Lack of HDR Training in Residency Program (For Physicians and Medical Physicists)

October 18, 2009 · Written by ·

If you graduate from a residency program that does not offer or use an HDR after-loader for patient treatments, what problems, if any, could you encounter at your first job? The answer is simple, if you are expected to treat patients with an HDR after-loader as part of your job responsibilities, you are not qualified to be listed as an Authorized User (AU) in the HDR material license, and hence you cannot independently treat patients with an HDR after-loader. That is, you are not legally able to fulfill this part of your job description. It’s a potentially embarrassing circumstance in addition to one that may inconvenience physician scheduling.

According to NRC 10 CFR part 35.690, if you are not a board certified radiation oncologist, the law requires that you have the following training in order to be listed as an AU in the HDR material license and to treat patients with HDR independently:

You must have completed a structured educational program in basic radionuclide techniques applicable to the use of a sealed source in a therapeutic medical unit that includes:

(i)  200 hours of classroom and laboratory training in the following areas—
(A) Radiation physics and instrumentation;
(B) Radiation protection;
(C) Mathematics pertaining to the use and measurement of radioactivity; and
(D) Radiation biology; and

ii) 500 hours of work experience, under the supervision of an authorized user who meets the requirements in §35.690 or, equivalent Agreement State requirements at a medical institution, involving—
(A) Reviewing full calibration measurements and periodic spot-checks;
(B) Preparing treatment plans and calculating treatment doses and times;
(C) Using administrative controls to prevent a medical event involving the use of byproduct material;
(D) Implementing emergency procedures to be followed in the event of the abnormal operation of the medical unit or console;
(E) Checking and using survey meters; and
(F) Selecting the proper dose and how it is to be administered;
(G) Device operation
(H) Safety procedures for the device use
(I) Clinical use of the device

For more information, visit:

Considering the above guidelines, these are some useful tips to the following groups of individuals:

For ASTRO: Inform all the Radiation Oncology Residency Program Directors about the law.

For Residency Program Directors:  If you don’t have an HDR in your facility, try to get one. HDR training should be a part of every physics residency program.

For Residents: If your program does not have an HDR after-loader or offer HDR after-loader training, make arrangements with sites nearby that possess an HDR after-loader and arrange to complete your 500 hours training there during your residency program.

For Medical Physicists: Share this information with your radiation oncologist colleagues. If you are responsible for amending the material license and are expecting a new radiation oncologist to join the group, be sure he or she has all the relevant paper work (documenting the necessary training) available before leaving his/her institution.

Finally, there is a similar law for medical physicist to be listed as an Authorized Medical Physicist that was previously posted on this blog. Click on this link for further information.

Posted in: Education / Training, Employment, State / Fed Regs ·Tags: no tags


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