In 2002, the ABR announced a policy whereby a prerequisite for certification in radiologic physics after 2012 would be completion of a CAMPEP accredited educational program. In recognition of the fact that half of this lead-in time had now passed, the ABR convened a Summit meeting for the purpose of obtaining the perspective and opinions of associated organizations and stakeholders concerning options for transition from the current eligibility requirements.  The Summit, held on August 17, 2007, was attended by leaders from the AAPM, CAMPEP, ACR, ACMP, CCPM, the ABR and directors of CAMPEP accredited programs (both medical physics graduate programs and residencies).  

The Summit format included a series of introductory presentations followed by general discussion with the objective of reaching a consensus position. First, the background and history of the ABR initiative to revise the eligibility requirements for certification in radiologic physics starting in 2012 was reviewed by Richard Morin, Ph.D. (ABR Trustee in Diagnostic Radiologic Physics) who served also as the moderator of the Summit. A principal factor leading to the 2002 policy statement was concern among the ABR trustees and exam committee chairs regarding the level of knowledge of candidates applying for certification who come from non-structured medical physics graduate programs. Another point now coming to the forefront is the fact that the ABR certification process for radiologic physics is one of only two within the 24 boards of the American Board of Medical Specialties (ABMS) that does not require a formal residency.

The second speaker, John Hazle, Ph.D. (President, CAMPEP) presented an overview of the activities of CAMPEP and a perspective of the current operational status. The challenges ahead were clear with regard to establishing the operational capacity to review the increase in applications expected in response to the 2012 timeline.  He reported that the CAMPEP guidelines for residency accreditation had been revised in 2006 to facilitate program review. As a bottom line, he was confident that CAMPEP could develop the capability to serve as the accrediting body for medical physics educational programs and accommodate any increase in demand that may arise leading up to the 2012 transition.

The perspective of the director of a CAMPEP accredited graduate program was presented by Charles Coffey, II, Ph.D. He pointed out that many graduate program directors had introduced adjustments in response to the original ABR policy statement that the eligibility requirement involved completion of a CAMPEP accredited educational program and not the more stringent condition of an accredited medical physics residency as recommended by the recent AAPM Board resolutions. The importance of estimating medical physics manpower needs and production was emphasized. Another issue brought forward was the potential impact that the newly evolving doctorate of medical physics (DMP) might have on MS programs, the economics of the DMP, and the overall timetable for certification for candidates holding a DMP. A number of critical questions were put on the table with personal answers offered for some, ending with the expressed willingness to roll up the sleeves and engage in the work ahead.  

The final formal talk was given by Michael Herman, Ph.D. (Chair, AAPM TG 133) and addressed current AAPM TG 133 activities in defining alternate pathways for clinical medical physics residency (including affiliated residencies). The draft report has been posted on the AAPM website and is available for member review (http://www.aapm.org/org/committees/TG133/reports/report_draft_ v4.1_7_13_07 .doc). His presentation reflected the theme of TG Report 133 that patient care is paramount in the practice of medical physics and that properly trained medical physicists are essential to ensuring that high quality medical care is provided. Confidence was expressed that both the number of required residencies and the funding to support those residencies could be in place to meet a 2012 timeline.

At the request of the moderator, the perspective of a medical physics residency director was presented by Eric Klein, Ph.D. He described the strengths of residency programs from the viewpoint of his institution and emphasized the critical importance of the clinical experience in preparing the candidate for board certification as well as for a successful career in medical physics. 

The ensuing discussion touched on many issues associated with the ABR policy transition in 2012. The original policy statement as enunciated by the Board specified that as of 2012 and thereafter certification in radiologic physics would require that the candidate had successfully completed a CAMPEP accredited educational program that could have included either a graduate degree (MS or PhD) or a residency. In response to the TG 133 report, pros and cons of requiring a residency were expressed. A general consensus evolved that the new policy should state that an accredited medical physics residency (clinical, 2 years) is required.  This reflected the AAPM Board resolution passed in March 2007 and reconfirmed in July 2007 that completion of a CAMPEP accredited residency should be required. The impact that this revised policy might have on existing graduate programs was discussed. There appeared to be unanimous agreement that the quality of clinical training leading to eligibility for the ABR Board examinations would be elevated by requiring a CAMPEP accredited residency.

The imperative to ensure that an adequate number of residencies were in place was underscored. A major issue centered on the economics and the requirement that sufficient funding be available. Options for securing that funding were discussed. Organizations (AAPM) expressed a commitment to working toward the goal of ensuring availability of adequate residency opportunities by the 2012 target date. The critical aspect of supporting CAMPEP as an effective accrediting organization was emphasized.

The importance of providing clear communication to the candidates with regard to time lines was stressed. It was agreed that the action date should remain as 2012. Safeguards would be in place for candidates who are already in the pipeline; namely, those candidates whose application for certification had been accepted prior to 2012 would be subject to the rules in effect before the new policy.

Viewpoints were expressed on a number of other related issues. There was a general feeling that the preferred pathway on the medical physics track would be progression through a CAMPEP accredited graduate program followed by the accredited residency (in parallel with an accredited medical school followed by a residency for physicians). It was considered important that the CAMPEP accredited graduate programs continue to be acknowledged as having a clear advantage with regard to eligibility status. The consensus was to underscore the value of being in a CAMPEP accredited graduate program. However, there was concern that this would preclude the traditional non-medical physics degree candidate from entering the discipline - individuals whose contributions have enriched the field of medical physics. An option discussed here was that those candidates with an acceptable “outside” doctorate degree wishing to pursue a career in medical physics would be required to enter an extended residency designed to provide an appropriate didactic component as well as the clinical training. It was recognized that defining pathways such as these fell under the purview of CAMPEP and presented opportunities for evaluation by that organization.

In summary, the general consensus of the Summit was that the ABR policy should require a clinical residency for candidates applying for certification after 2012. However, it was recognized by the attendees that this consensus was not binding on the ABR. The Physics Trustees would take these decisions under advisement as they formulate a final policy to be presented to the full ABR Board of Trustees for approval. It is expected that an official policy statement on this topic will be issued by the ABR by the end of October 2007.