Confidence and proficiency levels of medical dosimetry graduates

The purpose of this study was to examine the confidence and proficiency levels of medical dosimetry graduates as they transition from student to professional during their first employment as medical dosimetrists. In addition, this study explored the support provided by employers to assist those medical dosimetry graduates during this transitional period. With assistance from the Medical Dosimetrist Certification Board (MDCB), individuals who graduated from a Joint Review Committee on Education in Radiologic Technology accredited medical dosimetry program between 2011 and 2018 and earned MDCB certification between 2012 and 2018 were invited to complete an original survey detailing their experiences during their first employment as medical dosimetrists. Data were collected using Qualtrics and analyzed with IBM's SPSS. Most (93, 56.7%) participants indicated a moderate confidence level in their abilities to function as medical dosimetrists and suggested it took approximately 6 months (56, 34.1%) to feel confident in their role as medical dosimetrists in the professional clinical setting. Regarding treatment planning techniques, participants indicated low proficiency levels in proton beam and brachytherapy plans and high proficiency levels in 3-dimensional conformal radiation therapy, intensity modulated radiation therapy, and electron beam plans. These findings suggest that educators should consider strengthening curricula and offering additional clinical rotations specific to those areas that lacked proficiency. Most (128, 78.0%) did not complete a dosimetry-specific new employee training program, but believed such support would have been somewhat helpful (44, 34.4%) during their transition from student to professional. Hiring managers and dosimetry supervisors may find it beneficial to implement support measures to assist medical dosimetry graduates as they transition from student to professional.     

A quantitative comparative study of medical dosimetry graduates with and without prior radiation therapy certification

All but a small number of formal medical dosimetry programs require radiation therapy certification for admission. The problem is a lingering perception from the radiation oncology community that medical dosimetry students must have a prior radiation therapy certification and/or experience. There is a paucity of evidence in the literature to support the perception that prior radiation therapy certification equates to better job performance as a medical dosimetrist. The purpose of this quantitative comparative study was to investigate outcomes of medical dosimetry graduates with and without prior radiation therapy certification (RTT and non-RTT). The researcher used archival records to examine comparison data of medical dosimetry graduates with and without radiation therapy certification including track of enrollment, admissions cumulative grade point averages (CGPA) and science grade point averages (SGPA), medical dosimetry program GPAs, radiation therapy work experience, Medical Dosimetrist Certification Board (MDCB) exam pass rates, program completion rates, and job placement rates. Surveys were used to collect and analyze data from clinical supervisors at affiliate internship sites and from employers of program graduates. Key findings from the quantitative study revealed that no relevant differences existed between RTT and non-RTT medical dosimetrist graduates with regard to GPA and program effectiveness data. However, for RTT and non-RTT students combined, there were significantly lower GPAs noted for individuals who did not graduate from the program or graduates that did not pass the MDCB exam on first attempt. Thematic findings from the surveys revealed non-RTT medical dosimetrist students/graduates required more initial training and supervision and differences were noticed among the non-RTT medical dosimetrist students/graduates based on their prior degree. Clinical supervisors and employers had no reservations about hiring RTT or non-RTT medical dosimetry graduates from the program.     

The incidence of burnout or compassion fatigue in medical dosimetrists as a function of various stress and psychologic factors

Burnout and compassion fatigue (CF) adversely affect medical professionals, including those employed in radiation oncology. Previously conducted research acknowledged the presence of burnout in populations of radiation therapists, radiation oncologists, and oncology nursing staff. The aim of the following research was to measure the incidence of burnout or CF in the specific population of medical dosimetrists surveyed. As professional members of the radiation oncology team, this group had not been included in published research data to date. The hypothesis of the subsequent study stated that a comparable incidence of burnout would be observed among medical dosimetrists as had been reported by earlier researchers for a population of radiation therapists. A survey tool based on the Maslach Burnout Inventory (MBI) and distributed to full members of the American Association of Medical Dosimetrists (AAMD) was utilized as the research measurement method. Results obtained indicated an incidence rates of burnout or CF for medical dosimetrists were less than the rates previously measured for radiation therapists (53% vs 11% for emotional exhaustion [EE] and 45% vs 27% for depersonalization [DP]). The incidence of burnout was based on the Burnout Inventory (BI) developed for the research project. Each of the subscales, EE, DP, and decreased personal accomplishment (PA), was considered and analyzed independently. Although not as prevalent among medical dosimetrists as a variety of additional radiation oncology professionals, a significant portion of the population demonstrated signs of burnout or CF. Future concerns abound for the population of medical dosimetrists as a large number of members scored positive for intermediate risk of burnout and CF. Additionally, a large portion of the population was found to be rapidly approaching retirement.     

