Talk:Radiation therapist

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This page seems to mix up some things between radiation therapists and radiation oncologists, at least in the United States. In fact, 90% of what is listed here is the job of a radiation oncologist...?Fuzbaby (talk) 00:56, 14 July 2009 (UTC)

Apparently you don't even know the field. ROs prescribe the dose & technique & sim method (ie. what and where), then sim therapists will sim the patient by using conventional, CT, MRI, or nuclear medicine imaging to collect the data for treatment planning. Then the dosimetrists (mostly were therapists in the States, while in most other countries they are all therapists) & physicists will design the treatment plans, and therapists will administer the treatments to the patients. Physinmed (talk) 23:51, 8 August 2009 (UTC)

I have read over the entire page again and the information presented is very accurate. Even though in the US therapists often experience a narrower scope because of their lower education requirement, but these jobs are still being done by the therapists. ROs only prescribe, consult with patients on the decision of treatments, follow up with the patients, do clinical markups, QA the plans (dosimetrists also do the QA but the final say lies on the shoulders of physicists), and approve verification images taken (often on the 1st day only). Physinmed (talk) 23:51, 8 August 2009 (UTC)

The ROs have very limited understanding of treatment planning and medical physics. This is why all of the planning aspects are being done by dosimetrists, physicists, or therapists. However they do have a strong understanding in radiobiology and oncology treatments. This is why these careers exist. Physinmed (talk) 23:55, 8 August 2009 (UTC)

Please remember to assume good faith. If I worked in the field, I wouldn't be asking the question. From your initial post, I can tell that you have a particular point of view, I'd be interested in hearing the other one (i.e. a RO). Thank you though for reading the article, however, I find some of your claims highly specious (for instance, the claim that a RO has limited understanding of treatment planning). Perhaps you would be so kind to provide some references to back up your claims? I have spent a small amount of time so far in an American radiation oncology department, and what you say sounds like you perhaps practice or have a perspective from a different country. Fuzbaby (talk) 06:08, 11 August 2009 (UTC)

You pretty much assumed what you thought about without doing any further investigations. A question mark after a statement doesn't make that sentence a question. What I described before is how the US radiation oncology field looks like since I am a medical physicist in radiation oncology and I work with oncologists, residents, and therapists everyday. Physinmed (talk) 23:42, 13 August 2009 (UTC)

My husband is a radiation oncologist at UPenn. His residency included a full year of radiation physics that they do with the PhD students (and hence have way more physics training than a therapist with an undergrad degree) and a rotation in dosimetry; he can do all dosemitry but doesn't normally as part of his job. About 1/2 of his department also have physics degrees (masters or PhD) in addition to their medical degrees. The oncologist defines where the tumor is and how much radiaton should go to it, then the dosimetrist and physicist make a plan based on the oncologist's outline of how much they want to go where (perscribes the dose plans). The oncologist and the physicist must both sign off on that. The technologist mainly delivers the radiation, i.e. they are the tech that positions the patient in the room and operates the machine. I think the above comments by Physinmed represent a tech in Canada, and perhaps not accurately at that as his comments show he has no understanding of the training the oncologist goes through. I'll post a quick quote from the American society that certifies radiaton technicians:

"Radiation therapists administer targeted doses of radiation to a patient's body to treat cancer and other diseases. When the radiation strikes human tissue, it produces highly energized ions that gradually shrink and destroy the nucleus of malignant tumor cells. Radiation therapists are highly skilled medical specialists educated in physics, radiation safety, patient anatomy and patient care. They typically see their patients three to five days a week throughout a four to seven week treatment plan.

Medical dosimetrists determine how much radiation will be delivered to a tumor site. Under the supervision of a medical physicist, they calculate and generate radiation dose distributions that follow the radiation oncologist's treatment plan. Medical dosimetrists use their knowledge of physics, anatomy and radiobiology to design optimal treatments that target the tumor while sparing the healthy tissue around it."

