The current standard of practice in healthcare/medical training contradicts this. Medical students tend to view lectures as inefficient learning tools and do not go to lectures. The reality is closer to the fact that you are bribing someone for the opportunity to take a standardized exam.

Anyone in this profession needs to seriously question the direction the field is moving, especially in the US (AAPM). Anyone thinking of getting into the field needs to find a way to get an honest assessment of what the field is like from someone they trust...

I would add that academics programs and residencies are selling "medical physics". The self-interest ingrains a biased and unrealistic view of the job market.

 

[Granny11]

AtomicPile, I hope you don't mind me asking, but what exactly is your connection to the medical physics field? I'm just curious why you seem to be so exasperated by medical physics. If you're in the field and hate it...why not switch?

I'm not trying to sound critical, I'm just genuinely curious what it is that happened to make you think this way.

 

[Choppy]

For those just joining the discussion:

Qball uses a unique definition of physics which excludes any form of applied physics, and hence fields such as astronomy, space physics, geophysics, computational physics, and about 95% of experimental physics in particle and condensed matter is also not physics.

AtomicPile still has yet to provide any actual evidence to support this idea that the medical physics job market is saturated and has instead nit-picked evidence that suggests the contrary. Obviously, I have a vested interest in the the medical physics community over the coming years, and despite arguing the contrary point, I would try to be open-minded about growth or lack thereof in the field.

I did a back of the envelope calculation last night and if you take all of the student members of the AAPM, DOUBLE that number to account for those not registered, as a basis pool of potential medical physicists (regardless of program) and then adjust to account for things like time spent in graduate school, other career options (academia, industry, going into other branches of medical physics besides radiation oncology physics), etc. we would barely be meeting the projected demand.

 

[qball]

For those just joining the discussion:

Qball uses a unique definition of physics which excludes any form of applied physics, and hence fields such as astronomy, space physics, geophysics, computational physics, and about 95% of experimental physics in particle and condensed matter is also not physics.

AtomicPile still has yet to provide any actual evidence to support this idea that the medical physics job market is saturated and has instead nit-picked evidence that suggests the contrary. Obviously, I have a vested interest in the the medical physics community over the coming years, and despite arguing the contrary point, I would try to be open-minded about growth or lack thereof in the field.

I did a back of the envelope calculation last night and if you take all of the student members of the AAPM, DOUBLE that number to account for those not registered, as a basis pool of potential medical physicists (regardless of program) and then adjust to account for things like time spent in graduate school, other career options (academia, industry, going into other branches of medical physics besides radiation oncology physics), etc. we would barely be meeting the projected demand.

... and Choppy lives in a fantasy world where the day to day calibrations of machines and QA forms counts as basic research.

And FYI:

Astronomy != physics. No pretense of physics here, either.

As for the other fields, I would not say they are doing "physics research" either. But then again you don't seem to understand the difference between being in an applied field and being in a field that does basic research.

 

[qball]

From a recent NYTimes article on how medical physicists are a bunch of screw-ups,

"In the world of radiotherapy, medical physicists play a vital role in patient safety — checking the calibration of machines, ensuring that the computer delivers the correct dose to the proper location, as well as assuming other safety tasks."

QED

http://www.nytimes.com/2010/01/24/health/24radiation.html?pagewanted=3

 

[AtomicPile]

For those just joining the discussion:

AtomicPile still has yet to provide any actual evidence to support this idea that the medical physics job market is saturated and has instead nit-picked evidence that suggests the contrary...

In the flavor of a StarKist tuna commercial:

"Sorry, Choppy. Physicists want good sound advice, not advice that sounds good."

First of all, nothing beats the reality of applying for jobs.
1.) You meet people trying to find jobs for their students, family members and in laws.
2.) You find out quickly that companies just put out obligatory job ads to see who is on the market.

Let's assume Choppy's number are right. Your future vis a vis some of the major headlines of medical physicist employers:

-01/2010 Varian Medical Systems Receives Certification to Assemble X-Ray Tubes in China
-11/2009 Varian Medical Systems lays off 150 people, Palo Alto CA

-12/2008 TomoTherapy Inc, the manufacturer of Hi Art system, said it has reduced workforce by approximately 12% through a combination of layoffs and the elimination of open positions. As of September 30, 2008, the company had 721 employees.

-4/2009 Elekta implemented a "deep hiring" freeze and has reduced its existing role-call by attrition.

-4/2009 GE Healthcare plans to layoff 179 employees at its GE Healthcare Monitoring Solutions plant in Milwaukee.

