Recommended Guidelines on National Schemes for Continuing Professional
Development of Medical Physicists*
The European Federation of Organisations for Medical Physics EFOMP Policy Statement No. 10
* Approved by EFOMP Officers in December 2000 and
published in Physica Medica - Vol. XVII, N. 2, April-June 2001.
Abstract
Modern Health Care
Services are met with ever-increasing demands on competence, specialisation and
cost effectiveness. The Medical Physics Services in hospitals face the same
demands. Continuing Professional Development (CPD) is vital to the Medical
Physics Profession in order to: embrace the pace of change occurring in medical
practice; promote excellence within the Profession; and assist in the
protection of the Public against incompetence. Furthermore, CPD is a
prerequisite of some statutory registration schemes, and is a requirement of
the Medical Exposure Directive. The European Federation of Organisations for
Medical Physics (EFOMP) commends National Member Organisations to encourage participation
in CPD.
In order to assist in
the harmonisation and promotion of this best practice EFOMP presents a set of
general requirements for use as a template in the design of a CPD scheme. It
uses a credit point system and recommends that CPD should be assessed on the
basis of a 5-year cycle with a total of 250 credit points being earned during
that period. Two major categories of CPD activities are recognised. Firstly
attendance at pre-assessed courses, with one credit point allocated per full course
hour. Secondly self-directed learning split into 8 subgroups: formal local
hospital education activities, reading of textbooks and articles, lecturing,
training visits, publications, congress contributions, implementation of new
technologies and active membership in task groups.
KEYWORDS: Continuing
Professional Development, CPD scheme, EFOMP, Medical Exposure Directive,
Qualified Medical Physicist.
1. Preamble
Modern Health Care Services
are met with ever increasing demands on competence, specialization and cost
effectiveness. The Medical Physics Services in hospitals face the same demands.
Continuing Professional Development (CPD) is vital to the Medical Physics
Profession to embrace the pace of change occurring in medical practice; it
promotes excellence within the Profession, and assists in the protection of the
Public against incompetence. Furthermore, CPD is a prerequisite of some
statutory registration schemes, and is a requirement of the Medical Exposure
Directive [2].
2. Introduction
Since its inauguration in
1980, the main objective of the European Federation of Organisations for
Medical Physics (EFOMP) has been to harmonise and promote the best practice of
Medical Physics in Europe. In order to accomplish this goal, EFOMP has
presented a number of unanimously adopted Policy Statements, making
recommendations on the appropriate general responsibilities and roles of the
Medical Physicist and proposing guidelines for education, training and
accreditation programs in Medical Physics.
The requirement for knowledge,
skill and experience in the field of Medical Physics has been the subject of
several Policy Statements, the most recent issued in 1999: “Radiation
Protection of the Patient in Europe: The Training of the Medical Physics Expert
in Radiation Physics or Radiation Technology” [1]. This Policy Statement
constitutes the EFOMP response to the Medical Exposure Directive, Council
Directive 97/43/Euratom of 30 June 1997 on health protection of individuals
against the dangers of ionising radiation in relation to medical exposure, and
repealing Directive 84/466/Euratom [2].
European legislation has been
a driving force, leading many professional organisations to propose harmonised,
high quality professional standards. For EFOMP, the European Union’s Directives
concerning basic safety standards and the radiation protection of the patient
have given impetus to the discussion of education and training requirements in
Medical Physics, especially Medial Radiation Physics. Whilst these Directives
are binding only on EU Member States, they do affect every European country.
Furthermore, whilst they deal primarily with Medical Radiation Physics, they
effectively set the standards for the whole Medical Physics profession. In many
European countries, Medical Physics Services extend beyond the traditional
sphere of Medical Radiation Physics, encompassing scientific, technical and
management support for medical technology throughout the hospital.
In the Medical Exposure
Directive, the Medical Physics Expert is defined as an expert in their own right, with a well-defined
professional role, requiring them to act as well as give advice. The definition
also sets out requirements for appropriate theoretical and practical training.
