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The UTHSCSA Experience in Setting up a DMP Program

Niko Papanikolaou and Geoffrey ClarkeRadiological Sciences Program

University of Texas Health Sciences

What does DMP stand for ?

a. Disguised Medical Professionb. Doctor of Modern Philosophyc. Doctor of Medical Physicsd. Debt of a Medical Physicist

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American Board of Radiology(certification of Radiologists, Radiation

Oncologists & Medical Physicists)

American Association of Physicists in Medicine

(education policies & standards)

Commission for the Accreditation of Medical Physics

Education Programs (CAMPEP)

AMERICAN BOARD OF RADIOLOGYRADIOLOGIC PHYSICS EXAMINATION

FUTURE REQUIREMENTS• Beginning in 2012, in order to take the American Board

of Radiology Part 1 examination in Radiologic Physics, candidates must be enrolled in or have graduated from a CAMPEP accredited education program (e.g., MS, PhD, or residency).

• Beginning in 2014, in order to take the American Board of Radiology Part 1 examination in Radiologic Physics, candidates must be enrolled in or have completed a CAMPEP accredited residency program.

www.theabr.org

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Looking ahead• Minimum training requirements in 2014 to enter

the medical physics profession:– 2 yr didactic instruction (MS degree)– 2 yr clinical training (residency)

• Professional degree in medical physics does fulfill minimum training requirements

To DMP on not ? That is the questionShakespearean dilemma for UTHSCSA faculty

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80% or more of the medical physicists identify themselves as being cliniciansWith DMP we can differentiate the pathways: clinical and researchHigher cost of education for DMPUltimately less PhD degrees resulting in reduced progress and innovation

The Impact of the Professional Doctorate (PD) in Medical Physics(AAPM White Paper)submitted on July 11, 2008, from the Working Group on a PD for Medical Physics:R Christensen, T Harms, J Hazle, W Hendee, K Hogstrom, M Martin, B Thomadsen, C Coffey

Encourage initial PD programs to:- strive for excellence in both academic and clinical medical physics training as evidenced by quality medical physics didactic curricula, board-certified clinical faculty, and state of the art clinical facilities.- facilitate student problem solving and independent thinking, by the incorporation of a research component (e.g., commensurate with the research experience demonstrated by submission of an abstract to a national scientific meeting or in a peer reviewed medical physics journal).

Initiate an effort with AAPM-affiliate regulatory agencies, scientific, professional, and medical organizations to emphasize that board certification, not the post-graduate degree, is the credential for clinical physics competence.

The PD Degree is an additional viable solution to the need for well trained medical physics professionals as outlined by the Board-eligibility requirements for 2014.

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CAMPEP data: MS/MSc graduates

CAMPEP data compiled by Ed Jackson

CAMPEP data: PhD graduates

CAMPEP data compiled by Ed Jackson

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CAMPEP/SDAMPP Graduate Program Survey ResultsOn Plans for a DMP program

CAMPEP data compiled by Ed Jackson

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Survey Questions and Student Responses• Would you (the student) apply to a DMP? (14%)• If there was a DMP when you applied would you

have selected that path ? (20%)• How will the DMP affect the profession?

– Stature of the profession– Clinical training– Salary– Role of research– Attracting new students no change– Satisfaction of disparate professional classes– Role of current MS and PhD physicists in the field

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History of DMP Program Development at UTHSCSA

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Our Rationale• In 2009 we reviewed the arguments in favor and

against the DMP program and decided we wanted to have one. We wanted to give our graduates (MS) a secure path to board eligibility

• We already have CAMPEP accredited programs offering both MS and PhD degrees in medical physics as well as an accredited residency program

• We also have an accredited medical dosimetrytraining program

Demand for Medical Physics Training

• UTHSCSA received 66 applications for 10 slots in our program for 2012-2013

• Currently CAMPEP-certified residencies produce ~80/yr. therapy physicists+ ~6 imaging physicists/yr.

• 30 CAMPEP-certified residencies produce ~150/yr. medical physics graduates/yr.

