Masters degree during TEAP, I imagine it would certainly be harder again to ... be known for their outgoing nature, however getting through TEAP will be much.
Australasian Physical & Engineering Sciences in Medicine Volume 32 Number 1, 2009
GUEST EDITORIAL As a physicist who has recently completed Radiation Oncology TEAP, I have been asked to convey my experiences and views. Hopefully that is what I have done below. I have expressed my own views on TEAP in the hope they will be of use or interest. The training program is now producing its first accredited physicists and, hopefully, ensuring a high quality of training. However development of this program started before I knew what a medical physicist was and I’m sure this development is set to continue. The program has had to be flexible during these initial years allowing for the necessary changes which are needed to take anything from theory into practise. These changes have occurred throughout my training and did provide additional challenges to supervisors and registrars. Despite the difficulties presented to the registrars by changing the program, the changes have resulted in a better program which is simpler to understand and better focused1. While the number of changes is slowing as the program asymptotes towards what we believe is best, there are certainly still improvements which can be made. These improvements should be lead by the registrars and supervisors who are most aware of any difficulties which still exist. I often find it hard to be critical of the training program as it has allowed me to learn and grow into my chosen profession certainly with advantages over physicists who came to the profession prior to its introduction. I also feel that in many cases I have been very lucky even within the TEAP program. I have had a supportive department, an enthusiastic supervisor who I found easy to work with and a large physicist group to learn from. Thanks to NSW Health, I had a fully funded supernumerary position2. My department has an active research program that has created a culture encouraging research and publication. This made it easy to achieve the research requirements of TEAP leading to publication of my work3. As this was the first paper I had ever written I found it challenging, sometimes disheartening but a worthwhile experience. Through the review process, I received criticism of my writing and scientific method. This was certainly a really worthwhile requirement of the program. Even with all of these advantages, TEAP was not easy. I am sure many people remember or are still experiencing the conflicts involved in studying part-time and working full-time. I feel it must be even harder for registrars who do not have the advantages I had. Part of the motivation for the training program was the lack of qualified physicists in Australia and New Zealand. As this problem has not yet completely been resolved, it is often hard for clinical physicists to find the time required to train a registrar. Equally it is hard for the registrar to work on their training when they are aware of the pressure
other physicists are under. There is no simple solution to this problem. While I found time an issue while completing a Masters degree during TEAP, I imagine it would certainly be harder again to attempt to complete a PhD while training and yet the research experience gained would be of great benefit to the registrar and possibly the medical physics community in general. Should we therefore encourage potential registrars to start or possibly finish a PhD before they enter the program, or instead to hold off until they are accredited? Perhaps I am underestimating future registrars who could complete TEAP and a PhD concurrently. Certainly the current TEAP program, possibly by necessity, appears to encourage a master’s degree over a PhD and it really is for the current workforce to decide if changes to TEAP are necessary and possible on this issue. I feel I was lucky to be trained at the Royal Prince Alfred Hospital as I had multiple physicists whose opinion and training could be sought. While physics may be black and white, there are certainly shades of grey in its application to medical physics. It is these areas which make the input of more than one physicist into the training of a registrar so preferable. It is often the conflicts in advice and training, and resulting discussion which lead to a better understanding of a particular area. It is for these reasons that I believe it may be desirable at times for a physics registrar to move hospitals during their training. This could be facilitated by state health departments employing registrars rather than individual hospitals or by compulsory training rotations to other departments. There are many valid objections to registrar rotations or permanent relocations. Certainly when understaffed physics departments have invested time in training a registrar they may not wish to have them leave as they become more useful. It has also been suggested that it would not be good to employ someone who has been trained in the ways of another hospital. This is however precisely why a registrar should not be “locked” into one single hospital. The training of physicists should allow them to work at any centre in the future and this would be improved by a permanent move or even secondment to another centre. Certainly radiation oncology registrars and radiation xi
Claridge x Guest Editorial
Australas. Phys. Eng. Sci. Med. Vol. 32, No 1, 2009
therapists gain experience in other departments and this is not seen as unusual or unworkable but in fact as beneficial. I thought it may be useful to use this forum to also give some advice to current registrars. Hopefully the advice will be useful but as it only comes from my experiences it may not be universally applicable. 1. To new registrars but applicable all, I advise you to be proactive and get involved in the department. Physicists may not be known for their outgoing nature, however getting through TEAP will be much easier and more enjoyable if you get involved in the clinical work. Most people would be happy for you to join in or observe what they are doing and if you need to learn something specific ask someone to teach you. There is an amazing amount you can learn from the Radiation Oncologists, Radiation Therapists, Engineers and other physicists. 2. Take opportunity to attend conferences and workshops and get involved in clinical trials or specialty groups at your hospital. 3. More practically, I would suggest starting work on competencies early and recording all the work that went into completing them. Some competencies take significant amounts of time to complete and it is difficult to find time for this later on. 4. It is also worthwhile to start studying for the theory exams early. The overlaps between your exam study, the competencies you are working on and your clinical work will not be obvious until you start the study. Then you will realise how useful the study is to everything else. 5. Throughout the training I would suggest writing short reports on completed work and training. This provides proof of completed competencies and may be reworked into a portfolio report. In your final two
years, plan projects which can be written into portfolio reports. These should cover the five core areas and will lead to better quality portfolio reports. 6. I found that I worried about the exams and I’m sure nothing I will write will stop future registrars worrying also. All I can offer as advice on this subject is to have other physicists give you mock oral and practical exams and listen to their feedback. By passing my exams, I have finished TEAP and, as required, moved on to some degree. I am however sure this will not be the end of my involvement in TEAP. As I have seen the benefits of TEAP for myself and other registrars, I have also seen the benefit for physics departments. While learning, registrars question existing department practises and bring in up-dated knowledge. So it is not for purely altruistic reasons but also for selfish ones that I wish to continue to have registrars training where I work and to supervise registrars in the future. Me as a supervisor! Scary thought! References 1. ACPESM Radiation Oncology Medical Physics Clinical Training Guide, ACPSEM, Australia, 2008. 2. Metcalfe, Peter, Educate to dominate, Aust. Phys. Eng. Sci. Med. 30 (4) xiii-xiv, 2007. 3. Mackonis, E.C., Suchowerska, N., Zhang, M., Ebert, M., McKenzie, D.R. and Jackson, M., Cellular response to modulated radiation fields, Phys. Med. Biol. 52 (18) 5469-82, 2007.
Elizabeth Claridge Mackonis, Department of Radiation Oncology, Royal Prince Alfred Hospital, Sydney
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