A code of ethics for the medical dosimetrist - The American Association of Medical Dosimetrists Experience

The Committee on Protocol and Ethics of the American Assoclation of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was adopted as AAMD policy in October 1995.     

Leading past COVID-19: An analysis of remote work now and beyond

In response to the coronavirus disease 2019 (COVID-19) pandemic, many cancer centers and clinics deployed remote work options for their employees. Due to the rapid response needed during this crisis, little to no feedback was obtained from dosimetrists. This study aimed to assess the productivity level and job satisfaction of medical dosimetrists in response to changes in working conditions due to the COVID-19 pandemic. With the assistance from the medical dosimetrists certification board (MDCB), critical data was gathered via an original instrument conducted and distributed by The University of Texas MD Anderson Cancer Center–School of Health Professions to all current practicing certified medical dosimetrists registered with the MDCB. Data were collected using Qualtrics and analyzed with IBM's SPSS. Most (326, 77.7%) participants indicated they transitioned to a version of remote work due to COVID-19. Almost half of the participants (208, 49.5%) reported increased job satisfaction due to the option to work remotely. The participants reported being extremely satisfied with the individual (247, 58.8%) and department (201, 47.9%) productivity levels even after implementing remote work options. Most participants (225, 53.6%), independent of age and years of experience, would prefer to stay in a hybrid role even after COVID-19 abates. These findings suggest that most dosimetrists prefer to perform their job remotely or asynchronously. A one size fits all job model design may make it difficult for organizations to attract, retain, and grow top dosimetrists. Industry leaders and employers may benefit by embracing this change as dosimetrists may value work-set-up flexibility over other employer-based benefits. Further research is needed to assess the unintended consequences of remote work environments in this profession.     

CT pulmonary angiography versus ventilation-perfusion scintigraphy in pregnancy: implications from a UK survey of doctors' knowledge of radiation exposure

PURPOSE: To prospectively investigate the fetal dosimetry knowledge of health care professionals involved in the management of pulmonary embolism. MATERIALS AND METHODS: One hundred sixty-one health care professionals consented to participate in this study, which had ethical board approval. The individuals surveyed were from 14 hospitals (seven university and seven community hospitals) in the United Kingdom, and 68 trainees were included. These health care professionals included 102 radiologists, 13 nuclear physicians, seven dual-accredited radiologist-nuclear medicine physicians, 16 medical physicists, and 23 pulmonologists. The interview included eight questions. Two questions asked which examination-computed tomographic (CT) pulmonary angiography or ventilation-perfusion (V/Q) scintigraphy-gave (a) the larger radiation exposure (effective dose) to an adult and (b) the larger fetal dose. Two questions assessed the magnitude of the dose differences between these two tests. Four questions asked for an estimate of the dose to both adult and fetus from CT pulmonary angiography and scintigraphy. Subgroup analysis was performed by using the Fisher exact test. RESULTS: Of the 161 professionals surveyed, 93 (58%) appreciated correctly that V/Q scintigraphy delivers a higher fetal dose than does CT pulmonary angiography. Three of 161 professionals were able to answer all eight questions correctly. In terms of the knowledge that V/Q scintigraphy has a higher fetal dose than does CT, there was no statistically significant difference in correct answers between specialties (P > .05), between university and community hospitals (P = .13), or between attending physicians and residents (P = .52). CONCLUSION: This survey reveals that there is a lack of knowledge of fetal dosimetry in the imaging of pregnant women suspected of having pulmonary embolism.     