• Projections are for ~200 trained medical physicists per year needed for USA

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Medical Physics Workforce• Bureau of Labor Statistics lists ~870 physicists

working in “general medical & surgical hospitals”• AAPM estimates ~4600 working medical

physicists in US• Texas Board of Licensure for Professional

Medical Physicists (2012 data): – 344 licensed medical physicists with TX

address– 106 temporary medical physics licenses with

TX addresses

The past…• The year is 2009

– May: committee on graduate studies for our program met and formally proposed the creation of the new DMP degree to replace the MS pathway

– The idea was presented to the departments of radiology and radiation oncology, since their support is critical for the success of this new program. Both department chairs and faculty committed their support

– June: Graduate Faculty Council endorses DMP program concept

– September: SoM Education Committee approves DMP program (This program will be under SoM)

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The past…

• The year is 2011*: – March: DMP approved by UTHSCSA

Executive Committee – This new degree, if approved, will be part of

the Medical school (not the graduate school as we now have for the MS and PhD tracks)

– October: DMP proposal approved by UT System

*2010 is a dormant year; requirement for new University President and new SoM Dean delays action on DMP program

The past…• The year is 2012:

– April: Texas Higher Education Coordination Board upon review of proposal, arranges for a site visit of three experts.

– July: The recommendations from the site visitors are reviewed by THECB Committee on Academic and Workforce Success which approves final DMP program proposal

– October: DMP program approved by THECB with the provision that MS track will be terminated

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The past…• The year is 2013:

– Southern Association of Colleges and Schools has to also review and approve the new degree. DMP was approved by SACS in February 2013

The present• A new application was developed, specifically for

the DMP program• A transition path is offered to the existing MS

students• Starting spring of 2013, we will no longer admit

students in the MS path for either imaging or therapy medical physics

• Student selection is underway, for slots in the 1st, 2nd and 3rd years of DMP

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The future

• Obtain CAMPEP accreditation• Monitor resources and financial impact of

the new program and refine the model as necessary

• Finalize the Hub and Spoke arrangement with San Antonio Military Medical Center

“To boldly go where no man has gone before...”

Captain Charles Coffey II of the USS Vanderbilt

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RESOURCES

Radiological Sciences Graduate Program

• Medical Physics(CIP 51.2205)

– Radiation Therapy Physics (MS, PhD)

– Diagnostic Imaging Physics (MS, PhD)

– Medical Health Physics (MS only)

• Radiation Biology(CIP 26.0209)– Radiation

Biophysics (PhD)

– Neuroscience Imaging (PhD)

– Human Imaging (MD resident/PhD)

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Radiological Sciences thru 2012MS Program• 40 graduates• 5 continued to PhD

PhD program• 7 radiation biology

track graduates• 92 medical physics

track graduates– 17 went into pure

research careers (18%)

– 90% still in work force: research, clinical or industry

MS to DMP Transition Plan

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Therapy Physics Residency

• Gained CAMPEP accreditation in 2010.– 3 residents have completed program

– 2 residents currently in program

Dosimetry School

• Gained JRCERT accreditation in 2009 as a certificate (post BS) program.– 15 students have completed program since

accreditation (~40 since inception)

– 5-6 students enrolled in program annually

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Imaging Physics Residency

• Informal, not yet accredited program

• Jointly with US Air Force, MARP Inc.– 1 resident completed program

– 1 resident in the program (rotating with MARP, Inc.)

Costs and Funding

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Funding Assumptions• Some of the current GPRS funds will be used to

support the DMP program.• Same number of support staff for administration • Proposed DMP program will have common

courses with graduate program• Faculty mentors will have fewer PhD to allow for

increased load of clinical mentoring.• Formula funding rates at current PhD student

level.

