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70% 60% 50% 40% 30% 20% 10% 0% D. Adlienė et al. / Medical Physics in the Baltic States 7 (2009) 109 - 113 Medical physicists Relevant specialization PhD students Others 2003-2005 2004-2006 2005-2007 2006-2008 Fig. 3. Employment of graduates from MSc study program Medical Physics at Kaunas University of Technology 2.2. MP study program at Vilnius University Considering the need for medical physicists in Lithuania on the one hand and the number of graduates produced by the KTU program on the other, it can be seen that there is a clear contradiction between the legal documents and the real possibilities. For this reason in 2008 the Physics Faculty of Vilnius University (VU) proposed a new MSc program “Medical Physics” designed to offer a new field of studies for the increasing number of 1st cycle graduates with a view to meeting the above mentioned requirements for medical physicists in Lithuania. The new program seeks to harmonize the Lithuanian higher education regulations with European and world-wide professional requirements for medical physicists, following both the EFOMP and the Institute of Physics and Engineering in Medicine (IPEM) recommendations [3, 9], and the “Dublin” descriptors [10], for qualifications awarded to students who complete the higher education second cycle. They correspond with EC directive 2005/36/EC [11] on the recognition of professional qualifications and promote the mobility of students, graduates and teachers in these programs. The Medical Physics Interdisciplinary Master’s Program requires two years of study. It is composed of study modules together comprising 80 credits (120 ECTS) and includes 240 hours of scientific research work, 120 hours of cognitive scientific research practice and 680 hours for preparing the final diploma work. The integration of graduates into the professional medical environment, and structuring of the prerequisites for postgraduate studies in the clinical environment are facilitated by the joint responsibility of the Physics and Medicine Faculties for the program and its administration by the Medicine Faculty. Students in this program will have the possibility of acquiring skills in scientific research and practical work by carrying out work in scientific laboratories and clinics of the VU Oncology Centre, and the Santariskes Clinic Radiology Centre. In particular the new Scientific Research Centre at the Institute of Oncology of Vilnius University provides high-level training and research possibilities in biomedical physics and nanomedicine. Teachers (11 professors, 10 associate professors and 7 lecturers with 111 PhD) presenting lectures and practical works are highly qualified in appropriate scientific fields. They are active teachers and scientists whose research corresponds to the scientific orientations of the program and the majority participate in international projects related to biomedicine. The content of the Medical Physics program and the list of competences were developed by considering the benchmarks prepared by IPEM and recognized by EFOMP [6, 9], in which there is a normal correlation of medical, physics and engineering sciences: Radiotherapy, Radiation Protection, Diagnostic Radiology, Nuclear Medicine, Medical Imaging, Ultrasound etc. as well as the essential knowledge of biomedical sciences (Anatomy, Physiology). With a view to the future, elements relating to the medical application of non-ionizing radiation, new optical methods, and nanomedicine have been included in this program (for detailed subject list see Table 2). Table 2. Courses at VU Courses Credits * Compulsory courses Safety (mechanical, electrical, chemical, 4 biological, radiation) Radiobiology 3 Basics of human anatomy and physiology 4 Statistical methods in medicine and 3 mathematical modeling Ionising radiation and its interaction with biological tissues 3 Medical imaging methods 1, (Diagnostic Xray, Magnetic Resonance Imaging) 7 Medical imaging methods 2, ( Optical biopsy) 5 Quality medicine assurance and management in 3 Radiotherapy. Dosimetry 5 Physics of non-ionising radiation 4 Applied radionuclide physics 4 Nuclear medicine and molecular imaging 3 Basics of nanomedicine 3 Research work 6 Cognitive scientific research practice 3 Master‘s thesis 17 Optional courses Applied ultrasound in medicine, 3cr Lasers in medicine, 3 cr Physiological Measurement and Functional Assessment (EKG, EEC, audiology etc.), 3 cr 3 Total 80 * Lithuanian credits. 1 Lithuanian credit = 1.5 ECTS In order to qualify, a medical physicist must acquire a complex set of competences, so the new program follows the suggestions of Tuning [12] and EFOMP [4], by giving graduates both Generic Competences and Subject-Specific Competences (in this case: those required of a physicist at master’s level, by a medical physicist as a healthcare professional, core medical physics competences and competences for the various specializations of medical physics (Fig 3)).
