What is Medical Physics?
Q1: What does a Medical Physicist do?
The American Association of Physicists in Medicine (AAPM) provides a general explanation of the roles of a Medical Physicist divided into three areas of activity: clinical service and consultation, research and development, and teaching. In a broader sense, the Medical Physics field can be divided into three main categories: radiation therapy, diagnostic imaging, and nuclear medicine.
Medical Physicists specializing in radiation therapy will spend the majority of their time in a clinical setting interacting with oncologists, dosimetrists, and therapists on radiation treatments for patients with cancer. These treatments are typically performed using either external beam radiation, generated by linear accelerators (linacs), or brachytherapy, in which radioactive sources are placed inside the body. It is the job of the Medical Physicist to not only help create the treatment plans for patients, but also to administer the radiation safety program. Additionally, a Medical Physicist will oversee the technical aspects of the radiation oncology department including commissioning, calibration, and quality assurance (QA) for all radiation sources and delivery equipment in the department.
Imaging Medical Physicists work to ensure safe, accurate, and reliable medical imaging used for diagnosis and treatment. They develop and maintain QA programs to ensure high quality imaging for radiography (x-ray) units, CT (computed tomography), and MRI (magnetic resonance imaging), all while minimizing patient dose and meeting regulatory standards. Additionally, they must effectively communicate scientific, technical, and safety-related information to the diverse members of the clinical staff.
Those Medical Physicists that decide to focus on nuclear medicine will work with PET (positron emission tomography) scanners, gamma cameras, and various radiopharmaceuticals (biological molecules with a radioactive marker) in order to obtain functional images of patients to diagnose and treat a variety of diseases and medical conditions. Similar to radiation therapy and imaging, medical physicists working in nuclear medicine will be involved in technical aspects of quality assurance, patient safety, and advanced image analysis while working hand-in-hand with clinical staff.
To provide more insight into the role of the medical physicist in radiation therapy, a video created for radiation oncology patient education can be viewed below;
This video highlights the interaction between radiation oncologists, dosimetrists, therapists, and medical physicists and may be helpful in understanding the entire treatment process. A wealth of other information can be found on the RT Answers website.
Q2: How do I become a Medical Physicist?
The Commission on Accreditation of Medical Physics Education Programs (CAMPEP) is the governing body for all institutions that have Medical Physics graduate and residency training programs. Typical pathways for becoming a clinical Medical Physicist involve graduate study within a CAMPEP-accredited Medical Physics program and subsequent completion of a CAMPEP-accredited residency program. However, there are many medical physics career opportunities in academia, industry, and government that do not necessarily have a clinical component. There are several graduate degrees available in Medical Physics, including the MS, PhD, Professional Doctorate degree (often called a "DMP"), and Graduate Certificate. The degree a student chooses will depend on the student's career interests.
Students interested in a career in academia will pursue a PhD, as it is generally considered a prerequisite to establish an academic career in education or research. Students interested in a clinical career could earn any of these degrees. Most clinical medical physicists will seek board certification by the American Board of Radiology (ABR) (see next question). An MS degree from a CAMPEP accredited institution is the minimum necessary to enter the board certification process. The DMP is a professional doctorate degree (like the MD) which includes didactic education and clinical training. The Graduate Certificate is only for those who already hold a PhD in physics or a related scientific discipline, and provides the core elements of medical physics graduate education.
If a student chooses to pursue board certification, a 2 year CAMPEP accredited Medical Physics residency program will be required after the completion of the graduate degree (the DMP is an exception as the 2-year residency is built into the DMP program). After completion of the residency, the student will be eligible to take the board certification examination from the American Board of Radiology (ABR). Additional descriptions of the respective degrees are provided in Q6. Those pursuing careers in academia, industry, or government may choose not to pursue board certification. There may be others who wish to pursue certification but not be able to obtain entry into the limited number of residency positions (see Q8) yet can still pursue a clinical medical physics position. While board certification is desirable as a verification of the candidate's clinical competence, it is not required for clinical practice (see Q3).
