Working together for the future of the MPE - BHPA · Dosimetry Nuclear Medicine 8 M Bardies 13th...

Working together for the future of the MPE

Are we the last generation?

PART 2

Intro by Jan Vandecasteele

Concerns about education and internship

Quality of new MPE’s is sometimes insufficient (cfr FANC is responsible of recognition AND

accountable)

A lot of diversity in training of MPE across Universities

A (to) broad inflow of diplomas into the profession

Possible solution:

Interuniversity? (all together) centrally organized high quality education for MPE with limited inflow

(via testing) organized by FANC/BHPA?

In combination with longer (2 years, 3 years?) and PAID internship cfr EFOMP

Initial recognition in 3 domains?

Two projects are at hand and are being discussed at a very preliminary stage:

1. Interuniversity (postgraduate) deliberation on format: theoretical and practical not BHPA

2. How to persuade government to pay for interns: letter of concern after publication of RD

supported by universities (rectors?), BHPA, FANC, BeSTRO, EFOMP?... BHPA


What can we do :

Create letter of concern: Who wants to help? Message: new RD is super, but we need money to

assure safe and high quality RT, NM and RX in Belgium…accidents have happened for which

colleagues were held accountable!!

Budget impact analysis: impact of new legislation (new RD) on health care budget, impact of paid

internship on health care budget, compare with all other European countries…

Ask independent expert

Timing is everything; after the publication of RD, long enough to be outside of appeal date…

Send letter to newspapers? media attention? Contact the Cabinet to ask for meeting to discuss

the issue…


1. From Europe

• Hilde Bosmans and Marco Brambilla

2. From the medical jury

• Kristof Baete

3. From the Walloon community

• Gauthier Coussement

4. Towards the future…

• Nick Reynaert

5. Closing statements: Agree/Disagree

Education and Training of Medical Physics Experts in Europe, working to a European

MPE

Marco Brambilla,

Head of Medical Physics Department

University Hospital of Novara, Italy

[email protected]

President of the EFOMP

SYMPOSIUM BHPA 2020 Work Together For The Future

Definition of Medical Physicist

• Clinically qualified in the field of medical physics

• Competent to practice independently

Qualification of Medical Physicist

• Master’s degree in medical physics or equivalent at EQF level 7

• Formalised in-service clinical training scheme (2 years minimum)

Guidelines for education & training

Approval of NRS

• It is EFOMP’s policy to increase the quality of physicists working in a health care environment

• Europe wide acceptance of the certified Medical Physics Expert is seen as a good foundation for this goal

• Europe wide acceptance of MPE needs – Agreement concerning level of education (theoretical) – Agreement concerning training schemes (practical) – Agreement concerning attitude (social, CanMEDS) – Agreement concerning registration demands (some guarantee)

Demands for MPE and NRS

• Education and training of MPE (PS 12.1: Physica Medica 2014)

• Role and status of MPE (PS 7.1: Physica Medica 2016)

• Radiation Protection and MPE (RP 174: EU Guidelines 2014)

• Guidelines for NRS (PS 6.1: Physica Medica 2016)

• NRS and professional development (PS 10.1: Physica Medica 2016)

Criteria for NRS approval

1. Clear statement of aims 2. Registration Council must be in charge 3. Clear, documented criteria for registration 4. Training programme in accordance with RP 174 5. Definition of MPE domains (radiotherapy, imaging, hospital physics) 6. Re-registration system in place including criteria for re-registration 7. Rules for professional conduct (ref. PS 11) 8. Procedure in case of professional misconduct

EFOMP continued NRS approval in 2016

• Based on new demands

• False start (due to a lack of a good procedure)

• Few NMOs applied for approval (Austria, Finland, Germany, Greece Netherlands): none approved yet!

