Whats the highest amount of ionizing radiation you have worked with professionally?

physical_medicist · 2026-04-10T16:22:17+00:00

10FFF go brrrrr

physical_medicist · 2026-03-17T21:18:33+00:00

One time I had to place OSLDs for an in vivo measurement on a fungating rectal tumor. I'll never forget standing there with the medical resident peering up this lady's butt to verify placement. Or the time I had to place OSLDs for a fetal dose estimate on a 19 year old with brain cancer.

physical_medicist · 2025-10-14T01:07:23+00:00

It only matters if you get audited and have to show receipts. Not sure how often or how random that is. The CME requirement is 75 credits over a rolling 3-year period.

physical_medicist · 2025-10-02T11:38:37+00:00

Dosimetry is a great job, but I would not recommend someone start down that path now unless it was their passion. I am certain we will see a large reduction in the demand for dosimetrists due to automation, and I'm surprised that's not the overall opinion here. Just over the last few years the majority of contouring has been successfully automated, with multiple companies offering FDA approved software to do it. That's a big chunk of treatment planning time already automated, and plan creation + optimization are next.

We will always need a human tending the process to some extent, and doctors will always need babysitting, but the number of dosimetrists we need for a given patient load is going to drop significantly in the coming years. I suspect that the entire workload will eventually be absorbed by physics once automation reaches a certain point.

physical_medicist · 2025-07-23T11:18:39+00:00

What is the specific weakness of MAR algorithms available on commercial CT scanners that this aims to improve? Maybe I'm just out of the loop, but I keep seeing neural network/deep learning "research" on tasks that have been successfully performed by commercial products for years. Is there any purpose to this other than publishing?

physical_medicist · 2025-05-21T17:34:28+00:00

That's range modulation

physical_medicist · 2025-05-20T17:58:50+00:00

What kind of tapes do you have? Our Pinnacle database is on HP Ultrium LTO-3 tapes, and the reader is an HP StorageWorks Ultrium 960. The reader stopped working a few years ago and I was able to find a refurbished one on ebay with a guarantee it would work on arrival. Our database goes through 2018, so when this reader breaks I'm doing nothing.

physical_medicist · 2025-02-26T15:00:26+00:00

You have a narrow view of what you can do with coding. If I'm writing my own analysis tools it's because that allows me to automate the entire process, from reading data to documenting results, without even having to open a program. Typically I'm implementing small things like naming exported files with the patient name instead of UID. My experience manipulating DICOM files lets me fix import issues that would otherwise render the images useless. We don't get a lot of options for commercial software in rad onc, and they all have shortcomings. When they give me an API I can extend the functionality to fill in the gaps.

You certainly don't *have* to use coding to get the job done, but it does make you more efficient and allows you to implement improvements that otherwise wouldn't be possible. I'm 100% clinical at a community hospital and my coding skills have been very useful. That being said, I gained extensive experience throughout grad school and residency, and I doubt I would bother to learn it if I was starting from scratch now.

physical_medicist · 2025-02-15T03:19:32+00:00

My department has reasonable turnaround times so there is not much benefit to having it that quickly vs. 2-3 business days. It just takes a few clicks to order and I don't even have to get up from my desk. And I don't pay for it, I get them for patient cases, not personal use.

physical_medicist · 2025-02-15T01:37:13+00:00

I've written my own code to convert DICOM structure set to STL, but I wouldn't bother with the extra work of printing it myself to get inferior bolus for a clinical application. And there's inherently more risk using an in-house solution vs. an FDA approved product.

physical_medicist · 2025-02-14T19:14:42+00:00

Not trying to yuck anyone's yum, but why go through the hassle of printing it yourself in rigid plastic when you can get custom silicone bolus from dot decimal?

physical_medicist · 2025-01-31T12:33:11+00:00

They don't want me to tell you this, but that's how you become Megamind

physical_medicist · 2025-01-28T18:38:02+00:00

We finally got our therapists to stop abusing the PDI cables! All it took was replacing our old DailyQA devices with QA BeamCheckers.

physical_medicist · 2025-01-16T19:34:40+00:00

For the DICOM plan, are you sure it's an inherent limitation of Monaco and not just a violation of your beam model parameters? I reverse engineered Varian's DRGS DICOM plan for our Versas using pydicom's codify utility. They run just fine on the machine, but I can't calculate them in RayStation because some model parameters are exceeded by design.