Q3: What is ABR Board Certification? Is ABR Board Certification required to practice Medical Physics?
Certification by the American Board of Radiology (ABR) requires the candidate to pass three exams (2 written, 1 oral). Part 1 is typically taken after the first year of didactic course work in a CAMPEP-accredited graduate program, whereas Parts 2 and 3 are taken after completion of a CAMPEP-accredited residency. If a student has attended a non-CAMPEP-accredited graduate program or non-CAMPEP-accredited residency, that student is ineligible to take the ABR exams and cannot become board certified by the ABR.
In addition to certifying medical physicists, the ABR certifies physicians in radiology and radiation oncology and is a member of a larger certifying body, the American Board of Medical Specialties (ABMS), which certifies physicians in many different specialties. Medical physicists are actually the only non-physician members of the entire ABMS. Certification by the ABR is thus a prestigious accomplishment and indicates that you have obtained what the ABR examiners believe is the appropriate level of competency to independently practice medical physics. It is important to note that obtaining this certification is not required to practice medical physics nor is it required to obtain state or other licensure. However, applicants for a medical physics position that have ABR Certification or are eligible to eventually become ABR certified ("ABR eligible") are more marketable than an applicant that is not certified or eligible. In fact, many positions (typically in the clinical setting) will state that they will only accept applicants that are ABR certified or ABR eligible. For this reason alone, it is highly advantageous to become ABR certified as a Medical Physicist.
Q4: What are the undergraduate requirements for graduate study in Medical Physics?
Although specific requirements for each institution can vary, there are some basic undergraduate requirements that all graduate institutions expect from applicants. Typically, completion of 2-4 semesters of calculus and differential equations is required as well as at least 2 years of undergraduate physics courses, including at least 3 upper level physics courses. Typical candidates for graduate study will hold an undergraduate major in physics or a physical science, mathematics, or an engineering discipline. For many schools, a major in physics is not required for admission. However, a physics minor or equivalent may be required in order to fulfill the required number of undergraduate physics courses.
Specific undergraduate requirements for each graduate institution can be found on their individual websites. CAMPEP has a listing of all current institutions that have Medical Physics graduate programs and links to each specific programs website. The list can be found on the CAMPEP webpage.
Q5: What should I look for in a Medical Physics graduate program?
There are many important factors which should be considered when choosing a graduate program. Below is a brief list that may be helpful in making your decision:
- CAMPEP Accreditation: One important factor in choosing an institution for graduate study in Medical Physics is whether or not the program is accredited by CAMPEP. As stated previously, CAMPEP is the governing body for graduate education and training in Medical Physics. Accreditation indicates that the program has been reviewed and found to meet the standards of CAMPEP. In order to meet these standards, a program must have high quality courses, instructors, facilities, research opportunities, and many other program aspects evaluated by CAMPEP. In addition, eligibility for ABR certification is contingent upon graduation from a CAMPEP-accredited residency program. Many residency programs only accept graduates from CAMPEP accredited graduate programs, and all entrants into CAMPEP accredited residency programs must have completed a minimum amount of graduate coursework from a CAMPEP accredited institution.
- Clinical Specialty: As mentioned earlier, there are three primary clinical specialties within Medical Physics: radiation therapy, diagnostic imaging, and nuclear medicine. When evaluating Medical Physics programs, it may be helpful to investigate the didactic, clinical, and research options available to students within each specialty. Additionally, researching the faculty and their individual areas of expertise will allow you to determine whether each field of study is appropriately represented at the institution. If you already have a particular specialty in mind, you should evaluate how many graduates this institution places in that specialty. Programs that offer tracks supporting all specialties are best for those who are currently undecided about which specialty they might wish to pursue a career.
