© SFRP, 2024

1 Introduction

Following International Organization for Medical Physics (IOMP) Policy Statement No. 1, medical physics is a branch of Applied Physics, pursued by medical physicists, that uses physics principles, methods and techniques in practice and research for the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being (IOMP, 2010). Medical physicists (position code according to the International Standard Classification of Occupations 2008, unit group 2111) has been classified in the sub-major group 21 ‘Science and Engineering Professionals’ (ILO, 2012). They are not belonging in the sub-major 22 ‘Health professionals’ but their occupation are recognized in the note as an integral part of the health work force alongside those occupations classified in sub-major group 22 (ILO, 2012; Prime Minister of Vietnam, 2020).

In Vietnam, pursuant to the Prime Minister’s Decision No. 34/2020/QD-TTg dated November 26, 2020 on Introducing classification list of occupations of Vietnam, medical physicists are recognized under the name ‘Nhà vật lý y tế’ (Prime Minister of Vietnam, 2020). At hospitals, medical physicists mainly work in the radiotherapy and nuclear medicine departments. The responsibilities of these staff are specified in the Decision No. 1895/1997/QD-BYT dated September 19, 1997 of the Minister of Health on Hospital Regulations, only in radiation treatment and nuclear medicine departments (Vietnam Ministry of Health, 1997). The regulations do not mention diagnostic medical physicists. The role and responsibilities of the workforce are shown in International Atomic Energy Agency (IAEA) Human Health Service Series No. 25. The growing medical imaging applications require increasingly professional human resources. Following Hoang et al., 2018. there is a certain growth in the number of medical physicists in Vietnam (Hoang et al., 2018a, 2018b). However, diagnostic medical physicists have not been mentioned clearly.

The purpose of this paper is to study the current status of medical physicists in diagnostic departments in Vietnam and estimate the lack of a workforce based on the IAEA methodology, which requires increasingly professional human resources. This is of outstanding importance since medical imaging is one of the main sources of patient exposure and contributes to a significant part of population exposure (Bourguignon, 2021). This asks for optimization procedures in the form of establishment of DRLs for instance (Bertho and Habib-Geryes, 2023). This is one of the main roles of medical physicists as underlined in IAEA recommendations (IAEA, 2013)

2 Material and method

A detailed algorithm to describe the required numbers of medical physicists in a diagnostic imaging department has been developed by the IAEA. The components of the algorithm include input variables, weighting factors and an output variable, with the output being the total number of medical physicists (N_MP) needed to deliver the service (formula 1) (IAEA, 2018):

(1)

where N₁ to N₆ are the estimated number of full time equivalent (FTE) of a clinically qualified medical physicist required to adequately provide these services for each of the following six factors. These factors are: equipment dependent, patient dependent, radiation protection related, service related, training related and academic teaching and research related. The factor ε compensates for the efficiency of scale (formula 2) (IAEA, 2018):

(2)

where RF is the reduction factor that can be applied to the additional medical physicists required and depends on the skill and expertise mix of medical physics staff. This factor could be of the order of 0.6–0.8, leading to a reduction of up to 40% for any N_MP exceeding 4.

Each N_X value is calculated individually according to the formula 3 (IAEA, 2018);

(3)

where w_i is the relevant weighting factor in terms of FTE per input quantity and n_i is the associated input parameter including equipment, patient, radiation protection, service data, training, academic teaching and research data (IAEA, 2018).

In Vietnam, the diagnostic imaging department is separate from the nuclear medicine department. Each department has different facilities, but in the same level hospital, basic facilities are equivalent. To estimate medical physicist requirements, the calculation method is based on a typical diagnostic imaging department from two different categories of health structures following Circular 08/2019/TT-BYT (Vietnam Ministry of Health, 2019). Tu Son District Health Center is a medium-sized hospital (240 beds). Bac Ninh General Hospital is large (∼1200 beds). The input parameter is shown in Table 1.

The current results of the medical physicists’ force are based on the 2021 statistics of the Vietnam Society of Medical Physics. This statistic is based on the supply of staff at participating hospitals.

3 Results and discussion

The results of the district health center workforce require ∼0.6 diagnostic medical physicists. So, their workload is lower than their ability. For district and provincial hospitals, the mandatory recruitment of medical physicists is not regulated. District hospitals should consider recruiting a diagnostic medical physicist. This employee can work in the Materials & Equipment Supplies Department additional tasks on medical equipment or in the most appropriate radiology department with technician duties. In another way, two district hospitals can hire a diagnostic medical physicist, but managing staff is difficult under Vietnamese law.

For the provincial general hospital model, the results require 1,2 diagnostic medical physicists. The recruitment medical physicist requirement is obvious because there are many complex image displays, procedures for imaging, intervention, radiation safety management, and large and diverse patients. Their workload is higher than their ability, so their job needs to be shared by radiologists or technicians.

According to the Health Statistics Yearbook, Vietnam has 20 central general hospitals, 20 central special hospitals, 162 provincial general hospitals, 177 provincial special hospitals, 712 district general hospitals, and 228 private hospitals (Vietnam Ministry of Health, 2021). Ideally, to estimate the lack of diagnostic medical physicists, by mechanical calculation, Vietnam needs 912.6 diagnostic medical physicists. At the present, Vietnam urgently needs 202 employees (20+20+162).

According to the survey of the Vietnam Society of Medical Physics, there are 157 medical physicists (table 2). There are no diagnostic medical physicists. From clinical practice point of view, diagnostic medical physicist duties are performed by radiologists, technicians, supply engineers, or medical physicists in other departments. We notice that 12 employees (7.6%) are in charge of radiation safety inspection, repair, and maintenance of medical imaging equipment, although they are not in diagnostic imaging departments. This is a good premise for this workforce to develop in the future.

4 Conclusions and recommendations

The shortage of diagnostic medical physicists in Vietnam is huge. This job is still a potential profession in Vietnam. The recruitment depends on the characteristics of each radiology department as well as the hospital. For province hospital level, the recruitment for a medical physicist is reasonable and very urgent.

In the process of developing the Vietnam hospital regulation, we suggest that the Ministry of Health considers adding roles and responsibilities of Medical Physics in the diagnostic imaging department.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

The authors declare that no financial support was received for the research, authorship, and/or publication of this article.

Ethical Approval

Ethical approval was not required.

Informed Consent

This article does not contain any studies involving human subjects.

Authors contributions

T-Q. Nguyen: Conceptualization, methodology, writing original draft, writing – review & editing. T-M. Nguyen: acquisition, analysis data for the work, writing original draft. H-N. Tran: Supervision, writing-Reviewing and editing.

Acknowledgements

The authors wish to thank Vietnam Society of Medical Physics for the updated statistics.

References

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