Funding Highlights

• Some new income will be realized through tuition+fees, which will be assessed at the medical school level (currently $16,894)

• Funds for first two years will be reallocated from graduate program

• Formula funding begins at the third year of any new program, such as the DMP

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Costs Highlights

• No additional infrastructure or equipment costs

• It is expected that additional faculty will be needed to mentor the increased number of students in clinical rotations

• Administrative costs shifted from existing program

Courses and Curricula

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Proposed Doctorate in Medical Physics: Degree Plan Overview

Year Educational Content Stipend

1 General medical physics courses (26 CU)

No

2 Track specific medical physics courses (25 CU)

No

3 Clinical training rotations (“residency” - 27 CU)

No

4 Advanced clinical training (“residency” - 20 CU)

Possibly

Degree RequirementsCategory

Semester Credit Hours

Clock Hours (if applicable)

Required Courses 39 710

Prescribed Electives (track specific)

9 135

Free ElectivesNot

Applicable____

Capstone Project 2 30

Clinical Rotations 48 3840

TOTAL 98 4715

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Required CoursesPrefix and Number Required Courses SCH

RADI 5005 Fundamentals of Radiation Dosimetry 3RADI 5007 Statistics in the Radiological Sciences 1RADI 5011 Radiation and Nuclear Physics 3RADI 5015 Physics of Diagnostic Imaging 3RADI 5020 Principles of Health Physics I 3RADI 5025 Basic Radiation Biology 3RADI 6012 Physics of Nuclear Medicine 3RADI 6016 Diagnostic Imaging Physics II 3RADI 6023 Clinical Medical Physics 6RADI 6024 Radiological Anatomy & Physiology 3RADI 6030 Physics of Radiotherapy 3RADI 6033 Advanced Radiotherapy Physics 3RADI 6049 Introduction to Magnetic Resonance Imaging 2RADI 6097 Research (Capstone Project) 2

*Clinical Rotation 48

Elective Courses

Prefix and Number Prescribed Elective Courses SCH

RADI 5018 Physics Measurements in Diagnostic Imaging 3RADI 6014 Physics of Dental Imaging 2RADI 6016 Advanced Diagnostic Imaging 3RADI 6019 Medical Image Processing 3RADI 6031 Special Topics in Radiation Therapy I 3RADI 6033 Advanced Radiotherapy Physics 3RADI 6035 Special Topics in Radiation Therapy II 3RADI 6050 Advanced Magnetic Resonance Imaging 2RADI 6051 Statistical Parametric Mapping 3RADI 7005 Treatment Planning in Radiation Therapy 2

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Education Program

• No dissertation or extended research project although clinical research projects will be assigned to the students

• Capstone project over two terms involves completing Practice Quality Improvement (PQI) Project as per ABR MoC

• Introductory clinical training will take place during the first two years of the program

Clinical Training

Two years of clinical rotations emphasizing developing clinical competencies including:• Practice-Based Learning and Improvement• Developing Interpersonal and Communication

Skills• Developing Professionalism• Problem solving

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Student Evaluations

• Comprehensive exams at end of first year• Oral exams at end of each clinical rotation

for years 3 and 4• Monthly written exams for years 3 and 4• Yearly exams at end of year 3 and 4

Summary

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Student: Why choose DMP• Clear, condensed pathway to ABR medical

physics certification and clinical career• Eligible for student loans throughout course of

didactic and clinical studies

UTHSCSA: Why start a DMP• A dedicated educational program for students

going into clinical careers, compared to student preparing for research careers

• Provides a method to reduce institutional costs (student stipends) while increasing funding (state formulas) for graduate medical physics education

• Ensures that students working in clinical capacities have substantial medical and medical physics didactic training

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SAM QuestionBeginning in what year, in order to take the American Board of Radiology Part 1 examination in Radiologic Physics, candidates must be enrolled in or have completed a CAMPEP accredited residency program ?

a. 2011b. 2012c. 2013d. 2014e. 2015

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SAM QuestionAccording to the Texas Board of Licensure for Professional Medical Physicists, approximately what percent of the total medical physics licenses issued were temporary?

a. 5%b. 10%c. 15%d. 20%e. 25%

SAM QuestionAccording to AAPM, how many practicing medical physicists (all disciplines) are there in the United States?

a. 1600b. 2600c. 3600d. 4600e. 5600