Medical Physicist or Clinical Engineer?
The Choice is yours
Medical physics and bioengineering underpin much of the practice of modern medicine. It was the development of radiotherapy in the 1930s that first led to the employment of physicists in hospitals on a regular basis. In the 1950s, the contributions that could be made by physics and engineering became more apparent with the advent of radionuclide techniques and the beginnings of instrumentation development, rehabilitation engineering and research into the applications of biomaterials.
Nowadays, physicists and engineers are involved in a vast range of activities in health care. They design, make and maintain aids for disabled people, systems for physiological measurement in anaesthetic, intensive care and other environments, imaging scanners, precision surgical instruments and medical robots, to name but a few. They are responsible for the measurements and calculations that make radiotherapy safe and effective. Many of the most remarkable advances in medicine can be traced back to the work of physicists and engineers. For example, much of the pioneering research into radionuclide scanning, ultrasonic imaging, computed tomography, magnetic resonance imaging, functional electrical stimulation, image-guided surgery, anaesthetic monitoring and three-dimensional radiotherapy planning was done in laboratories in the United Kingdom.
Medical physics and bioengineering are highly interdisciplinary subjects. Those who practice them need a good grasp of anatomy, physiology, pathology and biology in order to work effectively. In the National Health Service, they are graded as clinical scientists and medical technical officers. They work side-by-side, often in clinical teams, to support the activities of the medical staff, to innovate and to maintain high standards of quality and safety. They are involved in the evaluation of the efficacy of their work and its clinical outcomes. Another very important activity is that the teaching: the next generations of medical physicists, bioengineers and medical technical officers need to be trained and many other staff groups need to have a grasp of physical and engineering principles relevant to their work. They need constantly to keep up-to-date through the process of continuing professional development.
Medical physics and bioengineering provides a satisfying and fulfilling careers for people coming from a wide variety of backgrounds, including pure and applied physics, electrical, electronic and mechanical engineering, applied mathematics, statistics, computing and the biological sciences. As much of the practice of medicine becomes increasingly specialised, medical physics and bioengineering will continue to be both an essential element of its foundation and in the vanguard of progress and innovation.
The majority of medical physicists and clinical engineers are employed in the NHS. New graduates, who usually have a good honours degree in science or engineering, enter the professional grades at Grade A as Trainees or as Associates. The training scheme is a two year programme which involves training in three major subject areas plus aquaintanceship in at least three other areas. Training takes place in departments with appropriate accreditation. In addition, trainees must complete a recognised M.Sc. Successful completion of the training programme results in the award of the Diploma of IPEM and allows the trainee to compete for posts in a particular speciality at Grade B.
Grade B is the main professional grade covering a wide range of responsibilities. Posts at the lower end of the grade have a large element of higher training in a particular subject area with individuals working towards corporate membership of IPEM and, in some cases, registration as Chartered Engineers with the Engineering Council. At the upper end of the grade, appointments carry a high level of individual responsibility. Although further academic qualifications are not mandatory, many individuals study part-time for a Ph.D. degree.
The highest grade in the profession is Grade C at which level the individual is usually in charge of a scientific department or a major departmental sub-division or has made a distinguished contribution in the field. The most senior clinical scientists have equivalent status to their medically qualified consultant colleagues.
For technical staff who are employed as medical technologists or medical physics technicians there are no formal entry requirements, but, for entry as a trainee medical technologist on to the Medical Technical Officer (MTO) grades, a person must be eligible for admission to BTEC/SCOTVEC national certificate/diploma in science or engineering. Some join with A levels/Higher grades, whilst others enter after completing a science or engineering degree, HNC or HND.
Trainee MTOs undergo an agreed programme of in-service training relevant to their particular speciality, which will also include an introduction to other specialities. This training involves competence based practical experience in the required skills. This will normally be consolidated by attending a course (on day or block release) at a college of further education, leading to a relevant BTEC National Certificate.
There are five medical technical officer grades, MTO1 to 5. The career grade which most staff can expect to achieve is MOT3. To be eligible for promotion to this grade staff should normally have five years relevant experience. Staff employed on the MTO4 grade may manage technical work of a section within a department whilst staff on the MTO5 grade will normally have significant managerial responsibilities.
Throughout a career as a scientist, engineer or technologist working in medicine, an individual must constantly up-date their knowledge and skills, keeping abreast of the new developments in equipment and techniques. A system for monitoring Continuing Professional Development is being developed by the Institute of Physics and Engineering in Medicine.
The Author: Professor P N T Wells, President, Institute of Physics and Engineering in Medicine: www.ipem.ac.uk
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