Where have all the medical physicists gone?

Medical physics has always been a ‘below-the-radar’ profession, something that your average person may never even realize exists. Even in that context, medical physicists are incredibly hard to find these days. Today, in a profession that counts roughly 4-5k professionals, there are hundreds of open positions across the US. This puts immense pressure on physicists who are putting forth extraordinary efforts in clinics while frequently operating with less than half their normal staffing level. Trends in radiation oncology look to only exacerbate the challenge with treatment and equipment complexity increasing and direct patient involvement rising. Solving this challenge in the long-term will require thinking differently and acting differently while aggressively maintaining the rigorous quality standards of medical physicists. 

What is driving today’s shortage? 

The current labor market has seen unprecedented tightening as people exit the workplace combined with significantly increased ‘churn’ as individuals are more open to exploring new opportunities and new geographies. This is driving unprecedented vacancy levels and wages, but that story is no different from so many other professions. What makes medical physics unique is that the flow of new talent into the profession was further constrained by a residency requirement implemented in 2014. The residency program does a beautiful job preparing medical physicists to succeed in an incredibly complex field. However, aspiring physicists must compete aggressively to capture one of the limited residency slots available, with some talented candidates failing to get a slot. Secondarily, the residency requirement has effectively cut off experienced foreign-trained medical physicists from entering the US. 

Does the shortage feel the same everywhere?

The resourcing crunch can look very different from clinic to clinic. Some clinics have high and recurrent vacancies while others are successful at maintaining stable teams. Some smaller clinics do not have a full workload for a physicist, but still, require an onsite physicist for SRS/SBRT and machine QA. This can lead to high turnover by resources who feel underutilized or not challenged while also creating pockets of untapped capacity that can further exacerbate the shortage elsewhere. Meanwhile, clinics with vacancies are often faced with a protracted and costly search for permanent replacement physicists. Well-intentioned searches may end with outcomes such as imperfect candidates who accept but quickly leave, desperate offers at astronomical compensation to get to a “yes,” or use of expensive temps/locums, which can be as much as 2x the rates of a stable workforce.  

What complications lay ahead? 

The role of the medical physicist only gets more critical as more complex radiation is delivered over fewer fractions and at higher intensity, demanding increased precision. Physicists will remain a key element of the team to safely and effectively provide the radiation treatments designed by physicians. This trend also has the potential to transform the clinic workflow, resourcing, patient management, and billing model built around a more traditional 6-8 week course of treatment.  

How can we invest today to build a strong future for the medical physics profession?

At Aspekt Solutions, we see three key focus areas:

  1. Open the aperture to introduce more talent into the profession. This should include expanding residency slots, mainly those available to masters-level candidates, not just Ph.D. and exploring pathways for experienced, non-US talent capable of demonstrating competency to enter the market on a streamlined path to board certification without reverting to a residency.
  2. Focus on the highest value activities critical to patient care and quality. The medical profession has adopted advanced practitioners, nurses, and assistants so physicians can focus on patient engagement. So too, medical physicists need supporting, non-certified professionals to help meet the dizzying list of tasks on their plates. These professionals are critical to implementing working models that more efficiently distribute the work between team members. 
  3. Deploy enabling technologies such as AI to simplify or automate activities that can increase efficiency and quality. These tools can streamline repetitive tasks (e.g., generating organ contours or grading the quality of treatment plans), highlight unexpected results (e.g., facilitated chart checks), and improve quality by making highly-complex activities more manageable (e.g., adaptive planning).