Accreditation of Medical Physics Residency...

Argentina, 2013

Doracy P. Fontenla, Ph.D., FACMP, FAAPM

Program Director for Medical Physics Education

Memorial Sloan Kettering Cancer Center

NY,USA

Accreditation of Medical Physics

Residency Programs

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Define Accreditation, Certification, and Licensure

Describe USA Model for Accreditation

Address possibilities for LA

Scope of this Presentation:

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Definitions

• Medical Physics is the application of physics and

related sciences to the practice of medicine.

• Medical Physics is a 100+ years old profession.

• However, the International Labor Organization

has only recently classified Medical Physics as a

profession in the International Standard

Classification of Occupations-08”

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Training : From the beginning

• At the beginning: merging from other professions, physicists learn (and create) on the job.

• From the 1950’s to the early 1970’s, students were trained in medical physics and health physics (IAEA training program at University of Tennessee).

• Post – Doctoral fellowship programs (Mostly 2-3 Years) : Wisconsin, MSKCC, MD Anderson.

• Last 10 - 15 years medical physics education started to be formalized as such: Master’s and Ph.D. Programs in Medical Physics created at several Universities.

• Number of Medical Physics Residencies increased.

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• Professional process in the USA :

Accreditation,

Certification,

Licensure.

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ACCREDITATION

The formal process by which an independent

recognized body (professional and/or

governmental) evaluates and recognizes that

a program or a clinical site meets pre-

determined requirements criteria is called

accreditation.

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• Accreditation is a voluntary, non-governmental

process of peer review.

• Accreditation serves as recognition that a

program provides a quality service or education.

• Accreditation purpose is to ensure that a

program or institution meets defined standards.

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CERTIFICATION

• Certification (or credentialing) is the formal

process by which an authorized body

(governmental or non-governmental)

evaluates and recognizes the knowledge

and proficiency of an individual, which must

satisfy pre-determined requirements or

criteria.

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LICENSURE

• Licensure is the official recognition of

Medical Physics as a profession in the

medical field .

Presently, in the USA, it is required in :

• Texas

• Florida

• Hawaii

• New York

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Certification & Licensure

Licensure is the process whereby a government

agency grants permission to an individual to

engage in a given occupation, upon finding that

the applicant has:

Met predetermined qualifications,

and

Has attained the minimal degree of competence

necessary to ensure that public health, safety, and

welfare will be reasonably protected.

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Certification & Licensure

Licensure is distinct from certification in that while:

Certification is an affirmation from professional peers that an individual has attained a minimal level of professional competence,

Licensure is a State sanction that an individual is recognized to practice a profession in that State (US Law).

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• As it is with most health professions,

Certification of Medical physicists should

be mandatory.

• It helps achieving a homogeneous

professional standard at the national

(and international) level which ensures

quality and safety in radiation medicine.

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AAPM created an accreditation board: the Commission on Accreditation of Medical Physics Educational Programs (CAMPEP).

CAMPEP provides accreditation of hospital based medical physics residencies, and universities educational training programs.

CAMPEP accreditation is a recognition that such a program conforms to the standards approved by the AAPM.

CAMPEP

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Commission on Accreditation of Medical

Physics Educational Programs (CAMPEP)

Sponsored by the following five organizations:

•American Association of Physicists in Medicine

(AAPM)

•American College of Radiology (ACR)

•Canadian Organization of Medical Physicists (COMP)

•Radiological Society of North America (RSNA)

• American Society of Radiation Oncology (ASTRO).14DPF,MSKCC,NY

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Commission on Accreditation of Medical

Physics Educational Programs (CAMPEP)

“ CAMPEP Mission: to promote consistent quality

education of medical physicists by evaluating and

accrediting Graduate, Residency and Continuing

Education programs that meet high standards

established by CAMPEP in collaboration with its

sponsoring organizations.”

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CAMPEP offers specialized accreditation

of medical physics educational programs

such as:

•degree-granting programs,

• clinical residencies,

• continuing education,

and

short courses.

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Accreditation or Certification

• Accreditation is sometimes confused with Certification.

• Accreditation is a voluntary, non-governmental process of peer review, the objective of which is to ensure a program or institution has met a defined standard.

• Accreditation serves as public recognition that a program meets a quality level of education.

• In general, institutions and programs areaccredited and individuals are certified.

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• CAMPEP offers specialized accreditation of

three different categories of medical physics

educational programs:

• Degree-granting programs ,(Universities)

• Clinical residencies,

• Certificate programs, and continuing

education courses or programs.

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Accreditation Process

• CAMPEP accreditation of graduate and

residency programs requires programs to

submit a self-assessment report .

• A qualified survey team of professionals

reviews this document and conducts a site

visit to complete the evaluation.

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Where are the Guidelines?

Accessible from AAPM Webpage…

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Where are the Guidelines? • www.CAMPEP.org

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Section 3: Guidelines

for the Self Study

Document

Newly updated,

bulleted

http://campep.org/res.asp

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Where should Self Study be submitted?

• Should be submitted to the AAPM,MPCEC Representative, Jacqueline Ogburn

• Submit in electronic format (preferred)– As email attachment (if not too large to email)– On CD or DVD if large size (make 4 copies, to

send to reviewers)

• Paper copies (make 4 copies, to send to reviewers) (not really preferred at all!)

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How Much / Where to send the

application fee (NEW!)

MPCEC RepresentativeJacqueline Ogburn One Physics EllipseCollege Park, MD 20740phone - 301-209-3346fax - 301-209-0862

A fee is charged for each

application and re-application

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We don’t have a Medical Residency Program.

