AAPM Newsletter November/December 2013 Vol. 38 No. 6 by AAPM Docs

AAPM

N E W S L E T T E R The American Association of Physicists in Medicine We advance the science, education and professional practice of medical physics

n NOVEMBER/DECEMBER 2013 Volume 38 No. 6

Collaboration President Hazle emphasizes the continuing collaboration among AAPM, RSNA and IOMP

ABR Examination Report 2013 n AAPMâ&#x20AC;&#x2122;s Comments on 2014 Medicare Proposed Rules n Upcoming Events n Status of Agreement State Licensing Requirements for the Use of Radium 223 Dichloride n Headquarter News n

and more...

AAPM

NEWSLETTER

AAPM NEWSLETTER is published by the American Association of Physicists in Medicine on a bi-monthly schedule. AAPM is located at One Physics Ellipse College Park, MD 20740-3846

CONTENTS

NOVEMBER/DECEMBER 2013 Volume 38 No. 6

EDITORIAL BOARD EDITOR Mahadevappa Mahesh, MS, PhD

Johns Hopkins University E-mail: mmahesh@jhmi.edu Phone: 410-955-5115 John M. Boone, PhD Eileen Cirino, MS Robert Jeraj, PhD George C. Kagadis, PhD E. Ishmael Parsai, PhD Charles R. Wilson, PhD SUBMISSION INFORMATION Please send submissions (with pictures when possible) to: AAPM Headquarters Attn: Nancy Vazquez One Physics Ellipse College Park, MD 20740 E-mail: nvazquez@aapm.org Phone: (301) 209-3390 PUBLISHING SCHEDULE The AAPM Newsletter is produced bimonthly. Next issue: January/February Submission Deadline: December 12, 2014 Posted Online: Week of january 6, 2014

www.AAPM.org

Articles in this Issue

Events / Announcements

AAPM President’s Column

Summer Undergraduate Fellowship Program

Chairman of the Board’s Column

RSNA / AAPM Online Physics Modules 16

AAPM President-Elect’s Column

2014 AAPM Summer School

AAPM Executive Director’s Column

Radiation Oncology Program Accredidation Meeting

Editor’s Column

56th Annual Meeting & Exhibition

Legislative & Regulatory Affairs Report

AAPM Tuesday Evening Reception at RSNA

Education Council Report

DREAM Diversity Recruitment

ABR Physics Trustees Report

Staff Announcements

Health Policy & Economic Issues

Person in the News

CAMPEP News

AAPM Spring Clinical Meeting

Website Editor’s Report

Editor’s Note I welcome all readers to send me any suggestions or comments on any of the articles or new features to assist me in making the tablet edition a more effective and engaging publication and to enhance the overall readership experience. Thank you.

AAPM President’s Column

John D. Hazle, Houston, TX

On RSNA, ICMP, IOMP and more

irst off, I’d like to once again promote our partnership with the Radiological Society of North America to promote accredited imaging physics residency programs by providing partial support to non-accredited programs willing to seek CAMPEP accreditation through AAPM/RSNA Imaging Physics Fellowships. To refresh your memory, the AAPM board voted last summer to allocate $560,000 to fund 4 new programs (over a 5-6 year period). Each new program is provided $35,000 per year for up to four years to cover approximately ½ the cost of a resident for each year (two sequential trainees for two-year residencies). We approached RSNA last year and asked that they match this amount to establish another 4 programs. The value to RSNA would be helping us to make sure that the imaging physics manpower needed to supportradiology departments in post-ABR 2014 era would be adequate. While supportive of the idea, they were concerned about the aggressiveness of our timeline to start the program and that there might not be enough quality programs responding to the request for proposals. Therefore, they decided to commit only $280,000 to the partnership with an option for us to come back later and seek additional support. We formed a fellowship selection and monitoring committee, chaired by Bob Pizzutiello with AAPM members Don Peck and Chuck Willis and RSNA members George Bissett and Reed Dunnick (both in leadership positions at RSNA). This committee pushed to get the details of the program established, put out a request for proposals, reviewed submissions and selected three new programs to receive fellowships in a little over six months. The RSNA leadership was so impressed with the response of our members, and their radiology chairs, that at their board meeting two weeks ago they agreed to commit another $280,000 to the program, matching our $560,000 commitment. That means that we will eventually create eight new CAMPEP accredited imaging residency programs. Once again, thanks to Bob and his committee, and to the RSNA, for working together to give this program such a successful start! We look forward to many more qualified applications for the 2014 fellowships and beyond. Finally, the support and collegiality of the RSNA leadership can’t be overstated. They view the AAPM as partners in promoting high quality radiology clinical services, education and research - and they’ve put their money where their mouth is to show their commitment!!! I’d next like to report on a few activities from the International Conference on Medical Physics (ICMP) honoring the 50th anniversary of the International Organization of Medical Physics (IOMP) that was held from September 1-4 in Brighton, England. The AAPM was one of four founding members of the IOMP with the Hospital Physicists Association from England, the Canadian Organization of Medical Physicists and the Swedish Medical Physics Society. The meeting was well attended with over 800 participants. I was invited to give a short

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

introduction from the AAPM at the Conference Opening and Colin Orton gave a historical perspective on the IOMP in that session. The AAPM was well represented with about 30 members in attendance. Two noteworthy awards were given, both to AAPM members. The first was the Marie Curie Award for Lifetime Achievement which was presented to Chuck Mistretta for the outstanding portfolio of scientific accomplishments over the last 40 years, from digital subtraction angiography to applications of compressed sensing in image reconstruction. Chuck is now attempting to expand his sphere of influence by developing a HYPRswing for the Professional Golf Association! Chuck has been trying to teach me this technique with little success! Later in the week at IOMP proud father Chuck’s academic son, Willi Kallender, received the Gray Medal from the ICRU for his contributions to computed tomography associated radiation dosimetry. ICRU also honored Willi with a very nice dinner in recognition of the award. During the dinner, Willi pointed out to me that it was 25 years ago that he filed the patent for spiral CT. Doesn’t time fly when you’re having fun! For those of you who don’t know, Willi was Chuck’s graduate student at the University of Wisconsin. Congratulations to Chuck and Willi for this recognition of your contributions to medical physics!!! A note of thanks to Rick Morin is in order. Rick just completed his rotation as an AAPM Trustee to the American Board of Radiology representing Diagnostic Medical Physics.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