Member States are explicitly required to ensure that Medical Physicists have
access to continuing education and training after qualification in addition to
their basic theoretical and practical training. The above-mentioned Policy
Statement [1] presents the EFOMP recommendations on the role and competency
requirements of this Medical Physics Expert together with the principles of education, training and Continuing
Professional Development (CPD).
In the recent EFOMP Policy
Statement, “Continuing Professional Development for the Medical Physicist” [3],
general criteria for structured CPD were presented, aimed at fostering the
growth of national CPD Schemes. Accordingly, all Medical Physicists who have
completed their basic education and clinical training should be actively
involved in CPD in order to maintain and increase competence and expertise
after qualification.
3. Definitions
EFOMP has recommended a
certain level of education and training to start working independently and to
register as a Qualified Medical Physicist [1, 4]. Continuing Professional Development activities [3] should
continue directly after qualification, ensuring increasing competence and
leading to a higher level of qualification, for example the level where the
Medical Physicist may act as a Medical Physics Expert. The EFOMP approach is summarized in the definitions below:
3.1. Continuing Professional Development [CPD]:
• CPD is the planned
acquisition of knowledge, experience and skills (both technical and personal)
required for professional practice throughout one’s working life.
• CPD is an ethical and moral
obligation for each Medical Physicist throughout their professional career in
order to maintain the highest possible professional standards.
3.2. The Qualified Medical Physicist:
• There is a significant
divergence across European in the length and style of the academic component of
physics qualifications. However, most countries will be able to recognise the
Qualified Medical Physicist defined in the guidelines below.
• The entry criterion to
Medical Physics education and training is a basic university education in
physical sciences, engineering or equivalent.
• Recognition as a Qualified
Medical Physicist is achieved by a further 2 to 4 years theoretical education
and practical training in Medical Physics (depending on the national education
system) under supervision of a Qualified Medical Physicist, preferably a
Specialist Medical Physicist. At least half of the time should be spent in a
clinical environment. The education and training should follow current EFOMP policies.
(The total time for the basic education and the Medical Physics education and
training would be around 7 years.)
• The Qualified Medical
Physicist is competent to act independently.
• The Qualified Medical
Physicist has the minimum qualifications required for enrolment in an EFOMP
approved National Register for Medical Physicists.
• The Qualified Medical
Physicist should have a formal recognition from a National Competent Authority,
and should be enrolled in an EFOMP approved National Register for Medical
Physicists [4].
3.3. The Specialist Medical Physicist:
• Within the EU, as defined in
the Medical Exposure Directive [2] “in relation to medical exposure”, the
Medical Physics Expert is equivalent to the Specialist Medical Physicist. In
other disciplines, the term Medical Physics Expert is not relevant.
• The Qualified Medical
Physicist qualifies to become a Specialist Medical Physicist by gaining
advanced clinical experience and undergoing specialist training of at least two
further years duration, mostly in one sub-speciality, within the first period
of an EFOMP approved National CPD Scheme. (i.e., total education & training
at least 9 years).
• The Specialist Medical
Physicist is competent to give advice on all professional matters in their
sub-speciality.
• The Specialist Medical
Physicist may have a formal recognition from a National Competent Authority and
should continue to be enrolled in an EFOMP approved National Register for
Medical Physicists.
4. Aims and Objectives
The most important factor in
the EFOMP approach to achieve harmonisation in the qualification of the Medical
Physicist in Europe is the establishment of education, training and CPD schemes
according to EFOMP recommendations.
The objectives of the
Guidelines on Schemes for Continuing Professional Development are:
• To promote CPD in the
medical physics community.
• To provide a framework,
which allows the National Member Organisations (NMOs) to create their own CPD
schemes.
• To guide the NMOs in
establishing a credit system for CPD.
• To ensure harmonisation in
Europe in the assessment of CPD related activities.
As recommended in the EFOMP
Policy Statement “Continuing Professional Development for the Medical
Physicist” [3], all Medical Physicists should be involved in CPD after
recognition as a Qualified Medical Physicist. While EFOMP recognises that it has no statutory authority in this
area, EFOMP fully supports CPD undertaken on a voluntary basis as a practical
contribution to enhancing patient care.
