MO-D-P-618-01: Update From the President's Adhoc Committee On Alternative Paths to Medical Physics Residency Training

We all support the fundamental philosophy that both a thorough groundwork in physics and structured clinical training is essential for individuals who will be involved in the practice of clinical medical physics. A structured clinical training program, such as a CAMPEP accredited medical physics residency, followed by board certification (by the ABR or equivalent) provides the mechanism for people with graduate degrees in various technical (physics) fields to acquire and demonstrate clinical competency. As reported in the April Point Counter Point by Amols and Herman, graduates of CAMPEP accredited residency programs pass the full ABR on the first attempt at a 95% rate, whereas the average ABR taker passes at 53%. Under current and foreseeable market conditions however, the demand for qualified medical physicists far exceeds the supply of individuals being produced by existing accredited programs. There are currently 11 (10 Therapy, 1 Imaging) accredited residency programs (with ∼5 under consideration). A back of the envelope calculation suggests that approximately 50 accredited residency programs would be required to support the current demand. Thus, in the short run (and to provide a jumpstart for additional qualified trainees), alternate pathways must be developed to insure an adequate supply of clinical medical physicists while at the same time insuring academic excellence, diversity, and clinical competency. The question remains: how can we establish a mechanism that produces enough qualified people, without creating a huge financial burden or an unrealistic set of conditions that few individuals can meet. Providing the mechanism to bring medical physicists into practice who are properly prepared to discharge clinical duties in the patient care setting is a very high priority. The concept of CAMPEP accredited structured mentorship programs could provide a viable and high quality pathway for training future clinical medical physicists of various backgrounds. A proper and thorough pathway for training a clinical medical physicist has three essential components: 1. A graduate degree in medical physics,physics, (or equivalent — this may need discussion). 2. Clinical training in a CAMPEP accredited clinical training program. This means either a clinical residency in one of 11 accredited programs or a structured mentorship (accredited by CAMPEP). In the structured mentorship, the idea is that a junior physicist (or some other trainee) could be entered into training under the guidance of a CAMPEP accredited mentor. The mentor is responsible for delivering the training consistent with AAPM report 36 and documenting it. 3. Sit for the ABR or equivalent exam. The ABR must accept only candidates who have been trained in these CAMPEP accredited programs, be it a residency, or the structured mentorship. ABR has stated this is a goal for 2012 and we should strongly support this goal. Issues and caveats: 1. How do we address graduates from CAMPEP accredited MS and Ph.D. programs? Do they get a break? They still need documented clinical training. However, if one comes from a CAMPEP accredited graduate program, some advanced placement may be given in the residency training process for those items in report 36 already achieved and documented. 2. It is also understood that not all facilities can offer training in all aspects of the practice as outlined in AAPM report ♯36. In such cases, the mentor (and trainee) is required to develop relationships with other training facilities that would provide and document the needed supplemental education to complete the requirements of the training program. 3. Mentors of the structured programs would be evaluated and reviewed in the same way and at the same frequency as accredited residency programs. A mentor could be deferred, denied accreditation by the same process in place at CAMPEP for current residency programs. CAMPEP should be encouraged to accomplish this. Without such expanded and structured pathways to qualified clinical practice, we will continue to experience a shortage of competent clinical medical physicists, who will do poorly on the certification exam, give medical physics a bad name and worst of all increase the possibility of harming patients. Educational Objectives: 1. To review the essential components of a thorough clinical medical physics training pathway 2. To discuss alternative pathways to help provide sufficient competent medical physicists who have followed the defined structured pathway.