MedicalMedical PhysicsPhysics asas aa CareerCareer

AmericanAmerican AssociationAssociation ofof PhysicistsPhysicists inin MedicineMedicine (AAPM)(AAPM) PublicPublic EducationEducation CommitteeCommittee 20032003

February 9, 2005, version 1.0 WhatWhat isis aa MedicalMedical Physicist?Physicist?

AA medicalmedical physicistphysicist isis aa professionalprofessional whowho specializesspecializes inin thethe applicationapplication ofof thethe conceptsconcepts andand methodsmethods ofof physicsphysics toto thethe diagnosisdiagnosis andand treatmenttreatment ofof humanhuman disease.disease. TheThe MedicalMedical PhysicistPhysicist BridgesBridges PhysicsPhysics andand MedicineMedicine

Medical Physicist

Physics Medicine TheThe MedicalMedical PhysicistPhysicist isis PartPart ofof thethe MedicalMedical TeamTeam

TherapyTherapy ImagingImaging

PhysicianPhysician (Radiation(Radiation PhysicianPhysician (Radiologist,(Radiologist, Oncologist,Oncologist, Surgeon,Surgeon, ……)) Cardiologist,Cardiologist, ……)) MedicalMedical PhysicistPhysicist MedicalMedical PhysicistPhysicist MedicalMedical DosimetristDosimetrist PhysicsPhysics AssistantAssistant PhysicsPhysics AssistantAssistant RadiologicalRadiological TechnologistTechnologist RadiationRadiation TherapistTherapist MedicalMedical PhysicistPhysicist RewardsRewards

ChallengeChallenge ofof applyingapplying thethe principlesprinciples ofof physicsphysics toto medicinemedicine SatisfactionSatisfaction ofof developingdeveloping newnew technologytechnology forfor medicalmedical useuse ContributingContributing toto thethe wellwell--beingbeing ofof patientspatients ReceivingReceiving competitivecompetitive compensationcompensation WhatWhat dodo wewe meanmean-- aa qualifiedqualified medicalmedical physicist?physicist? AnAn individualindividual whowho isis competentcompetent toto practicepractice independentlyindependently inin oneone oror moremore ofof thethe subfieldssubfields inin medicalmedical physics.physics. CertificationCertification andand continuingcontinuing educationeducation (to(to demonstratedemonstrate competence)competence) TrainedTrained toto bebe familiarfamiliar withwith thethe principlesprinciples ofof physicsphysics usedused inin thethe equipmentequipment andand instrumentsinstruments FamiliarFamiliar withwith governmentgovernment regulationsregulations andand lawslaws FamiliarFamiliar withwith performanceperformance specificationsspecifications ofof equipmentequipment FamiliarFamiliar withwith physicalphysical limitationslimitations ofof instruments,instruments, calibrationcalibration procedures,procedures, andand computercomputer algorithmsalgorithms MedicalMedical PhysicsPhysics DisciplinesDisciplines (Subfields)(Subfields)

TherapeuticTherapeutic RadiologicalRadiological PhysicsPhysics DiagnosticDiagnostic ImagingImaging PhysicsPhysics MedicalMedical NuclearNuclear PhysicsPhysics MedicalMedical HealthHealth PhysicsPhysics

AAPM By-Law TherapeuticTherapeutic RadiologicalRadiological PhysicsPhysics

TheThe therapeutictherapeutic applicationsapplications ofof xx--ray,ray, gammagamma ray,ray, neutron,neutron, electron,electron, andand chargedcharged--particleparticle beams,beams, andand radiationradiation fromfrom sealedsealed radionuclideradionuclide sources.sources. TheThe equipmentequipment associatedassociated withwith theirtheir production,production, use,use, measurement,measurement, andand evaluation.evaluation. TheThe qualityquality ofof imagesimages resultingresulting fromfrom theirtheir productionproduction andand use.use. MedicalMedical healthhealth physicsphysics associatedassociated withwith thisthis subfield.subfield.

