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NCRP 52nd Annual Meeting, Meeting the Needs of the Nation for Radiation Protection

How Did We Get Here? Session Q&A (Session Chairs Kathryn H. Pryor and Richard E. Toohey)

Held, Kathryn

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doi: 10.1097/HP.0000000000000624
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Questions For Lawrence T. Dauer, Ruth E. McBurney, Wayne D. Newhauser, Kathryn H. Pryor, and Richard E. Toohey

Lawrence T. Dauer

Q

There hasn't been much discussion on whether radiation research and related areas are actually too boring for young professionals. Isn’t it possible that a post-doc in a university cancer program might actually prefer to be working on a project related to radiotherapy or immunotherapy rather than radiation protection and low dose?

L. Dauer: That's very interesting. At an institution just across the street from us, they are working on joint radiotherapy and immunotherapy projects, and certainly I think there are plenty of very interesting topics out there, especially in the current therapeutic field. However, I think that many aspects of the fields of radiation protection and low dose remain very fruitful. I know many of us wouldn't be here except for that serendipitous talk in the hallway where you're like: "What's that?"

Q

Based on your straw poll at the start of the talk, lots of the more senior professionals had benefited from fellowships: do you still think those are still the answer, or was that a 20th century solution that will not be effective in the 21st century?

L. Dauer: I think it's both. I think that we do need more fellowships. I know that, even in my own institution, several folks are being funded through fellowships, and not only government fellowships right now. It's hard to look around the room at the wisdom and not recognize the importance of that fellowship at a really important time in your own career. But, currently, the larger question is where the future funding is going to come from. I don't think we can just say: “Oh, we're brain-draining so we need more funds.” That's not going to fly in today’s economic climate. I think we need to make the plea that it is essential that we advertise and acknowledge the benefits of radiation and find a way to move forward through partnerships, both academic and governmental.

R. Toohey: As you might know, ORISE (Oak Ridge Institute for Science and Education) performs polls of students, and they also keep track of radiation science-related federal funding. I looked at those and if you chart federal fellowship program funding with student numbers, not surprisingly, they track very closely. If you fund it, they will come.

Q

Getting funding for low-dose radiation research is extraordinarily difficult. Study sections appear to defer everything to being an adaptive response, making it harder to get funding approval for novel work. In the view of the radiobiology research needs, what kind of solutions would you offer?

L. Dauer: I don't know. That's part of the reason why we're here for 2 d: to discuss that very item. I really think it goes back to leaning on the benefits side. If we stand up and say we simply don't understand the risk as well as we would like to, I'm not sure you're going to get so much funding for that given the length of time this has been an active field of inquiry. I think if, instead, we say: “Listen: we have the ability to change the quality of people's lives, how long they live, and, for example, how cheaply they can get electric power and how we can continue to have a climate that we can all literally live in.” I think those are better selling points. You emphasize the importance of radiobiology in that equation and the rest, but even then I'm not totally sure. Randy [Hyer] and everyone in PAC 7 (Program Area Committee on Radiation Education, Risk Communication, Outreach, and Policy): you need to come up with message maps that will help us through this crisis.

R. Toohey: Another quick comment. We had our first meeting of Council Committee (CC) 2 (Meeting the Needs of the Nation for Radiation Protection) yesterday. Wayne Newhauser, who's Program Director of Medical Physics at LSU (Louisiana State University), made the statement that we need to get very specific and focus on things that we can sell, such as if we get the research done on X, it's going to enable us to give more effective treatments at lower cost and with better patient outcomes. That you can sell.

Q

I have a postgraduate degree in radiation protection in a foreign country. How can I get accreditation to practice my profession in the States?

L. Dauer: Each of the professional societies has specific requirements and pathways for accreditation for those trained in other countries. I recommend checking with the specific profession in the states for specific accreditation information.

Q

Using the increase in cancer rates as justification for more radiation professionals for diagnosis and treatments is one-sided. Should the focus be equally on understanding and potentially reducing the increase?

L. Dauer: As radiation protection professionals, we stand on the principles of justification (benefit outweighs the risk) and optimization [ALARA (as low as reasonably achievable)] and right sizing the dose to meet the need. Both are essential.

Ruth E. McBurney

Q

How much of the workforce crisis is a result of climbing compensation rates relative to competing professionals?