I’m not sure what the time commitment is for our trustees, but I believe that it approaches that of those of us in the Executive chain at AAPM – it is not insignificant!!! So thank and congratulate Rick next time you seem him. He will be replaced on the ABR board with Tony Siebert. I guess Tony needed to fill the “time gap” left by his rotation out of the AAPM executive chain! So, please congratulate Tony on this recognition of his lifelong effort to the certification process and the ABR. AAPM continues to be recognized as an authority on the issue of radiation dose. As previously communicated, the Working Group on Standardization of CT Nomenclature and Protocols was recently given a Special Citation Award by FDA’s Center for Devices and Radiological Health (CDRH). Next week, John Boone will be giving a presentation to the National Academy of Sciences on the radiation dose and risk implications of x-ray based airport screening systems. Finally, based on the recommendation of Jim Brink from the Association of University Radiologists, the AAPM was invited to sponsor a symposium in 2015 on radiation dose management in the emergency room. This symposium is developed to help ER physicians understand how to manage radiation dose in their unique practice. The AAPM has committed $15,000 to support the symposium and Dianna Cody will represent us on the organizing committee. Participation in this symposium will allow AAPM to expand the scope of physician peers that are aware of the critical role we play in managing radiation dose in radiological procedures, while also contributing to high image quality that results in better patient care. One initiative that is just taking shape is a Task Group to examine our nominating process for the executive chain (President, Treasurer and Secretary) and Board Members-At-Large. We received some feedback about the slate that was presented for elections last year and while the process was carried out in accordance with our By-Laws and policies, EXCOM and the Board felt that evaluation of the process was in order. Barry Wessels has agreed to chair this group. He is putting together a diverse group to make recommendations about the process. The selection of candidates is a complicated process that balances prior contributions experience with the organization, to leadership qualities, to a desire to have as diverse leadership as possible while achieving the goal of having high-quality leaders who are willing, and able, to make the substantial time commitments needed to keep the organization running at top speed. I look forward to working with Barry over the next year or so in facilitating this process. In closing, my term as President is nearing an end. I will be turning over the role of President to John “Badger” Bayouth soon after that meeting. The AAPM will be in his, and then President-Elect John “Mustang” Boone’s, capable hands. I very much look forward to seeing many of you in Chicago at the RSNA meeting. The combined program is exciting and I’m sure that those of you who make it to Chicago will not be disappointed.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Chairman of the Board’s Column

Gary A. Ezzell, Phoenix, AZ

I am not done with my changes

here is a poem by Stanley Kunitz called “The Layers” that begins: “I have walked through many lives, some of them my own, and I am not who I was, although some principle of being abides, from which I struggle not to stray.”

Being part of a volunteer organization like AAPM means touching and being touched by many lives, both the people we work with and the patients we work for. Our association’s greatest strength, in my opinion, is the breadth of involvement by so many of our members. And there seems to be no lack of desire from many younger members to be involved. But getting started is often not easy. When asked about how to get involved, I repeat the standard liturgy: “see what task groups and committees exist, email the chairs, attend the meetings at AAPM, show interest …” However, when I look back on how my own involvement started, it was not because of my own initiative. Far from it. For purely personal and idiosyncratic reasons going back to junior high school, I used to be disinclined to participate in any organization. So I never asked to be involved. On the contrary: I was asked. A work colleague who chaired the local AAPM chapter asked me to be the chapter representative to the Board of Directors and did not take “no” for an answer. Later on, I was asked to work on the scientific program for the Annual Meeting. Much later, I was asked to stand for election as an officer. That has been the pattern. Nearly everything I have done with and for the AAPM is a consequence of someone asking me to do it. Point being – those of us who are involved need to take the initiative to seek out and invite others to join in. And those of us who are more senior and work with good people who are more junior should promote them within the AAPM structure. I ended up being on an early IMRT working group because a colleague suggested to the chair that he involve me. So – while it is helpful for a junior person to knock on the door, it is even more helpful if a senior person brings them to the door and opens it. That poem “The Layers” ends with: “I am not done with my changes.” While that applies to me personally, it certainly also applies to AAPM. As long as we continue to bring in new leaders who are committed to our profession and its “principle of being”, then we will adapt and abide. This is my final newsletter article as an AAPM officer. Among the lives that have touched mine

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

during these years, I want to particularly acknowledge with respect and gratitude the superb AAPM staff. Angela Keyser, Michael Woodward, Lisa Schober, Lisa Rose Sullivan, Karen MacFarland, and Nancy Vazquez are among those with whom I have worked most closely and who have made the work such a pleasure.

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AAPM Newsletter | Volume 38 No. 6 | November/December 2013

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AAPM President-Elect’s Column

John E. Bayouth, Madison, WI

Don’t Be Irrelevant by Being Irrelevant

edical Physicists should reclaim their position as primary equipment purchasing decision makers. A disturbing trend in healthcare is for equipment purchasing decisions to transition into the domain of healthcare administrators and away from Medical Physicists. Posting educational information on our associations website targeting hospital administrators, like the following, is not doing the trick: “Medical physicists are involved in the negotiating the purchase of high tech, million dollar machines to ensure you get the best value for your money. They write specifications to guarantee that your hospital is getting the equipment it needs.” Not wanting to make a costly mistake hospital administrators recognize the necessity of engaging our technical expertise when evaluating a +100 million dollar capital equipment purchase (e.g., particle therapy delivery systems), but they have apparently grown quite comfortable with making mistakes on +3 million dollar systems. I believe a well-educated and engaged Medical Physicist can significantly improve the outcomes of equipment purchase, helping both the purchasing institution and the patients who are imaged/treated on these systems, as well as keep our technical exhibitions during local chapter meetings and national AAPM meetings robust. Multiple organizations have long recognized the important role to be played by the Medical Physicist in the process of selecting new technologies. For example, The American College of Radiology’s Guide to Medical Physics Professional Practice clearly identifies a fundamental responsibility of Medical Physicists is the “Development of purchasing and acceptance specifications for imaging and radiation therapy equipment.” The need for a Medical Physicist to play this role is also clear. A decade ago Robert Kriz observed in a Point-Counterpoint article(1) “Writing performance specifications and acceptance tests into bid documents is happening less frequently, partly because of the formation of large purchasing groups.” The root cause and consequences of this observation are easily anticipated: “Because of the size of the purchase, university management took charge of the negotiations, with disastrous consequences. Price was the only consideration in these negotiations, and systems were downgraded, needed options were dropped, less powerful generators were acquired, and lowend imaging chains were substituted, all without the knowledge or advice of the physicist.” Unfortunately, this problem persists. In the 2011 AAPM Summer School Fang-Fang Yin et al. (2) made the direct connection between patient safety and equipment selection, where they argued the decisions should be base on “not just on what other people are using” but rather on

AAPM Newsletter | Volume 39 No. 5 | September/October 2013

“functionality, accuracy, reliability.” The performance specifications for the equipment should be clearly identified during the system evaluation/selection process. So, how did we get to this point? As with most problems the reasons are numerous. Long gone are the days when a departmental group would visit the manufacturing factory or a clinical site where the system was installed and in operation. During those visits the majority of questions would quickly become technical and driven by the Medical Physicist. Today, organizationally mandated conflict of interests concerns keep us from making such visits, resulting in a loss of the direct and detailed investigation of systems as performed in the past. This leads to purchasing based on subjective impressions. (3,4).

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What should AAPM do to improve our ability to successfully reclaim our position as primary equipment purchasing decision makers? Well the conventional AAPM response would be to have a task group, and maybe that’s the way to go. Alternatively, I’m thinking we might benefit from developing a workshop or symposia on the process of developing a Request for Information (RFI) and Request for Proposals (RFP). Learning to develop an RFI/RFP is not a skill set we develop during graduate or residency training in Medical Physics, nor do I believe we should. Rather, this type of learning is falls into continuing education or professional development. In fact, creation of a robust and effective RFI/RFP contains a good bit of artistic skill along with technical expertise.