What should we do?• Need to provide what a Medical Residency would

contribute:

– Conferences

• New patient conference

• Treatment planning conference

• Quality Assurance conference

• Morbidity & Mortality conference

– Teaching opportunities – residents, nurses, etc.

– Journal club

– Need to verify attendance at conferences

(e.g. 70% of available conferences)

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Accreditation Process

Need to submit an application.

Site visit by a Survey Team:

• The Survey Team consists of senior medical physicists with experience in both clinical practice and educational programs.

• Generally, the survey team also includes a physician.

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Accreditation Process

• After full evaluation of the program, a

recommendation is made to the CAMPEP

Board of Directors.

• CAMPEP Board of Directors makes the final

decision on accreditation.

• Renewal of accreditation requires submission

of an updated self- assessment report and

possibly a site visit.

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Continuous Professional

Development program

• Accreditation and certification do not provide

a permanent standing.

• A regular re-certification system should be

implemented in order to demonstrate that the

Certified Medical Physicist maintains current

knowledge on modern technologies, methods

an practice standards.

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• Professional certification (and accreditation as well) should ideally be conducted by national boards.

• International Boards could provide guidelines on standards, requirements and format of certification.

• International Boards could perform accreditation of training programs and certification systems.

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What else is on the CAMPEP webpage?

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What is in the Guidelines?

Most attention is focused on Topic 3. True of this Workshop also.

HOWEVER, other sections hold important information about the entire process.

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What else is on the CAMPEP

webpage?

Application Template

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New Template:

Follows Section 3 of the Guidelines

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CAMPEP Accredited Programs in Medical

PhysicS:

1. Accredited Degree Programs (MS, Ph.D.):

38 Universities:

USA (42), Exterior (8)

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CAMPEP Accredited Graduate Programs in

Medical Physics

2. Accredited Certificate Programs in Medical Physics :

US (42) Exterior (8)

A program of didactic coursework, identified in AAPM

Report 197 S (and adopted by CAMPEP), offered by a

CAMPEP-accredited graduate or residency program,

intended to enable individuals with a PhD or equivalent

terminal degree in physics or a related discipline to meet

the didactic requirements needed to enter a CAMPEP-

accredited residency program.

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CAMPEP Accredited Residency Programs in

Medical Physics

3. Accredited Residency Programs in Medical Physics:

accreditation of clinical residency programs in radiation

oncology physics or medical imaging physics.

The goal is to ensure that a residency program provides

rigorous and thorough full time clinical training in a

similar fashion to that provided by medical residency

training programs.

Therapy: 61 US(54) Exterior (7)

Imaging: 8 US (7) Exterior (1)

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Courses Needed

(at Post-Grad level)

• 3 Medical Physics at Post-Grad Level:

(Ex. Radiological Physics , Medical Physics Dosimetry, Radiation Safety ,Courses in Imaging).

Plus:

• Radiobiology

• Anatomy and Physiology

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Professional Credentials

• Board Certifications– American Board of Radiology– American Board of Medical Physics

• Licensure and Registration– Texas (first in 1992), Florida, New York, and

Hawaii– Licensure being pursued in California, and

nationally – Many states require board certifications– Many states require registration

• Professional Society Memberships

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Hub and Spoke

• Medical Physics Residency Education

Programs (Hub) encompassing affiliate

sites (Spokes).

• Shall ensure that uniform standards

and procedures are maintained across

all participating institutions.

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Hub and Spoke

Procedure

• The primary Program site the one employing the Program Director .

• Spoke site under separate governance & budget.

• All correspondence between CAMPEP through Program Director.

• Program Director has ultimate responsibility for insure program compliance

• All records related to operation of the program must be available at all sites

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Hub and Spoke

POLICY

• Medical Physics Residency Education

Programs encompassing affiliate sites

(spokes) shall ensure that uniform standards

and procedures are maintained across all

participating institutions.

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Accreditation Applications for Hub & Spokes

Programs include

Accreditation Applications for Hub & Spokes

Programs include

• Official letter from each institution confirming

participation of named affiliates (spokes)

• Diagram describing the organizational

structure & clear accountability lines

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Accreditation Applications for Hub & Spokes

Programs include

• Official letters from all affiliate sites

requesting CAMPEP accreditation.

• Letters of agreement between the

affiliate sites and primary site describing

liability, responsibility, accountability and

any financial arrangements.

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Final Thoughts

• The self study is a clear description of all program expectations.

• It provides all the necessary information for the CAMPEP evaluation for accreditation approval.

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Final Thoughts

• It defines (and documents) all aspects of the program:

– How residents will be selected

– What they will be expected to do

– How they will be evaluated

– How they will evaluate the program and mentors

– What will happen if they fail to meet expectation

– What facilities and faculty are available at the site

– How program changes and improvements will be made

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Questions:

Should CAMPEP accredit programs in Latin America?

Should Latin America have its own Accreditation Board?

Maybe LA should create an Accreditation Board based on IAEA and/or ALFIM (with representatives of each of the Medical Physics Societies member of ALFIM) ?

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Summary

• We presented the framework for the medical physics profession in the USA , from its creation to the present times.

• We discussed the process of Certification, Accreditation and Licensure as present defined in the USA.

• We presented possible options for extending this accreditation process to LA institutions.

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Doracy P. Fontenla, Ph.D., FACMP, FAAPMProgram Director for Medical Physics Education Associate Attending Physicist Dept Medical PhysicsMemorial Sloan Kettering Cancer CenterNY,USA

doracy@earthlink.net

fontenld@mskcc.org

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Muito Obrigada !!