R. McBurney: Speaking from the state perspective, I know a lot of the states are losing staff, both to retirement and going to other locations, either in another government agency, state or federal government, and also taking jobs outside of the state government, for example, to some of the licensee facilities. But all are staying in health physics pretty much.

Q

How many health physicists are typically involved in a state radiation control program?

R. McBurney: I think that depends on the size of the program. When I was working in Arkansas, we had six health physicists and then some administrative staff. When I started working for the State of Texas, it had just grown from a staff of 31 (this is in 1981) and we had about 1,600 licensees and about 10 times that many x-ray facilities. We had two nuclear power plants and they were going to be regulating a low-level waste site and then also uranium facilities. It grew from a staff of 31 health physicists that year to 100 plus other administrative staff. It really depends on the scale of what has to be regulated.

Q

Are states allowed to use consultants, retirees for regulatory inspections? This could lead to a lower cost pool for the expertise that you need.

R. McBurney: Some states do have outside inspectors that they hire—they have consultants—but for the most part, most of the inspections are done by the state employees.

Wayne D. Newhauser

Q

The graph showing the increase in CAMPEP (Commission on Accreditation of Medical Physics Education Programs) accredited medical physics programs—could much of this increase be due to the granting of accreditation, not the creation of new programs?

W. Newhauser: Many universities started medical physics programs because they saw the success of some of the programs that were established early on. So most of the growth is from the creation of relatively new programs.

Q

Given the small number of Bachelor of Science graduates in health physics, is there a reason to have more than two or three undergraduate programs in the entire country?

W Newhauser: Yes. I think the education system needs geographic diversity and redundancy. There are many students who can't afford to attend out-of-state schools. There are many students who aren't able or willing, for one reason or another, to relocate across the country to attend school. And we have seen many universities shutter their health physics programs in recent years. So I do believe it is in the national interest to maintain a robust and distributed set of programs.

Q

In review study sections, the response is often, “We know enough about radiation so we'll fund other priorities.” Any suggestions on how to change this general attitude? What happens to the medical physics market when we've cured cancer?

W. Newhauser: Let me give one example of a high-priority research area. Roughly every other one of us will get cancer at some point in our lives and about two-thirds of those lucky folks will receive radiation. When we treat patients, there's an image acquired of the region of the body that receives radiation, and there's a plan created to treat that local region. But there's a radiation dose to the whole body, and we know that radiation is carcinogenic. If we lumped all of the second cancers together, they'd be the fourth or fifth most common form of cancer. In clinical practice, we ignore the stray radiation exposure, and we do not estimate carcinogenic risks. As survival of the primary cancer increases, this will become increasingly important. In fact, even if we cure all the primary cancers, we would be busy taking care of the survivors. Already there are nearly 20 million cancer survivors in the United States, about half of whom have received radiation. We need to take care of them; we need to understand what's going on with their treatment-related conditions. In the future, it appears likely that radiation will continue to play a role in the cure of cancer and that cancer will become more like a chronic disease, meaning instead of having one fatal cancer, patients may sequentially have 10 nonfatal cancers. And even if the utilization of radiotherapy were to decline or stop, there is increasing use of imaging and other physics technologies in medicine; e.g., for dementia and other chronic conditions. I believe the long-term demand for medical physicists will remain strong.

J. Williams: I think you're preaching to the converted here, but the original question was how do we educate the study sections to understand that gap because they're turning around and saying how much longer do we have to fund radiation?

W. Newhauser: I doubt that that can be done as a practical matter. I think probably what needs to be done is there need to be set asides for radiation protection related research. We're such a small field that if you go into a study section where there's perhaps one radiobiologist or one physicist, it's just very hard to come out of there with funding. I think probably we need separate study sections that are related to radiation protection.

Q

The question here is looking at changes in AAPM (American Association of Physicists in Medicine) vs. HPS (Health Physics Society) membership and they're actually wondering whether the CAMPEP (Commission on Accreditation of Medical Physics Education Programs) programs have actually moved people toward AAPM instead of into HPS. Do you have any comment on that?

W. Newhauser: I don't think I would necessarily ascribe that to CAMPEP per se. The fact that medical physics is accredited and there's a clear definition of what a qualified medical physicist is, and there are a lot of really good-paying interesting jobs in medical physics, I think is why the students these days are more interested in medical physics than health physics. But I'm optimistic that health physics can be made more attractive. I personally find health physics very interesting. I actually earned a Master’s degree in health physics and am still very passionate about it. I think we will have to work on creating and promoting interesting opportunities for future health physics students.