 

[AtomicPile]

AtomicPile, I hope you don't mind me asking, but what exactly is your connection to the medical physics field? I'm just curious why you seem to be so exasperated by medical physics. If you're in the field and hate it...why not switch?

I'm not trying to sound critical, I'm just genuinely curious what it is that happened to make you think this way.

Hi Granny,

Facts can be used to fix problems. Unfortunately, I find that the job statistics are based on a practice comparable to "cargo cult science". So I am taking the time to show people where to go in their own research. It is not perfect, but I am learning how to best express my experience in a "retaliation free" environment.

 

[Granny11]

Hi Granny,

Facts can be used to fix problems. Unfortunately, I find that the job statistics are based on a practice comparable to "cargo cult science". So I am taking the time to show people where to go in their own research. It is not perfect, but I am learning how to best express my experience in a "retaliation free" environment.

I'm not sure that quite answers my question. Are you involved in the medical physics field, or just 'researching' it?

 

[AtomicPile]

I'm not sure that quite answers my question. Are you involved in the medical physics field, or just 'researching' it?

Hi Granny,

Got the training, got the badge, and I still apply to medical physics positions. I take the third and last part of the ABR therapy exam in the summer.

 

[Choppy]

In the flavor of a StarKist tuna commercial:

"Sorry, Choppy. Physicists want good sound advice, not advice that sounds good."

First of all, nothing beats the reality of applying for jobs.
1.) You meet people trying to find jobs for their students, family members and in laws.
2.) You find out quickly that companies just put out obligatory job ads to see who is on the market.

Let's assume Choppy's number are right. Your future vis a vis some of the major headlines of medical physicist employers:

-01/2010 Varian Medical Systems Receives Certification to Assemble X-Ray Tubes in China
-11/2009 Varian Medical Systems lays off 150 people, Palo Alto CA

-12/2008 TomoTherapy Inc, the manufacturer of Hi Art system, said it has reduced workforce by approximately 12% through a combination of layoffs and the elimination of open positions. As of September 30, 2008, the company had 721 employees.

-4/2009 Elekta implemented a "deep hiring" freeze and has reduced its existing role-call by attrition.

-4/2009 GE Healthcare plans to layoff 179 employees at its GE Healthcare Monitoring Solutions plant in Milwaukee.

I don't think it will come as a surprise to anyone that the economy in north america is in a slump right now. Not that I pay much attention to politics, but didn't President Obama's state of the union address just underscore a need for job creation? Automobile manufacturing for example is barely keeping its head above water.

So why should the healthcare industry be any different? It is somewhat insulated from economic fluctuation because it is so heavily influenced by govenment funding (more so in Canada), but when money is tight, hiring stalls just like anywhere else.

What I'm saying, is that this is temporary. In the coming years, the projected increases in cancer cases is going to drive up the demand for radiation therapy significantly. In my own province, the number of linacs is going to increase by about 30% over the next 5-8 years.

 

[qball]

I don't think it will come as a surprise to anyone that the economy in north america is in a slump right now. Not that I pay much attention to politics, but didn't President Obama's state of the union address just underscore a need for job creation? Automobile manufacturing for example is barely keeping its head above water.

So why should the healthcare industry be any different? It is somewhat insulated from economic fluctuation because it is so heavily influenced by govenment funding (more so in Canada), but when money is tight, hiring stalls just like anywhere else.

What I'm saying, is that this is temporary. In the coming years, the projected increases in cancer cases is going to drive up the demand for radiation therapy significantly. In my own province, the number of linacs is going to increase by about 30% over the next 5-8 years.

Not necessarily. New research may provide alternatives to radiation therapy that are equally or more effective. Radiation therapy has a lot of side effects, including the introduction of secondary cancers, and is a less-than-ideal option for treatment. As our understanding of carcinogenesis evolves there will surely be treatments to stop it in its tracks before it becomes life threatening.

 

[Choppy]

Not necessarily. New research may provide alternatives to radiation therapy that are equally or more effective. Radiation therapy has a lot of side effects, including the introduction of secondary cancers, and is a less-than-ideal option for treatment. As our understanding of carcinogenesis evolves there will surely be treatments to stop it in its tracks before it becomes life threatening.

This is a good point. There is always the probability that new treatments will come along that will change the current paradigm. Of course, the chances of something like that happening exists in just about any field.

The higher probility, in my opinion, is that the technology for cancer treatments is going to get more complex in the future. We're likely to see more detailed image guidance and adaptive RT, MRI-based guidance, and laser-accelerated ion beams which will substantially bring down the cost of proton facilities. So medical physicists are likely to see their clinical duties increase.