The process should begin with an 1-800-871-7930 assessment of need. Although this Complete online catalog at includes identification of the technical www.moellerinc.com/academy specifications of the system, one needs Offering Medical Physics and Radiation Safety Consulting Services to understand the breadth and depth of intended applications. This allows the Medical Physicist to reconcile these two sets of information to evaluate if the proposed solution can precisely, accurately, and efficiently execute the required tasks. Equipment selection and purchasing should include an assessment of need, request for information, vendor demonstrations, tender process, selection, and purchase.(5)

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

If this type of workshop makes its way through the council evaluation/review process I encourage you to consider attending. If you are not able to do so, look for a video library listing for this type of conference, I would love to make this content widely available to our members. Maybe you don’t feel this type of exercise provides you direct value. Consider these arguments. First, when left without technical and clinical direction hospital administrators will likely make the purchase of equipment a pure business decision. It is relatively simple to look at a set of numbers and identify the lowest number. Obviously, there is more to the story. Only the end users of the technology can possibly understand the nuances of how the system can be used to address specific clinical needs (e.g. is temporal resolution of the CT scanner a limitation to its clinical use?). The Medical Physicist should be the expert who spans the technical details and clinical knowledge to successfully navigate this process. There is no need for us to negotiate a final price, but we should remain engaged in the process to assure critical elements of the system do not “disappear” from the quotation in order to meet a negotiated price. My second argument is pragmatic. I have no doubt the vendors are keenly aware of who the decision makers are in the purchasing process. The Medical Physicists’ role in purchasing equipment impacts our local chapter and national AAPM meetings. I’m sure the vendors are very fond of all of us, who wouldn’t be? But I hypothesize their level of financial commitment is directly proportional to our influence in the decision making process for new purchases. This is not an experiment I’d like to conduct. If the Medical Physicist’s role becomes more irrelevant in purchasing decisions, our organization could loose out on nearly one-half of our current revenue, and that’s a fast track to irrelevance. 1. R. Kriz and L. Hubbard, “The provision of consultative physics services as commodities undermines the professionalism of medical physics.” Med. Phys. 30, 98-100 (2003) 2. F.F. Yin, et al. “Human Performance and the Quality and Safety of Radiation Therapy.” AAPM Summer School 2011. 3. J. Czernin and H. Schelbert, “PET/CT imaging, facts, opinions, hopes, and questions,” J. Nucl. Med. 45, 1S–3S (2004). 4. W. V. Vogel, W. J. Oyen, J. O. Barentsz, J. H. Kaanders, and F. H. Corstens, “PET/CT: Panacea, redundancy, or something in between?” J. Nucl. Med. 45, 15S–24S (2004). 5. B. Curran, “Planning the Purchase of a Radiation Therapy Treatment Planning System.” Med. Phys. 34, 2651 (2007).

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Are you interested in applying your physics or engineering knowledge in medicine? Want to make a clinical impact this summer?

Summer Undergraduate Fellowship Program We provide opportuniies for excellent undergraduates to gain experience in medical physics at leading clinical and research insstuuons. A large menu of mentor-defined projects is available and Fellows select their mentor according to their mutual interests. Fellowships are offered for weeks during the summer (May through September) and available to students not in their final year. See hhp://www.aapm.org/educaaon/GrantsFellowships.asp for more details.

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AAPM Executive Director’s Column

Angela R. Keyser, College Park, MD

Important events and dates to remember AAPM events during RSNA 2013 Visit AAPM at Booth 1108 in McCormick Place - South Building - Hall A to charge your mobile devices at AAPM’s new booth! Pick up information on association programs, the current list of AAPM publications, and complimentary copies of Medical Physics as well as check out the recent advancements in the AAPM Virtual Library. Make plans to join your colleagues on Tuesday, December 3 from 6:00 PM – 8:00 PM at the Chicago Hilton for annual AAPM Reception. Special thanks to Landauer, Philips, RTI Electronics and Siemens for their financial contributions to offset the costs for this event. The most up-to-date schedule for AAPM meetings during the RSNA meeting is available online .

Mark your calendar with 2014 Meeting Dates The Spring Clinical Meeting is scheduled for March 15 – 18 at the Denver Marriott Tech Center in Denver, Colorado. The 2014 Summer School, SRS/SBRT/SABR: Safely and Accurately Delivering Highprecision, Hypofractionated Treatments, will be held June 22 – 26 at University of Vermont in Burlington. The 56th AAPM Annual Meeting will be held July 20 – 24 in Austin, Texas.

Your Online Member Profile This is a reminder to keep your AAPM Membership Profile information up to date by going to website and making any changes necessary. Please, upload your picture if you have not already done so. Remember to review the “Conflict of Interest” area of the Member Profile to self-report conflicts per the AAPM Conflict of Interest Policy.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

2014 Dues Renewal 2014 dues renewal notices were recently distributed. You may pay your dues online or easily print out an invoice and mail in your payment. Twenty AAPM Chapters have elected to have HQ collect chapter dues. Make sure to check to see if your chapter is participating. If it is, we hope that you will appreciate the convenience of paying your national and chapter dues with one transaction!

Headquarters News In October we welcomed Abby Pardes to the AAPM HQ team as our new Graphic and Web Designer. Along with providing web design and support for AAPM and other related websites, Abby will provide the necessary support to bring the AAPM Virtual Library in-house. She worked for a number of years at the American College of Cardiology and is familiar with the world of non-profits. I firmly believe that part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of high performing association management professionals. The following AAPM team members have celebrated an AAPM anniversary in the last half of 2013. I want to publicly thank them and acknowledge their efforts.. Lisa Rose Sullivan Penny Slattery Michael Woodward Farhana Khan Noel Tyler Yan-Hong Xing Tammy Conquest Corbi Foster Jackie Ogburn Janet Harris

20 years of service 17 years of service 17 years of service 15 years of service 8 years of service 7 years of service 6 years of service 6 years of service 6 years of service 1 year of service

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AAPM Newsletter | Volume 38 No. 6 | November/December 2013

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Editor’s Column

Mahadevappa Mahesh, Baltimore, MD

From the Editor’s desk

elcome to the final issue of the 2013 AAPM Newsletter. This year we started delivering the Newsletter on a new platform that included tablet devices. The transition to the new format has gone fairly smoothly and I wish to explore all the available tools (embedded videos, etc.) to further enhance the readers experience next year. This issue contains many interesting articles including the President’s column discussing the collaboration of AAPM with other professional societies and how it is impacting our profession. President-Elect’s column on becoming irrelevant by being irrelevant with regard to equipment purchases, Educational council-chair’s report on medical physics residency and to ABR Physics Trustees’ report on 2013 ABR Exam. As the last issue of this year, I would like to thank all of the Corporate Affiliates who continue to support the Newsletter and its new platform that is striving to provide greater opportunity for the affiliates to reach out to the readers. I would also like to thank Ms. Nancy Vazquez, for all of her work on the Newsletter and Ms. Farhana Khan for facilitating in posting the Newsletter on the AAPM website through this year. I would also like to thank Al Tokel of neoPromo Media Group and his staff with whom we contract to format and deliver the Newsletter in its current form. I would also like to express my sincere thanks to Angela Keyser, Michael Woodward and the headquarters’ staff and to the Newsletter Editorial Board for their support and timely advice. Finally, I would like to thank my wife and kids for their cooperation in this task. As this issue arrives at your desk, we are entering the holiday season and I wish you and your family a very happy holiday season. As always, I look forward to receiving any comments/suggestion related to the Newsletter.