In the field of the use of
ionising radiation in radiology the European Association of Radiology (EAR)
published, in 1997, Guidelines for Continuing Medical Education [5]. Similarly,
programs for Continuing Professional Development have been and are being
developed at a national level within the Medical Physics Community. These may
be credit based or out-come based (e.g., portfolio). The NMOs of EFOMP have
different work practices and varying training systems. The EFOMP Guidelines
presented here are for a credit based CPD scheme. They are intentionally
flexible, thus allowing the NMOs to set up their own detailed CPD schemes
within this framework and under their present local and national circumstances
and constraints. The concept of CPD is related to the knowledge, skill and experience
acquired rather than to the amount of time used to acquire them. The outcome of
CPD should lead to an improvement in professional practise. As quantitative
out-come based systems are developed, these Guidelines may be revised.
EFOMP recommends that NMOs set
up their own National Schemes for CPD, in agreement with the national Health
Authorities and in accordance with the Guidelines presented here. National
Member Organisations are then invited to submit their respective CPD Schemes to
EFOMP for formal recognition.
Guidelines for formal
recognition by EFOMP of National Registration Schemes for Medical Physicists
have already been established in 1995 [4]. EFOMP approval includes the
requirement for “a regular renewal mechanism with a requirement for evidence of
continuing activity in relevant areas”. CPD is now being recommended as the
best way to meet this requirement. National Member Organisations will be
responsible for the administration of their National CPD schemes, in a similar
manner to the EFOMP-approved National Registration Schemes.
If an NMO feels it needs to
differ substantially from the guidelines set out in this policy document then,
when seeking EFOMP recognition of their scheme, they should write formally to
the registrar explaining in detail their reasons for non-compliance.
5. Recommended Guidelines
All National Member
Organisations should develop their own detailed CPD Scheme according to the
following general requirements. Each CPD Scheme should be based on a
quantitative assessment of the individual’s CPD activities. Both the CPD Scheme
and the credit point system recommended here are intentionally very general and
flexible, as mentioned above, and NMOs are challenged to design their own CPD
Schemes and credit point systems to meet local requirements.
There are two forms of EFOMP
recognition of the National CPD Schemes: conditional and full approval. Conditional
approval is awarded for a time period of three years, if the CPD Scheme does
not fully comply with the requirements. Full approval is awarded for a time
period of five years. At the end of the approval period or in the case of a
modification of a National CPD Scheme, a renewal of the approval is required.
5.1. General requirements on National CPD Schemes
The most important aspect of
CPD is the outcome of the CPD activity rather than the length of time involved
in its participation. Nevertheless the following quantitative guidelines are
suggested.
5.1.1. DESCRIPTION OF THE
CPD SCHEME -
To maintain professional competence 50 credit points of formally agreed and recorded CPD should be undertaken per annum. The CPD Scheme should be based on a 5-year cycle with a total of 250 credit points. Because circumstances vary from time to time and with them the opportunity to earn CPD points NMOs may feel it appropriate to maintain a five-year rolling average of 50 credit points per annum. The minimum time of professional activity within the 5-year cycle, required for the renewal of registration, should be specified by the NMO. CPD activities should be classified into two categories:
• Category 1 (see 5.2.1)
activities are attendance at pre-assessed COURSES, i.e. lectures, scientific meetings, workshops, refresher/training
courses etc. The assessment of the COURSE should be related to its contents and relevance and should be regulated
by the NMO.
• Category 2 (see 5.2.2)
activities are different types of planned and agreed self-directed learning
tasks.
5.1.2. NOTIFICATION OF
CURRENT CPD STATUS:
• NMOs should develop a
model for recording of credit points for the individual Medical Physicist.
• A National CPD record should
be maintained by the NMO.
• All Qualified Medical
Physicists and Specialist Medical Physicists enrolled in CPD should report
their CPD credit point records to the NMO for validation and record keeping.
