Medical dosimetrists are one of a small number of scientific or technical professions that provide essential services in the health care system.  They are involved primarily in radiation oncology and the scope of their professional activity includes managing the clinical care of individual patients.  A comprehensive workforce study of medical dosimetry has been completed.  Project goals include the following:
    a) to compile existing data and collect any new data required to understand the roles, responsibilities, education, certification, clinical practice and career paths of medical dosimetrists in the United States;
    b) to develop a national standard productivity profile which may be used as a benchmark for staffing;
    c) to develop accurate and reliable projections of the supply of and demand for medical dosimetrists through 2030;
    d) to understand the workforce implications in the event that accredited training programs and slots are not sufficient to maintain the current supply of medical dosimetrists;
    e) to recommend specific steps and timelines that should be taken by AAMD and other stakeholders to advance the professional service of medical dosimetry.

Learner Outcomes:

1. Summarize the information documented in the medical dosimetrist workforce study
2. Explain what new information has been discovered and reported in the workforce study
3. Discuss how to use the medical dosimetrist workforce study to justify medical dosimetrist staffing
4. List future training and service aspects of medical dosimetry practice

CE Credits = 1.0

Michael Mills, PhD, Professor Emeritus
University of Louisville

Brian Napolitano, Senior Manager, Dosimetry and Physics Administration
Massachusetts General Hospital

The SARS CoV-2 coronavirus and its accompanying illness COVID-19 have dramatically changed the healthcare landscape.  As of this writing, there are over 8 million confirmed cases of COVID-19 in the United States and over 217,000 deaths attributable to the pandemic.  COVID-19 is particularly dangerous for cancer patients who experienced worse outcomes than those not undergoing cancer treatment.  In early March 2020, the Department of Radiation Medicine at Northwell Health made the decision to continue treating through the height of the pandemic in New York.  Medical physics and dosimetry made workflow modifications to ensure the health and safety of patients and staff.  Initiatives included expanded work-from-home, modified on-site coverage, expanded communication options, and appropriate use of personal protective equipment while on site.  In the 6 weeks immediately following the implementation of the modifications, we measured the impact of modified procedures on efficiency and quality of treatment planning and chart checks.  We found that efficiency and quality remained high despite the alternative work environment.  The physics and dosimetry group also anonymously completed a web-based survey to assess the personal impact of the changes.  Most staff responded positively.  

As of late 2020, cases of COVID-19 have dropped and physics and dosimetry staff have trickled back into the office.  It is possible, however, that our area will see a resurgence of COVID-19 or a similar epidemiological event.  The assessment of our pandemic preparedness plan gives us confidence that we can maintain high quality and efficient care should we need to activate our plan again.  

Learner Outcomes

1. Identify potential impacts of COVID-19 and other pandemics on radiation therapy clinical workflow
2. Discuss mitigation strategies to maintain clinical efficiency, quality, and safety
3. Discuss the applicability of lessons learned in pandemic to the "normal" work environment

CE Credits = 1.0

Adam Riegel, PhD, DABR, Senior Physicist
Northwell Health System

Jeffrey Antone, Chief Medical Dosimetrist
Northwell Health System

Today there is increased awareness around the long-term consequences of physical, mental, and emotional abuse. Medically necessary radiologic procedures routinely administered to cancer patients often mimic experiences of those who have suffered abuse and can lead to retraumatization. Triggers include feeling powerless, being immobilized and told to remain silent, exposing intimate body parts, laying in darkness, and being inflicted with pain. The WHO estimates sexual violence affects one-third of women worldwide and reports of childhood abuse rates in medical populations range from 22%-44%. One representative US study reported 45% of patients in a primary care clinic had suffered some childhood adversity, 41.2% of children and youth had experienced physical assault in the past year, and 11% of girls age 14-17 had experienced sexual abuse during that time. Given that more than 17 million people worldwide are diagnosed with cancer every year, if only 30% have exposure to past traumatic stressors, five million people annually may view their cancer experience through the emotional lens of prior trauma. Abuse survivors can make up a meaningful portion of the oncology population, with radiological procedures having a particular impact on breast, gynecology, prostate, colorectal, anal, head and neck, brain and CNS patients. This presentation aims to create awareness and advocate for the integration of trauma-informed care. Attendees will understand the incidence of abuse in clinical populations, the risk of retraumatization during radiologic procedures, and learn SAMHSA's Six Principles of Trauma-Informed Care. Relaxation techniques to ease the procedure experience for patients will be demonstrated and practiced.

 Learner Outcomes:

1. Discuss the incidence of abuse in clinical populations
2. Identify the risk of retraumatization during routine diagnostic/treatment radiologic procedures
3. Outline SAMHSA's Six Principles of Trauma-Informed Care
4. Explain anxiolytic mind-body techniques to ease the experience for at-risk patients

CE Credits = 1.0

Leigh Leibel, MSc, C-IAYT, ACSM-CET, Mind-Body Specialist, Adult Integrative Oncology
Herbert Irving Comprehensive Cancer Center, NYP/Columbia University Irving Medical Center

Lee Culp, Annual Conference Committee Chair
AAMD

Sponsored by Accuray

Accuray Precision^® is a comprehensive treatment planning solution for all Accuray treatment delivery systems (CyberKnife^®, Radixact^®/TomoTherapy^®) paired with an integrated database, the iDMS^® Data Management System. iDMS system enables Accuray Precision to be well integrated into the radiation therapy department.

Key capabilities of Accuray Precision include: 

• Multi-modality image fusion with proprietary deformable image registration
• Fully featured contouring suite with auto segmentation
• Plan templates and scripts to enable speed and consistency
• Fast GPU-based plan optimization using VOLO^TM optimizer
• Motion synchronization plan generation
• Efficient QA plan generation

Clinicians can use Accuray Precision to plan precise and efficient patient treatments for all Accuray delivery systems to deliver more, better, faster.

Learner Outcomes: 

1. Discuss the Accuray Precision Treatment Planning System
2. Outline the iDMS Data Management System
3. Explain the unique aspects of treatment planning for CyberKnife system

CE Credits = 1.0

Madhavi Kapa, MS, Director of Product Strategy
Accuray

Colin Sims, MSc, Advanced Treatment Planning Director
Accuray

Trinh Nguyen, Dosimetrist
Massachusetts General Hospital, Radiation Oncology