For More Information: www.aapm.org/meetings/2014AM

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

RSNA / AAPM Online Physics Modules The RSNA/AAPM Online Physics Modules are designed to educate radiologists and radiology residents about

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physics@rsna.org Please note: For all modules completed prior to 8/22/2013, RSNA resident members can access their physics completed transcripts through the ‘education credits’ section of myPortfolio on myRSNA, using their RSNA login information. This is true for all resident members, regardless of whether your institution uses myPortfolio for its residency training records. If anyone cannot locate this completion record, (s)he can request a PDF transcript by e-mailing physics@rsna.org.

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AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Legislative and Regulatory Affairs Report

Lynne Fairobent, College Park, MD

Notable events in legislative and regulatory affairs International Atomic Energy Agency Safety in Radiological (SAFRAD) Procedures - An Educational Reporting System â&#x20AC;&#x201C; Debbie Gilley The International Atomic Energy Agency (IAEA) collects data on patients who have undergone fluoroscopically guided interventional procedures that result in prolonged x-ray exposures. The purpose of this reporting system is to follow these patients for possible side effects and assess the deterministic effect from the procedure. Information exchanged from the SAFRAD learning system is expected to raise awareness of radiation doses that can be received from intervention procedures; demonstrate patient doses that lead to deterministic injuries; identify dose optimization practices, and provide a method to estimate the risk of injuries from high dose procedures. IAEA is interested in capturing information on patients who have undergone 60 minutes of fluoroscopy, have a KAP (or DAP) value greater than 300 GY.cm2 for cardiac or neurological procedure; have received a Ka, r greater than 5Gy, have received a peak skin dose greater than 3 Gy; have received a number of cine-series images greater than 20. In addition to these triggers the SAFRAD system collects information on patients that have had an observed radiation injury; patients that have undergone multiple fluoroscopically guided interventional procedures within the last 12 months; patients who have had the wrong procedure performed or procedures was performed on the wrong patient; or procedure performed on a pregnant patient. Currently the SAFRAD system has 214 entries from 19 facilities. There are 127 patients that are being followed and there are 16 reported deterministic effects. To improve the understanding of the trigger dose indictors for the specific type of procedure, the system needs more entries. If you are interested in participating in this project, the IAEA has prepared a PowerPoint presentation on their website or contact the SAFRAD team.

Status of Agreement State Licensing Requirements for the Use of Radium 223 Dichloride â&#x20AC;&#x201C; Debbie Gilley This report provides information on the licensing requirements for Ra223 Dichloride currently available for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases and no known visceral metastatic disease.1

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

The US Nuclear Regulatory (NRC) adopted the Advisory Committee on the Medical Uses of Isotopes (ACMUI) recommendation on guidance to licensees who wish to provide this service.2 The ACMUI advises the U.S. Nuclear Regulatory Commission (NRC) on policy and technical issues that arise in the regulation of the medical uses of radioactive material in diagnosis and therapy.3 The 37 agreement states depending of the requirements may need to adopt regulation that are equivalent to NRC. This is called compatibility and there are different requirements based on the purpose of the regulations. Compatibility is defined using the classification system described below: Compatibility A concerns program elements involving basic radiation protection standard or related definitions, signs, labels or terms necessary for a common understanding of radiation protection principles. The State program element should be essentially identical to that of NRC. Compatibility B = Program element with significant direct transboundary implications. The State program element should be essentially identical to that of NRC. Compatibility C = Program element, the essential objectives of which should be adopted by the State to avoid conflicts, duplications or gaps. The manner in which the essential objectives are addressed need not be the same as NRC, provided the essential objectives are met. Health and Safety Issues Program elements identified by H&S in the column are not required for purposes of compatibility; however, they do have particular health and safety significance. The State should adopt the essential objectives of such program elements in order to maintain an adequate program. With respect to the Radium 223 Dichloride radiopharmaceutical therapies. Agreement states are required to meet the condition of Health and Safety in the â&#x20AC;&#x153;Use of unsealed byproduct material for which a written directive is required; safety instructions. (10 CFR 35.300, 10 CFR 35.310(a) Safety instruction 10 CFR 35.310 is a compatibility D; training and experience for user of unsealed by-product material for which a written directive is required is a Compatibility B; the definition of a written directive 10 CFR 35. 40 (a) (b) (compatibility H and S). There are numerous other radiation safety requirements with different compatibility requirements.4 However Agreement States are not required to use the guidance information provided by NRC and can create there own requirements to meet their specific state regulations. In an effort to identify variation in requirements from one agreement state to another, a survey of agreement states was completed on October 3, 2014. 27 agreement states responded.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

The table below provides the results of the survey for each participating state. State

Using NRC guidance on the use of radium 223 dichloride

AR CA CO

X X X

IL KA LA MA MD

X** X X X

Developed Using NRC their own guidance but guidance with additional material requirements X

Description of additional requirements

Licensee submits therapeutic procedures checklist, decontamination procedures, storage and handling guide, dose calibrator procedures and an administration guide as part of their amendment package.

We are paying special attention to the dose calibrator settings and whether or not the linearity performed by the licensee is adequate for the small activities per dose that are typically used with this radiopharmaceutical. Requires all doses to be assayed prior to administration. Requires the Authorized User to meet the full requirements of 41.237 equivalent to 10 CFR Part 390.

Requires the staff to use additional safety equipment (goggles and face shields) and syringe shields (not for the radiation protection but to distinguish the radium 223 dichloride from other syringes used in the process (saline). Syringes must be clearly labeled.

This table continues on the next page.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Some additional reporting requirements: They require procedures for handling the radiopharmaceutical per drug manufacturer’s protocol and the names of the authorized user and documentation of training and experience to safely and effectively use Radium 223 dichloride. Verification measurement of the unit dose prior to administration. AU may transfer

* These states developed their own guidance but used the NRC guidance as a basis. ** They have not received any request to license the use of Ra223 dichloride, but if the do, they will use NRC guidance. As with all guidance documents, these are time sensitive and you may wish to acquire the latest information from the individual agreement states. The AAPM Government Affairs Office provides a link on the website to provide AAPM members with state contact information.

Save the Dates - NCRP: Achievements of the Past 50 Years and Addressing the Needs of the Future - March 10–11, 2014 The 50th Annual Meeting of the National Council on Radiation Protection and Measurements (NCRP) will be held at the Hyatt Regency in Bethesda, Maryland, March 10–11, 2014. The program theme is NCRP: Achievements of the Past 50 Years and Addressing the Needs of the Future and will celebrate the 50th year since our Congressional charter in 1964. Notable contributions to radiation protection policies and programs will be recalled, but the speakers will focus primarily on important challenges and opportunities to address the needs of the nation for the future. Presentations will be given by leading experts in each of the seven areas of protection to be covered with ample opportunities to ask questions verbally or textually. All questions will be answered! Program Chair and NCRP Honorary Vice President, Kenneth R. Kase, will synthesize and summarize the diverse topics covered, and will expand on the opportunities and challenges in science, operations, and communications faced as we strive to address the needs of the nation in the 21st century. NCRP President, John D. Boice, Jr., will close the 2014 Annual Meeting by briefly summarizing NCRP’s perspective on future needs in radiation protection and mission obligations in accordance with our Congressional charter. Registration is free. Online registration is now open. For additional information contact James R. Cassata, PhD, CHP by email, 301-657-2652, ext. 20, or 301-907-8768 (fax).