MP Competences Generic Competences Subject-Specific Competences Instrumental Interpersonal Systemic Fig. 3. Medical Physicist Competences D. Adlienė et al. / Medical Physics in the Baltic States 7 (2009) 109 - 113 Physicist at Master’s level MP as a Healthcare Professional Core MP competences Competences of Specialization Despite the difficult task of dovetailing curriculum regulations to the strict EFOMP requirements, the program has successfully passed national Quality Accreditation analysis and was approved by the Ministry of Science and Education. It seems that our intention to introduce this program is well timed. The program is now in the process of implementation with a prospective starting date in 2010. 2.3. Problems, opportunities and future prospects When preparing, implementing and carrying out the Medical Physics study programs, problems related to studies and Professional licensing and the placement of young specialists were encountered: o in Lithuania today there is not one professor working directly in the field of medical physics; o there is a lack of equipment, and specialized laboratories; o no normative qualifying requirements for medical physics as a government licensed profession have been set, o the degree offered is a Master of Biophysics, and not Medical Physics(!); o there is no, or very little, discussion with employers, who are reluctant to invest in young specialists able to begin independent work, according to EFOMP recommendations, only after a 2 year practicum. Opportunities for the medical physicist are expanding rapidly. The increasing number of EU directives [7, 13- 16], concerning medical devices, safety from physical agents and personal protective equipment, as well as the multiplication and growing sophistication of medical devices themselves, call on the expertise of medical physicists. The need to train far greater numbers of medical physicists to meet these needs places even greater importance on the role of today’s medical physicists in health care institutions. Lithuania, where the number of medical physicists is totally inadequate, is particularly concerned by this situation. To solve these problems and strengthen the preparation of medical physicists in Lithuania, discussions are under way to create a joint study program within Kaunas University of Technology and Vilnius University, calling on the best specialists and using the infrastructure of both institutions in the interests of study quality. The complementary strengths of the two universities in medical physics will enable the joint program to educate medical physicists in all the 112 important fields of contemporary health care. The involvement of foreign partners is also being considered. 3. Conclusions After this overview of the education and training of medical physicists in Lithuania, it can be stated that: • Lithuania is experiencing a serious shortage of medical physicists. • Kaunas University of Technology at present offers the only program for the training of medical physicists in Lithuania; Vilnius University is in the process of implementing its Medical Physics program and is planning a starting date in 2010. • Following EU directives and EFOMP recommendations, Kaunas University of Technology and Vilnius University have the opportunity to join their efforts and create a new joint program for the education and training of medical physicists for all important fields of contemporary health care. 4. References 1. Caruana C. J., Padovani R. and Christofides S. Physics and society: the medical physics profession and its contribution to healthcare. GIREP Conference, Book of Abstracts, ISBN 978-9963- 671-79-3, 2008. 2. EFOMP, Policy Statements No 2- 12, 1984-2008 Available from http://www.efomp.org/policyst.html. 3. Malaga declaration – „EFOMP‘s Position on Medical Physics in Europe“, 2006. 4. Cristofides, S, Schlegel, W et al. An initial EFOMP Position on the Tuning process for Masters Programs in medical Physics in Europe. Proceedings of World Congress on Medical Physics and Biomedical Engineering. IFMBE Proceedings 25/XIII, ISBN 978-3-642-03897-6, p. 70 ff. 5. Eudaldo, T, Olsen, K. The present status of Medical Physics Education and Training in Europe: An EFOMP survey. Physica Medica 2008; 24 (1): 3-20// Available from http://www.efomp.org/policyst.html and Presentation at X th EFOMP Congress. Pisa 20- 22, September 2007. 6. EFOMP PS 7: Criteria for the staffing levels in a Medical Physics Department. Approved by EFOMP Council September 1997. Available from http://www.efomp.org/online/images/docs/policy/sta fflev.pdf 7. EC. Directive 1997/43/Euratom of 30 June 1997 on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure. Official Journal L 180, 09/07/1997, pp. 0022 - 0027. 8. Adlienė, D., Adlys, G. Medicinos fizikų rengimo problemos Lietuvoje. Proceeding of the Conference “Biomedical Engineering”. Kaunas, 2000. p. 21-24. 9. EFOMP (1984, 1997, 1998, 1999, 2009). Policy Statement No. 2, 7, 8, 9, 12). Available from http://www.efomp.org/online/index.php?option=co
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2009 PROCEEDINGS OF THE 7 th INTERN
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