AAPM By-Law CellCell KillingKilling ByBy IonizingIonizing RadiationRadiation DiagnosticDiagnostic RadiologicalRadiological PhysicsPhysics

TheThe diagnosticdiagnostic applicationsapplications ofof xx--rays,rays, gammagamma raysrays fromfrom sealedsealed sources,sources, ultrasonicultrasonic radiation,radiation, andand radioradio frequencyfrequency radiationradiation andand magneticmagnetic fieldsfields TheThe equipmentequipment associationassociation withwith theirtheir production,production, use,use, measurementmeasurement andand evaluationevaluation TheThe qualityquality ofof imagesimages resultingresulting fromfrom theirtheir productionproduction andand useuse MedicalMedical healthhealth physicsphysics associatedassociated withwith thisthis subfieldsubfield

AAPM By-Law DiscoveryDiscovery ofof XX--raysrays

On 8 Nov 1895, Wilhelm Conrad Röntgen (accidentally) discovered an image cast from his cathode ray generator. MedicalMedical NuclearNuclear PhysicsPhysics

TheThe therapeutictherapeutic andand diagnosticdiagnostic applicationsapplications ofof radionuclidesradionuclides inin unsealedunsealed sourcessources TheThe equipmentequipment associationassociation withwith theirtheir production,production, use,use, measurement,measurement, andand evaluationevaluation TheThe qualityquality ofof imagesimages resultingresulting fromfrom theirtheir productionproduction andand useuse MedicalMedical healthhealth physicsphysics associatedassociated withwith thisthis subfieldsubfield

AAPM By-Law Gamma Camera Scan

Liver metastasis from prostate carcinoma

IV administration of Tc99m

Accumulates in areas of increased blood flow due to active bone metabolism, oedema of inflammation or the angiogenesis associated with tumours MedicalMedical HealthHealth PhysicsPhysics

TheThe safesafe useuse ofof xx--ray,ray, gammagamma ray,ray, neutron,neutron, electron,electron, andand otherother chargedcharged particleparticle beamsbeams oror radionuclidesradionuclides inin medicinemedicine (for(for diagnosticdiagnostic oror therapeutictherapeutic purposes).purposes). TheThe instrumentationinstrumentation requiredrequired toto performperform appropriateappropriate radiationradiation surveys.surveys. TheThe medicalmedical physicistphysicist oftenoften servesserves asas radiationradiation safetysafety officerofficer

AAPM By-Law EmergencyEmergency ManagementManagement ofof RadiationRadiation CasualtiesCasualties

CAUTION

February 9, 2005, version 1.0 WhatWhat isis thethe MedicalMedical PhysicistPhysicist’’ss PrimaryPrimary Discipline?Discipline?

4% 1%1% 3% Radiation Therapy

15% Imaging Physics

Nuclear Medicine

Health Physics

Engineering

Administration

76%

Source: 2002 AAPM Survey WhatWhat isis thethe MedicalMedical PhysicistPhysicist’’ss PrimaryPrimary Responsibility?Responsibility?

4% 2% 3% Clinical 5% Academic 8% Research

Administrative

Regulatory

Product Development

78%

Source: 2002 AAPM Survey GeneralGeneral AreasAreas ofof ResponsibilityResponsibility ofof thethe MedicalMedical PhysicistPhysicist

ClinicalClinical ResearchResearch EducationEducation RegulatoryRegulatory ComplianceCompliance ClinicalClinical ResponsibilitiesResponsibilities ofof thethe MedicalMedical PhysicistPhysicist DailyDaily clinicalclinical supportsupport EquipmentEquipment acquisitionsacquisitions SiteSite planningplanning QualityQuality assuranceassurance DoseDose calculationscalculations LiaisonLiaison betweenbetween otherother medicalmedical professionals,professionals, manufacturers,manufacturers, andand regulatoryregulatory agenciesagencies ResearchResearch andand DevelopmentDevelopment OpportunitiesOpportunities forfor thethe MedicalMedical PhysicistPhysicist

DevelopDevelop newnew therapeutictherapeutic oror diagnosticdiagnostic proceduresprocedures ImplementImplement and/orand/or integrateintegrate newnew equipmentequipment intointo clinicalclinical useuse InvestigateInvestigate oror evaluateevaluate therapeutictherapeutic oror diagnosticdiagnostic outcomes/performanceoutcomes/performance BasicBasic scientificscientific researchresearch EducationalEducational FunctionsFunctions ofof thethe MedicalMedical PhysicistPhysicist GraduateGraduate programsprograms inin MedicalMedical PhysicsPhysics ResidencyResidency programsprograms MedicalMedical PhysicsPhysics DiagnosticDiagnostic RadiologyRadiology RadiationRadiation OncologyOncology NuclearNuclear MedicineMedicine OthersOthers (Cardiology,(Cardiology, Gynecology,Gynecology, ……)) AlliedAllied HealthHealth ProfessionalsProfessionals OtherOther trainingtraining opportunitiesopportunities AAPMAAPM annualannual meetingmeeting andand summersummer schoolschool ACMPACMP seminarsseminars OtherOther professionalprofessional societysociety meetingsmeetings TherapeuticTherapeutic RadiologicalRadiological PhysicsPhysics

