ESR News September 2015

The role of the Medical Physics Expert in Diagnostic and Interventional Radiology

John Damilakis, Professor of Medical Physics

The new European Union (EU) Basic Safety Standards (BSS) Directive (1) defines the ‘medical physics expert’ as ‘an individual or, if provided for in national legislation, a group of individuals, having the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to medical exposure, whose competence in this respect is recognised by the competent authority’. Educational qualification of medical physicists is usually accomplished in two phases. The first phase of the education programme is completion of a bachelor’s degree in physics or an equivalent degree in a relevant subject. The second phase is completion of a master’s degree in medical physics. Medical physicists who have clinical responsibilities should have completed a structured, accredited clinical training residency. The European Commission’s ‘European Guidelines on Medical Physics Expert’ publication (2) states that this residency should be in the specialty of diagnostic and interventional radiology, nuclear medicine, or radiation oncology and the duration should be typically two full-time year equivalents. This means that clinically certified medical physicists are professionals with master’s degrees in medical physics and two years of clinical training in a medical physics specialty. The ‘medical physics expert’ level in a given specialty of medical physics requires structured accredited advanced experience and continuous professional development (CPD). To become a ‘medical physics expert’, a clinically certified medical physicist needs an additional minimum of two full-time year equivalents (2).

The main role of medical physicists in everyday clinical practice is to optimise the use of radiation to ensure the safety and quality of diagnostic or interventional procedures. The EU BSS states that “Member States shall ensure that depending on the medical radiological practice, the medical physics expert takes responsibility for dosimetry, including physical measurements for evaluation of the dose delivered to the patient and other individuals subject to medical exposure, give advice on medical radiological equipment, and contribute in particular to the following:
(a) optimisation of the radiation protection of patients and other individuals subject to medical exposure, including the application and use of diagnostic reference levels;
(b) the definition and performance of quality assurance of the medical radiological equipment;
(c) acceptance testing of medical radiological equipment;
(d) the preparation of technical specifications for medical radiological equipment and installation design;
(e) the surveillance of the medical radiological installations;
(f) the analysis of events involving, or potentially involving, accidental or unintended medical exposures;
(g) the selection of equipment required to perform radiation protection measurements;
(h) the training of practitioners and other staff in relevant aspects of radiation protection.”

It is important to emphasise that the medical physicist is a member of the multidisciplinary team responsible for diagnosing or treating patients with x-rays. Unfortunately, cases of unintentional exposure to ionising radiation have been reported which have led to significant overexposure of patients or to exposure of unborn children. Effective communication is needed among radiologists, medical physicists and radiographers to avoid errors and to optimise diagnostic and interventional procedures.

1. Council of the European Union. (2013). Council Directive 2013/59/Euratom laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom. Official Journal L-13 of 17.01.2014.
2. European Commisssion, ‘European Guidelines on Medical Physics Expert’, Radiation Protection No 174, Directorate-General for Energy, Directorate D – Nuclear Safety and Fuel Cycle, Unit D.3 – Radiation Protection, 2014