- Residency Placement Rate: There currently are not enough medical physics residency positions to meet clinical demand. While the number of these positions continues to increase, so does the number of graduates from medical physics graduate programs, and the number of graduates currently far exceeds the number of residency positions. Thus, the competition for residency positions is fierce and becomes more competitive every year. For those interested in a clinical career, residency placement rates have never been a more important factor in choosing a graduate program. Each university is required to publish their residency placement rates every year on their website, making the information easily accessible to anyone. Statistics presented should mention the enrollment/graduation numbers for each degree granted by the institution as well as the number of students accepted into residency programs. CAMPEP has accumulated each institution's web link containing those statistics for 2014 into one file which can be accessed at this webpage
- Student to Faculty Ratio: The number of students admitted each year vs. the number of faculty available to you as a student can be an important factor in deciding which program to attend. Some students may work better in student groups and would enjoy having a larger class size, while others may find more one-on-one time with the instructor to be more valuable.
- Student Research: Researching the faculty and their individual areas of expertise will allow you to determine whether your interests are appropriately aligned with opportunities at an institution. For students interested in academic careers, involvement in grant writing and opportunities for multidisciplinary collaborations should be carefully considered. Students should also explore federally funded or institutionally funded training grants and fellowships that allow for full immersion into project-defining and grant writing processes.
- Multidisciplinary Education: Students considering a non-clinical career path should evaluate each institution on their educational requirements and opportunities for coursework outside of clinical medical physics specialties. While all CAMPEP-accredited programs will provide students with a solid foundation in clinical medical physics education, experience and auxiliary coursework in related fields can be advantageous for non-clinical career path development and for bolstering a research profile. For students interested in industry careers, faculty and departments that have close and long-standing collaborations with companies are advantageous. Participating in a collaborative project with industry gives insight into the way such projects are conducted and can be of great value in the future career of the student.
- Ask around: If you feel drawn to one institution and want to know more about it on a personal level, simply contact the program director and ask if there are any students that you could contact to get a little more information. They will be able to give you a better understanding of the day to day life as a student at that institution than you would find anywhere else.
Q6: What kinds of decisions do I need to make while in graduate school?
The two biggest decisions you will make while in graduate school (and one that you might make before you even attend) is which degree pathway you plan to take and whether or not you would like to become board certified by the ABR. A description of each degree is listed below along with a simple flowchart outlining the timeline involved for each.
There are currently four degree pathways available from CAMPEP-accredited programs for those interested in the field of Medical Physics and each vary slightly in the amount of didactic coursework, clinical experience, overall time to completion, and cost. The decision regarding which degree a student should apply to and complete depends on the relative experience, background, and overall goals of the student. Some information regarding each degree is listed below that may help in the decision process.
Master of Science Degree (MS): ~2 years of didactic coursework culminating in a Master's project/thesis
A physicist with an MS degree is typically employed to perform clinical work, or in industry or government. While a physicist with an MS degree will not have the same opportunities for faculty appointment at academic institutions, he/she is on the same level professionally as a physicist with any of the other degrees listed here. A non-academic hospital will rarely have a preference for the specific degree that the physicist holds, and the experience and certification of the physicist will mean more in a clinical setting than the particular degree that the physicist holds.
Doctor of Philosophy (PhD): ~2-3 years of didactic coursework and >2 years of research culminating in a Ph.D. dissertation
A physicist with a PhD degree can serve in any of the same clinical, industrial, or governmental roles as those with an MS but may also choose an academic career, performing research and/or teaching and mentoring students. While many physicists with an MS degree also perform research, teach and mentor students, and even hold an academic appointment, those without a PhD are often limited in terms of faculty appointment and application for research funding. The completion of a PhD serves to demonstrate the graduate's ability to perform independent research and create a research niche, in addition to being the terminal degree in the profession. These are commonly considered prerequisites for many academic and research roles.