AnAn IntroductionIntroduction

February 9, 2005, version 1.0 ModernModern RadiationRadiation TherapyTherapy UsingUsing HighHigh EnergyEnergy XX--raysrays andand ElectronsElectrons IsocentricIsocentric PatientPatient RadiationRadiation TherapyTherapy TherapeuticTherapeutic GainGain A compromise between tumor control and normal tissue complications

100 Tumor Cell Killing

50 Normal Tissue Damage Complication (%) Complication Tumor Control (%)

Dose (Gy) ExternalExternal BeamBeam RadiationRadiation TherapyTherapy

45 Gy 65 Gy 70 Gy 25 Gy

78 Gy 76 Gy

3D Conformal Technique for Treating Prostate Cancer 99--FieldField HeadHead && NeckNeck IMRTIMRT CaseCase

Int J Radiat Oncol Biol Phys 2001;51:880-914 TargetTarget LocalizationLocalization andand ImmobilizationImmobilization UsingUsing UltrasoundUltrasound inin ProstateProstate RadiationRadiation TherapyTherapy ExampleExample ofof FunctionsFunctions InIn TherapyTherapy PhysicsPhysics

•Clinical Medical Physics Dosimetry, radiation safety, quality assurance, etc.

•Research and Development Develop new therapeutic equipment or procedures, etc.

•Education Training of medical physicists, physicians, technologists, radiation therapists, and medical dosimetrists.

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities EquipmentEquipment andand facilityfacility specificationspecification andand acquisitionacquisition

Pd 2 B = pri x WUT

Shielding calculations

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities

EquipmentEquipment commissioningcommissioning

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities

CalibrationCalibration ofof radiationradiation sourcessources

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities

PlanningPlanning ofof patientpatient proceduresprocedures

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities

CalculationCalculation ofof patientpatient dosedose 60Gy in 30 Fractions

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities • ManagementManagement ofof specialspecial procedure:procedure: stereotacticstereotactic radiosurgeryradiosurgery TherapyTherapy ResponsibilitiesResponsibilities

CalibrationCalibration andand qualityquality assuranceassurance

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities DevelopmentDevelopment ofof newnew devicesdevices andand techniquestechniques

Contributed By: Dong (MD Anderson) TherapyTherapy ResponsibilitiesResponsibilities

RadiationRadiation safetysafety TherapyTherapy ResponsibilitiesResponsibilities

RegulatoryRegulatory compliancecompliance (examples)(examples)

U.S. Nuclear Regulatory Commission DiagnosticDiagnostic RadiologicalRadiological PhysicsPhysics

AnAn IntroductionIntroduction

February 9, 2005, version 1.0 ComponentsComponents inin DiagnosticDiagnostic ImagingImaging

ClinicalClinical imagesimages ImagingImaging PhysicsPhysics andand PrinciplesPrinciples QualityQuality ControlControl (QC)(QC) teststests RadiationRadiation dosedose andand effectseffects inin patientspatients ShieldingShielding oror sittingsitting considerationsconsiderations DiagnosticDiagnostic UseUse ofof XX--raysrays AngiographyAngiography –– SubtractionSubtraction ImagingImaging ComputedComputed RadiographyRadiography

AC-3

ADC / EDR

Hard Copy PACS Soft-Copy Read QCW

Network ComputedComputed TomographyTomography PrinciplePrinciple X-rays

intensity

angle Computed Tomography (CT) Back Projection

Use 1D projection as a template

Back projection of pixel brightness

PROJECTION RECONSTRUCTION

http://www.colorado.edu/physics/2000/index.pl Example of a CT Image of Abdomen

Axial image looking up from the feet.

