Medical physics is generally speaking the application of physics concepts, theories and methods to medicine. A medical physics department may be based in either a hospital or a university. Clinical medical physicists are often found in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiation Oncology.
However, areas of specialty are widely varied in scope and breadth e.g., clinical physiology, neurophysiology (Finland), and audiology (Netherlands). In the case of research based university departments, the scope is even wider and may include anything from the study of biomolecular structure to microscopy and nanomedicine.
“Medical Physics Services will contribute to maintaining and improving the quality, safety, and cost-effectiveness of healthcare services through patient-oriented activities requiring expert action, involvement or advice regarding the specification, selection, acceptance testing, commissioning, quality assurance including quality control, and optimised clinical use of medical devices and regarding risks from associated physical agents; all activities will be based on current best evidence or own scientific research when the available evidence is not sufficient.
The scope includes risks to volunteers in biomedical research, carers and comforters; it also includes risk to workers and the public when these have an impact on patient doses” (based on a mission statement to be found in:’Guidelines on the Medical Physics Expert – Qualification and Curriculum Development Frameworks’ (Caruana C. J. et al.) – a project funded by the European Commission).
The term ‘Physical Agents’ refers to ionising and non-ionising electromagnetic radiations, static electric and magnetic fields, ultrasound, laser light and any other Physical Agent associated with medical devices. As stated in the introduction at the moment the profession is mostly concerned with those devices used in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiation Oncology and associated physical agents (ionising radiation in X-ray based imaging, radionuclides in Nuclear Medicine, magnetic fields and radio-frequencies in Magnetic Resonance Imaging, ultrasound in Ultrasound imaging and Doppler measurement).
This mission includes the following 11 key activities:
1. Scientific problem solving service: Comprehensive problem solving service involving recognition of less than optimal performance or optimised use of medical devices, identification and elimination of possible causes or misuse, and confirmation that proposed solutions have restored device performance and use to acceptable status. All activities are to be based on current best scientific evidence or own research when the available evidence is not sufficient.
2. Dosimetry measurements: Measurement of doses suffered by patients, volunteers in biomedical research, carers, comforters and persons subjected to non-medical imaging exposures (e.g., for legal or employment purposes); selection, calibration and maintenance of dosimetry related instrumentation; independent checking of dose related quantities provided by dose reporting devices (including software devices); measurement of dose related quantities required as inputs to dose reporting or estimating devices (including software). Measurements to be based on current recommended techniques and protocols. Includes dosimetry of all physical agents.
3. Patient safety / risk management (including volunteers in biomedical research, carers, comforters and persons subjected to non-medical imaging exposures. Surveillance of medical devices and evaluation of clinical protocols to ensure the ongoing protection of patients, volunteers in biomedical research, carers, comforters and persons subjected to non-medical imaging exposures from the deleterious effects of physical agents in accordance with the latest published evidence or own research when the available evidence is not sufficient. Includes the development of risk assessment protocols.
4. Occupational and public safety / risk management (when there is an impact on medical exposure or own safety). Surveillance of medical devices and evaluation of clinical protocols with respect to protection of workers and public when impacting the exposure of patients, volunteers in biomedical research, carers, comforters and persons subjected to non-medical imaging exposures or responsibility with respect to own safety. Includes the development of risk assessment protocols in conjunction with other experts involved in occupational / public risks.
5. Clinical medical device management: Specification, selection, acceptance testing, commissioning and quality assurance/ control of medical devices in accordance with the latest published European or International recommendations and the management and supervision of associated programmes. Testing to be based on current recommended techniques and protocols. 6. Clinical involvement: Carrying out, participating in and supervising everyday radiation protection and quality control procedures to ensure ongoing effective and optimised use of medical radiological devices and including patient specific optimization.
7: Development of service quality and cost-effectiveness: Leading the introduction of new medical radiological devices into clinical service, the introduction of new medical physics services and participating in the introduction/development of clinical protocols/techniques whilst giving due attention to economic issues. 8: Expert consultancy: Provision of expert advice to outside clients (e.g., clinics with no in-house medical physics expertise).
9. Education of healthcare professionals (including medical physics trainees: Contributing to quality healthcare professional education through knowledge transfer activities concerning the technical-scientific knowledge, skills and competences supporting the clinically-effective, safe, evidence-based and economical use of medical radiological devices.
Participation in the education of medical physics students and organisation of medical physics residency programmes. 10. Health technology assessment (HTA): Taking responsibility for the physics component of health technology assessments related to medical radiological devices and /or the medical uses of radioactive substances/sources.
11: Innovation: Developing new or modifing existing devices (including software) and protocols for the solution of hitherto unresolved clinical problems. In the case of RESEARCH BASED UNIVERSITY departments the mission is wider and to emphasize this fact we often speak of BIOMEDICAl.
PHYSICS (formerly Medical Biophysics): Biomedical physics is the use of physics concepts, theories and methods for the greater understanding and development of clinical practice AND EXPERIMENTAL MEDICINE.
This is a wider definition than Clinical Medical Physics Services and would include physics based aspects of life science research which would have a future impact on clinical practice (e.g., various forms of microscopy, nanodevices, spectrometry, biomolecular structure, cell biology physics). Most basic
science departments within faculties of medicine / health science are now being grouped under the generic term ‘biomedical sciences’.
Many biomedical physics departments today are of necessity multi-disciplinary and may include not only physicists but also engineers, mathematicians and sometimes chemists and physicians. (Ref: Caruana C.J., Wasilewska-Radwanska M., Aurengo A., Dendy P.P., Karenauskaite V., Malisan M.R., Meijer J.H., Mornstein V., Rokita E., Vano E., Wucherer M. (2008). The role of the biomedical physicist in the education of the healthcare professions: an EFOMP project. Physica Medica – European J of Medical Physics, 25, 133-40).