Medical dosimetry virtual clinical education: Mentors’ perspectives

The COVID-19 pandemic affected the United States in early 2020, and many universities began offering their curriculum remotely. The majority of medical dosimetry programs started to offer both didactic and clinical education in a virtual setting. With COVID-19 social distancing and patient protective measures, many clinical medical dosimetrists also began to work in a remote or hybrid setting. Medical dosimetry students interact and learn from their clinical mentors in this remote clinical environment. The purpose of this study was to investigate the perspective of medical dosimetry mentors concerning the effectiveness of virtual clinical education for medical dosimetry students as a result of COVID-19. The Medical Dosimetry Mentor Perspective on Virtual Clinical Education (MedDos_VCE) survey measured medical dosimetry mentors’ perceptions of the students’ virtual clinical experience during the COVID-19 pandemic. The subject of the study was medical dosimetry mentors who participated in a remote clinic due to the COVID-19 pandemic since March 2020. The MedDos_VCE questionnaire measured (1) the mentors’ assessment of instructional quality in remote clinical education; (2) opportunities for and quality of interaction between students and medical dosimetry mentors; and (3) suggestions for success from medical dosimetry mentors for students and other mentors who are participating in virtual clinical education. The majority of the clinical mentors were satisfied with the quality of virtual clinical education and students’ learning outcomes. They felt that students experienced a good mix of patients, problems, and clinical experience and engaged in the day-to-day activities of a medical dosimetrist. Challenges exist and mentors offered practical suggestions for success for students and mentors in the virtual clinical environment.     

The radiation oncology workforce: A focus on medical dosimetry

The 2012 Radiation Oncology Workforce survey was conducted to assess the current state of the entire workforce, predict its future needs and concerns, and evaluate quality improvement and safety within the field. This article describes the dosimetrist segment results. The American Society for Radiation Oncology (ASTRO) Workforce Subcommittee, in conjunction with other specialty societies, conducted an online survey targeting all segments of the radiation oncology treatment team. The data from the dosimetrist respondents are presented in this article. Of the 2573 dosimetrists who were surveyed, 890 responded, which resulted in a 35% segment response rate. Most respondents were women (67%), whereas only a third were men (33%). More than half of the medical dosimetrists were older than 45 years (69.2%), whereas the 45 to 54 years age group represented the highest percentage of respondents (37%). Most medical dosimetrists stated that their workload was appropriate (52%), with respondents working a reported average of 41.7 ± 4 hours per week. Overall, 86% of medical dosimetrists indicated that they were satisfied with their career, and 69% were satisfied in their current position. Overall, 61% of respondents felt that there was an oversupply of medical dosimetrists in the field, 14% reported that supply and demand was balanced, and the remaining 25% felt that there was an undersupply. The medical dosimetrists׳ greatest concerns included documentation/paperwork (78%), uninsured patients (80%), and insufficient reimbursement rates (87%). This survey provided an insight into the dosimetrist perspective of the radiation oncology workforce. Though an overwhelming majority has conveyed satisfaction concerning their career, the study allowed a spotlight to be placed on the profession׳s current concerns, such as insufficient reimbursement rates and possible oversupply of dosimetrists within the field.     

Military internal medicine resident performance on the American Board of Internal Medicine Certifying Examination

The mission of military graduate medical education in internal medicine is to produce high-quality military internists prepared to practice in military environments. Board certification in internal medicine is an important outcome of internal medicine residency training. The American Board of Internal Medicine Certifying Examination (ABIMCE) first-taker pass rate of the graduates of an internal medicine residency program is a key measure of the quality of the program. We compared the ABIMCE first-taker pass rates for military and civilian internal medicine residency program graduates. Military internal medicine residency graduates had higher first-taker pass rates than their civilian counterparts. This is likely a reflection of the high-quality residents and the faculty at military programs. These results support the notion that military internal medicine residency programs continue to fulfill their mission of training high-quality internists.     