"Radiation therapists are highly skilled members of the cancer management team. They are responsible for accurately recording, interpreting and administering the treatment prescribed by radiation oncologists. During treatment, therapists help physicians use fluoroscopy, X-ray films or CT scans to localize and outline anatomical areas requiring treatment." From ASRT. Qwasit (talk) 23:15, 12 August 2009 (UTC)

First of all, I am a medical physicist. Residents do get a little bit of training in physics but the amount of knowledge they know in terms of radiation oncology physics is very little. I know this because physicists often act as physics instructors for the residents. The residents also learn treatment planning and dosimetry knowledge from the physicists and dosimetrists. Nonetheless the physicists and dosimetrists are the specialists in developing the plans, not the oncologists. The oncologists must know how to read the plan (and related knowledge) so they can prescribe and QA the plans(I have mentioned that in my first response). The oncologists can probably plan very simple treatments too but when it comes to complex planning like IMRT or stereostactic radiosurgery, physicists and dosimetrists are the specialists in creating the plans since they are the ones that are constantly in contact with the technology (eg. up to hundreds of beams for radiosurgery treatments).

In terms of the responsibilities of the oncologists, the physicists, the dosimetrists and the therapists, I think Qwasit basically repeated everything I have said except that hers was more detailed than mine. Since you don't work in the field I assume that you do not know that most dosimetrists are also radiation therapists who received more advanced training. Even though dosimetrists don't have to have a radiation therapy background (can have a physics degree too) but if you work in the field you will find that the employers still prefer the ones who are registered/certified both as therapists and dosimetrists.

In terms of the background education of the oncologists, I can tell you that most them do not have a degree in medical physics (if you still have any questions regarding this please contact the physician association and find out). Oncologists only have a limited understanding of radiation oncology physics (on the other hand medical physicists have a limited understanding of human anatomy too) and that is why they come to us for physics consultations in the radiation therapy processes. If oncologists were also physics/dosimetry experts then clinics wouldn't need to spend 200,000$ or more to hire a staff physicist.Physinmed (talk) 23:19, 13 August 2009 (UTC)

To clarify what I wrote: an oncologist can do everything a dosimetrist can do, and a therapist (in the US they are different, they have the same background training but then go on different pathways), but its not effecient for them to do that job, thats why therapists exist. I'd actually point out that maybe in Canada oncologists know little of physics, but not in the US; here they know about the same but one does it every day and one doesn't. And physicists no nothing about medicine...not just anatomy! That said, here at least they work in a team approach, and none would try to belittle others' knowledge (like it seems they do in Canada)...and here at least, a radiation oncologist costs about 350,000 to an institution, precisely because their extensive medical training is combined with a solid physics and radiobiology training, the physicist about 125,000. —Preceding unsigned comment added by Qwasit (talk • contribs) 01:55, 15 August 2009 (UTC)

Oncologists are not physicists, they do not possess the same amount of knowledge in physics as medical physicists do. If you still have any questions regarding this issue please talk to the American Medical Association. In terms of wage, the average income for medical physicists ranges from $120,000-$200,000 for Master's degree positions and $150,000-$300,000 for PhD positions. The average I believe is over $150,000. And according to the US Bureau of Labor Stats the mean wage of specialists physicians is in the range of $170,000-$190,000. And again I am an American physicist and I am talking about the United States of America, not Canada.Physinmed (talk) 22:26, 27 September 2009 (UTC)

I don't know about your physics salary numbers, but the radiation oncologist physician numbers are way off. As of 2008 the AAMC reports: Mean Salary $327,700 Median Salary $300,000 for physicians. As to the level of physics knowledge, it seems the above was commenting that the oncologist had about the same level of physics training as the master's physicist. Also, if I'm not mistaken, physicists must undergo additional training in medical oncology after their degree, while the MD training includes both within a residency program. Fuzbaby (talk) 23:55, 27 September 2009 (UTC)

I got my figures from the US Bureau of Labor Stats (2008). Anyway physicists have at least 6-7 years of pure physics training excluding residency. PhD medical physicists usually have more than 10 years of specialized training. Radiation oncologists do not have that much training in physics. If you still don't believe that radiation oncologists are not the experts in medical physics please email your concerns to the medical association and/or the American Association of Physicists in Medicine. Physicists do go through addition training (residency in medical physics, can be radiology, nuclear medicine, or radiation oncology) but not in medical oncology (medical oncology uses chemotherapy drugs). The proposed Doctor of Medical Physics (DMP) degree will include residency into its curriculum.Physinmed (talk) 22:44, 19 October 2009 (UTC)

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