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Medical physics and bioengineering
underpin much of the practice of modern medicine.
It was the development of radiotherapy in the
1930s that first led to the employment of physicists
in hospitals on a regular basis. In the 1950s,
the contributions that could be made by physics
and engineering became more apparent with the
advent of radionuclide techniques and the beginnings
of instrumentation development, rehabilitation
engineering and research into the applications
of biomaterials.
 Nowadays,
physicists and engineers are involved in a vast
range of activities in health care. They design,
make and maintain aids for disabled people, systems
for physiological measurement in anaesthetic,
intensive care and other environments, imaging
scanners, precision surgical instruments and medical
robots, to name but a few. They are responsible
for the measurements and calculations that make
radiotherapy safe and effective. Many of the most
remarkable advances in medicine can be traced
back to the work of physicists and engineers.
For example, much of the pioneering research into
radionuclide scanning, ultrasonic imaging, computed
tomography, magnetic resonance imaging, functional
electrical stimulation, image-guided surgery,
anaesthetic monitoring and three-dimensional radiotherapy
planning was done in laboratories in the United
Kingdom.
Medical physics and bioengineering are highly
interdisciplinary subjects. Those who practice
them need a good grasp of anatomy, physiology,
pathology and biology in order to work effectively.
In the National Health Service, they are graded
as clinical scientists and medical technical officers.
They work side-by-side, often in clinical teams,
to support the activities of the medical staff,
to innovate and to maintain high standards of
quality and safety. They are involved in the evaluation
of the efficacy of their work and its clinical
outcomes. Another very important activity is that
the teaching: the next generations of medical
physicists, bioengineers and medical technical
officers need to be trained and many other staff
groups need to have a grasp of physical and engineering
principles relevant to their work. They need constantly
to keep up-to-date through the process of continuing
professional development.
Medical physics and bioengineering provides a
satisfying and fulfilling careers for people coming
from a wide variety of backgrounds, including
pure and applied physics, electrical, electronic
and mechanical engineering, applied mathematics,
statistics, computing and the biological sciences.
As much of the practice of medicine becomes increasingly
specialised, medical physics and bioengineering
will continue to be both an essential element
of its foundation and in the vanguard of progress
and innovation.
The majority of medical physicists and clinical
engineers are employed in the NHS. New graduates,
who usually have a good honours degree in science
or engineering, enter the professional grades
at Grade A as Trainees or as Associates. The training
scheme is a two year programme which involves
training in three major subject areas plus aquaintanceship
in at least three other areas. Training takes
place in departments with appropriate accreditation.
In addition, trainees must complete a recognised
M.Sc. Successful completion of the training programme
results in the award of the Diploma of IPEM and
allows the trainee to compete for posts in a particular
speciality at Grade B.
Grade B is the main professional grade covering
a wide range of responsibilities. Posts at the
lower end of the grade have a large element of
higher training in a particular subject area with
individuals working towards corporate membership
of IPEM and, in some cases, registration as Chartered
Engineers with the Engineering Council. At the
upper end of the grade, appointments carry a high
level of individual responsibility. Although further
academic qualifications are not mandatory, many
individuals study part-time for a Ph.D. degree.
The highest grade in the profession is Grade
C at which level the individual is usually in
charge of a scientific department or a major departmental
sub-division or has made a distinguished contribution
in the field. The most senior clinical scientists
have equivalent status to their medically qualified
consultant colleagues.
For technical staff who are employed as medical
technologists or medical physics technicians there
are no formal entry requirements, but, for entry
as a trainee medical technologist on to the Medical
Technical Officer (MTO) grades, a person must
be eligible for admission to BTEC/SCOTVEC national
certificate/diploma in science or engineering.
Some join with A levels/Higher grades, whilst
others enter after completing a science or engineering
degree, HNC or HND.
Trainee MTOs undergo an agreed programme of in-service
training relevant to their particular speciality,
which will also include an introduction to other
specialities. This training involves competence
based practical experience in the required skills.
This will normally be consolidated by attending
a course (on day or block release) at a college
of further education, leading to a relevant BTEC
National Certificate.
There are five medical technical officer grades,
MTO1 to 5. The career grade which most staff can
expect to achieve is MOT3. To be eligible for
promotion to this grade staff should normally
have five years relevant experience. Staff employed
on the MTO4 grade may manage technical work of
a section within a department whilst staff on
the MTO5 grade will normally have significant
managerial responsibilities.
Throughout a career as a scientist, engineer or
technologist working in medicine, an individual
must constantly up-date their knowledge and skills,
keeping abreast of the new developments in equipment
and techniques. A system for monitoring Continuing
Professional Development is being developed by
the Institute of Physics and Engineering in Medicine.
The Author:
Professor P N T Wells, President, Institute of
Physics and Engineering in Medicine
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