• Professional Matters Committee is responsible for the process of approval

Process re-started in 2018

1. Procedure started with an invitation to all NMOs to apply for NRS approval (or renewal)

2. Meanwhile EFOMP will work on a procedure concerning MPE registration based on an approved NRS

3. Europe wide approval of MPE certification is much more complicated due to trust, language, culture, protection etc.

Procedure for NRS approval (six months)

1. NMO applies for NRS approval using appropriate form 2. Form is send to EFOMP PMC and examined by PMC chair 3. If OK, then form is judged by all PMC members 4. PMC members send their conclusion to PMC chair 5. PMC chair writes a report for the EFOMP board including a recommendation for

approval or rejection of the evaluated NRS 6. EFOMP board makes a final decision based on PMC recommendation (no

amendments allowed) 7. EFOMP General Secretary informs NMO about approval and validity period (ten

years)

Procedure for NRS approval (six months) • Until now, 3 NMOs applied for NRS approval: All were granted approval.

A request for NRS approval by the French SFPM is now under consideration.

Germany (DGMP) The Netherlands (NVKF) OGMP - Austria

A forthcoming European survey on Education & Training in the European countries (associated with EFOMP);

• In the first week of 2020, EFOMP has promoted a survey on how national registration schemes for MPEs are implemented in different European Countries. The results will be presented during the European Congress of Medical Physics in Torino.

The ESTRO-EFOMP Working Group on Revision of the Core Curriculum for MPEs in Radiotherapy September 2019. The revision includes new developments in radiotherapy and similarities between the professions of radiotherapists and medical physicists. Several EFOMP representatives are members of the working group: Internet Manager Efi Koutsouveli, PMC chair Ad Maas and ETC vice chair Christoph Bert.

Promoting education and training programs

Promoting education and training programs ESMPE - Past Editions

Edition Period Title Specialty Duration (Hours) Scientific Chair

1st 2013 Jul 4-6

Clinical Medical Device Management:

Specification, Acceptance testing,

Commissioning, QC and Advanced

applications in Whole-body PET/CT

Nuclear Medicine 19 M. Brambilla

2nd 2014 Jul 10-12

Advanced Kinetic Modeling and

Parametric Methods. Advanced SPECT

and PET Applications in Cardiology,

Neurology and Oncology

Nuclear Medicine 19 M. Brambilla

3rd 2015 Jan 29-31Digital Mammography and Quality

Controls

Diagnostic

Radiology18 G. Gennaro

4th 2015 Jul 2-Jul 4 Radiopharmaceutical dosimetry Nuclear Medicine 17 M. Bardies

5th 2016 Jan 28-30

Computed Tomography Imaging:

Dosimetry, Optimization and Advanced

Clinical applications.

Diagnostic

Radiology20 A. Torresin

6th 2016 Jul 7-9

Practical aspects of Radiation

Dosimetry in Targeted Radionuclide

Medicine Therapy

Nuclear Medicine 18 M. Bardies

7th 2017 Jan 26-28 Imaging in Radiotherapy Radiotherapy 19 G. Loi

8th 2017 Jul 6-8

Magnetic resonance Imaging:

Advanced clinical applications Safety

aspects Quality controls

Diagnostic

Radiology18 D. Lurie

9th 2018 Jan 25-27Computed Tomography. Technology,

Dosimetry, Optimization

Diagnostic

Radiology17 M. Kortesniemi

10th 2018 Aug 22 Statistics in Medical Physics Data management

and Research8 M. Brambilla

11th 2018 Aug 22 IMRT&VMAT in practice Radiotherapy 8 G. Loi

12th 2018 Aug 22Fundamentals of Nuclear Medicine

DosimetryNuclear Medicine 8 M Bardies

13th 2019 Jan 24-26Fundamentals of Nuclear Medicine

DosimetryNuclear Medicine 17 M Bardies

14th 2019 Jul 4-6State of the art and new trends of

angiographic equipment

Diagnostic

Radiology18 A Trianni

15th 2019 Oct 10-12 Treatment Planning Systems Radiotherapy 19 B. McLean

16th 2020 Jan 23-25Innovation in technology in Nuclear

MedicineNuclear Medicine 17 S. Vanderberghe

Promoting education and training programs ESMPE - Upcoming Editions


EUROPEAN EXAMINATION BOARD (EEB)

http://www.efomp.org


Improve the education of health professionals involved in the practice of medical physics by accrediting medical physics education and training events

Set the standard for accreditation systems for education and training in medical physics in Europe

