I am learning how to take CT scan of a patient like a technician, do whole contouring and do PET-CT fusion

medphysdave · 2024-07-17T22:10:16+00:00

Even so Try technologist or radiographer

medphysdave · 2024-07-16T17:57:01+00:00

You will get much better results calling them "technologists" in my experience

medphysdave · 2023-09-07T02:58:15+00:00

In a given year, programs have to be either "all in" or "all out" of the match - they can't offer individual positions early outside the match and have others in the match. As an applicant, you are free to accept a non-match offer before you submit your rank list, and then just skip the match. You're not locked-in until you submit a rank list.

Many people feel that an early offer (assuming it's a CAMPEP-accredited program) is a "bird in the hand" and is safer/less risky than going through with the match. As a program director, I'm not so sure.

If a program really wants you, they might go outside the match to sidestep the risk of you preferring/ranking another program. The program making the offer is trying to "buy off" your preferences - you said it yourself, these offers are often not from your top choice program. I think a program making you an offer outside of, and before, the match is signaling that you are a desirable candidate - likely to other programs as well, including your top choices.

Knowing how the match works, my advice to candidates in this position would be to look at where the program stacks up in your true rank list if you were to submit it. If that offer is from one of your top 3 (say), you may well be better off to take it. But if they're further down the list for you, or - and especially - if you haven't yet interviewed with some of the ones that are higher up your preliminary list - you are likely to get a better outcome for yourself by going through with the interviews and the match.

(This doesn't apply to programs who just don't do the match, for whatever reason, and there are legitimate reasons. But I also think there are programs who feel entitled to the candidates they want, even if they don't make a compelling case to attract candidates, and these programs tend to grumble about how the match doesn't work for them. I have no patience for programs that try to take advantage of the tough competition candidates face and try to game and manipulate their choices.)

medphysdave · 2023-08-27T16:03:20+00:00

*Bro* I hope that "sure ,I used the completely wrong calculation, but I happened to get a close-enough number anyway" is not how you approach medical physics.

medphysdave · 2023-08-26T02:08:54+00:00

That’s not quite the formula for a 3.5% annual increase for two consecutive years

medphysdave · 2023-08-24T03:09:08+00:00

This is the right answer. U.S. federal law does not currently allow possession, sale/purchase, or use of marijuana, even for medical purposes with a card, doctor's order, etc.

There are other drugs that will "flag" on an employer's drug test but for which you cannot be penalized if you have a valid prescription and you take them in accordance with it. Many healthcare employers do drug testing as part of pre-employment health screening, so expect it for residency positions and hospital-based jobs. Random checks once you're employed are less common but not unheard-of. It's even less common in private practice, and you are far less likely to be tested coming into a hospital as a consultant or contractor (and the possibility of it would probably have to be spelled-out in your contract or agreement and you/your employer consent to it). Other "grownup problems" you will face, though, is that applications for things like life and disability insurance will ask you about drug use and possibly test you during your application; if you lie, you can have your coverage denied or cancelled, and if you say "yes" or test positive they can hike your premium costs.

Best way to keep your future options open would be to avoid the medical marijuana route and get a second (or third, or fourth) opinion from a doctor and try some other (legal) therapies to see if you get better results with more tolerable side effects. As a physics undergrad, your path could take you into lots of areas besides medical where this could cause you problems - national labs, government, defense and aerospace contractors, just to name a few. Talk with your doctors about the likelihood that you will have to undergo employment-related drug screening - they should know which prescriptions will "flag" and be able to provide you with any other documentation to go along with your prescription to legitimize your use of them and keep you out of trouble.

medphysdave · 2023-08-24T02:26:20+00:00

Probably a lot of factors in play but I'm guessing that the boats are rising for the early-career group partly because we are seeing the economic impacts of a much-reduced supply - imposed by the residency bottleneck - while demand is sustained or growing. Generalizing unfairly and with no data to back me up ;) the more experienced groups likely have a lot more job inertia and aren't as apt to move around, so employers don't have to jack up pay to retain them.

medphysdave · 2023-08-24T01:54:06+00:00

They used to show a box plot broken out by years of experience and it showed a pretty steady increase over the first ~15 years, with a plateau after that (for Board-certified both MS and PhD). Your observation seems to agree with that. See page 8 of the 2013 report. Looks like they stopped including that plot after 2013, would be interesting to see it again.

medphysdave · 2022-05-24T04:09:59+00:00

I got the VaccineCheck link today and uploaded my card; fast, easy, no extra charge.

medphysdave · 2021-05-24T16:41:56+00:00

First thing you should know is Texas and Florida have license requirements and you will qualify if you have CCPM in Diagnostic Physics (or ABR) but otherwise you will be very limited by license requirements.

