Freitag, 27. April 2012

Medical physics


Medical physics
Medical physics is generally speaking the application of physics concepts, theories and methods to medicine. A medical physics department may be based in either a hospital or a university. Clinical medical physicists are often found in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiation Oncology. However, areas of specialty are widely varied in scope and breadth e.g., clinical physiology, neurophysiology (Finland), and audiology (Netherlands). In the case of research based university departments, the scope is even wider and may include anything from the study of biomolecular structure to microscopy and nanomedicine.
In the case of CLINICAL MEDICAL PHYSICS SERVICES the mission statement is as follows:
“Medical Physics Services will contribute to maintaining and improving the quality, safety, and cost-effectiveness of healthcare services through patient-oriented activities requiring expert action, involvement or advice regarding the specification, selection, acceptance testing, commissioning, quality assurance including quality control, and optimised clinical use of medical devices and regarding risks from associated Physical Agents; all activities will be based on current best evidence or own scientific research when the available evidence is not sufficient. The scope includes risks to volunteers in biomedical research, workers and public (when associated with patient safety and including carers and comforters)”
(based on a mission statement to be found in:'Guidelines on the Medical Physics Expert - Qualification and Curriculum Development Frameworks' (Caruana C. J. et al.) - a project funded by the European Commission)
The term ‘Physical Agents’ refers to ionising and non-ionising electromagnetic radiations, static electric and magnetic fields, ultrasound, laser light and any other Physical Agent associated with medical devices. As stated in the introduction at the moment the profession is mostly concerned with those devices used in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiation Oncology and associated physical agents (ionising radiation in X-ray based imaging, radionuclides in Nuclear Medicine, magnetic fields and radio-frequencies in Magnetic Resonance Imaging, ultrasound in Ultrasound imaging and Doppler measurement).
This mission includes the following 11 key activities:
1. Comprehensive Physics Problem Solving Service: Recognition of less than optimal performance or clinical use of medical devices, identification and elimination of causes, and confirmation that proposed solutions have restored devices and use to acceptable status. All activities are to be based on current best evidence or own scientific research when the available evidence is not sufficient.
2. Physical Agents Dosimetry Measurements: Measurement of patient (including volunteers in biomedical research), occupational and public doses (including carers and comforters ) and dose related quantities; selection, calibration, maintenance of dosimetry related instruments; independent checking of dose related quantities provided by commercial dose reporting or estimating devices (including software devices); measurement of dose related quantities required as inputs to commercial dose reporting or estimating devices (including software).
3. Patient Safety / Risk Management (including volunteers in biomedical research: Evaluation of clinical protocols to ensure the ongoing protection of the patient (including volunteers in biomedical research) from the deleterious effects of Physical Agents associated with the use of medical device in accordance with the latest published evidence or own research when the available evidence is not sufficient. Includes the development of risk assessment protocols.
4. Occupational and Public Safety / Risk Management (when associated with patient safety and including carers and comforters): Evaluation of clinical protocols to ensure the ongoing protection of workers and public (when associated with patient safety and including carers and comforters) from the deleterious effects of Physical Agents associated with the use of medical devices in accordance with the latest published evidence or own research when the available evidence is not sufficient. Includes the development of risk assessment protocols.
5. Clinical Medical Device Management: Specification, selection, acceptance testing, commissioning and quality assurance including quality control of medical devices in accordance with the latest published European or International recommendations and the management and supervision of associated programmes.
6. Clinical Involvement: Carrying out, participating, and where appropriate managing and supervising the everyday, routine and non-routine clinical radiation protection and quality control procedures to ensure effective use of devices and patient, staff and public safety including patient specific optimization.
7. Development of Service Quality and Cost-Effectiveness: Participation in the introduction of new devices and techniques into clinical service and new medical physics services whilst giving due attention to economic issues. Introduction of new devices and techniques should be based on current best evidence or own scientific research when the available evidence is not sufficient.
8. Expert Consultancy: Provide expert advice to outside clients (e.g., smaller clinics with insufficient in-house medical physics expertise).
9. Education of Healthcare Professionals (including Medical Physics trainees). Contribute to quality healthcare professional education through knowledge transfer activities concerning the technical-scientific knowledge, skills and competences supporting the clinically-effective, evidence-based and economical use of medical devices and safety issues concerning associated Physical Agents. Participation in the education of Medical Physics students and organization of Medical Physics residency programmes.
10. Health Technology Assessment (HTA): Take responsibility for the technical component of a Health Technology Assessment related to medical devices and /or Physical Agents and associated activities.
11. Innovation: Develop new or modify existing devices (including software) and protocols for the solution of hitherto unresolved clinical problems.
In the case of RESEARCH BASED UNIVERSITY departments the mission is wider and to emphasize this fact we often speak of BIOMEDICAL PHYSICS (formerly Medical Biophysics): Biomedical physics is the use of physics concepts, theories and methods for the greater understanding and development of clinical practice AND EXPERIMENTAL MEDICINE. This is a wider definition than Clinical Medical Physics Services and would include physics based aspects of life science research which would have a future impact on clinical practice (e.g., various forms of microscopy, nanodevices, spectrometry, biomolecular structure, cell biology physics). Most basic science departments within faculties of medicine / health science are now being grouped under the generic term ‘biomedical sciences’. Many biomedical physics departments today are of necessity multi-disciplinary and may include not only physicists but also engineers, mathematicians and sometimes chemists and physicians. (Ref: Caruana C.J., Wasilewska-Radwanska M., Aurengo A., Dendy P.P., Karenauskaite V., Malisan M.R., Meijer J.H., Mornstein V., Rokita E., Vano E., Wucherer M. (2008). The role of the biomedical physicist in the education of the healthcare professions: an EFOMP project. Physica Medica - European J of Medical Physics, 25, 133-40).