EBAMP AIMS

Hosted by

Bridging knowledge

across specialities

Organized by

Congress venue

H.C. Ørsted Institute

Niels Bohr Institute

ecmp2018.org

2nd European Congress of Medical Physics Copenhagen - August 23-25 2018

836 participants 102 invited speakers 4 Satellite meetings 12 Refresher Courses 9 Joint sessions 28 Scientific sessions 2 Focus sessions (E&T and Prof) 485 accepted abstracts or posters 259 oral presentations Budget ~ 315 kEuro Congress Results: + 89.000 euro

The Congress

Education of the medical physicist in Europe by Hilde Bosmans

• Remains extremely variable among the different member states

– Number of years and payment y/n

– Number of specialties

– Entry to the profession

– Career

RP174 Guidelines

Will be completed with KSCs in AI (AI Working group, by F. Zanca)

EFOMP’s examination board

EFOMP educational activities

• EUTEMPE-RX

• ESMPE school

Quality of the internship and activity reports

BHPA2020 Symposium – La Louvière

prof. dr. Kristof Baete

Chair of the Medical Jury – FANC [email protected]

https://fanc.fgov.be

Medical Jury (MJ)

• Royal Decree of July 20th, 2001 – ARBIS – RGPRI – chap. VI, art. 54.9 – Medical Jury = official advisory body of the Agency (FANC)

• The task of the MJ is to advise the Agency – regarding chapter VI and art. 75, recognitions & licenses – advice can be positive, conditionally positive, postponed, negative – individual files – generic (upon proposal of the Agency) – qualitative assessment of the internship & activity reports – advice of MJ is not binding – not following the advice has to be motivated – meetings 4 times a year, see FANC website for dates – reading is a big assignment

• Internal Rules, FANC Decree, May 22th, 2007 – composition, agenda, meeting reports, conflict of interest, …

19 February 2020 Quality of the internship and activity reports – Medical Jury 47

Members of the MJ • Medical physics experts

– RT: Jean-Marc Denis, Alex Rijnders, Dirk Verellen

– RX: Caro Franck, Nico Buls

– NM: Alain Seret, Kristof Baete

• Radiation protection experts – Ria Bogaerts, Myriam Monsieurs, Vera Pirlet

• Physicians – medical specialists – RT: Karin Haustermans, Xavier Geets

– RX: Peter Smeets

– NM: Anne-Sophie Hambye, François Jamar

– Occupational: Chris Verbeek, Martine Decleir, Ulrik Van Soom

• FANC representatives • An Fremout

• Karen Haest

• Sophie Leonard

• Petra Willems

• Marleen Vandecapelle

• Secretary • Rita Latour

• Dorota Dziedzic


FANC Decree Jan 11th, 2019

Members of the MJ • Medical physics experts

– RT: Jean-Marc Denis, Alex Rijnders, Dirk Verellen

– RX: Caro Franck, Nico Buls

– NM: Alain Seret, Kristof Baete

• Radiation protection experts – Ria Bogaerts, Myriam Monsieurs, Vera Pirlet

• Physicians – medical specialists – RT: Karin Haustermans, Xavier Geets

– RX: Peter Smeets

– NM: Anne-Sophie Hambye, François Jamar

– Occupational: Chris Verbeek, Martine Decleir, Ulrik Van Soom

• FANC representatives • An Fremout

• Karen Haest

• Sophie Leonard

• Petra Willems

• Marleen Vandecapelle

• Secretary • Rita Latour

• Dorota Dziedzic

Core members Art. 51.7 – Medical physics experts

Art. 53 – Users Art. 75 – Occupational physicians


Essential components for good report writing

• clear, concise, correct, unambiguous • careful, take your time, prepare in time • be honest, work ethics, personal reflection • structure the report, scientific level • in accordance with legislation, good practice • balance content, layout, data & figures • just simply write, as if you would explain • support material as an addendum, if needed • proofread, deliver on time, keep a backup copy


Internship and activity reports

• MPE internship program: FANC Decree, November 7th, 2012 – WIP -> new FANC decree (technical regulation) regarding internship programs

