RADIATION PROTECTION IN THE BASIC CURRICULUM OF MEDICAL STUDENTS

Under Article 7 of the new European Directive on health protection of individuals against the dangers of ionising radiation in relation to medical exposure (Council Directive 97/43/Euratom) one of the paragraphs on "Training" states that: Member States shall encourage the introduction of a course on radiation protection in the basic curriculum of medical and dental schools

This brief paper is an outline proposal suggesting that the Education Committee of the European Association of Radiology (EAR) might work with medical physicists specialising in radiation protection who are affiliated to the European Federation of Organisations of Medical Physics (EFOMP) through their National Organisations to formulate a course that will fulfil the above need but at the same time be sufficiently original and innovative to capture and retain the interest of medical students. A good course could be the radiologists' shop window for clinical students.

Some topics that might be considered are:

1. Radiation in the environment
   
2. Applications of different types of radiation in medicine
   
3. Molecular basis for extreme radiosensitivity of biological tissues
   
4. Radiobiological effects at the cellular and whole body level; genetic and somatic effects; threshold and non-threshold effects.
   
5. Evidence for radiation induced cancer in humans
   
6. Principles of radiation protection and legislation - justification, optimisation and limitation, organisational arrangements for advice on radiation protection; the medicolegal position
   
7. Risks from radiological examinations

   7.1 How they are calculated

   7.2 Explaining radiation risks to patients

   7.3 Radiation sensitive groups
   

8. Personal protection and personal monitoring - how, why, when, where; dose limits; typical doses to staff and associated risks; simple precautions
   
9. When and how to request an X ray

   9.1 Basic physics of the X ray process - to get across the message that if the suspected clinical condition has not led to any change in tissue atomic number, thickness or density, an X ray is unlikely to be helpful

   9.2 Plain film X rays and CT compared and contrasted

   9.3 Examples of good and bad practice in requesting X rays - making the best use of a Department of Clinical Radiology

   9.4 Utilising existing radiological information - films and/or reports

   9.5 Writing out an X-ray request form
   

10. Principles of protection in nuclear medicine

    10.1 Administering radioactive materials to patients

    10.2 Effective doses

    10.3 Special problems - eg radioactive patients returning home, nursing mothers
    

11. Research projects that involve radiation
    
12. Screening projects involving radiation - eg mammography, bone densitometry
    
13. Alternative imaging modalities not involving X rays

    13.1 Ultrasound

    13.1.1. Basic physics of image formation and Doppler effect

    13.1.2 Important clinical examples of application

    13.2 MRI

    13.2.1 Basic physics

    13.2.2 Important clinical examples of application
    

14. Overall diagnostic strategy - a concluding lecture or lectures, perhaps using selected clinical conditions, to illustrate that both the choice of diagnostic tests and their logical sequence must be carefully worked out:

    a) because it is good clinical practice

    b) because it is consistent with the principles of justification and optimisation

    c) because it makes the best use of increasingly scarce resources

This list is not intended to be comprehensive - nor has there been put down much detail under some of the headings.

Information: Dr. P. P Dendy <philip.dendy@mail.com>

Last update: 2001-03-19