Medical Physics: Masters or PhD?

[kbk5033]

Medical Physics: Masters or PhD??

I am currently a Nuclear Engineering Masters student planning to graduate in May 2013. I am now applying to both Masters and PhD Medical Physics programs, however I am not exactly sure which route to take. Is it worth going for the PhD if I plan to do clinical work in hospitals? Prestigious schools, such as Columbia and UPenn, only have Masters programs which makes me question the necessity of a PhD if you do not plan on doing research all your life. Also, could someone in the field also explain the demand for/responsibilities of the different specialties (i.e. nuclear medicine, diagnostic imaging, radiation oncology, medical health physics)?

Thanks a bunch!

 

[EricVT]

A Ph.D. in medical physics would be beneficial (and all but required) if you aspire to hold academic appointment at a university. You will be much more likely to secure funding for research projects and be given the opportunity to teach graduate-level courses. You could also have the opportunity to eventually serve as the program director and/or chief of medical physics in academic environments. I would say that opportunities to serve on professional committees is also increased for Ph.D. holders.

M.S. level medical physicists are also often employed in academic environments, but they may be limited to "staff" status instead of faculty (the difference depends entirely on where you work). They may or may not have their own funded research programs, though many M.S. level physicists still involve themselves in clinical research of various scale. They may often serve as clinical instructors for students, but are less often found as the instructor-on-record for graduate-level courses at universities. Many M.S. level physicists find employment in community-based hospitals and cancer centers, or free-standing clinics.

Speaking in broad terms, Ph.D. holders are likely to be found in academic settings and M.S. holders are likely to be found outside of academic settings. It's far from a rule, though, as there are plenty of Ph.D. holders in community hospitals and plenty of M.S. holders in universities.

Historically, Ph.D. holders have been more competitive for clinical residency positions. Now that residencies are becoming mandatory for board certification by the American Board of Radiology, it's a point that might be worth considering (though there are a number of residencies out there who accept M.S. level physicists without reservation).

Salary levels can vary quite a bit for any particular person, but official salary surveys show Ph.D. level medical physicists as earning a median income ~10% higher than M.S. level physicists.

Either path will allow you to become a competent medical physicist and excel in your clinical duties.

Do you have a passion for research and/or teaching? Do you have any experience with clinical medical physics that would help you make a reasonable guess about how happy you would be with that as a career choice?

 

[kbk5033]

I truly appreciate your response!

Unfortunately, I do not have a passion for research or teaching and I also do not have any clinical med physics experience. I am basing my decision to go into this field because of my interest in a couple of courses (med physics & health physics) I recently took during my nuclear engineering studies.

Also, from what I have noticed, there isn’t a high demand for diagnostic imaging in this field. For example, there are about 6 times more accredited residency programs for radiation therapy than for diagnostic imaging. So it seems like radiation therapy is the way to go. Is this true?

 

[EricVT]

Diagnostic medical physicists tend to be an underutilized resource in radiology departments, probably because of a lack of medical billing codes that apply to their work. Many radiology departments do not even have on-site physics support and instead choose to bring in consultants every now and then to perform needed quality assurance work. This saves them money, but they miss out on the value of having an on-site physicist for clinical consultation, troubleshooting, process improvement, etc.

This is quite the opposite in radiation oncology (therapy), where medical physicists actually generate revenue for the department and are therefore highly integrated into every aspect of the radiotherapy process. Consequently, there are a larger number of practicing medical physicists that work in radiation oncology (~85% of the total number).

Diagnostic medical physicists are valuable to the field because their specialty -- imaging technologies -- are omnipresent. Even a radiation oncology physicist will need a solid understanding of diagnostic physics to be competent in their work. However, diagnostic physics positions do tend to be scarcer and the associated residencies are rarer still.

 

[kbk5033]

oh ok, that makes sense now. Thank you so much! Are you currently a med physicist in the field? If so, would you recommend it as a good career to pursue?

 

[EricVT]

Yes, I am a currently practicing medical physicist in radiation oncology. There are a few others on this forum as well.

I am very satisfied with my career choice, though I will also admit that it isn't for everyone. As with any career, I think it is wise to spend as much time as you can getting exposure to the field before committing yourself to it. A few points worth sharing about therapeutic medical physics:

Medical physicists have the opportunity to make a profound impact on the lives of patients through their work. We have the opportunity to be clinical leaders and experts in clinical implementation of highly complex equipment and technologies. We can also be scientific and educational professionals. It's a rare mix of opportunities that can be extremely rewarding to the right type of person if they are in a work environment where they are allowed to prosper.