5.2. Requirements on the credit point system
• The credit point, cp, is the
unit of CPD; 1 cp typically corresponds to one full hour of educational
activity in Category 1. Since category 2 activities are diverse in character,
there is no similar simple equivalence between credit points and hours spent.
• In order to ensure a
well-balanced CPD over the five-year period, the total of 250 cp should be
earned on the basis of about 50 cp per year.
• The 250 cp should be achieved
as a mixture of Category 1 and 2 activities as prescribed below.
• Courses organised by other
NMOs, specialist groups, or at an international level, where the course content
is relevant to Medical Physics practice and where there is prior CPD approval
by the hosting organisation, should give credit points recognised on that same
basis.
• Credit points in excess of
the required 250 cp should not be carried forward into the following cycle of
five years, unless a the system of a rolling five year average has been
adopted.
To allow for maximum
flexibility in setting up a National CPD Scheme, the credit points in all
categories may vary within a range of ± 30% of the recommended value.
5.2.1. CATEGORY 1 CREDIT
POINTS:
• NMOs should require that all
course organizers apply prospectively for CPD approval of the event and for
credit point assessment. For repeated Courses, renewed application and CPD
approval should be required.
• NMOs should notify course
organisers as to the number of Category 1 credit points awarded, and this
figure should be included in the advertisement of the event.
• Course organisers should
provide the participants with documents describing the course content and, if
combined with examination, the results.
• Each participant in a
Category 1 activity should retain a document, which includes the content of the
course and the results of an examination if applicable.
• Category 1 events should be
classified into events with and without examinations. Basically, one full hour
of educational activity should correspond to one cp. However, events with
examination should be ranked higher.
• A total of 100-150 cp of
Category 1 is recommended per 5-year cycle. (This corresponds roughly to
attending a 2-day meeting twice a year.) If an NMO feels that it needs to
differ from this recommendation, at least 50 cp per 5-year cycle (corresponding
roughly to attending one 2-day meeting per year) should be expected.
5.2.2. CATEGORY 2 CREDIT
POINTS –
Due to the large variety and
differing local availability of Category 2 events, EFOMP is recommends that the
following classes of CPD activities may be considered.
• Formal local hospital
educational activities, e.g., attendance at lectures, seminars, regular
organized teaching activities: 1 cp per full lecture-hour or per meeting.
• Formal on the job training
activities and experiences, e.g., development of interpersonal skills, time
management etc. Up to 10 cp per year.
• Planned self-directed
learning, e.g., reading of textbooks, journals etc., including computer-based
‘distance learning facilities’: up to 10 cp per year.
• Preparation and delivery of
formal lecture or seminar: up to 10 cp for the first time presentation and 3 cp
for a repeated presentation.
• Visits to other departments
for special training: up to 5 cp per year.
• Publication of a) a paper in
a recognised scientific journal: up to 20 cp, depending on the type of the
journal (e.g., peer reviewed/non-peer reviewed) and on the contribution of the
author (single author, co-author); b) a textbook: up to 50 cp, depending on the
authorship and the size of the contribution.
• Oral or poster presentation
at a congress: up to 10 cp per presentation, depending on the type of congress
(international, national, regional) and the authorship (single author, co-author).
• Implementation of new
technologies/procedures with a significant impact of Medical Physics: up to 5
cp per activity and 10 cp per year for a documented implementation and
development of new technologies and procedures, depending on the complexity of
the technology.
• Active membership in tasks
groups relevant to Medical Physics (working groups, standardization committees
and equivalent): up to 5 cp per membership and year, depending on the type of
group (international, national, regional, local) and scientific relevance
(dosimetry protocols, equipment standardisation, radiation protection etc.),
altogether not more than 15 cp per year.
6. Summary
The Guidelines presented here
constitute a set of general requirements on the design of the CPD Scheme itself
and the credit point system. CPD should be assessed on the basis of a 5-year
cycle, and a total of 250 credit points should be earned during this period.