Q

What do you think is driving the 2% increase in cancer incidence? Is it the population aging, the environment, exposure? What's the impact of increased medical dose on increased cancer incidence?

J. Boice: The increase is in the number, not in the incidence rate. The rate in terms of mortality is actually going down when we do an age adjustment. The problem is that the population is getting older. As you get older, there's a higher probability of developing cancer. So the issue is that the number of cancer occurrences each year is increasing dramatically because we're aging and our population growth is phenomenal. Most of us can remember when the population of the United States was 160 million and now it's 340 million. So when we talk about incidence rates, those are fairly stable, as are the mortality rates that take age into account. The issue therefore is population growth and the aging of the population.

W. Newhauser: And the mortality from cardiac disease has really dropped, which then leaves cancer as the next major health care problem.

Q

Do you expect that medical physicists will take over more duties of the health physicist whether they want to or not? Given the fact that radiation biology is equally important to the safety of medical applications, should board certification actually include, for the physicists, a certain amount of training in radiation biology?

W. Newhauser: First of all, with the radiation biology that is so important: yes, absolutely. That's a part of the core curriculum that CAMPEP requires for medical physics training. It's interesting: one of my students the other day came into my office and she said she was interested in a career either in health physics or medical physics and was exploring the differences. She said medical physics has four subspecialties. I said, “Really, I'm only aware of three.” She said therapy, diagnostic radiology, nuclear medicine, and medical health physics. I said, “I don't think that's really a subspecialty. I think health physics is its own field.” She said, “No, no, go to the AAPM website.” And sure enough, they've put that in now as a subspecialty. I don't know what the answer to that is, but anecdotally, I hear it is increasingly hard to find health physicists in some areas and for some tasks. For example, at nuclear power plants, if they can't find a qualified health physicist, you still have to hire some other type of radiation professional to get the job done. You've got to do what you've got to do.

Q

Due to the decrease in state funding of public institutions, do you think there's going to be a point when the public institutions will actually all decide to look at becoming private? If so, what will become of the training programs?

W. Newhauser: That's a really good question and I'm not deep enough into the administration to answer that, but anecdotally, I know that several major universities would like to do that because they're receiving so little support from the states; that's shrunk from roughly 80% of the state university's budget to now on the order of 10%. When it gets down that low, it's usually in the university's interest to just cut the ties, get rid of all of the extra oversight and bureaucracy. It would be a happy trade-off to receive 10% less revenue and be free of the legislature. But many of the universities are land grant universities, and you just can't do that. But the dramatic cuts to state universities are clearly a complicated problem that needs a solution. I just don't know what it is.

Q

Have you/the society studied the impact of the new JC (Joint Commission) Diagnostic Medical Imaging Requirements on staffing levels for “qualified” diagnostic medical physicists? The JC requirements are restrictive, and some hospital organizations are applying these competencies to the testing of all imaging equipment, not just CT (computed tomography), MRI (magnetic resonance imaging), PET (positron emission tomography), and NM (nuclear medicine) imaging, as stated in the standard. Many state-licensed health physics professionals do not meet these standards.

W. Newhauser: No, I have not studied this, but I expect that several societies are looking very carefully at this, including HPS, AAPM, RSNA (Radiological Society of North America), and others. There are strata of qualifications and standards that vary with the particular subspecialty and task, and rightly so.

But your point is especially timely at this meeting, which focuses on the radiation workforce. The health physics profession is in severe decline, and the mismatch you mentioned offers insight into underlying problems and potential solutions. Specifically, problems arise if there is a discrepancy in the standards required to enter a profession and the standards expected by regulators and accrediting bodies. In the case of health physics, it is my understanding that the profession lacks a consensus definition of the characteristics of a “qualified health physicist.” Furthermore, it is my understanding that regulators do not require “qualified health physicists” to perform health physics-related tasks.

By definition, each profession controls who may enter its circle, what qualifications are required to practice, and so forth. I believe the health physics professional societies should work together to define what a “qualified health physicist” is. Furthermore, they should do this in a way that is acceptable to their members as well as regulators, accrediting bodies, and other constituents (thereby avoiding most of the mismatches of the sort you mentioned). For certain activities that truly call for “qualified health physicists” (however that might be defined), statutes and standards should be amended to require them. I realize that achieving this goal will take time and effort.