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

NCRP announces Lauriston Taylor Lecturer and the Warren Sinclair Keynote Speakers for 2014. Congratulations to Dr. Fred Mettler is the Lauriston S. Taylor Lecturer and Dr. Jerry Bushberg the Warren K. Sinclair Keynote Speaker. Xofigo safety guidance http://www.xofigo-us.com/product-information/. 2 Nuclear Regulatory Commission (NRC), Advisory Committee on the Medical Uses of Isotopes (ACMUI), Report on Licensing for Radium-223 (223 5 Ra) Dichloride, November 20, 2012, available here . 1

The ACMUI membership includes health care professionals from various disciplines, who comment on changes to NRC regulations and guidance; evaluate certain non-routine uses of radioactive material; provide technical assistance in licensing, inspection, and enforcement cases; and bring key issues to the attention of the Commission for appropriate action. 3

NRC Office of Federal and State Materials and Environmental Management Programs (FSME), Procedure Approval, Compatibility Categories and Health and Safety Identification for NRC Regulations and Other Program Elements - SA-200, June 5, 2012 go to web. 4

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

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Education Council Report

George Starkschall, Houston, TX

Two important questions facing the Education Council

uring the recent 2013 AAPM meeting, as Chair of Education Council, I had to attend many meetings. Invariably, two questions were asked of me at these meetings: Are there going to be a sufficient number of residents to meet workforce needs after the 2014 deadline that requires candidates who wish to take the ABR exam to complete a CAMPEP-accredited residency? What is the AAPM doing about the mismatch between numbers of students graduating from accredited graduate programs and the number of residency positions available for these graduates? These are both excellent questions and demonstrated our membersâ&#x20AC;&#x2122; concern for the future of our field. Let me try to address each of these questions in turn. The first question results from the American Board of Radiology policy that applicants who wish to take the ABR examination on or after 2014 must have successfully completed a CAMPEP-accredited residency program. The issue that we are facing is that we need to make sure there are a sufficient number of residency positions to produce a sufficient number of Board-eligible medical physicists to meet the needs for qualified medical physicists in the community. Determining the exact number of medical physicists that we are going to need each year is a very difficult task, and there is a great deal of uncertainty in the numbers; the best estimates we have suggest that we will need 125-150 residents per year in radiation oncology physics and 25-30 residents per year in imaging physics to meet the need for clinically qualified medical physicists. As of October 10, 2013, 67 radiation oncology physics residencies had achieved CAMPEP accreditation and 9 residencies were in the process of accreditation review. If we assume that a program can accommodate an average of 1.5 residents per year, this gives us approximately 114 residents per year in radiation oncology physics. Nine imaging physics residencies had achieved accreditation and 4 were in the process of accreditation review, thus giving us approximately 20 residents per year in imaging. In addition, several programs have incomplete applications, and are likely to enter the review process before the end of the calendar year. Furthermore, one DMP program has been accredited, 3 programs are in the process of development, and 3 are under consideration at their respective institutions.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

I am optimistic that we can reach our minimum goal of residency positions by July 1, 2015. That particular date is when the first cohort of MS students who will need to complete a residency program to take the ABR exams are likely to have completed their degrees and need to enter a residency program. But that would give us the bare minimum of residency positions. We still should have more residency positions. What is the AAPM doing to increase the number of residency positions? One of the primary impediments to establishing a medical physics residency has been funding of residency positions. The AAPM has begun an initiative in collaboration with the RSNA to provide funding for new imaging physics residency programs. In this initiative, the AAPM and RSNA will provide 50% support of residentsâ&#x20AC;&#x2122; stipends in these new imaging physics residency programs for up to 5 years. A program that applies for such a grant must demonstrate adequate resources to support a program, support efforts to achieve CAMPEP accreditation, and provide a commitment to sustain the funding of the residency program beyond the initial grant period. An initial request for applications resulted in the granting of awards to three new programs: The University of Alabama Birmingham, Memorial Sloan-Kettering Cancer Center, and University of Wisconsin. We are looking forward to offering awards to additional programs this coming year. In addition, we are encouraging private medical physics practices to establish residency programs. Often, these practices are small and cannot take on more than a single resident at a time. In addition, they do not have the resources to support the overhead necessary to maintain a residency program. A solution to this problem is for these practices to join an existing residency program in a hub and spoke arrangement, in which the larger existing program provides the infrastructure, and the private practice provides the training site and the supervision of a resident. In order to provide interested parties, both potential spokes and potential hubs, with information regarding developing a Self-Study for a hub and spoke system, we are planning another residency training workshop, most likely in the spring of 2014. The second question that was asked during the AAPM meeting really identifies two issues. The first issue is that many more individuals are graduating from CAMPEP-accredited graduate programs than there are residency positions for these graduates. The second issue is that graduate programs are producing almost twice as many MS graduates as PhD graduates, whereas residencies are accepting almost twice as many PhD graduates as MS graduates. What can the AAPM do about this? First of all, let us identify what we cannot do. First, we cannot limit graduate programs as to the number of students they may have. This is a suggestion that some have proposed, but the

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

AAPM does not have any authority to limit numbers of students in graduate programs, nor does any other organization. Any limitation in the number of students in a graduate program has to be voluntary on the part of the graduate program. Nor can we increase the number of residency positions to accommodate all the graduates of CAMPEP-accredited graduate programs. It has been a difficult task to encourage the establishment of programs to ensure that there are a sufficient number of residency positions to meet workforce needs. It would likely be impossible to increase the number of residency position by 50-100%. Moreover, having that many residency positions may not necessarily be a good idea either; as it would just shift the overproduction problem two years down the line. We would then have invested resources in the clinical training of additional medical physicists without a sufficient number of jobs for them. What, then, can the AAPM do? First, we can encourage graduate programs to establish committed clinical training opportunities for its graduates. There are two models for this. One model is the targeted residency, first established by the Louisiana State University program, in which a sufficient number of residency positions are available and committed to students in their graduate program. Graduates of their program have the option of seeking a residency elsewhere, but students enter the graduate program knowing they are assured of a residency position. The second model is the professional doctorate program, first established by the Vanderbilt University program, in which the two years of clinical training are incorporated into a fouryear graduate program. Students completing the professional doctorate program are assured that they will receive clinical training and become qualified to sit for the ABR examination. Furthermore, we hope that by establishment of more private practice-based residencies through the hub-and-spoke model, we can provide more opportunities for graduates of MS programs. The private practice residencies are more likely to accept MS graduates than the academic residencies; often academic residencies have institutional restrictions that prevent them from accepting physicists who do not hold a doctorate degree. Recently CAMPEP notified all accredited graduate and residency programs of the requirement to post information on a publicly-accessible website showing numbers of program graduates in the workforce, in residency programs, in educational programs, etc. This information is likely to impact on the desirability of a program to potential students. A graduate program with a poor record of graduate placement is not as likely to be as attractive to potential students as a program that successfully places all of its graduates. The reality is that some graduates of medical physics programs will not be placed in residencies and consequently not be able to find employment as clinical medical physicists. What effect changes in health care such as the Affordable Care Act and the CARE bill will have on the market for clinical medical physicists is something beyond our control. However, we could be

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

doing a better job in publicizing non-clinical career opportunities. We have been placing such great emphasis on the need for high-quality clinical education that we may have neglected non-clinical careers. A medical physics education not only prepares the graduate for a career as a clinical medical physicist, but also provides the graduate with the knowledge to work in research, regulatory agencies, industry, and entrepreneurship, among other areas, along with the skills to be a problem-solver in a technological health care domain. These skills can be transferred to areas outside the clinic. Students in medical physics graduate programs need to be made aware of non-clinical opportunities, and there is no better group of individuals to acquire and provide this information to our student community than the students themselves. Consequently, I have invited the Students and Trainees Subcommittee to address this issue. We medical physicists are capable of coming up with other creative solutions to our problem of potential oversupply of medical physics graduates, and I will certainly welcome other ideas or ways we can address this issue. My email address is in the AAPM Directory and I shall be looking forward to hearing from you.

