Medical Physics STP Programme

8/12/2019 Medical Physics STP Programme

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Introduction to the Medical Physics STPProgramme(Northern Training Consortium)

Overview

Dr Alison Mackie

Degree Programme Director

(MSc Medical Physics)

Newcastle University

Dr Robyn Cooke

1styear STP Healthcare Science Trainee

(Medical Physics)

Dr Darren Thompson

1styear STP Healthcare Science Trainee(Medical Physics)

Grace Keane

1styear STP Healthcare Science Trainee

(Medical Physics)

Jonathan Wyatt

2ndyear STP Healthcare Science Trainee

(Medical Physics)


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Masters Programme:Clinical Science (Medical Physics)- a Modernising Scientific Careers Vocational Programme

Dr Alison Mackie

Degree Programme Director(Regional Professional Lead for Medical Physics and Clinical Engineering, Northern Training Consortium)


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Teaching Locations:

Medical Physics, Freeman Hospital Newcastle University


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Programme Structure

Generic Module:

Common to all divisions of Healthcare Science

Division/Theme Specific Modules:Common to a division or theme

Specialist Modules:

Specific to a specialism

Dissertation modules

Year 3SpecialistPractice

Specialist Medical Physics[30]

Research Project 2MSC8004[30]

Year 2SpecialistPractice

Research Skillsfor Health Care

ProfessionalsMCR8201[10]

Specialist Medical Physics[20]

Research Project 1MSC8003[30]

Year 1

CoreModules

Introduction to HealthcareScience, Professional Practiceand Clinical LeadershipMSC8001[20]

Introduction to Medical PhysicsMPY8001[40]


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MPY8001: Introduction to Medical PhysicsFirst Year Module [40 credits]Initial (6/52) residential block

Module Lead: Dr Alison Mackie

5 Themes:Radiation Safety Physics (RS)Radiotherapy Physics (RT)

Imaging with Ionising Radiation (IIR)Imaging with Non-Ionising Radiation(INIR)Clinical Engineering (CE)

Claire-LouiseChapple RS

Gill Lawrence RT

IanDriverIIR

MikeDrinnanCE

Andy BlamireINIR

Summative Assessment:

40% - unseen written exam60% - assignments (x4)


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Blended Learning StrategyMPY8001

Face to Face (130 hrs)

Lectures(60 hrs)

Practicals(18 hrs) learning by doing

Tours(6 hrs) link theory to clinical practice

Tutorials(46 hrs) - problem based learning

Independent Learning (supported by VLE, Blackboard)

Directed reading & revision

4 summative assignments (aligned to workplace rotations)

Formative assessment


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MSC8001: Introduction to Healthcare Science,Professional Practice and Clinical LeadershipFirst Year Module [20 credits]

Initial (6/52) residential block + 9 days MarModule Lead: Dr Judith Kuit

Learning outcomes (know, understand, reflective learning & leadership skills):

Basic science underpinning healthcaree.g. anatomy & physiology, physics, genomics, IT, bioinformatics

Walk a mile in the patients moccasinsThe patient journey through the healthcare system & the integrated sciencethat underpins patients response to disease, injury and treatment.

5 domains of Good Scientific PracticeProfessional

Scientific

Clinical

Research, Development & Innovation

Clinical Leadership

Summative Assessment:25% - unseen 2 hr MCQ exam75% - assignments (x2)


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MCR8201: Research Skills for Health Care ProfessionalsSecond Year e-Module [10 credits]4 hrs/week for 13 weeksModule Lead: Dr Jenny Yeo

Learning outcomes:

Know & Understand:

legal & ethical issues re different forms of clinical research

principles of research governance

Develop the skills to:participate in NHS clinical research

be aware of the evidence base behind current practice

critically appraise published literature

recognise where research is relevant to development of clinicalpractice

Summative Assessment:10% - participation in discussion groups90% - assignments (x2)


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MSC8003: Identifying & Planning a Research ProjectSecond Year e-Module [30 credits]Module Lead: Dr Mike Drinnan

Students are guided through project development in 4 stages:

1. Identifying a research question and methodology

2. Literature review3. Research proposal4. Approval planning

Supervision is from both the students workplace (professional / clinical mentor)and from the module lead (with specialist support as required).