Liver metastasis from colon carcinoma CTCT -- CoversCovers OffOff !!!!!! Quality Assurance of CT Scanner Magnetic Resonance Imaging (MRI) Zero External Magnetic Field

Point in random directions. Magnetic Resonance Imaging (MRI) In Strong External Magnetic Field

Strong Magnetic Field

Some line up. Some line down. Just the majority line up. Out of 1 million ~ 500,002 UP – 499,998 DOWN. Magnetic Resonance Imaging (MRI) Flipping Spins

Main magnetic field (~ 1.5 T) Wobbling ‘gyroscope’ motion. Precession Bulk Magnetisation N ‘M’ EMFs Radiofrequency induced Pulse

S To computer Magnetic Resonance Imaging (MRI) Nuclear Relaxation and Image Contrast

Spin-Lattice (or T ) Relaxation. Z 1 Tipping back up of the bulk magnetisation (M). Direction of Re-aligns with B. magnetic field B M

T1 ~ 1 second for tissues. Mz X

Proton density variations < 10% Y T1 variations can be ~ 700% Magnetic Resonance Imaging (MRI) Axial Brain Images

Proton density T1-weighted T2-weighted weighted MRMR SpectroscopySpectroscopy

NAA

Cr GABA PCr Glu, Gln Lactate Lipids Ins Cho Cr Asp Glu NAA Gln MRMR SpectroscopySpectroscopy

T1+C Cho/Cr Map Lipids MedicalMedical NuclearNuclear PhysicsPhysics

AnAn IntroductionIntroduction

February 9, 2005, version 1.0 MedicalMedical NuclearNuclear PhysicsPhysics

FunctionalFunctional andand morphologicalmorphological imagingimaging

RadionuclideRadionuclide therapiestherapies NuclearNuclear MedicineMedicine

RadioactiveRadioactive materialmaterial attachedattached toto agentagent PhysicalPhysical HalfHalf--lifelife ofof radioactiveradioactive materialmaterial BiologicalBiological HalfHalf--lifelife ofof radioactiveradioactive materialmaterial -λt AAt == AA0 ee RadiopharmaceuticalRadiopharmaceutical administeredadministered toto patientpatient WaitWait forfor distributiondistribution RadioactivityRadioactivity yieldsyields imagesimages ofof functionfunction ImageImage Fusion:Fusion: MRIMRI andand NMINMI

MRI (anatomy) NMI (functional) Positron Emission Tomography (PET) β+ Decay

Proton-rich radioisotopes e.g., 15O, 11C, 18F

Produced by proton bombardment in a particle accelerator called a CYCLOTRON

Decay by: p → n e+ ν e+ = positron. This is ANTI-MATTER.

18 F – ½ life ~ 110 minutes. Get that cyclotron 11 C – ½ life ~ 20 minutes. ⇒ near the scanner!! 15O – ½ life ~ 2 minutes!! Positron Emission Tomography (PET)

Rings of dense & segmented scintillation crystals (BGO) coupled to PMT’s surround patient.

2 x 511 keV photons emitted back-to-back at annihilation.

~ 1mm Positron Emission Tomography (PET)

Determining LINE OF RESPONSE (LOR) :

POSITION detecting of crystal.

CO-INCIDENCE circuits determine if detector directly opposite detected same event (within ~ 2ns).

ENERGY of photon determined.

Eliminates stray or scattered γ rays.

Image ⇒ projection reconstruction along multiple LORs (like in CT). Image of Human Brain - Stroke

Glucose molecule labelled with Fluorine-18.

Intravenous “Dead” areas of brain No glucose metabolism administration. ExampleExample ofof QualityQuality AssuranceAssurance LinearityLinearity CorrectionsCorrections NuclearNuclear MedicineMedicine QCQC ImageImage MedicalMedical HealthHealth PhysicsPhysics

AnAn IntroductionIntroduction

February 9, 2005, version 1.0 RadiationRadiation DosesDoses andand DoseDose LimitsLimits

Flight from Los Angeles to London 5 mrem Annual public dose limit 100 mrem Annual natural background 300 mrem Fetal dose limit 500 mrem Barium enema 870mrem Annual radiation worker dose limit 5,000 mrem Heart catheterization 45,000 mrem Life saving actions guidance (NCRP-116) 50,000 mrem Mild acute radiation syndrome 200,000 mrem