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ABR Physics Trustees’ Report

Jerry Allison, PhD; Geoffrey Ibbott, PhD; and Anthony Seibert, PhD

ABR Examination Report 2013

his is a report on the ABR examinations for medical physics in 2013. The oral exams were given in June in Louisville, and the written exams were administered at Pearson VUE testing centers throughout the country in August. The exams are all validated by psychometric means and show a high degree of reproducibility from year to year. Recent factors that seem to be affecting candidate performance are: • An increase in CAMPEP-trained candidates • An increase in CAMPEP-trained residents • A bolus of individuals who wished to enter the system because of the requirement for CAMPEP training, which began in 2012 • Increased numbers of candidates who previously failed the exams. Under the ABR’s 2012 “Board Eligible” Policy, candidates can take the written exams annually until their board eligibility period expires.

Number of Candidates The overall number of candidates continues to rise. This has been driven by an increase in the number of medical physics training and residency programs and an increase in the number of applicants who applied to meet the deadlines imposed by the requirements for a CAMPEP-approved training program in 2012 and a CAMPEP-approved residency in 2014. The number of candidates from recent years is shown below.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Pass Rates While pass rates vary somewhat from year to year, the overall results are similar to previous years. Because diagnostic medical physics and nuclear medical physics have fewer candidates, there is more variation in the pass rates for those two disciplines.

Oral Exams The number of oral exam candidates continues to increase. This year we had to increase the number of therapeutic medical physics panels and the number of sessions for diagnostic medical physics. This may be due to: • The change in requirements in 2012 • An overall increase in the number of medical physicists being produced • More repeat candidates due to changes in ABR requirements

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

A comparison of the number of first-time oral candidates and repeat oral candidates is shown below.Â

Oral Exam Pass There are three possible results from an oral exam: A candidate can pass, fail or condition. The charts below show the Pass Rates for first-time candidates and repeat candidates. The pass rates for all categories remained similar to historical experience. Because of the small number of nuclear and diagnostic medical physics candidates, there is more variation from year to year than in therapeutic medical physics.

The pass rates for repeat candidates are generally lower than for first-time takers.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

The chart below shows the distribution of scores for both first-time takers and repeat candidates. Viewed separately, the first-time takers and the repeat candidates form a bimodal distribution. This reflects variations in the training and experience of the candidates. Data are not shown for diagnostic and nuclear medical physics because the numbers of candidates are small.

If we combine all the disciplines, we see a good stability of pass rates over the last five years.

In the last two years, we have been able to report the performance of candidates from CAMPEP-approved graduate training programs and CAMPEP-approved residency-trained candidates versus all oral exam candidates. This year, the passing rate for CAMPEP residents declined somewhat, compared to last year, but is still much better than the total pool, which of course includes the CAMPEP residents. CAMPEP residents had a conditioned rate of 16 percent and a failure rate of 10 percent, which is quite low as compared with the entire pool of candidates, which includes the CAMPEP candidates.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Future Exams There will be no significant changes for the Part 1, Part 2, or Oral exams for 2014. In 2015, the Oral exams will move to Dallas, where they will be held in June. In addition, revised oral exam categories will be used in 2015. These categories remain the same for therapeutic medical physics but sort the oral questions in different ways for diagnostic and nuclear medicine phys-ics. This report leaves the overall content unchanged but presents it in ways that more closely reflect current practice.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

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Health Policy/Economic Issues

Wendy Smith Fuss ,M.P.H. AAPM Health Policy Consultant

AAPM Submits Comments on 2014 Medicare Proposed Rules

APM recently submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the 2014 Medicare proposed rules that apply to hospital outpatient departments, freestanding cancer centers and physician payment. CMS will address public comments in the 2014 HOPPS final rules, which will be published on our about November 1st. To read the complete AAPM comment letters to CMS, click here.

Medicare Hospital Outpatient Prospective Payment System (HOPPS) In a major proposal effective January 1, 2014, CMS proposed packaging seven new categories of supporting items and services in payments for primary services for both hospital outpatient services and ambulatory surgical center services. The proposed payment policy would package more than 2,000 procedures and services and no longer make separate payment unless certain conditions are met. The proposed policy significantly impacts radiation oncology by packaging 22 procedure codes that it considers ancillary services, which includes radiation therapy planning, simulation, treatment device codes and medical physics consultations. AAPM opposes implementing this proposal for 2014 and has serious concerns regarding the impact on patients and funding of medical physics support of radiation oncology. In comments to CMS, AAPM strongly opposed the packaging of medical physics consultation codes 77336 and 77370 for the following reasons: â&#x20AC;˘ The packaging proposal creates a situation where the date of service or billing date becomes a primary determinant of whether a certain code will be paid separately or not. This will provide incentives for hospital radiation therapy departments to schedule and bill services so as to maximize reimbursement. To this end, it could encourage departments to change workflows in a way that could compromise medical physics oversight and safety. This may result in distorted, suboptimal radiation oncology services provided to the patient and disruption in the process of care.

â&#x20AC;˘ Packaging of medical physics consultation codes will lead to a loss of direct financial accountability of medical physicist work and would significantly reduce medical physics resources around the country. Hospital administrators would no longer be able to track the work and revenue associated with our sub-specialty. If hospital administrators cannot track reimbursement performance for a line of services, they are motivated to reduce those services. In this case, the implication is that Medicare patients may no longer have adequate access to the critical oversight that medical physicists provide to ensure the accuracy of both the planning and delivery phases of radiation therapy treatments. AAPM Newsletter | Volume 38 No. 6 | November/December 2013

â&#x20AC;˘ The reluctance or inability of departments to bill for separate CPT codes included in packaged services that will not be paid separately will skew the hospital data on patient charges and work performed that CMS collects and uses each year to set reimbursement levels under HOPPS. This could result in inaccuracies in the data used for the calculation of the payments for radiation therapy services in future years. â&#x20AC;˘ A preliminary analysis of the outpatient claims data shows that packaging of several radiation oncology codes that were previously included in the Bypass List will also lead to less claims used for rate setting for several radiation oncology APCs, which also results in inaccurate payment rates. Further, AAPM strongly supported the Advisory Panel on Hospital Outpatient Payments (HOP Panel) recommendation that CMS delay implementation of the calendar year 2014 proposal related to Expanded Packaging as well as Comprehensive APCs and Cost Center Based Reimbursement Changes for CT & MRI until the data can be reviewed by the HOP Panel at the Spring 2014 meeting regarding interactions between proposals and potential cumulative impact. It is likely that based on the HOP Advisory Panel recommendation and other stakeholder input that the expanded packaging proposal may be delayed at least one year.