Q

Medical physics has driven many scholars into the medical field with specific program training. Currently, scholars from tracks of radiation therapy and diagnostic imaging can be directed to the medical field. But understanding many aspects of radiation biology is equally important to the safety of the medical application of radiation. Shouldn’t the board set a license for folks with advanced training of radiation biology?

W. Newhauser: Today, to my knowledge, only two medical specialty certification boards offer certification to non-physicians. The American Board of Radiology certifies medical physicists and the American Board of Medical Genetics and Genomics certifies individuals in various areas of medical genetics. So there are clear and very successful precedents for certification of clinicians with scientific training. Clearly, the radiobiologic aspects of radiation therapy are important and likely to become more so in the future as new fundamental knowledge of radiobiology is translated into clinical practice; e.g., molecular targeted therapies, personalized medicine and so forth. So the answer is yes, it should.

Unfortunately, there also needs to be an emphasis on the lack of viability of small programs in the context of state support. Universities have dropped from ~86% to <15% in terms of state funding. Typically, this means that, just as in business, universities must pay attention to return on investment. For the average faculty member to have a break-even return on investment (R01), they need to administer from 300 to 350 student credit hours annually or bring in between $300,000 to $350,000 annually, as measured by expenditure. Since funds will be reallocated to programs with the best return of investments, radiation science, with its small levels of enrollment and poor research funding, is simply not viable.

Kathryn H. Pryor

Q

Larry started his discussion by asking the audience about our own age distribution and who's retired and who isn't retired. A question to both of you: Do you think part of the problem is that older radiation science professionals are not retiring so that the loss of the generation is the fact that there are no positions for the middle age groups to move into? As long as we gray-hairs sit here, there's no place for the younger people to move up into.

K. Pryor: Yes, I think that is partially true and part of the problem. People seem to be delaying retirement and working longer for a variety of reasons—some financial, some professional. Older professionals have a wealth of knowledge and the ability to mentor younger professionals. Instead of staying in management roles, perhaps the answer is to retain older professionals in a mentoring role. We need to mentor younger radiation protection professionals so that when they do have opportunities to move into senior positions, they are equipped with the knowledge and ability to do so.

L. Dauer: We need to be investing in active and ongoing mentoring. That should be the key. I know in our own institution, this has been a major effort for us and, for example, if you were to look at just the group I'm blessed to work with, there are a number of young people who tomorrow could take over because of training, shared experience, and what we've invested in them. I'm sure many of you had that happen to you, and that's how you are even here today. This is essential. At the same time, I do think it's really important to retain wisdom at your side somehow, really important to have such experiential wisdom.

Q

What efforts have been made to reach out to ASRT (American Society of Radiologic Technologists)? The ASRT has a membership of about 300,000 and could be a good source of potential workforce growth in filling the pipeline.

K. Pryor: The HPS has not made a specific effort to reach out to the ASRT, but this is a great suggestion and has been forwarded to HPS leadership. We have made continuing efforts to reach out and recruit a different group of technologists for membership in the HPS—those belonging to the NRRPT (National Registry of Radiation Protection Technologists). The ASRT members would be well suited to help fill the pipeline with some additional education and training.

Q

Are there any initiatives to reach out to small liberal arts colleges to find students to fill the pipeline of radiation professionals?

K. Pryor: There are no current specific initiatives for the HPS to reach out to liberal arts colleges to recruit future radiation professions. As long as the students are completing STEM (science, technology, engineering, and mathematics) courses, they would be well suited to enter graduate programs in health physics and radiological sciences. In addition, with assistance from NRC's (U.S. Nuclear Regulatory Commission’s) Integrated University Program (IUP), a number of small liberal arts colleges have developed appropriate curricula and received scholarships and fellowships to increase the number of practicing radiation safety professionals. However, it is very important to pair a solid STEM education with mentoring from active members of the professional societies, such as the HPS.

Q

Could the HPS consider creating some type of membership category specific to health physicists working in federal agencies? This could potentially increase membership in the HPS and promote support of HPS members by the federal agencies.

K. Pryor: That approach has not been specifically considered.

Q

With regard to attracting and retaining students, do we need to lower the academic program standards?

K. Pryor: No, I don’t believe that the academic program standards are the issue. Attracting and retaining students seems more dependent on providing financial support to the students, having opportunities to participate in research projects, and providing them with interesting job opportunities for them upon graduation.

