ETC Agenda, May 4, 2018

Education and Training of Medical PhysicistsMeeting

Friday, May 4, 2018

2:00 – 3:00 pm, Eastern

Meeting Agenda

Members: Joann Prisciandaro (chair), Jacqueline Zoberi(vice-chair), John

Antolak, Jay Burmeister, Wolfram Laub (abs), Kip Matthews (abs), Osama Mawlawi, Robert Pizzutiello (abs), Julianne Pollard-Larkin (abs), Anthony Seibert, and Dennis Stanley

  1. Old Business
  2. Review of on-line publications from the STSC
  3. The Working Group to promote non-clinical career paths for medical physicists have generated a series of seven blogs related to training, skills, and career options for trainees interested in a non-clinical career.
  4. Posting have been circulated to ETC members for comments (attached to end of document).
  5. In addition to the WG’s website, the WG intends to post these blogs online at: and
  6. A version of the posts including edits will be circulated to the ETC members, and members will be asked to review and return their comments by May 18th.
  7. WG intends to release the posts every two weeks.
  8. John asked about how students would handle comments received between postings. Would the subsequent posts be edited to address the comments, and whether another round of reviews may be needed.
  9. Dennis indicated this was discussed by the WG, and unless there was a substantial change, or need for one, the posts would not be changed based on comments.
  10. John inquired about fast tracking the edits, as the comments may change the focus of future posts. Dennis will discuss whether this option should be considered with the WG.
  1. Challenges and opportunities for ETC and its daughter SC, WG, and TG
  • During the Education Council retreat, all committees were asked to present challenges and opportunities ETC will face over the next year. The following is the list that was presented to EC:
  • Concerns about communication between program directors and applicants during match interviews; some inappropriate questions have been asked of applicants; who can we provide guidance for interview process and mechanism for complaints to be registered
  • The SC on the Oversight of MedPhys Match was asked to (1) set up a means for reporting inappropriate interview practices, and (2) develop guidelines and means for promoting and sharing these with program directors.
  • This will be discussed by SC during the annual AAPM meeting. However, is this AAPM’s responsibility, or rather the programs? Individual programs should be complying with employment law practices.
  • Although this may be better handled by SDAMPP, they may not have the resources to address this issue.
  • SC could provide some examples of best practices, and issues encountered. Share available resources with PD (Kristy Hendrickson manuscript for instances demonstrating some issues encountered by applicants, and University of Washington’s code of conduct).
  • Some gamesmanship by some programs during match process; should perhaps clarify written guidelines for program directors
  • There may not be a great deal that we can do to address this issue. Some suggestions have been made about posting potential interview dates early.
  • Dennis asked about organizing regional interview weeks. Challenging in practice due to faculty/staff schedules, as well as clinical and professional commitments.
  • SDAMPP still working on formulating the WG on residency training
  • Hopeful this will move forward due to interest expressed by individuals in SDAMPP, but no updates.
  1. Aligning expectations of grad and residency programs
  • In June 2017, CAMPEP circulated a survey to PD in June 2017 which primarily sought to determine if PDs perceived significant variations inthe preparation of incoming residents depending on the CAMPEP-accredited graduate or certificate program completed by the resident.
  • 81.1% of PD responded(representing 86 of 106 accredited programs at the time), and based on their responses, 20% of PD indicated that they believe there is a need for improvement in the preparation of the six core areas identified in AAPM TG197S by candidates.
  • EC was asked whether the members believed we needed to make improvements/changes (i.e., recommendations in the curriculum for grad and certificate programs).
  • ETC is being asked to work on this issue to see if anything needs to be improved and what we would recommend
  • Jay indicated this would be something that his WG could review and discuss. Joann will share the survey results with Jay and his team.
  • Students wanting ABR certification even if they go into non-clinical careers
  • ETC requested clarification on this topic. Per James Dobbins:

“The issue was that there are students taking the ABR certification process and looking for residencies as a kind of safety net even though they intend on a non-clinical career. This just leads to a logjam in the residency process with students who intend on non-clinical careers. They want to hedge their bets by doing the residency/ABR route even though they want to work in industry or academia. Perhaps there is nothing we can do about this, but I think the issue was raised for discussion and consideration.”