Aim:develop the necessary skills to develop a researchproposal & successfully complete & write a dissertation in thethird year.

Summative Assessment:15% - Project administration summary document35% - Project literature review and analysis50% - Project proposal


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Medical Physics Specialism ModulesSecond Year Specialist Modules [20 credits]10 day residential block (last week Feb Y2)

Module Leads:MPY8005 (RT1): Gill Lawrence, Consultant Clinical Scientist, Head of Radiotherapy Physics, Newcastle HospitalsMPY8007 (RS1): Dr Claire-Louise Chapple, Consultant Clinical Scientist, Head of Imaging Physics & Radiation Safety, Newcastle HospitalsMPY8009 (IIR1): Dr Ian Driver, Consultant Clinical Scientist, Head of Nuclear Medicine Services, Newcastle HospitalsMPY8011 (INIR1): Prof Andy Blamire, Professor of MRI Physics, Centre for Ageing & Vitality, Newcastle University

Summative Assessment:40% - unseen written exam60% - assignment (x1)

First Year of Specialism Teaching


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MSC8004: Research DissertationThird Year e-Module [30 credits]Module Lead: Dr Mike Drinnan

Students supported to complete their dissertation through:

1. Summary checklists available through the VLE;2. Module lead & specialist support upon request;3. Statistical advice & support upon request.

Supervision is primarily from the students workplace(professional / clinical mentor). Intellectual Property Rightstherefore remain with the workplace.

Summative Assessment:5% - 250 word Abstract (akin to a scientific conference submission)

15% - E-poster (akin to a scientific conference poster - standard PowerPoint)15% - Oral presentation of project (workplace: 10 minutes + 5 minutesquestions)65% - Dissertation (3500 in a research paper format)


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Medical Physics Specialism ModulesThird Year Specialist Modules [30 credits]13 day residential block (mid-Sept Y3)

Module Leads:MPY8006 (RT2): Gill Lawrence, Consultant Clinical Scientist, Head of Radiotherapy Physics, Newcastle HospitalsMPY8008 (RS2): Dr Claire-Louise Chapple, Consultant Clinical Scientist, Head of Imaging Physics & Radiation Safety, Newcastle HospitalsMPY8010 (IIR2): Dr Ian Driver, Consultant Clinical Scientist, Head of Nuclear Medicine Services, Newcastle HospitalsMPY8012 (INIR2): Prof Andy Blamire, Professor of MRI Physics, Centre for Ageing & Vitality, Newcastle University

Summative Assessment:40% - unseen written exam60% - assignment (x1)

Second Year of Specialism Teaching


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Medical Physics Programme Strategiesto Support STP Programme Outcomes:

1stacademic year aligned to STP workplace rotations

All underpinning medical physics knowledge delivered in the initial academic block (no restriction on rotation order).Clinical practice and academic learning support each other.

Blended learning

Supports different learning styles through a variety of teaching methods.

Distance learning

Formative assessment opportunities e.g. self-assessment question sets, example examination papers, formativeassessment opportunities for most summative assignments.

Academic assessments (ALL modules): 2 birds with 1 stone

Relevant evidence for workplace competencies can upload to OLAT.

Developing the medical physicists/innovators of the future

Teaching to support students to be able to develop and deliver the scientific services/technologies of the future(horizon scanning 5+y) e.g. proton therapy, novel techniques, specialist applications.