Contents

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[edit]Areas of specialty

[edit]Medical imaging

Para-sagittal MRI of the head in a patient with benign familial macrocephaly.

[edit]Treatment of disease

[edit]Physiological measurement techniques

ECG trace
Used to monitor and measure various physiological parameters. Many physiological measurement techniques are non-invasive and can be used in conjunction with, or as an alternative to, other invasive methods.

[edit]Radiation protection

[edit]Medical computing and mathematics

CT image reconstruction

[edit]Education and training

[edit]In North America

In North America,[1] medical physics training is offered at the bachelor's, master's, doctorate, post-doctorate and/or residency levels. Several universities offer these degrees in Canada and the United States.
As of October 2010, twenty-seven universities in North America have medical physics graduate programs that are accredited by The Commission on Accreditation of Medical Physics Education Programs (CAMPEP).[2] The same organization has accredited forty-three medical physics clinical residency programs.[2]
Professional certification is obtained from the American Board of Radiology, the American Board of Medical Physics, the American Board of Science in Nuclear Medicine, and the Canadian College of Physicists in Medicine. As of 2012, enrollment in a CAMPEP-accredited residency or graduate program is required to start the ABR certification process. Starting in 2014, completion of a CAMPEP-accredited residency will be required to advance to part 2 of the ABR certification process.[3]

[edit]In the United Kingdom

The person concerned must first gain a first or upper second-class honours degree in a physical or engineering science subject before they can start the Part I medical physics training within theNational Health Service.[4][5]
Trainees can complete Part I training in fifteen months provided they hold an MSc from an IPEM accredited center in the United Kingdom or the Republic of Ireland (National University of Ireland, Galway). For these candidates, the Part I training consists of pure clinical experience. Trainees applying for Part I trainee holding only a degree in a engineering or physical science subject must undertake a combined study and clinical training programme. This programme consists of two years of clinical placement, during which the trainee will study for an MSc in Medical Physics which is approved by the Institute of Physics and Engineering in Medicine (IPEM). The MSc will be either at University College London, Swansea, Sheffield, Surrey, Birmingham, Leeds, Manchester, Aberdeen,Glasgow, King's or Queen Mary's. Open University also offers a Master of Science in Medical Physics, but the prospective student should first check that this degree will satisfy the accreditation requirements or that it is accepted before embarking on it. Successful completion of the Part I training programme leads to an IPEM Diploma. The trainee can then apply for a Part II position, which consists of the IPEM's Part II training which takes a further two years and leads to Corporate Membership of the IPEM, and registration as a Clinical Scientist (if successful).
Note that some training centres offer a contract for the full four (three) years of the scheme, while some offer only part I training, with a requirement to reapply for part II.
As of October 2011, the scheme will be changing again as part of Modernising Scientific Careers.

[edit]Legislative and advisory bodies

[edit]See also

[edit]References

  1. ^ How does someone become a Medical Physicist?. AAPM. Retrieved on 2011-06-25.
  2. ^ a b CAMPEP Accredited Graduate Programs in Medical Physics. Campep.org (2011-06-01). Retrieved on 2011-06-25.
  3. ^ IC RP CAMPEP addendum. Theabr.org. Retrieved on 2011-06-25.
  4. ^ Medical physicist. NHS Careers. Retrieved on 2011-06-25.
  5. ^ Training as a clinical scientist and the scientist training programme (STP). NHS Careers. Retrieved on 2011-06-25.

[edit]Further reading

  • Amador Kane, Suzanne (2009). Introduction to Physics in Modern Medicine, Second Edition. CRC Press. ISBN 978-1-58488-943-4.
  • Khan, Faiz (2003). The Physics of Radiation Therapy. Lippincott Williams & Wilkin. ISBN 978-0-7817-3065-5.
  • Attix, Frank (1986). Introduction to Radiological Physics and Radiation Dosimetry. Wiley-VCH. ISBN 978-0-471-01146-0.

[edit]External links

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