  • Maybe the question is "What is the proper preparation for a medical physics student to pursue a non-clinical career?”
  • Number of residencies not sufficient for all graduate students. If industry is interested in having students with residency training, maybe they should fund some residency slots.
  • Vendor would be involved in the decision for selecting the candidate.
  • A similar process is in place for VA hires. John suggested this proposal could be developed into a white paper.
  1. New Business
  2. Program Spotlight and annual meeting proposal (Stanley)
  3. Program spotlight – ongoing series proposed for graduate and residency programs to showcase their programs. SC would reach out to PD to determine if they are interested in participating. There is a simple application process with questions including interesting/exciting aspects of the program. Programs would be highlighted a routine basis, e.g., weekly or biweekly, depending on the response. Program spotlights would not be run Jan – March.
  4. This would be supplementary to the blog posts
  5. Designed for Facebook and Tweeter
  6. The spotlights would undergo ETC review/approval through Hootesuite similar to the STSC blogs
  7. Question format is available for review in attachment.
  8. To ensure consistency, STSC would provide an example post to PD
  9. Annual meeting proposal – SC would like to advertise student related events on social media during the annual meeting. They have developed sample posts/pictures, and they would like to request pre-approval. Example posts are available for review in attachment.
  10. Follow-up from EC retreat
  • Liaisons with industry, clinical training of industry personnel, internships, entrepreneurship, business training for grad students (WG MP GEPC, PC? Ad hoc on industry needs?)
  • Update for 197 will involve a review of curricular needs to help students prepare for non-clinical careers. Additionally, Jay has been involved in discussions through SDAMPP on industry internships.
  • Promotion of these internship should perhaps be reserved for industry.
  • The WG on non-clinical careers reached out to the career posting website for a posting topic on non-clinical opportunities. The STSC will advertise these positions through their blogs.
  • EC has requested the Working Group on Medical Physics Graduate Education Program to consider this when working on the update to 197
  • As indicated above, the Working Group on Medical Physics Graduate Education Program will discuss curricular needs for those interested in a non-clinical career
  • Standardization of DMP programs (ETC)
  • Jay developed an outline for the white paper, and has reached out to WG chair and vice-chair to develop this outline further.
  • Update from the recently reactivated Imaging Physics Residency Workgroup
  • No time to discuss
  • Location of Working Group on a Professional Doctorate Degree for Medical Physics (WGPDDMP) in committee tree? Should it be moved up one level? ETC was to make a suggestion (ETC)
  • WG currently under the Medical Physics Residency Training and Promotion SC
  • No time to discuss

Post #1: Introduction to Non-Clinical Careers and General Advice

Introduction

Medical physics started as a clinical profession; however, its unique training has allowed its students to pursue an ever-expanding number of careers. Despite this expansion, the best-guided path is the clinical career path. Information, guidance, and additional training for non-clinical careers remains sparse and less than 50% of students (median: 3.3 years of experience with medical physics; 165 respondents) feel knowledgeable about their non-clinical career options [1].

Student unawareness of non-clinical careers is, in part, because current medical physics graduate programs are heavily biased towards clinical careers. Many programs are staffed by physicists who hold primary appointments as clinical medical physicists. The remaining faculty tend to be made up of physicists working in academic research. This means that students are well prepared and knowledgeable about those two career paths, but not as knowledgeable about other careers. Residency programs, by their nature, are not incentivized to discuss or train their residents on non-clinical topics. Most programs strive to obtain (or maintain) Commission on Accreditation of Medical Physics Education Programs (CAMPEP) accreditation, which is focused on the clinical training of medical physicists. Thus, non-clinical training is not prioritized and students are not necessarily informed of all the opportunities open to them as they enter the world of medical physics.

Although students are primarily educated about their clinical opportunities, there is no guarantee that students will be able to pursue an American Board of Radiology (ABR) -certified clinical career. In 2014, the ABR required that students that entered into the ABR process to complete a CAMPEP-accredited residency program prior to their eligibility for full board certification. This improved and standardized clinical training, but also limited the number of physicists able to become ABR certified. In 2015, CAMPEP reported that 332 students graduated with a master's degree, doctoral degree, professional doctorate, or certificate; yet there were only 112 residency positions that participated through the MedPhys Match [2,3]. This disparity demonstrates the need to educate medical physics students about non-clinical career opportunities available.

To address this unmet need, the Working Group to Promote Non-Clinical Careers in Medical Physics (WGNCMP) was formed. The mission of WGNCMP is to investigate opportunities for trained medical physicists outside of the clinic, and to disseminate this information as well as the necessary training to obtain these positions. This series of blog posts is intended to educate current and potential medical physicists about the options available to them beyond clinical physics and includes comparisons to the career of a board certified clinical physicist and entry requirements for these alternative careers.

General Advice

The 2015 AAPM Professional Survey reports that 81% of its members work in primarily clinical roles [4]. The remaining 19% work primarily in academic, administrative, regulatory, or industrial roles. However, it is unclear how many non-AAPM physicists work in non-clinical roles in fields that could be considered as part of medical physics. A separate report from the Centers for Health Workforce Studies discusses an independent model for non-clinical medical physicists [5]. In this report, it is noted that board certification is typically not a requirement for employment, and that specialization in a category such as therapy or diagnostic imaging isn’t as prevalent. The lack of certification and specialization requirements may make non-clinical jobs potentially easier to obtain, while frequently offering comparable pay and potentially better work-life balance to clinical positions. Non-clinical career paths are open to physicists with either a master’s or doctoral degree. These factors make non-clinical careers attractive to those physicists who are not exclusively interested in a clinical career. Additionally, physicists looking to change career paths from clinical to non-clinical do not face the same “administrative” hurdles as one trying to go in the reverse direction.