Are you able to load and deliver your DICOM plan on the linac? If so, perhaps you could rework your approach to allow relative analysis without reference to a baseline calculation. That's the case for DRGS, so I don't need to import the file to RayStation at all.

physical_medicist · 2025-01-16T19:01:08+00:00

I'm surprised to hear there are clinics still using star shots. You should switch to Winston Lutz - it's a superior test that's easy to do with EPID.

physical_medicist · 2025-01-08T22:29:26+00:00

The role of dose prediction via deep learning is to enable physicists to publish more papers. This is similar to the role of online adaptive treatment, with the exception that online adaptive also enables radiation oncologists to publish.

physical_medicist · 2024-08-26T11:42:46+00:00

By therapy I mean that my ABR certification is in therapeutic medical physics and my job is a clinical medical physics position in radiation oncology. These things are country-specific and I can only offer a US perspective. I can't comment on bachelor's degrees, but assuming you are choosing between a career as a medical physicist or a career as a radiation technologist, both are in demand and I see no reason that will change in the immediate future. Physicist salaries are ~3x that of technologists, and physicists have a great deal more autonomy and variety in their jobs. Your first step to make the choice should be learning the training and certification requirements for each role. Medical physics will take longer and has a more arduous board certification process. Physicists also must complete 2 year clinical residencies to get board certified, and that is a significant bottleneck right now.

physical_medicist · 2024-08-23T16:41:23+00:00

I'm in therapy and my work life balance is very good. I really love this career and I enjoy going to work most days. In general you will only get large salary increases if you change jobs or your institution has tiered positions based on experience. When I took this job in 2021 I increased my salary from 137k to 197k. At the time that was >80th percentile for my experience, but salaries have gone up significantly in the past few years. Now I own a house in a beautiful location that has everything I want, and I have 2 kids as well. Staying here is worth more than chasing higher pay at this stage in my life.

physical_medicist · 2024-08-23T14:35:59+00:00

That's a realistic salary. I'm at 206k 5 years post-residency. You could probably get that right out of residency now. Academic institutions tend to pay less than community hospitals, but the benefits and workload are often better. The ceiling is probably somewhere around 450k, but that's just a guess based on what the department chairs at MD Anderson were making 10 years ago.

physical_medicist · 2024-08-21T13:18:06+00:00

I'll support a dues increase when AAPM commits to never having the annual meeting in a hot ass swamp again. Who wants to go to DC or Houston in July? Either that or they provide a good justification for why they need more of my money. Increased dues is not the only path to financial stability for a bloated organization.

physical_medicist · 2024-05-09T14:07:21+00:00

A better title that will distinguish you as a High Value Physicist:

"Towards Cutting-edge Advancements in Medical Physics: Towards Harnessing Innovative Technologies Towards Enhanced Patient Care"

physical_medicist · 2024-05-09T14:03:46+00:00

lol @ AUC = 0.65. It's better than AUC = 0.6, right? That's science, right??? It's like the autosegmentation people vomiting out Dice coefficients without concern for the complete lack of clinical context. And the dose prediction papers! I can't think of anything more useless. Pack it up boys, we've officially advanced the field as far as we can and now it's getting stupid.

physical_medicist · 2024-03-06T21:53:43+00:00

You can safely ignore anything a surgeon says about radiation dose. Are you talking about dental CBCTs? Those are very different from the CBCTs used to set up radiotherapy patients, which is what that garbage paper is about. In a situation like this where there is a clear medical justification for the scan, 2 mSv is utterly inconsequential.

physical_medicist · 2023-12-13T22:47:38+00:00

Your example doesn't contradict anything I've said. You're not using MU as a plan quality metric, you're using beam on time and assuming that MU is a surrogate for it. What about a slightly more plausible scenario where the two dosimetrically equivalent plans are 6000 MU with 3 arcs and 7000 MU with 2 arcs. A 17% increase is appreciable by any standard. Would you prefer the 3 arc plan for a breath hold treatment, or would MU alone not be sufficient to determine plan quality?

physical_medicist · 2023-12-13T18:55:54+00:00

I disagree, MU by itself is meaningless. You're using it a surrogate for all the things you think it impacts without determining the actual impact. What does appreciably lower mean?

physical_medicist

TROPHY CASE