Professional Doctorate in Medical Physics (DMP): ~2 years of didactic course work combined with 2 years of tuition based, non-salaried clinical residency
The DMP is a relatively new degree which incorporates both didactic and clinical training. The didactic component is typically similar to that required for a PhD, however, the DMP student completes a 2 year clinical residency instead of a thesis research project. Since research is an important component of medical physics practice, DMP programs also require a significant research component (typically significantly larger than that required for the MS degree.) Graduates from CAMPEP accredited DMP programs are automatically eligible for ABR certification as the 2 year clinical residency program completed in years 3 and 4 of the DMP is equivalent to a CAMPEP accredited residency program. However, unlike typical residents who are paid a salary to complete their residency, a DMP student will pay tuition for this training. Some may consider the guarantee of ABR eligibility as sufficient to offset the additional cost of the program.
Graduates from a DMP program can perform clinical, industrial, or governmental work similar to those with an MS. However, the DMP will likely appeal most to those pursing a clinical career since residency training and certification are most important for this career path. DMPs would be unlikely to be hired for the academic positions traditionally reserved for PhDs, particularly those requiring a significant research component.
Graduate Certificate (GC): ~1 year of didactic course work
The Graduate Certificate program is designed for those students who already hold a PhD in physics, or other related field and who want to pursue a career in medical physics. The GC program is designed to provide the core essentials of medical physics didactic training, as described by AAPM Report #197S. This curriculum represents the required coursework to be eligible to enter a medical physics clinical residency program. A student would likely only complete a GC in order to be eligible to enter a CAMPEP accredited residency program, thus it is assumed that such a student is interested in a clinical career. However, since a GC student already has a PhD, an academic career is also a possibility.
For each of the 4 program options available, the ABR Part 1 exam can be taken during the first year of the degree (typically offered in July/August). In order to be eligible for ABR Part 2, a student completing an MS, PhD, or certificate program must also complete a CAMPEP accredited residency program which provides a minimum of 2 years of full time clinical training. The residency program must be completed by August 31 of the year in which the Part 2 exam is to be taken (it is assumed here that the candidate has already passed Part 1). A student in a DMP program is eligible for ABR Part 2 after completion of the degree (assuming the student passed Part 1 during the program).
Q7: What is a Medical Physics Residency and how do I get one?
A Medical Physics Residency is a 2 year clinical training program that trains a recent graduate to be proficient in the many clinical aspects of the Medical Physics profession. AAPM Report #249 describes the fundamental elements of such a training program. In addition, CAMPEP provides a set of standards that must be met in order for the program to be accredited. The purpose of these guidelines is to ensure that each resident receives a comprehensive training experience.
To be eligible for entry into a CAMPEP accredited residency, a student must have completed an MS, PhD, or GC degree from a CAMPEP accredited institution (or have completed all but 2 of the courses required for a GC since CAMPEP allows a resident to complete one graduate course per year while in a residency training program). Instituted for the first time for the 2014-2015 application cycle, the Medical Physics Matching Program (the "MedPhys Match") was created to ensure a fair application process for all graduates applying for a residency. The process opens in October and allows submission of applications to all Medical Physics residencies participating in the match program on one website within a common application process. The application is part of the AAPM website and is called the Medical Physics Residency Application Program (MP-RAP). After submission, selected applicants are invited to interviews throughout the following months. After all interviews have been completed, applicants rank their choice of institutions and institutions rank their choice of applicants. The match program then applies an algorithm to determine the best match for all applicants and programs.
Q8: What are my chances of getting a Medical Physics residency? What do I do if I'm not accepted into a residency?
For the 2014-2015 match application cycle, 112 residency positions were available, compared to 402 initial applicants. Based on these numbers alone, the chance of an individual obtaining a residency is approximately 25%. However, the chances of any specific student obtaining a residency are dependent on a number of factors including, but not limited to: quality/reputation of the graduate program, academic performance, clinical medical physics background, letters of recommendation, previous research, and interpersonal skills.