• MPE recognition is not a title, but it is what is legally required to exercise the job of a medical physics expert in Belgium

• no need for writing a course, the internship report should be a personal reflection of the medical physics competences that have been acquired during the MPE education and training program

• the internship report should cover the necessary areas of competence in the domain

• guidelines for the activity report, see FANC website – model that is helpful to assess the quality of the reports systematically – FANC provides a useful template as the framework for the report (update WIP)


Internship and activity reports

• continuous education • it is very helpful that the report has page numbers • for a reworked or revised report, indicate or mark any changes in

color • the Agency may suspend, revoke, withdraw, in whole or in part …

permits, approvals, recognitions, … • the holder has the right to be heard by the Agency • the reports are reviewed by all members of the Jury • an advice of the Jury is the decision of the complete Jury, and not

from individual experts within the Jury


Thank You

For Your Attention

On behalf of all members of the Medical Jury


New Royal Decree « MPA »

What French-Speaking High Schools have foreseen

[email protected] - Symposium BHPA 2020 – Educational Session – 7/2/2020

Gauthier Coussement (MPE) - Haute Ecole Léonard de Vinci


Present Situation:


Bachelier de Spécialisation interdisciplinaire en radiothérapie

• Started in 2017

• 60 ECTS

• 3 students (only!!!)



Completely REVIEWED last year



Completely REVIEWED last year

Newcoming Royal Decree « MPA »



Meetings of the Pedagogical Council

Jean-François Daisne Milan Tomsej High School Members

Veronique Baart Gauthier Coussement Aude Vaandering


New version 2019

Underlying motivation:

ESTRO vision of RTT’s


New version 2019



- delivery of treatments


New version 2019



- delivery of treatments

- treatment planning

Sous-section 2 - L’assistant en radiophysique médicale. (MPA) Art. 92. Minimum of 20 credits Ces crédits doivent porter sur les matières suivantes : • radiophysique ; • éléments de radiobiologie ; • technologie en radiothérapie ; • techniques en radiothérapie ; • dosimétrie en radiothérapie ; • assurance de qualité et, en particulier, les procédures de contrôle de qualité des équipements

radiologiques médicaux en radiothérapie ; • règles pratiques de la radioprotection, y compris leurs bases physiques ; • législation belge relative aux applications médicales des rayonnements ionisants.


30 Credits – Radiation Physics, Planning (15 ECTS Courses / 15 ECTS internship)


30 Credits – Clinics, Techniques, Technology (15 ECTS Courses / 15 ECTS internship)


Gauthier Coussement

Dr Nicolas Meert

Dr Jean-François Daisne

Equipe physique St LUC

Ayhan Findik

Dr Laurette Renard

Milan Tomsej

Dr Vincent Remouchamps

Prof Xavier Geets

Anne De Bouver

Dr Philippe Martinive

Dr Vincent Barvaux

Hassan Khadira

Veronique Baart

Dr Frédéric Cavallin

Dr Olivier De Hertogh

Lionel Derue

Monica Somoano + Dirk Van Gestel

Dr Selma Ben Mustapha

Severine Cucchiaro

Valérie Jarbinet

Denis Doumont

Dr Castadot

Dr De Hertog

Dr Pascal Vannuffel

Françoise Vanneste

Dr Nicolas Christian

Antoine Delor

Aude Vaandering

Christian Hunin

Dr Christophe Lonchay

Dr Lionel Duck

Inès Demaret

Manon Baiwir

Geneviève Vanooteghem

Younes Jourani


Result:

60 ECTS « spécialisation interdisciplinaire en radiothérapie »

• only accessible to

– nurses

–medical imaging technologists (TIM, TMB)

• Give the right to « congés éducation »


Started September 2019 and ongoing



3 students (only!!!)



3 students (only!!!) (again !!! !!!)



3 students (only!!!!!)

B-Stro (La Hulpe 27 september 2019)

Aude Vaandering : « there is a strong need for education…»


End of December 2019:

The royal Decree is signed !

And waiting for publication…


We asked the FANC for definitive version of article 92 regarding MPA training.


We asked the FANC for definitive version of article 92 regarding MPA training.