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2013 Medical Physics Students

Thanks to our lovely lecturers for being amazing!From the STP trainees 2013


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Imaging with IonisingRadiation (IIR)Dr Robyn Cooke1styear STP trainee


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Imaging with Ionising Radiation

Nuclear Medicine:Functional imaging using

radioactive isotopes

Diagnostic Radiology:Anatomical imaging using

transmission of x rays

+radioisotope Site-specific

pharmaceutical

Image with gamma

camera


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Examples of nuclear medicine scans:

Glomerular Filtration Rate (GFR) examinations Inject patient with radiopharmaceutical filtered by kidneys Assess blood activity in time

Dynamic kidney function scan (Renogram) As above take images at snapshots in time


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Myocardial Perfusion scan/ MUGA scan Assess blood flow/ heart muscle perfusion using 4D reconstructions

Lung perfusion and ventilation: Compare ventilation and perfusion imagesidentify blood clots
http://localhost/var/www/apps/conversion/tmp/scratch_9//upload.wikimedia.org/wikipedia/commons/1/15/Pulmonary_embolism_scintigraphy_PLoS.png


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Positron Emission Tomography (PET) Uses positron emitting isotope attached to pharmaceutical Often combined with CT to give functional+anatomical

information e.g., location/size of tumours

PET CT PET/CT
http://jnm.snmjournals.org/content/51/1/112/F2.large.jpg


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Examples of rotation activities (nuclear medicine)

Preparing

radioactive

samples:

Investigating

gamma cameraparameters using

various phantoms:

Write case studies

of patient scans:

Perform quality control

(QC) testing on

equipment:


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Fluoroscopy Live snapshots of x-ray often used to place devices in

position during surgery

Examples of diagnostic radiology scans:

Planar x-ray Transmission of x-rays for diagnostic imaging

CT 3D reconstruction of many x-ray images
http://localhost/var/www/apps/conversion/tmp/scratch_9//upload.wikimedia.org/wikipedia/commons/5/50/Computed_tomography_of_human_brain_-_large.png


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Examples of diagnostic radiology scans:

Mammography Low energy x-ray image to identify potentially cancerous growths

Dual Energy X-ray Absorptiometry (DEXA) Measure bone-density by using 2 x-ray energies

Angiography Use contrast agents to obtain an image of blood vessels

normal abnormal
http://www.blog.gurukpo.com/wp-content/uploads/2012/10/angiography-arteriography.jpghttp://en.wikipedia.org/wiki/File:Morbus_Fabry_DXA_01.jpghttp://en.wikipedia.org/wiki/File:Mammo_breast_cancer.jpg


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Examples of rotation activities (diagnostic radiology)

Consider safety,

e.g., x-ray room

design.

Radiation Safety

considered in this

rotation: see

Graces talk!

Performing QC on

equipment:

Investigating

acquisition settings on

imaging:


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Quality Control (QC) &Quality Assurance (QA)

Quality Control (QC): Regular testing of equipment to assess performance in clinical use Tolerance limits set on test results to indicate whether maintenance is required or

whether the machine can remain in clinical use Examples for IIR include:

Spatial resolution of detectors Energy resolution of detectors Image uniformity and linearity Identifying artefacts

Calibration

Quality Assurance (QA): Overarching programme concerning QC

Includes staff training, working practices, programme for QC, etc.

Why is it important? VITAL to know that what you image in a patient REPRESENTS what is in the patient!

VITAL in ALL aspects of medical physics, not just IRR!


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Radiation Safety

Grace Keane

Trainee Clinical ScientistMedical Physics


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Contents

About Me

Radiation Safety

Radiation safety then and now Competencies

Radiation Risks

Patient Dose audit


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About MeUniversity of York (2010 2013)

BSc Hons Physics

Talk given by an STP Trainee

Background reading on the scheme

Open days

2 weeks work experience at Newcastle Hospitals NHS Trust

Recruited onto STP as a medical physics trainee at Newcastle

Started training in September 2013

Completed the first 6 week teaching block at NewcastleUniversity

In the midst of my second rotation
http://www.google.co.uk/url?q=http://en.wikipedia.org/wiki/University_of_York&sa=U&ei=wazWUuTRMMSyhAeGg4D4DQ&ved=0CEgQ9QEwDA&usg=AFQjCNGjOpG5kYRnPTs55wkB5N5wdLbBowhttp://www.yorkvision.co.uk/wp-content/uploads/2013/01/lib.jpg


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Radiation Safety

3 million CT scans per

year

Cancer risks from DR, The British Journalof Radiology, 81 (2008), 362378


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Radiation Safety

Radiation

Safety
http://www.o2.co.uk/iphone/iphone-5/features


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Competencies

Undertake room design from first principles for a diagnostic X-rayfacility and surgical laser facility

Identify and plan an exercise to rehearse contingency plans (e.g.contamination incident, loss of source).