Lifelong learning and the maintenance of certification

Lifelong learning is critical to radiology and the method by which, as professionals, we have kept up to date on new knowledge and developments. The American Board of Medical Specialists and the American Board of Radiology, along with other professional societies such as the Council of Medical Specialty Societies and the ACR, identified a need and an opportunity to serve the public and our profession through the Maintenance of Certification (MOC) initiative. These issues of lifelong learning, public concern, and MOC—and their interrelationship—are discussed. Lifelong learning is defined as a continuation of medical education with an ongoing process of professional development along with self-assessment, which enables physicians to maintain the requisite knowledge, skills, and professional standards.Continuing professional development can be grouped into three categories: formal, nonformal, and informal learning. Examples from the author’s career illustrate key points. Future technologies and scientific discoveries affect radiology and make the commitment to lifelong learning even more critical. The challenge will be the maintenance of specialty certification and its components and competencies, along with the attainment of knowledge and the skills necessary in our unique practices for quality patient care in the evolving health care environment. These are important challenges to our boards, professional societies, specialty societies, institutions, and practicing community. It is critical to participate actively in these organizations and processes to continue development of the MOC initiative, because it is beneficial to patients, applicable to practicing physicians, and credible to public interests.     

Patient page. Diabetes and contrast agents

This patient education page provides general information concerning the radiologic sciences. The ASRT suggests that you consult your physician for specific information concerning your imaging exam and medical condition. Health care professionals may reproduce these pages for noncommercial educational purposes. Reproduction for other reasons is subject to ASRT approval.     

Operational medicine experience integrated into a military internal medicine residency curriculum

The optimal training of physicians should prepare them for the environment in which they will practice. During the past several years, the practice of internal medicine has shifted from a focus on the inpatient setting to one that includes an emphasis on the ambulatory clinic. Military internists must be further prepared to practice medicine with forward units, at field hospitals, and in other operational settings. Community-based teaching programs that reflect present and future practice are increasingly recognized as essential, yet details on the structure and implementation of such programs, especially those designed to teach field and operational medicine, are lacking. The Internal Medicine Residency Program at Walter Reed Army Medical Center has developed and implemented an operational medicine curriculum that includes a field medical training exercise. The program is driven by the residents and chief resident and requires little additional funding. Resident research continues to increase, morale remains high, and the first class to complete the 3-year operational curriculum achieved a 100% pass rate on the American Board of Internal Medicine certification examination. We describe our 3-year experience of implementing this program, with an emphasis on curriculum design and execution, qualitative assessment, and initial lessons learned.     

Perceptions of burnout in medical dosimetry within a postpandemic work environment

According to the World Health Organization, burnout is described as having a negative attitude regarding one's work and being exhausted. Previous studies have shown that occupational burnout exists amongst medical dosimetrists, however, the incidence of medical dosimetrist burnout before and after a pandemic warrant continued research. Medical dosimetrists could be experiencing increased burnout in the workplace postpandemic due to staffing shortages and increased remote planning, which may reduce work performance. The researchers utilized a survey to answer research questions regarding whether staffing shortages or remote planning influenced perceived occupational burnout among medical dosimetrists in a post COVID-19 pandemic environment. The survey was intended to assess levels of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). It was distributed electronically to 2591 certified medical dosimetrists in the United States through the American Association of Medical Dosimetrists (AAMD) membership database. A total of 160 responses were recorded, resulting in a response rate of 6% (160/2591). The results of this study indicated that increased staffing shortages have a direct relationship with increased burnout incidence. Increased remote work appears to be inversely related to the incidence of burnout among medical dosimetrists.     