• Still 20 credits (minimum)

• But accessible to every Bachelor degree


Meeting of the Pedagogical Council

12/3/2020:

What well be discussed:

-maintain the 60 ECTS Specialisation Bachelor for RTT’s



12/3/2020:



reate a 20 ECTS-certificate for MPA training only (15 Credits Courses 5 credits internship)



12/3/2020:



-create a 20 ECTS-certificate for MPA training only 15 Credits Courses 5 credits internship


…


?

Centralised Med Phys Education in Belgium

Nick Reynaert

Contents

• Feedback on EFOMP-ESTRO meetings: 25 September 2019/ 05 February 2020 (revision CC Radiotherapy Med Phys in Europe)

• Proposition on how to apply this in Belgium

New topics (radiotherapy)

Identification of new topics

O more quantitative imaging and imaging in general

O integration of all –omics

O hybrid machines

O big data/artificial intelligence

O automation

O modelling

O more emphasis on research

Shortcomings current MP education Belgium

• Heterogeneous

• Not enough focus on “the job”

• Internship not long enough/not paid

• Content not up to date

• Requirements (access, medical jury) need to be more transparent and strictly formalized

Currently being criticized abroad (even in France )

Proposal: Two-step process

• Universities provide academic education (Master 2 e.g.)

• Centralized professional education is installed

• Organised by BHPA – FANC

• Copying French model (with input from other countries) ?

French model

• Master 2 Med Phys organised by « certified » universities • « concours » (probably not needed in Belgium): 40 students/year • DQPRM in Paris (INSTN, SFPM: ASN): 4 months of courses (september-

december) with examination; 2 years of internship • Courses are provided by teachers from all over the country, these are paid • Interships being paid, hospitals receiving additional budget • Internship consists of Year 1: formally defined list of « tasks » (around 30) that require a report Year 2: Integration in routine and a one year project defined by department • They suppose after that people are expert in 3 domains • Considering going to three years …

Copying in Belgium ?

• Current university programs become first step of the process

• Belgian “DQPRM”: BHPA –FANC: courses in Brussels (in FANC?): maybe co-organised with SCK, followed by two years of internship on one specific domain (or 3 years for the 3 domains )?

• Teachers from all universities/hospitals (equilibrium academic/practical)

Advantages

• Homogeneous education

• Professional education focusing on all relevant aspects of the job

• Decreasing the gap with surrounding countries (mobility)

• More dynamic: directly adopting EFOMP-ESTRO (perfect timing)

• Direct integration of new legislation (again perfect timing)

• This centralization provides the means to start negotiating with government (paid internships needed if going to two/three years)

Remaining questions

• SCK ? (but should be centralized and easily accessible)

• Location: FANC ?

• How to enforce the internships being paid (EFOMP/ESTRO questionnaire: in 17 out of 21 countries they are paid) ?

• Would we be ready to play it hard ?

• What about combining different specialties: one extra year of internship (EFOMP/ESTRO questionnaire: only 2 out of 23 have a specific degree per discipline) ?

• If combining the three specialties: what about continuous education ?

• Radioprotection ?

Statements: agree/disagree…?

Education

• Medical physicists in other European countries are better trained

• There should be a single professional training program for MPE’s in Belgium with a national exam

• The internship for MPE should become paid

• Internship should be 2 year or more

• Internship should encompass all three domains (1 year RT, ½ year RX and ½ year NM) ? – Not descided, need first to be clearly defined

Conclusion

1. Create workgroup on future of education

Candidate members:

Dirk verellen, Kristof Baete, Nick Reynaert, Younes, Veronique Baart, Tom Vercauteren, Barbara Vanderstraeten, Klaus Bacher, Hilde Bosmans, Edmont sterpin, Tom Depuydt… + 3 people I do not know the name of on my picture taken during the session. Please send me an email if you would like to join!

2. Fanc will contact us soon regarding follow up interuniversity discussions

Thank you all for staying enthusiastic until the last presentation !!!

Jan Vandecasteele

Working together for the future of the MPE - BHPA · Dosimetry Nuclear Medicine 8 M Bardies 13th...

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