Medicare Physician Fee Schedule (MPFS) AAPM also provided written comments to CMS regarding the 2014 Medicare Physician Fee Schedule. For 2014, the CMS proposes to limit MPFS payment for practice expense relative value units (RVUs) to the amount paid in the hospital outpatient (HOPPS) or ambulatory surgical center (ASC) setting. The proposed policy change is particularly damaging to CPT codes which have high direct practice costs. 82 percent of the codes impacted have direct practice expense costs (i.e., non-physician clinical labor, medical equipment and supplies) that exceed the proposed payment cap amount, making them unsustainable in the office setting. For example, practice expense payments for planning a course of intensity modulated radiation therapy would cover only 65 percent of the current direct costs. In addition, payments for breast and lung cancer radiation oncology treatment episodes would decrease by 13 percent. AAPM urged CMS not to implement the proposal based on numerous reasons. In addition, CMS proposes to revise the Medicare Economic Index (MEI), which leads to across-the-board reductions in practice expense RVUs and to make a budget-neutrality adjustment to the conversion factor. CMS estimates that the proposed revision in the MEI and its related effect on RVU pools will lead to estimated reductions in Medicare payments for both Radiation Ther-apy Centers and Radiation Oncologists. CPT 77336 Continuing medical physics consultation would receive a 6.8 percent technical component payment reduction due to the MEI reclassification. AAPM advised CMS that based on an AAPM review of the proposed RVUs for radiation oncology codes 77261-77799, all of the technical component codes will incur RVU reductions in 2014. In fact 18 procedure codes will realize reductions greater than 10 percent as proposed for 2014 and 14 of the 18 codes will yield reductions greater than 25 percent.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

AAPM added that many of the codes with proposed RVU reductions in 2014, also realized RVU reductions in 2012 and 2013. AAPM commented that, “This proposed rule includes extreme, unpredictable shifts in pay-ment for numerous services in the MPFS.” AAPM is concerned that CMS is allowing devaluation of technical component services provided in freestanding and community-based cancer centers under the MPFS. CMS continues to propose new payment policies that negatively impact the specialty of radiation oncology. Radiation Oncologists and Freestanding Radiation Therapy Centers are negatively affected by the proposed cap on non-facility practice expense RVUs for certain services and by the Medicare Economic Index proposed change that would have the effect of further reducing practice expense RVUs. The impact of proposed 2014 policies yields a 13 percent reduction in payment to Radiation Therapy Centers, which is compounded by a 9 percent payment reduction in 2013 and a 6 percent reduction in 2012. AAPM is concerned regarding the viability of providing high quality TM radiation therapy and medical physics services in a freestanding setting. AAPM advised CMS of significant Different by Design concerns regarding these proposed AutoSetup No tank shifts Better data Database-driven software reductions in the 2014 MPFS. AAPM The 3D SCANNER introduces a better experience that has proven to be more wrote that, “Continued reductions to accurate, efficient, and reliable. Learn more at www.sunnuclear.com. RVUs and MPFS payments will have a deleterious effect on freestanding cancer centers and impact the provision of cancer care, especially in rural areas. Medicare beneficiaries deserve access to quality cancer treatment provided in freestanding and community-based cancer centers.” AAPM recommended that CMS stabilize radiation oncology relative value units (RVUs) and payments in order to ensure Medicare beneficiary access to life saving cancer treatments provided in freestanding and community-based cancer centers.

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AAPM Newsletter | Volume 38 No. 6 | November/December 2013

nnovation Dates to Remember December 2013: 2014 Annual Meeting website activated. View the site for the most up-to-date

meeting and abstract submission information. http://www.aapm.org/meetings/2014AM/

January 15: Web site activated to receive electronic abstract submissions. March 3 at 5 PM Eastern: Deadline for receipt of 300 WORD ABSTRACTS and supporting data.

This deadline recognizes other conference schedules. There will be NO EXTENSION OF THIS DEADLINE. Authors must submit their abstracts by this time to be considered for review.

March 12: Meeting Housing and Registration available online. By April 17: Authors notiďŹ ed of presentation disposition. By May 12: Annual Meeting ScientiďŹ c Program available online. June 4: Deadline to receive Discounted Registration Fees.

For More Information, Please Visit: www.aapm.org/meetings/2014AM/

innovation

CAMPEP News

William R. Hendee, Rochester, MN

CAMPEP Board selects a new president

he AAPM nominated four excellent candidates to replace me as a member of the CAMPEP Board of Directors beginning in January, 2014. I am pleased to announce that the Board selected Steve Thomas (Cincinnati) as a new board member. Steve accumulated a strong background in medical physics education during his many years at the University of Cincinnati, and added to his expertise by serving for several years as Associate Executive Director (Physics) of the American Board of Radiology. Steve will be an excellent addition to the CAMPEP Board of Directors. I am also pleased to announce that the CAMPEP Board selected Wayne Beckham (Victoria, BC) as its new president beginning in January 2014. Wayne has been a board member for several years and has served as CAMPEP Vice President for the past year. He has been a major contributor to the transition of CAMPEP through the 2012-2014 initiative. The next edition of the CAMPEP REPORT to be printed in the AAPM Newsletter will be written by Wayne. The Board is now composed of 13 members and a non-voting Executive Secretary. Members joining the Board last January are John Antolak PhD, Joann Prisciandaro PhD and Ed Jackson PhD (who was elected Secretary-Treasurer). Other members are Charlie Coffey PhD, Maryellen Giger PhD, Gino Fallone PhD, John Buatti MD, Dennis Balfe MD, Wayne Beckham PhD, myself, and three committee chairs: Brenda Clark PhD (GEPRC), Chester Reft PhD (REPRC) and Steven Goetz PhD (CEPRC). George Starkschall PhD serves as CAMPEP Executive Secretary, and Jacqueline Ogburn serves as Administrative Assistant. Every Board member is interested in the opinions and concerns of medical physics educators, students and residents, and no one should hesitate to contact any of them. Currently the CAMPEP Board is working on standards and curricula for graduate and residency programs in medical physics. These documents will draw from several publications and reports, including those from the AAPM, to establish appropriate standards and curricula for medical physics education. We hope to have this work completed and reflected in CAMPEP Policies and Procedures by the end of the year. The Board is also continuing to refine the organizationâ&#x20AC;&#x2122;s Policies and Procedures in an effort to address concerns and questions brought to it by program directors and others. We have had to postpone for a few months CAMPEPâ&#x20AC;&#x2122;s application for accreditation by the Council for Higher Education Accreditation. The postponement was necessary so that the Board could finish the standards and curricula documents and reflect them appropriately in

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

the Policies and Procedures. By the end of the year the Standards and Curricula documents will be posted on the CAMPEP website along with the Policies and Procedures and updated templates for preparing an accreditation self study or annual report. In this, my final report as CAMPEP President, I wish to acknowledge the hard work of members of the CAMPEP Board of Directors and its review committees, site visit teams, and application reviewers. CAMPEP is a voluntary effort that requires a substantial commitment of time and effort from a lot of folks. They have my utmost appreciation for their work, and I have enjoyed working with them immensely. Finally, it has been a privilege to serve as CAMPEP President for the past few years. It has been a rewarding experience for me, and I leave the position with total confidence that the CAMPEP Board and its review committees are strong and will continue to serve medical physics well far into the future.