LD50/60 for humans (bone marrow dose) 350,000 mrem Radiation therapy (localized & fractionated) 6,000,000 mrem RadioactiveRadioactive MaterialMaterial

• Radioactive material consists of atoms with unstable nuclei • The atoms spontaneously change (decay) to more stable forms and emit radiation • A person who is contaminated has radioactive material on their skin or inside their body (e.g., inhalation, ingestion or wound contamination) TypesTypes ofof RadiationRadiation HazardsHazards

Internal ExternalExternal ExposureExposure -- Contamination wholewhole--bodybody oror partialpartial-- bodybody (no(no radiationradiation External hazardhazard toto EMSEMS staff)staff) Contamination ContaminatedContaminated -- External externalexternal radioactiveradioactive Exposure material:material: onon thethe skinskin internalinternal radioactiveradioactive material:material: inhaled,inhaled, swallowed,swallowed, absorbedabsorbed throughthrough skinskin oror woundswounds CausesCauses ofof RadiationRadiation Exposure/ContaminationExposure/Contamination AccidentsAccidents NuclearNuclear reactorreactor MedicalMedical radiationradiation therapytherapy IndustrialIndustrial irradiatorirradiator Lost/stolenLost/stolen medicalmedical oror industrialindustrial radioactiveradioactive sourcessources TransportationTransportation TerroristTerrorist EventEvent RadiologicalRadiological dispersaldispersal devicedevice (dirty(dirty bomb)bomb) LowLow yieldyield nuclearnuclear weaponweapon Example:Example: FacilityFacility PreparationPreparation

ActivateActivate hospitalhospital planplan ObtainObtain radiationradiation surveysurvey metersmeters CallCall forfor additionaladditional support:support: StaffStaff fromfrom NuclearNuclear Medicine,Medicine, RadiationRadiation Oncology,Oncology, RadiationRadiation SafetySafety (Health(Health Physics)Physics) PlanPlan forfor decontaminationdecontamination ofof uninjureduninjured personspersons EstablishEstablish triagetriage areaarea PlanPlan toto controlcontrol contaminationcontamination InstructInstruct staffstaff toto useuse universaluniversal precautionsprecautions andand doubledouble gloveglove EstablishEstablish multiplemultiple receptaclesreceptacles forfor contaminatedcontaminated wastewaste ProtectProtect floorfloor withwith coveringcovering ifif timetime allowsallows Example:Example: PatientPatient ManagementManagement -- TriageTriage

TriageTriage basedbased on:on: InjuriesInjuries SignsSigns andand symptomssymptoms -- nausea,nausea, vomiting,vomiting, fatigue,fatigue, diarrheadiarrhea HistoryHistory -- WhereWhere werewere youyou whenwhen thethe bombbomb exploded?exploded? ContaminationContamination surveysurvey Example:Example: FacilityFacility RecoveryRecovery RemoveRemove wastewaste fromfrom thethe EmergencyEmergency DepartmentDepartment andand triagetriage areaarea SurveySurvey facilityfacility forfor contaminationcontamination DecontaminateDecontaminate asas necessarynecessary NormalNormal cleaningcleaning routinesroutines (mop,(mop, stripstrip waxedwaxed floors)floors) typicallytypically veryvery effectiveeffective PeriodicallyPeriodically reassessreassess contaminationcontamination levelslevels ReplaceReplace furniture,furniture, floorfloor tiles,tiles, etetc.c. thatthat cannotcannot bebe adequatelyadequately decontaminateddecontaminated DecontaminationDecontamination Goal:Goal: LessLess thanthan twicetwice normalnormal backgroundbackground……higherhigher levelslevels maymay bebe acceptableacceptable EducationalEducational OpportunitiesOpportunities ProfessionalProfessional TrainingTraining

AcademicAcademic TrainingTraining MSMS oror PhDPhD inin medicalmedical physics,physics, oror MSMS oror PhDPhD inin physicsphysics oror relatedrelated disciplinediscipline withwith postpost--graduategraduate academicacademic trainingtraining inin medicalmedical physics.physics.