Sports medicine and the law

Legal problems occur in sports medicine as well as in other fields. To whom do sports doctors owe their duty - to the club, to the team or to its members? Doping has become a part of competitive sport. What is the doctor's responsibility in relation to this? Medical "treatments" given sometimes on demand, in order to enable athletes to continue the game or competition despite the high risk of future severe irreparable damage, may constitute gross negligence. Consent given by athletes in such circumstances may be considered invalid. The club is obliged to insure its members against personal injuries. However, insurance companies may refuse to cover cases where a priori negligent medical treatment was demanded, or will sue the doctor for reimbursement. Medical confidentiality should be kept even regarding athletes, and disclosing any information is unlawful without the athletes' consent. Doctors' professional duty to the athletes should override any duty to the club that hired them, and professional medical opinion should override any caprice of the athlete.     

Performance of military-trained physician assistants on the physician assistant national certification examination

Although the first physician assistant (PA) program was born at a civilian academic institution, the impact of the military was immediately obvious as evidenced by the entire first class of PA students being Vietnam veteran Navy Corpsmen. Following initiation of the PA profession, the armed services established their own PA training programs that were eventually consolidated into a single interservice program in 1996. The mission of the Interservice PA Program is to produce high-quality PAs prepared to provide medical care in not only the traditional clinical arena but in the more unique situations seen in both peacetime and wartime military settings. PAs must complete an approved formal training program encompassing didactic and clinical training and pass a national certification examination to be licensed to practice. Pass rates are a key measure of the quality of a training program. We compared the national certification examination pass rates for our program with those of accredited civilian programs. Graduates of our program had a significantly higher pass rate and higher average scores than their civilian counterparts. These results are due to the strength of the program and faculty as well as the considerable hard work and dedication of the students who are drawn from a community that is, in many ways, non-traditional compared with other PA programs. These results demonstrate that the military training of PAs continues to provide high-quality health care providers who perform above their civilian-trained counterparts.     

International Space Station medical standards and certification for space flight participants

INTRODUCTION: The medical community of the International Space Station (ISS) has developed joint medical standards and evaluation requirements for Space Flight Participants ("space tourists") which are used by the ISS medical certification board to determine medical eligibility of individuals other than professional astronauts (cosmonauts) for short-duration space flight to the ISS. These individuals are generally fare-paying passengers without operational responsibilities. MATERIAL AND CONTEXT: By means of this publication, the medical standards and evaluation requirements for the ISS Space Flight Participants are offered to the aerospace medicine and commercial spaceflight communities for reference purposes. It is emphasized that the criteria applied to the ISS spaceflight participant candidates are substantially less stringent than those for professional astronauts and/or crewmembers of visiting and long-duration missions to the ISS. CONCLUSIONS: These medical standards are released by the government space agencies to facilitate the development of robust medical screening and medical risk assessment approaches in the context of the evolving commercial human spaceflight industry.     

Incidence of work related musculoskeletal disorders in medical dosimetry

Musculoskeletal disorders (MSDs) account for almost 70 million physician office visits per year in the United States and are the most common workplace injuries. These are conditions involving the nerves, tendons, muscles, and supporting structures of the body. Previous studies have concluded that computer users are at high risk of developing work-related musculoskeletal disorders (WRMSDs). As computer users, medical dosimetrists are at risk of developing WRMSDs, yet there is a lack of information regarding the incidence of WRMSDs among medical dosimetrists. The purpose of this study was to determine the incidence of WRMSDs and variables of workstation ergonomics that contribute to the increased risk of WRMSDs in medical dosimetrists. A Qualtrics survey was created to support the 3 research questions guiding this study. The survey was distributed to 2,646 full members of the American Association of Medical Dosimetrists (AAMD), which included only certified medical dosimetrists (CMDs), via email. The distribution of email surveys sent through the AAMD email distribution list resulted in 988 emails opened, for a contact rate of 37% (988/2646). One hundred sixty-four responses were recorded yielding a completion rate of 17% (164/988). Fifty-five percent (90/163) of participants responded that they have experienced WRMSDs. Forty-four percent (289/652) of responses indicated WRMSDs have a slight or moderate interference on work. Sixty-two percent (94/152) of participants felt that their workstations were not ergonomically designed; even greater 68% (104/153) did not feel their workstations were designed for their individually needs. Of those respondents 64% (98/152) would like to see further adaptations made to their workspaces.