The American Association of Physicists in Medicine cordially invites you to attend the AAPM Tuesday Evening Reception at RSNA during the 2013 AAPM / RSNA Meeting

Tuesday, December 3, 2013 6:00 pm – 8:00 pm Waldorf Room, Chicago Hilton • Chicago, Illinois

light hors d’oeuvres AAPM gratefully acknowledges the following sponsors for their contributions to this reception:

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

DREAM The DREAM program is a 10 week summer program designed to increase the number of underrepresented groups in medical physics by creating new opportunities, outreach and mentoring geared towards diversity recruitment of undergraduate students in the field of medical physics.

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“In my summer research, the objective was to isolate and detect a neutron signal produced during proton therapy treatments. It will aid me in the future as a medical physicist to be able to better serve and care for patients who suffer with cancer.” -Danielle Nicholson

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Undergraduate Juniors and Seniors majoring in Physics, Engineering, or other science degrees U.S. Citizens, Canadian Citizens, or Permanent Citizens of the U.S.

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Additional information and applications are available at http://www.aapm.org/education/grantsfellowships.asp

Add: Sponsored by the AAPM Education Council through the AAPM Education and Research Fund

Website Editor Report

George C. Kagadis, Rion, Greece

Website Editorial Board forms, AAPM Virtual Library gets on Vimeo

his is my second Newsletter report as the AAPM Website Editor and, as almost every other AAPM member, I am now making plans for the annual RSNA meeting in Chicago. As I informed you in my previous report, we were in the process of recompiling the Website Editorial Board and posted an ad in the AAPM Committee Classifieds for members interested in participating. I received a number of applications from members interested and willing to participate on the Board, and on September 30, 2013, I announced the new members. The Board is now composed of: Christos Alexakos, Ishtiaq Bercha, Charles Bloch, Jostin Crass, Eric Hendee, Mahadevappa Mahesh, Chris Marshall, Dimitris Mihailidis, Michael Olex, David Scaduto, Carter Schroy, Yunhong, Shi, Benjamin Sintay, Perry Sprawls and myself. AAPM staff Michael Woodward and Farhana Khan are also key participants to this Board. I would like to officially welcome those people to the Board and I look forward to working with them. Our first face-to-face Website Editorial Board meeting is going to take place during the upcoming RSNA Annual Meeting. The AAPM Virtual Library is in the process of being added to Vimeo and within the last month HQ staff have uploaded 300 videos (as of October 8, 2013). The 2012 Annual Meeting presentations are done and the 2011 Annual Meeting is currently being worked on. This has been highlighted on our website, Facebook and Twitter. I believe you will enjoy studying these videos as much as I do. Since AAPM began uploading the videos to Vimeo, there have been 2200 plays (as of October 8, 2013) from all over the world. These are likely people viewing who may never have found this content locked deep in the AAPM Virtual Library as it has been for the past ten years. Seven introductory videos from AAPMâ&#x20AC;&#x2122;s Committees and Subcommittees that debuted during the Indianapolis Annual Meeting are also accessible from Vimeo. I urge the Chairs of other AAPM Committees and Subcommittees to prepare such an introduction and send it to us to put together with the other introductions for presentation on our website, RSNA 2013 and during the next yearâ&#x20AC;&#x2122;s Annual Meeting in Austin, TX. Apart from that, AAPM has hired a Graphic and Web Designer, Ms. Abby Pardes, who will help us advance our website and provide the new web presence I have promised. I would like to welcome Abby aboard and I am looking forward to working with her on making our vision a reality. I hope you find the AAPM website useful, visit it often and send me your feedback or directly at george@mail.aapm.org.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

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Staff Announcements

Angela Keyser, College Park, MD

AAPM HQ Team...at your service!

Along with the AAPM Annual Meeting, Summer School, and Spring Clinical Meeting, AAPM also sponsors specialty meetings throughout the year. As weâ&#x20AC;&#x2122;ve seen the availability of the volunteer hour shrink, the HQ team now manages most non-technical, program-related tasks previously handled by volunteers. While all the members of the AAPM HQ team play an important role in the meetings and programs processes, the Meetings and Programs Department handle many of the major responsibilities.

Lisa Rose Sullivan is celebrating her 20th Anniversary as a member

of the AAPM team. She joined the staff in November 1993 as Projects Coordinator and was one of the original five Maryland staff members hired when the AAPM HQ offices relocated from NYC to College Park, Maryland. Lisa was promoted to Exhibits and Scientific Program Manager in 1998 and then to the management team as Director, Meetings and Programs in 2005. Lisa oversees the meetings and programs operations and manages the 6 meetings team members. She also serves as the staff liaison to the Education Council. AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Nancy Vazquez joined the HQ team as the 6th staff person in 1996,

serving as the Receptionist. She was promoted to Programs Manager in 1998 and took on the responsibility of managing the registration processes for the various AAPM-managed meetings. In 2007, the production of the AAPM newsletter was brought in house, with Nancy working directly with Editor Mahesh to produce the bi-monthly publication.Nancy is also the staff liaison to the Awards and Honors Committee. She manages the Awards and Honors nomination process and plans the yearly Awards and Honors Ceremony and Reception.

Karen MacFarland, Meetings and Programs Manager, joined the

team in 2003. Karen handles the meeting negotiations and logistics for many of the association meetings scheduled throughout the year, including the Annual Meeting and the Summer School. In 2007, she passed the Convention Industry Council exam to become a Certified Meeting Professional. Karen also serves as the staff liaison to the Science Council.

Corbi Foster joined AAPM in 2007 as Meetings and Programs

Manager. She handles the meeting negotiations and logistics for the Spring Clinical Meeting. Along with Karen, Corbi shares the responsibility for overseeing specialty meetings and various committee meetings held throughout the year.

Laurie Allen joined the team 2007 as the Customer Service

Representative. Later that same year, she was promoted to the newly created position of Programs Assistant, overseeing the meeting program development and abstract submission processes for the Annual Meeting, Spring Clinical Meeting and specialty meetings. When Laurie was promoted in 2007, Jacqueline Ogburn was hired to fill our Customer Service Representative position. In 2008, Jackie was promoted to the newly created position of Education Assistant and in 2011 was promoted to the position of Education Manager. Jackie oversees the operational aspects of the Associationâ&#x20AC;&#x2122;s educational activities, including the Online Learning, SAMs and Virtual Library programs. She also manages the AAPM grants and funding opportunities and provides staff support to CAMPEP.

Rachel Smiroldo Rachel Smiroldo started as a summer intern with the AAPM in 2010. Upon her graduation from college in 2011, she joined our staff as the Exhibits and Meetings Assistant. Rachel coordinates the exhibit programs for both the Annual and Spring Clinical meetings and assists with the registration processes for all meetings.

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

Person in the News

Priscilla Butler, MS, FACR, FAAPM American College of Radiology, Reston, VA

The Conference of Radiation Control Program Directors awarded this year’s John C. Villforth Lecture Award to Priscilla (Penny) Butler, MS, FACR, FAAPM a medical physicist and senior director of the American College of Radiology’s Department of Quality and Safety. Ms. Butler was recognized for her commitment to protecting patients, workers, and the public from unnecessary radiation exposure. As the recipient, Butler delivered the Villforth Lecture in which she focused on the Mammography Quality Standards Act, Image Wisely®, and Image Gently®.

SAVE THE DATE!

AAPM Spring Clinical Meeting March 15–18, 2014 ▶ Denver, Colorado ▶ Denver Marriott Tech Center Registration and Housing open on December 4th http://www.aapm.org/meetings/2014SCM/

AAPM Newsletter | Volume 38 No. 6 | November/December 2013

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