ClinicalClinical TrainingTraining ResidencyResidency inin clinicalclinical medicalmedical physics,physics, and/orand/or SupervisedSupervised onon--thethe--jobjob trainingtraining inin clinicalclinical medicalmedical physics.physics. PathwaysPathways intointo MedicalMedical PhysicsPhysics

B.S. in Physics M.S. or Ph.D. in Physics or related field or related field

Medical Physics M.S. or Ph.D. in Medical Physics Postdoctoral Training

Medical Physics Residency Program

On the Job Clinical Training On the Job Clinical Training in Medical Physics in Medical Physics

Practicing Medical Physicists

Contributed By: Dong (MD Anderson) ExampleExample GraduateGraduate ProgramProgram RequirementsRequirements (Univ. of Texas Graduate School of Biomedical Sciences, Houston)

M.S.M.S. ProgramProgram 3434 semestersemester hourshours ofof didacticdidactic curriculacurricula DiagnosticDiagnostic imagingimaging physicsphysics clinicalclinical rotationrotation RadiationRadiation therapytherapy physicsphysics clinicalclinical rotationrotation ThesisThesis Ph.D.Ph.D. ProgramProgram M.S.M.S. ProgramProgram requirementsrequirements 33 ResearchResearch tutorialstutorials OralOral candidacycandidacy examexam DissertationDissertation Contributed By: Hogstrom (MD Anderson) ExampleExample MedicalMedical PhysicsPhysics CurriculaCurricula (Univ. of Texas Graduate School of Biomedical Sciences, Houston)

RequiredRequired CoursesCourses MathematicsMathematics forfor MedicalMedical PhysicsPhysics ElectronicsElectronics forfor MedicalMedical PhysicistsPhysicists RadiationRadiation Detection,Detection, Instrumentation,Instrumentation, andand DataData AnalysisAnalysis IntroIntro MedMed PhysPhys I:I: BasicBasic InteractionsInteractions IntroIntro MedMed PhysPhys II:II: MedicalMedical ImagingImaging IntroIntro MedMed PhysPhys III:III: TherapyTherapy IntroIntro MedMed PhysPhys IV:IV: NuclearNuclear MedicineMedicine MedicalMedical PhysicsPhysics SeminarsSeminars (3)(3)

Contributed By: Hogstrom (MD Anderson) ExampleExample MedicalMedical PhysicsPhysics CurriculaCurricula (Univ. of Texas Graduate School of Biomedical Sciences, Houston)

RadiationRadiation BiologyBiology RadiationRadiation ProtectionProtection AnatomyAnatomy andand OncologyOncology forfor MedicalMedical PhysicistsPhysicists IntroductoryIntroductory BiochemistryBiochemistry (Ph.D.(Ph.D. only)only) EthicalEthical DimensionsDimensions ofof thethe BiomedicalBiomedical SciencesSciences ElectivesElectives PhysicsPhysics andand ApplicationsApplications ofof ElectronElectron BeamBeam TransportTransport CommissioningCommissioning andand QAQA ofof RTRT PlanningPlanning SystemsSystems DigitalDigital ProcessingProcessing ofof BiomedicalBiomedical ImagesImages PrinciplesPrinciples ofof MagneticMagnetic ResonanceResonance ImagingImaging PhysicsPhysics ofof PositronPositron EmissionEmission TomographyTomography

Contributed By: Hogstrom (MD Anderson) CAMPEPCAMPEP--AccreditedAccredited GraduateGraduate EducationEducation ProgramsPrograms AsAs ofof JulyJuly 2003,2003, therethere werewere 99 accreditedaccredited programs:programs: McGill University - Montreal University of Florida University of California - Los Angeles University of Kentucky Medical Center University of Oklahoma HSC University of Texas HSC - Houston University of Texas HSC - San Antonio University of Wisconsin Wayne State University