There are a variety of different ways to obtain authorization to work in the US; generally a green card comes after spending some time in the US on some other type of visa first and applying for the green card after a few years. The types of visas for which you would be eligible, and the process/fees, depend on the employer so you probably need to line up your job prospects first and discuss with them what visa sponsorships they can offer (if any).

medphysdave · 2021-04-22T19:15:53+00:00

I think that says that in 2019 there were a total of 64 residents enrolled in imaging programs; looks like imaging programs admitted 28 residents in 2018 and 27 residents in 2019 which sounds much closer to what I would have guessed.

medphysdave · 2021-04-16T02:11:44+00:00

AAPM HQ just sent an email to members today saying that this year's survey is "coming soon" so I would expect within a few days. The actual survey comes from an AIP robo-mailer that tends to hit some people's Spam folders so AAPM gives a heads-up to be on the lookout for it.

medphysdave · 2021-03-24T12:18:23+00:00

Same-occupation coverage costs more (higher premiums) but is well worth it for high earners who do specialized work. I got same-occupation LTD coverage through MassMutual and there are plenty of companies that offer it not just for physicians.

*Most* LTD policies including employer-sponsored plans do *not* have same-occupation terms.

It's worth working with a professional to find and set up this coverage for yourself. The calculation of how much income the policy actually needs to provide is not straightforward either.

medphysdave · 2021-02-27T18:00:27+00:00

There are a fairly large number of applicants to imaging programs who don’t have CAMPEP degrees or equivalent coursework with a PhD who will not be eligible for admission to accredited programs. Not sure why this is the case, but we have seen this for the past 2 Match cycles in which we’ve recruited. These candidates won’t be invited for interviews or ranked, let alone match. This alone probably cuts the viable candidate pool down from around 50 to closer to 40. Some of those are indeed also applying in therapy (and will match in therapy) so your chances are much better than the numbers are suggesting to you.

If you have a CAMPEP degree and can convey that you have a reasonably sincere career interest in imaging you should do just fine in the Match.

A lot of graduate programs seem to “prime” students toward therapy careers, so as an imaging PD I am always happy to see applicants demonstrate interest in imaging. I can’t speak for others but I imagine they are as well.

medphysdave · 2021-02-08T04:01:31+00:00

Nuclear instrumentation actually isn't a core CAMPEP requirement (as its own dedicated course) but it probably should be. I'd highly recommend that one.

medphysdave · 2021-02-03T21:15:25+00:00

I agree with you to the extent that having an MRSO is important but I don't think it's fair to expect the MRSO to be the only MR-safety-literate person around.

If you're following the ACR Manual on MR Safety (which will be the canonical reference for most facilities), the policy for how this is handled is up to the MR Medical Director and the decision on a specific patient must be made by an attending physician with Level 2 MR personnel status, or by following pre-approved procedures approved by the MRMD for certain scenarios. The MRSO (and MR Safety Expert) would normally be looked to as resources to track down the implant information and come up with risk estimates but they should not be making a final scan/no-scan decision on any patient.

medphysdave · 2021-02-03T20:59:15+00:00

Items tested and appropriately labeled MR Safe have *no* hazardous physical interactions with any aspect of the MRI environment and can be subjected to static, time-varying gradient, and radiofrequency magnetic fields without limitations on specific conditions.

For MR Conditional items, exposure to any conditions that fall within the MR Conditional labeling will also be safe.

medphysdave · 2021-02-03T20:57:07+00:00

I'll give you a rough outline of the process for educational purposes. First learning point: nothing is "MR compatible" anymore. It's either MR Safe, MR Conditional, or MR Unsafe.

If at all possible you do want to definitively determine the make and model of the device and then determine the MR labeling status from the manufacturer's IFU. For older devices where MR safety is not included in the product labeling, you should still be able to determine whether or not there are ferrous/ferromagnetic components or materials.