That, of course, is just an opinion.

 

[AtomicPile]

In my own province, the number of linacs is going to increase by about 30% over the next 5-8 years.

What province, are you in Canada?

 

[Choppy]

What province, are you in Canada?

Alberta.

 

[AtomicPile]

Alberta.

Canada's cold might create a local problem, but that translates into saying, "Canada has a shortage of medical physicists."

When passing out advice in a .com forum, as opposed to a .ca, you should state this clearly. The plain fact is that you are misleading a lot of people by your point of view.

I live in the USA. I have met medical physicists from all over the world. Australia, South America, France, Russia, India, Asia, England, Japan, New Zealand and Canada.

There is no shortage of medical physicists in the USA. For that matter there is no shortage in Australia or Japan. Some countries have a shortage by the mere fact that they use a different job title.

 

[Clancy Brown]

I have met medical physicists from all over the world. Australia, South America, France, Russia, India, Asia, England, Japan, New Zealand and Canada.

For that matter there is no shortage in Australia or Japan.

Wow Atomicpile you surprised me, I thought you were too ignorant to understand that there was a world beyond the North American borders ie USA and Canada.

"Australia wide there is a vacancy rate of almost 14% for Radiation Oncology Medical Physicists (ROMPs). A worldwide shortage of qualified physicists (ROMPs) makes it difficult to fill the vacancies by overseas recruitment. "

http://www.qld-cpc.org.au/domain_Medical%20Physics%20Career%20Information.htm

 

[Clancy Brown]

Also in New Zealand

Job Outlook
Medical physicists are in demand throughout New Zealand and chances of getting a job in this area are excellent.

Skill shortage information
There is an immediate term skill shortage for this job.

Source: Department of Immigration NZ, Skills Shortages

 

[AtomicPile]

Also in New Zealand

Job Outlook
Medical physicists are in demand throughout New Zealand and chances of getting a job in this area are excellent.

Skill shortage information
There is an immediate term skill shortage for this job.

Source: Department of Immigration NZ, Skills Shortages

Hi Clancy,

How many physicists does New Zealand & Aus need? Have fun bashing me, but that is my point. If your program outputs 100 medical physicists and your shortage is 5, then you are creating unemployed professionals. Are the people in your program expecting jobs in their home country? Are you sure that medical physics is different than health physics? Has that occurred to you?

In the USA you could contact Paul Keal at Stanford University (paul.keall@stanford.edu). He left New Zealand to come to the USA. Paul received his degrees at:

University of Waikato, Hamilton, New Zealand, B.S. (Physics and Mathematics)
University of Adelaide, Adelaide, Australia, M.S. (Health Physics)
University of Adelaide, Adelaide, Australia, Ph.D. (Physics)

Note that Paul did not get a degree in "medical physics". That should tell you something very powerful.

Here is a link to Australian College of Physical Scientists & Engineers in Medicine:

http://www.acpsem.org.au/index.php/component/jobline/

Note that engineer is part of the society's name and not physicists.

I imagine that Paul would appreciate a pay raise, so you could ask him to return and train the locals.

 

[Clancy Brown]

How many physicists does New Zealand & Aus need?

As many that are willing to come and work here I guess.

Have fun bashing me

I was being honest, and you did surprise me.

If your program outputs 100 medical physicists and your shortage is 5, then you are creating unemployed professionals.

There not enough people in the program to satisfy demand, hence 100% employment.

Are you sure that medical physics is different than health physics? Has that occurred to you?

I am actually highlighting the shortage of "Radiation Oncology Medical Physicist (ROMP)" ie Medical Physicist here in Australia

In the USA you could contact Paul Keal at Stanford University (paul.keall@stanford.edu). He left New Zealand to come to the USA.

Cool, thanks for the contact, for future reference

Here is a link to Australian College of Physical Scientists & Engineers in Medicine:

http://www.acpsem.org.au/index.php/component/jobline/

surely I would know my own accreditation body

I imagine that Paul would appreciate a pay raise, so you could ask him to return and train the locals.

Moot point, he may be paid more where he is; the pay is not the issue. I can make more as a Biomedical engineer as I would as a ROMP and with far less training.

Atomicpile, why don't you venture down here and work, you already have a link to the job board.

 

[AtomicPile]

Atomicpile, why don't you venture down here and work, you already have a link to the job board.

OK, Clancy. Send me your e-mail.