Undertake measurements to assess patient doseand image quality

Analyse recent radiation incidents and

summarise the types and causes of incidents
http://www.google.co.uk/url?q=http://commons.wikimedia.org/wiki/File:Radiation_warning_symbol.svg&sa=U&ei=1vzXUpHxLIqBhAeHtoCgDQ&ved=0CDAQ9QEwAA&usg=AFQjCNGGJctYolBCe3ORF0ZiI2OxO0-hAA


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Radiation Risks

Industries

Fishing

Construction

Clothing and Footwear

Coal Mining

Radiation workers

Risk of death per year

1 in 6000

Average annual risk of death in the UK from accidents in various industries and cancers

Potentially induced in radiation workers

1 in 800

1 in 10,000

1 in 57,000

1 in 250,000


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Patient Dose Audit

Participate in or review patient dose audit data

and compare and contrast against national standards


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Patient Dose Audit


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Thanks for listening&

Good luck!


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Imaging with Non-Ionising RadiationDr Darren ThompsonSTP Trainee (Medical Physics)


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Imaging with Non-IonisingRadiation Rotation

Magnetic Resonance Imaging (MRI) ~ 1 month

Ultrasound ~ 1 month

Lasers

Infra-red

Ultraviolet Visible Light

~ 1 month


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MRI Magnetic ResonanceImaging

Clinical and research scannersavailable in Newcastle hospitals

Very strong magnetic fields ~ 1.5 or3 T

Hydrogen protons align with field

Radio waves flip protons

Return to normal at characteristicrates for each tissue

Image contrast


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MRI

You will:

Observe and report casestudies

Perform Quality Control

checks Perform experiments toinvestigate different types ofcontrast

E.g. T1 and T2 weightedimages Each shows up different

pathologies


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MRI

Non-ionising radiation = safe ?

Risk Assessment more important in MRI than manythink


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High frequency vibrations from crystaltransducer.

Tissues of different density reflect sounddifferently.

Familiar images from obstetrics, check

foetal development. Other uses include: Echocardiogram (heart function) Distinguishing between cysts / tumours Examining blood flow

(Doppler Imaging)

+ many others

Ultrasound


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Ultrasound

Generally very safe but risksinclude:

Thermal and mechanical tissue

effects US scanners may be unstable, change

over time

Misleading image artefacts

Therefore Quality Control andsafety still very important.


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Lasers

Various powers and wavelengths for many different clinicalapplications.

IR Laser surgery using endoscope (prostate, breaking up urinary

stones).

Hair removal penetrate just below skin surface. LASIK eye surgery ablates surface with UV rather than penetrating

like visible light.

Safety practices very important!


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Infra-Red

Thermal Imaging Detect Raynauds

Phenomenon Temporary

restriction of bloodflow due tocold/stress/anxiety

Delay in re-warming indicates

severity


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Ultraviolet

Phototherapy treatspsoriasis, eczema.

Uses fluorescent UV lamps(similar to sunbed)

Risk of skin cancer

UV Laser for eye surgery


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Visible Light

Capillaroscopy Assess microangiopathy E.g. Normal compared to systemic

sclerosis

(autoimmune disease with abnormalgrowth of connective tissue)


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Radiotherapy Physics

Jonathan Wyatt


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What is Radiotherapy?

Killing tumoursusing radiation

From megavoltagelinear accelerators


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The Radiotherapy Process

1. CT Scan

2. TreatmentPlanning

3. TreatmentDelivery


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1. Quality Assurance and Calibration


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2. Treatment Planning


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3. Research and Development


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4. Medical Physics Expert


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Summary

50% of cancer patients would benefit fromradiotherapy in their treatment.

Radiotherapy physicists are essential

members of the radiotherapy team.

Radiotherapy physics combines interestingand demanding physics with helping to cure

people of cancer.

Medical Physics STP Programme

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