However, we work long hours and our efforts are not always recognized. Late nights and weekends are often a reality. Some mornings we will be in the clinic before everyone else and then we will still be there long after everyone else has gone home. We have to be self-motivating and find satisfaction for a job well done for ourselves. We have to have excellent time management skills but also be flexible with our schedules. A typical work day is full of distractions and interruptions as we are pulled away from our work to help with other things or answer questions.

The physicist is often the go-to person when there is a technical problem of any sort during the radiotherapy process. We have to have good communication skills as we will be directly interacting with people across a broad spectrum of educational backgrounds and job duties (physicians, engineers, nurses, therapists, clerical workers, dosimetrists, other physicists, administrators). We have to be able to step into and out of various roles depending on the department's need. There are times where we serve as the dosimetrist and directly perform treatment planning for patients. There are times where we work alongside therapists to assist with simulation of more complex patient cases. There are times where we work alongside administrators to evaluate the needs of the department or to help set strategic direction regarding things such as department accreditation. There are times where we work alongside the engineers to make needed repairs to equipment and to verify equipment performance prior to releasing it for clinical use. There is a large amount of work that can fall under the jurisdiction of the medical physicist.

A fair amount of what we do, though, is repetitive and can seem (to many people) mundane. Quality assurance essentially dictates that we perform the same tests day after day, week after week, month after month...but we always have to do it with a sharp mind and a sharp eye. There are guidelines established for the tests that should be performed, but the developmental work for implementing them and the creative opportunities we have for process improvement can be rewarding.

I would recommend researching as much as you can about the actual day-to-day work of a medical physicist. Ideally you could find a practicing physicist in your area that would be willing to have you shadow them for a while.

 

[Choppy]

+1 to EricVT's comments.

I have found medical physics to be an extremely rewarding career, but the road is long and often competative, stressful and uncertain when you're a student.

Once you have a position too, you have to shoulder a hefty load of responsibility. When a physician makes a mistake it usually effects only one person. But medical physicists hold responsibility for calibrating machines and establishing procedures and processes that can effect anywhere from dozens to thousands of people.

 

[cbs970]

Here is a recent post from an esteemed member of the Medical Physics List* re the US job and training market:

"re: jobs for new medical physicists
here is the problem as i see it. which is a perverse mismatch between degree programs, residency positions, and jobs. to whit:
1. there is currently a glut of newly minted MS level medical physics graduates. far more new graduates than available residency slots
2. residency program directors thus have the luxury of being in the drivers seat of a buyers market.
3. there is also a glut of newly minted physics PhDs (many of whom come from traditional physics programs rather than medical physics programs) who can't find jobs in traditional physics.
4. so medical physics residency programs have the choice of hiring a newly minted MS physicist, or, and here's the rub, for the same price a newly minted PhD. guess who they offer the job to?
5. but hospitals hiring new medical physicists often prefer a masters degree person rather than a PhD. MS physicists work for less money, and complain less about having to do scut work than prima donna PhDs.
Soooo...
Residency programs want PhD's, but hospitals want Masters degrees.
which means that Masters programs are training people for residency positions that do not exist, and residency programs are training PhDs for jobs that also do not exist."

Re residencies, see http://aapm.org/students/prospective.asp

* http://lists.wayne.edu/cgi-bin/wa?ACTED1=MEDPHYSUSA

 

[Choppy]

I'm not sure I agree with all of that, but it's not unreasonable.

For one, a residency positions are looking primarily for someone who's come through a medical physics program. The issue is that the candidate won't be able to obtain ABR certification without it. On the other hand, some programs are willing to overlook this if the residency comes with a research project that requires a specific skill set.

I also don't think it's fair to lump all hospitals together. A big part of what medical physicists do is research and particularly the larger ones support this and look for PhDs who are promising researchers to hire on.

There's also an entirely ignored market to consider for recent graduates at either level and that's the commercial companies. They will hire physicists for research and development, technical sales, project management, technical support (not so much the front line, but for the problems that come up that can't be solved by the flip-book), etc., and in for these scenarios more research experience is better.

Finally if you agree with the conclusion that cbs70 posted, then what's the solution?
(a) Get rid of all MSc-only medical physics programs?
(b) Get the ABR to lower its requirements?
(c) Something else?

I suspect the real answer is more along the lines of
(d) ignore the problem until you have a lack of qualified applicants for a posted position.

 

[kbk5033]

Thanks for all the info. It sounds like the most secure way to go is to get a PhD. Unfortunately, I am not quite interested in doing research for the rest of my life. Working as a clinical med physics is my key interest. I am just scared of being stuck if I can't get into a residency program. I am starting to question this career path all together :-/

 

[Choppy]

If you have NO interest in research then medical physics may not be for you. Being a clinical physicist will mean that you're generally not driving research, but at minimum you will be responsible for keeping yourself and the rest of your team up to date on recent advances in technology and developing a working knowledge on how to implement it on a clinical basis.