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Medical Physicists and the Global Health Challenge

W Ngwa1*, J Van Dyk2*, K Kisling3*, S Avery4*, E Sajo5*, (1) Harvard Medical School, Boston, MA, (2) Western University, London, ON, (3) UT MD Anderson Cancer Center, Houston, TX, (4) University of Pennsylvania, Philadelphia, Pa, (5) University Massachusetts Lowell, Lowell, MA


(Monday, 7/30/2018) 7:30 AM - 9:30 AM

Room: Room 209

In a world in which cancer is a growing global health challenge, leaders in cancer policy from the National Cancer Institute and 14 economically diverse countries, recently concluded that successful campaigns to control cancers will increasingly depend on international collaborations including in Radiation Oncology. Highlighting urgency for such participation, the recent World Health Organization Cancer Report describes the growing global cancer burden and disparities as alarming, a major obstacle to human development and well-being, with an annual economic cost of over US$ 2 trillion. One area with major disparities that would greatly benefit from global health participation is in Medical Physics, where Medical Physicists are increasingly being called upon to reach beyond the ‘bunker’ and impact the world in cancer care, research and education. This session will cover emerging approaches/models for involving medical physicists in global oncology, and highlight ongoing professional development opportunities and considerations for graduate students, residents, and staff/faculty medical physicists in global health.

Emerging Models in Global Health for Medical Physicists and experiences in parts unknown (Wilfred Ngwa, Harvard Medical School, UML)

In 2010, the New York times published a number of articles reporting that hundreds of patients had received overdoses of x-rays in different health facilities in the USA. AAPM and ASTRO leaders were called to testify in the US Congress on how they would address this. Since then policies have been put in place, with medical physicists working to enhance safe use of radiation in the USA. A similar but far worse silent crisis is affecting thousands, if not tens of thousands of patients in Africa and other Low and Middle Income Countries (LMIC), due the absence or alarming shortage of Medical Physicists. In parallel with this crisis and the growing cancer burden and disparities, there has been a major recent upsurge in Radiation Oncology global health interest. For example, an overwhelming 89.6% of residents surveyed recently expressed interest in participating in global radiation oncology experience during their residency training. Over the past years, a number of models for engaging participation of radiation oncology health professionals, including medical physicists in global health have emerged. These models will be presented along with experiences of those who have travelled or participated in global health in LMIC, advise and opportunities for those looking to participate: including via a new Quality Assurance and Review Center platform developed by the Harvard Global Health Catalyst and the University of Massachusetts which allows for remote treatment planning and quality assurance for safer use of radiation technologies in LMIC.

Medical Physics for World Benefit (Jacob Van Dyk, The University of Western Ontario, and MPWB)

There is increased recognition for the growing need of Medical Physicists in low-to-middle income countries LMICs). Unfortunately, there are very limited education and training resources in LMICs, especially where there are no existing radiation therapy and very limited diagnostic imaging capabilities. Sending physicists abroad from LMICs to high income countries (HICs) for education and training has various limitations. Furthermore, continuing medical physics education (CMPE) opportunities are unaffordable and/or not available locally. One of the partial solutions in support of training and education is to partner with international organizations. Organizations like the AAPM and ESTRO are great at providing short courses, especially as refresher or CMPE courses. However, these tend to be short term and there are only a limited number available. The IAEA also provides support for short courses. In addition, they provide fellowships for longer courses or training programs including Master’s degree support. However, the IAEA is also limited in its resources and further support needs to be provided from other partners. One of those partners is Medical Physics for World Benefit (MPWB). Its mission is to support activities which will yield effective and safe use of physics and technologies in medicine through advising, training, demonstrating and/or participating in medical physics-related activities, especially in LMICs. Operationally, its emphasis is on “partnering� with the goal of having individuals and/or educational or healthcare institutions in both LMICs and HICs work together to meet well-defined needs. Practically, it also seeks to work collaboratively with other organizations wishing to provide similar support including, but not limited to, Physicien Médical Sans Frontières (PMSF), the International Atomic Energy Agency (IAEA), the Canadian Organization of Medical Physicists (COMP), the American Association of Medical Physicists (AAPM), and the IOMP. Various projects are in progress, most of which relate to training and mentoring. One example project that is in progress is the development of an Open Syllabus for Medical Physics Residents. This project seeks to link the detailed list of topics in the IAEA Clinical Training documents to the best on-line materials available. The Open Syllabus will be posted on the MPWB website and made available to any training program around the globe. MPWB is a membership-driven organization for individuals who have a passion for reducing global health disparities, especially as related to medical physics. Its vision, mission and values are summarized on its website ( along with links to newsletters and other relevant activities.

Productive research collaborations with global partners to address challenges in low-resource clinics (Laurence Court and Kelly Kisling, MD Anderson Cancer Center)

There are many challenges to delivering safe and effective radiotherapy in low-resource settings. Medical physicists can help overcome these challenges through global health-focused research and by developing innovate radiotherapy solutions. The key to successfully developing these solutions is collaborating closely with partners from hospitals in resource-constrained countries throughout the development phase. We will present the experience and lessons learned from one such collaboration.

Building a USA/Africa Global Radiation Oncology CORE (Stephen Avery, University of Pennsylvania)

We are building on our current partnership with Muhimbili University of Health and Allied Sciences (MUHAS) and Ocean Road Cancer Institute (ORCI) to strengthen our global engagement by providing a roadmap for physics training. Our long-term goal is to develop a USA/Africa Radiation Oncology Core (ROC), with both practical (PROC) and virtual (IROC) components, dedicated to Research Education/training in Radiation oncology in East Africa. It also highlights desperately needed quality assurance tools for patient safety and encourages research collaborations for cancer control. We want to establish a regional center of engagement with East Africa to significantly increase research capacity, ensure radiation/patient safety and build research capacity to address an ongoing silent crisis which is undoubtedly causing significant loss of life and disability in Africa. This Core program will provide a hub for Radiation Oncology research/education in east Africa; benefiting students/researchers from neighboring countries. This presentation will give an overview of the plan to establish a MSc program in Medical Physics in East Africa.

Interactive Panel discussion on Medical Physicists and the Global Health Challenge (co-moderated by Wilfred Ngwa and Erno Sajo, University of Massachusetts Lowell)

This panel will discuss professional development, funding opportunities, and career paths for Medical Physicists in Global Health, and examine new approaches or models for Medical Physics Education, Research and Outreach to address the global health challenge.

Learning Objectives:
1. Learn about the emerging field of global oncology and new opportunities in global oncology care, research and education for Medical Physicists
2. Learn about ‘Parts Unknown’: the worst and the best experiences of Americans in resource-poor countries and recommendations for those interested in a global health experience in medical physics
3. Learn about possible career paths in Global Health, and funding opportunities/resources to support medical physicists in global oncology



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