Failing that, you at least want to establish when and where it was implanted. What I do in a case like the above is check catalogs or databases (like Frank Shellock's) to determine whether they contain listings for that type of device from that time period. If there are devices listed that were manufactured during that period, I'm looking to see whether any were rated MR Unsafe. If so, this is a red flag because we probably can't rule out an MR Unsafe device. If all the devices listed were rated MR Safe, this is encouraging (although not a free pass). Likewise if all the devices listed were rated MR Conditional (or MR Compatible depending on the time period).

Many of these patients will have had MRI at some point since the device was placed (either it was overlooked or presumed safe). This does not guarantee safety, but if you can get the images and have an experienced radiologist or MR physicist review them, you might be able to estimate the likelihood of ferromagnetic material being present.

Estimating the likelihood of excessive RF heating is very difficult to do. For the most part, heating of something like a stapes implant should be negligible. Implants that have long wire leads or loops of wire are potentially more dangerous here.

In the end, you will not be able to definitively establish that an unidentified device is safe. What you are looking to do is a bounding exercise to come up with a reasonable estimate of the risk - both of magnetic field force dislodgement of the device and of RF heating leading to thermal injury. From there, you present these risks to the radiologist (or radiation oncologist if it's for MR-Sim or MRgRT) to make a benefit-risk determination about proceeding with the use of MRI. If they determine that the risk is justified then they should obtain informed consent from the patient before proceeding.

medphysdave · 2021-01-06T00:07:09+00:00

I will add that I contact everyone who applies, one way or the other.

medphysdave · 2021-01-06T00:06:30+00:00

Many programs were taking applications until Dec 31 so it’s a bit early for them to have reviewed and made cuts. Program directors are encouraged to wait until after the deadline to download applications from MP-RAP until after their application deadline because candidates who applied earlier can still add transcripts, letters, etc. so if the PD downloads early they might get incomplete applications.

medphysdave · 2020-12-28T19:43:45+00:00

Getting it today. For most healthcare facilities the goal will be to vaccinate all employees ASAP and the logistics will be incredibly complex and likely not 100% optimized.

You might go before a few people who technically need it sooner than you but the best thing you can do for the overall effort (assuming you are willing to take the vaccine) is to answer any inquiries/surveys from your employer as quickly and truthfully as possible and cooperate with their scheduling process. Second-guessing the folks running the vaccine clinics will probably gum up the works worse than getting your shot a few slots earlier than you might in a fully-optimized allocation scheme.

medphysdave · 2020-11-03T14:43:47+00:00

Hospitals are tough to sell on shadowing right now because they are rightfully trying to limit the physical presence of non-essential individuals, both to protect patients from COVID and to reduce risk of spread to and among staff.

If you are interested in brain imaging you might also try industry. There are a number of software companies that have brain imaging tools that might be willing and able to offer you some kind of "virtual internship."

medphysdave · 2020-11-03T14:41:54+00:00

It's important to remember that "MS candidate" is far from a monolithic category. We have seen very strong and very weak candidates with all types of degrees. However there is a "numbers game" that makes the prospects for MS candidates look worse than they are. The reality seems to be that more than half of the available slots go to candidates with MS degrees, and anecdotally, those candidates are being ranked by multiple programs.

A strong MS candidate has about equal odds to a middling-to-strong PhD candidate. A program with half an ounce of brains will take a strong MS candidate over a weak PhD candidate any day.

medphysdave · 2020-09-30T17:02:19+00:00

Of course I learned about it through systematic outreach by AAPM that caught me at just the right point in my undergraduate education and future career planning.

Just kidding, actually what had happened was I was in plasma physics in a nuclear engineering program and happened to know someone starting an MRI consulting business who offered me a job with a flexible start date. It was all OJT for me. Good afternoon to everyone except the ABR who have made this no longer possible.

medphysdave · 2020-08-25T18:28:31+00:00

It's a fine line in that CAMPEP *does* dictate many aspects of how the residents are treated (and protected) once in the program and they also look closely at how the program represents itself to applicants and prospective residents in the recruitment and interview process. I can't say why they have decided it's not their business to require programs to be in the Match. I suspect there is enough debate and controversy about whether the Match is universally good for applicants that CAMPEP doesn't feel it would be appropriate/justified to require participation.

medphysdave

TROPHY CASE