In a series of interviews with professional non-clinical medical physicists, three common skills were stressed as a requirement of applicants: communication, interpersonal skills, and organization [6]. Communication includes being able to send effective, efficient, and courteous e-mails, present research to both fellow scientists and to a law audience, and write technical reports. Interpersonal skills include effective and professional interaction with co-workers, customers, and others. Organization is the efficient use of time, budget, and other resources and is an important quality for communicating with others. These skills are important for any career - clinical or non-clinical - and can be developed during training. Those surveyed recommended that students practice these skills while still in school and ask for feedback and criticism from both mentors and fellow students. Individual career paths require additional training, which will be described in depth in the blog posts to follow.

References:

[1] Tanny, S., Roth, A., Peeler, C., Rodrigues, A., and Ready, J. SU-E-E-04: Assessment of Medical Physics Students and Trainees Interest and Awareness of Non-Clinical Careers. American Association of Physicists in Medicine (2015), DOI:

[2] Clark, B. (2016). CAMPEP Graduate Program Report. Washington, D.C.

[3] AAPM (2015). MedPhys Match: The Medical Physics Matching Program Summary Results of the MedPhys Match for Positions Beginning in 2015. Ontario, Canada.

[4] AAPM (2016). Professional Survey Report Calendar Year 2015.

[5] Center for Health Workforce Studies (2010). Workforce Study of Medical Physicists in the U.S. Rensselaer, NY.

[6] WGNCMP interviews with professionals including: Maryann Abogunde, Michael Boss, David Catarious, Sandra Gabriel, Matthew Japzon, Paul Naine, Robert Saunders, Peter Scully, Jie Shi, and Michelle Svatos. These professionals worked at the National Institute of Science and Technology, US National Regulatory Commission, US Department of Energy, US Navy, Elekta, Duke University, National Foundation for Cancer Research, Sun Nuclear, and Varian at the time of their interviews.

Post #2: Non-Clinical Careers in Industry

Industry careers combine the knowledge of modern health-care delivery with scientific research, product development, and experimental design. Jobs are often in one of three primary areas: research and development, sales, or customer support. Research and development physicists create new and innovative products and may work at a managerial or individual product level. Sales people assist customers in acquiring the best products to address their needs and communicate unmet customer needs to their employer. Customer support physicists are involved in installation, training, and troubleshooting clinical devices.

The skillset needed within the medical industry, although sharing many similarities to medical physics education, requires a greater focus on specific areas to make a candidate more desirable to an industrial corporation. Physicists need to understand physics, software development, and clinical implementation. This is an iterative cycle to make a safe, quality, and reliable product. More specifically, the ability to work fluently with open-source computer programming languages (Python, Ruby, Javascript) and relate it to clinical applications is a skill highly sought after by industrial employees. Analytical skills along with a working knowledge of statistically related concepts, such as Failure Mode Effects Analysis (FMEA) and Statistical Process Control (SPC) are valuable. For employment directly related to research and development, a working knowledge of the regulatory standards governing medical equipment is important; specifically, knowledge of guidance documentation produced by the Food and Drug Administration (FDA) and the International Electrotechnical Commission (IEC). The most desirable soft skills are the ability to present and communicate effectively, the capacity to work well as a member of a functioning team, and a knowledge of basic finance to aid in product decision making [1].

To gain employment within an industrial setting, it is important to have completed at least one large, comprehensive project that demonstrates a strong command of advanced scientific and industrial comprehension. Ideally, the project will be relatable to the clinical health care environment, employ the use of quantitative data to represent a result and answer a clearly defined objective at the completion of the project. The use of computer programming within a research project is desirable. In many instances, research projects completed to satisfy the requirements of a master’s or doctoral degree will meet these criteria, although it may be advantageous to demonstrate a repertoire of completed projects.

Opportunities to sample a career in industry can be found in the form of internships as several large medical physics companies offer paid internships for students. While many industry careers do not require a doctoral degree, it is regarded highly by many industrial employers. Board certification is often not required, but demonstrable clinical experience is sought after. Participating in a clinical internship often provided by medical physics graduate programs is a great way to satisfy this requirement.

An alternative pathway from graduate studies to industry is the I-Corps program offered by both the National Institutes of Health (NIH) [2] and the National Science Foundation (NSF) [3]. This program seeks to commercialize promising academic research and give academic researchers valuable entrepreneurial experience. Additionally, the NIH offers seed funding mechanisms such as the SBIR and STTR that allow graduate students to perform collaborative research with industry during graduate school [4].

The salaries of industrial career physicists approach that of clinical physicists. The average self-reported salary of physicists working in industry range from $156,900 for uncertified physicists with a master’s degree (median 10 years of experience) to $217,100 for board-certified physicists with a doctoral degree (median 17 years of experience) based on the 2015 AAPM Professional Survey Report. Additional advantages of working in industry include standard work hours and the ability to positively affect clinical practice.

References:

[1] WGNCMP interviews with professionals including: Maryann Abogunde, Michael Boss, David Catarious, Sandra Gabriel, Matthew Japzon, Paul Naine, Robert Saunders, Peter Scully, Jie Shi, and Michelle Svatos. These professionals worked at the National Institute of Science and Technology, US National Regulatory Commission, US Department of Energy, US Navy, Elekta, Duke University, National Foundation for Cancer Research, Sun Nuclear, and Varian at the time of their interviews.