[For more info contact AAPM @ www.aapm.org or (301) 209-3350] CAMPEPCAMPEP--AccreditedAccredited ResidencyResidency EducationEducation ProgramsPrograms AsAs ofof JulyJuly 2003,2003, therethere werewere 55 accreditedaccredited programs:programs: RadiationRadiation TherapyTherapy PhysicsPhysics FairviewFairview UniversityUniversity MedicalMedical CenterCenter (Minneapolis)(Minneapolis) McGillMcGill UniversityUniversity (Montreal)(Montreal) UniversityUniversity ofof FloridaFlorida (Gainesville)(Gainesville) WashingtonWashington UniversityUniversity SchoolSchool ofof MedicineMedicine (St.(St. Louis)Louis) DiagnosticDiagnostic ImagingImaging PhysicsPhysics TheThe UniversityUniversity ofof TexasTexas M.M. D.D. AndersonAnderson CancerCancer CenterCenter (Houston)(Houston) [For more info contact AAPM @ www.aapm.org or (301) 209-3350] ProfessionalProfessional IssuesIssues AmericanAmerican AssociationAssociation ofof PhysicistsPhysicists inin MedicineMedicine (AAPM)(AAPM) MissionMission StatementStatement ToTo advanceadvance thethe practicepractice ofof physicsphysics inin medicinemedicine andand biologybiology byby encouragingencouraging innovativeinnovative researchresearch andand development,development, disseminatingdisseminating scientificscientific andand technicaltechnical information,information, fosteringfostering thethe educationeducation andand professionalprofessional developmentdevelopment ofof medicalmedical physicists,physicists, andand promotingpromoting thethe highesthighest qualityquality ofof medicalmedical servicesservices forfor patients.patients.

AAPM By-Law Total AAPM Membership 6000

5000

4000

3000

2000

Number of Members Number 1000

0

9 7 9 1 3 5 7 9 83 85 9 9 98 98 99 99 99 99 196 1971 1973 1975 1977 1979 1981 1 1 1 1 1 1 1 1 199 2001 2003 Year

AAPM Membership Service Recent Full Members 4,000

3,500

3,000

2,500

2,000

1,500

1,000 Number of Members Number of

500

0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Year AAPM Membership Service ProfessionalProfessional CredentialsCredentials ofof MedicalMedical PhysicistsPhysicists

EducationEducation:: M.S.M.S. (51%)(51%) oror Ph.D.Ph.D. (49%)(49%) inin medicalmedical physics,physics, physics,physics, nuclearnuclear engineering,engineering, oror relatedrelated disciplinediscipline CertificationCertification:: ByBy specialtyspecialty LicensureLicensure:: StateState licensurelicensure oror registrationregistration HospitalHospital CredentialsCredentials:: ProcedureProcedure specificspecific privilegesprivileges ProfessionalProfessional CredentialsCredentials

BoardBoard CertificationsCertifications AmericanAmerican BoardBoard ofof RadiologyRadiology AmericanAmerican BoardBoard ofof MedicalMedical PhysicsPhysics

LicensureLicensure andand RegistrationRegistration TexasTexas (first(first inin 1992),1992), Florida,Florida, NewNew York,York, andand HawaiiHawaii LicensureLicensure beingbeing pursuedpursued inin California,California, andand nationallynationally ManyMany statesstates requirerequire boardboard certificationscertifications ManyMany statesstates requirerequire registrationregistration

ProfessionalProfessional SocietySociety MembershipsMemberships ProfessionalProfessional SocietiesSocieties

MedicalMedical PhysicsPhysics ProfessionalProfessional SocietiesSocieties American Association of Physicists in Medicine American College of Medical Physics

SisterSister--ProfessionalProfessional SocietiesSocieties American Society of Therapeutic Radiology & Oncology Radiological Society of North America American College of Radiology Society of Nuclear Medicine International Society for Magnetic Resonance in Medicine American Brachytherapy Society Health Physics Society …… WhereWhere areare MedicalMedical PhysicistPhysicist’’ss PrimaryPrimary Employment?Employment?

6% 8% Private Hospital 8% Government Hospital 41% 1% University Hospital Government Physicist's Service Group Physician's Service Group Industry 33% 3%

Source: 2002 AAPM Survey AverageAverage IncomeIncome (MS(MS Degree)Degree)

Total Annual Income 140

) 120 100 80 60 No Certification 40 Certification

Salary (Thousands 20 0 0-2 3-4 5-9 10-14 15-19 20+ Years of Experience Source: 2002 AAPM Survey AverageAverage IncomeIncome (PhD(PhD Degree)Degree)

Total Annual Income 160

) 140 120 100 80 60 No Certification 40 Certification Salary (Thousands 20 0 0-2 3-4 5-9 10-14 15-19 20+ Years of Experience

Source: 2002 AAPM Survey ForFor MoreMore InformationInformation

http://www.aapm.orghttp://www.aapm.org

AmericanAmerican AssociationAssociation ofof PhysicistsPhysicists inin MedicineMedicine (AAPM) Public Education Committee 2003 February(AAPM) 9, 2005, version 1.0 Public Education Committee 2003