Two categories of CPD activities are introduced, attendance at pre-assessed
courses (Category 1) and self-directed learning (Category 2), and the credit
points should be about equally balanced between both categories. Category 1
credit points should be awarded on the general basis of one credit point per
full course hour. Category 2 credit points should be awarded according to the
relative importance and relevance of CPD in 8 subgroups: formal local hospital
education activities, reading of textbooks and articles, lecturing, training
visits, publications, congress contributions, implementation of new
technologies and active membership in task groups.
EFOMP recommends that National
Member Organisations encourage participation in CPD Schemes, to the benefit of
the individual Medical Physicist, the employer, the patient and the Medical
Physics Profession (3). All beneficiaries should share the responsibility for
CPD resources, i.e. the individual Medical Physicists, their employers,
professional bodies and public education and training bodies.
National Member Organisations
that have set up Schemes for CPD according to the above Guidelines are invited
to submit their respective CPD Schemes to EFOMP for formal recognition.
REFERENCES
[1] EFOMP Policy Statement No. 9: Radiation Protection
of the Patient in Europe: The Training of the Medical Physics Expert in
Radiation Physics or Radiation Technology. Physica Medica 1999: XV(3); 149-153.
[2] Directive 97/43/Euratom of 30 June 1997 on health
protection of individuals against the dangers of ionizing radiation in relation
to medical exposure. Official Journal of the European Communities N. L190,
9.7.1997; 22.
[3] EFOMP Policy Statement No. 8: “Continuing Professional Development
for the Medical Physicist”. Physica Medica 1998: XIV(2); 81-83.
[4] EFOMP Policy Statement No. 6: Recommended
guidelines on National Registration Schemes for Medical Physicists. Physica
Medica 1995: XI(4); 157-159.
[5] Continuing Medical Education CME Guidelines of the
European Association of Radiology/UEMS Radiology Section and Board Eur Radiol
1997: 1(7); 454-458.
An example of a suitable credit point system
|
|
|
Category 1 activities |
|
|
Attendance at pre-assessed courses (i.e., lectures, scientific
meetings, workshops, refresher/training courses etc.), national and
international |
general rule, 1 cp/h events with examination 2cp/h |
|
Total number of Cat. 1 credit points |
100 cp per 5-year cycle |
|
Category 2 activities |
|
|
Attendance at formal local hospital educational activities (e.g.,
lectures, seminars, regular organised teaching activities) |
1 cp/meeting or 1 cp/lecture-hour Max in this category 10 cp/year |
|
On the job training activities and experiences, e.g., includes
development of interpersonal skills, time management etc |
Up to 10 cp/year |
|
Planned self-directed learning (e.g., reading of textbooks, journals,
including ‘distance learning facilities’) |
Up to 10 cp/year |
|
Preparation and delivery of formal lecture or seminar |
10 cp for first time presentation 2 cp for repeated presentation Max in this category 15 cp/year |
|
Special training visits to other departments |
Up to 5 cp/year |
|
Publication of a) a paper in a recognised scientific journal b) a textbook |
a) 2 to 20 cp, depending on the type of journal (e.g., peerreviewed or
not) and on the contribution of the author b) 5 to 30 cp, depending on the authorship and the size of the contribution Max in this category 30 cp/year |
|
Oral or poster presentation at congress |
2 to 10 cp per presentation, depending on type of congress
(international, national, regional) and authorship (single author, co-author) Max in this category 15 cp/year |
|
Implementation of new technologies/procedures |
Up to 5 cp per activity and 10 cp per year for a documented
implementation and development of new technologies and procedures, depending
on the complexity of the technology |
|
Active membership in tasks groups (working groups, standardization
committees and equivalent) |
Up to 5 cp per membership and year, depending on type of group
(international, national, regional, local) and scientific relevance
(dosimetry protocols, equipment standardisation, radiation protection etc.). Max in this category 15 cp/year |
|
Total number of Cat. 2 credit points |
150 cp per 5-year cycle |
|
Total number of credit points |
250 cp per 5-year cycle |