The company that facilitates the matching process (National Matching Services, Inc) has publically available statistics for the 2014-2015 match cycle and will continue to provide statistics for subsequent years. That information can be found here.
A large majority of the residencies available through the match program can be applied to with any of the medical physics degrees available. As of 2015, however, there were 25 institutions (out of 90) that require a PhD to apply. As you begin the application process, be sure to take note of any institution with these restrictions.
If you are not accepted into a residency during your first application, you will need to decide whether you would like to gain more clinical experience and apply again the following year, try to go directly into a clinical position, or investigate non-clinical career paths. If you feel that a clinical position is still your preferred career path and you intend to apply for a residency during the next cycle, the time spent between application cycles would be best spent obtaining experience which would make you a more attractive candidate. Talk to residency program directors and find out what they are looking for in a resident candidate. You could also choose to apply for junior medical physics positions which do not require ABR eligibility. You can still apply for residency positions in the future, or may choose to continue to practice without ABR certification.
Q9: Are there enough jobs out there for all of the residency graduates?
The positions available in the medical physics profession are competitive and will require similar perseverance as that required to obtain a residency position. Estimates place the number of new medical physicists needed in the field every year to be between 150 and 200. Although these numbers are greater than the number of residency graduates in a given year, most of those residency graduates will complete their respective programs at roughly the same time (typically the end of June). Additionally, there are other medical physicists looking for positions at the same time who did not just graduate from a residency thus increasing the size of the applicant pool. The large number of applicants for any one position makes the process difficult and competitive. Thus, the ability to obtain ABR certification becomes even more important and worthwhile.
Other career options for residency graduates include purely academic positions and careers in industry. Academic positions for medical physicists are not very numerous, however, that depends on the definition of the field "medical physics". In principle, a well-trained medical physicist can be successful in a faculty role in any bioengineering or applied physics department. In industry, the possible spectrum of positions is even broader, from classical hardware R&D, to software development, to product sales, support, and training, etc.
Q10: Is the time spent obtaining medical physics education and training worth it?
The value of a position in the medical physics field is very dependent on the attitude and desires of the individual. Many physicists enter the field because they enjoy the possibility of helping patients, while others enjoy the technical challenges that come with developing new treatment techniques. Most medical physicists find their career a rewarding one (statistically, relatively few leave for another profession). We encourage you to peruse the various documentation available and talk with practicing medical physicists. Once you have done this and determined that medical physics is your career of choice, you'll need to answer these questions: "How much time and money am I willing to invest and how much risk am I prepared to bear to pursue the career I desire?" For many of us now in the profession, the answer was "whatever it takes."
Q11: What is the average salary for a Medical Physicist?
Every year, the AAPM compiles salary information from medical physicists in order to obtain information on trends within the field and provide competitive salary data to those currently in the field. Those surveys can be found on the AAPM website. Each annual survey contains a plethora of information broken down by experience, employment sector, sex, and specialty. As a general overview, the following median incomes were given for the 2014 survey:
- MS degree with no ABR Certification: $120,000/year
- MS degree with ABR Certification: $175,000/year
- PhD degree with no ABR Certification:$132,000/year
- PhD degree with ABR Certification: $185,000/year
Q12: What are the professional groups that are associated with the Medical Physics field?
Below are descriptions and links to a number of professional groups within the medical physics field:
AAPM – American Association of Physicists in Medicine
Define the scope of Medical Physics practice and recommends a standard educational path
CAMPEP – Commission on Accreditation of Medical Physics Education Programs
Accrediting body for educational and clinical training programs
ABR – American Board of Radiology
Certification board for the specialties of radiation oncology, diagnostic radiology, and medical physics
SDAMPP – Society of Directors of Academic Medical Physics Programs
Provides a collaborative forum for improving medical physics education and training, interprogrammatic collaboration, and the development and distribution of best practices.
IAEA – International Atomic Energy Agency
Serves as the world's central intergovernmental forum for scientific and technical co-operation in the nuclear field