Q

Why is the membership down for our younger people? Is it that they can't pay the $200 annual fee? Hard copy costs for the journals may be driving the cost. Maybe there could be a lower rate for members who opt out of the hard copy of the journal – for all ages, not just rates for early career or younger members.

K. Pryor: The dues structure for the HPS is not significantly different from other professional societies and is lower than a number of them. Dues of $200 a year is right in line with many other radiation-related professional societies. The HPS has an early career membership category with reduced dues for the first 5 y of membership. They have also considered a membership category which does not include the hard-copy of Health Physics, but there are financial constraints that make this difficult to implement at the current time. For many journals, the creation of the content in the final form accounts for the majority of the total cost, independent of delivery method. This is a concept that should be more seriously explored in the future.

Q

Have you considered a mentorship program or recruiting at universities through presentations?

K. Pryor: HPS has a Student Support Committee, staffed entirely by students or recent graduates. They represent many of the student branches at the various academic programs across the country. The student branches are also active in supporting our academic programs. The Student Support Committee has been active in reviving the mentorship program within HPS; extending it to other universities and/or recruiting through presentations is a good suggestion.

Q

Do you think that electronic access to journals has diminished participation in the professional societies in general?

K. Pryor: Electronic access to information has indeed changed the landscape, and the use of the internet and social media has somewhat diminished the core value of the traditional professional society. In the past, professionals had to travel to meet peers and colleagues doing similar work. Now, through tools such as electronic video conferencing, networking can be accomplished without ever leaving our computer. Many journals are accessible free-of-charge or for a modest charge per article. The leadership of the HPS has worked, and continues to work, to provide access to industry consensus standards, journal articles, and reports free-of-charge or at a discounted rate for its members. The important point to remember is that video conferencing, social media, and electronic access to information cannot replace the value of attending a professional meeting where you can network with a large group of radiation professionals from many different employment sectors.

Q

It is much more difficult for international students to find employment at the national laboratories than students from the United States. Can this situation get solved for retaining international professionals?

K. Pryor: The national laboratories are federally owned and are operated by contractors. In a number of places, there are many foreign nationals who are conducting research at the national laboratories. However, there are some positions that, due to the nature of the work, require that candidates be U.S. citizens. Some positions may also require that the candidate have, or be able to obtain, a security clearance.

Richard E. Toohey

Q

My local nuclear power plant employs no certified health physicists because "they don't need them." The radiation protection staff are all NRRPT certified; they are technicians. So do nuclear power plants need HPs?

R. Toohey: I've never worked in the nuclear power industry, but my understanding is, actually, that's a very true statement. Professional health physicists or certified health physicists tend to be a few people at the headquarters of the utility and not actually the onsite RP (radiation protection) managers. The radiation protection manager position has been well-defined by the Institute of Nuclear Power Operations, and most plants stick to that because the definition's been accepted by the NRC for compliance. So I don't see much of a need for professional health physicists in nuclear power per se; but, as I mentioned, as a plant shuts down and we move into D&D (decontamination and decommissioning) mode, we will need more people onsite. On the other hand, most plants that are shutting down now are going into long-term storage and won't go into D&D for 50 or 60 y.

Q

The availability of grant funds is key to training and job stability. Can this be achieved in part by awarding smaller awards to more investigators?

J. Williams: In ASTRO (American Society for Radiation Oncology) and RRS (Radiation Research Society) we've actually found almost more output and productivity from smaller grants.

R. Toohey: Actually, I don't know. I've spent my whole career in the U.S. DOE (U.S. Department of Energy) system and don't have much experience with grants. But I think it would certainly be a good idea for the one- or two-faculty-member smaller programs to be able to get some funding coming in to help demonstrate their value to the administration of the university.

Q

It appears that our speaker believes that the only radiation professional at risk is the health physicist. Given the introducer and some of the subsequent speakers, is this the only area that CC 2 is going to be concerned about?

R. Toohey: Partially guilty as charged. I don't believe HPs are the only RPs, but they are, let's say, the portion of the RPs who seem to be in the most critical situation.

There was an earlier question asking if HPS had any plans for reaching out to ASRT, and it should be noted that ASRT were fully represented, as was ASTRO and some of the other medical groups, at the WARP (Where Are the Radiation Professionals?) workshop. What emerged from that workshop, briefly, was that it looks like the medical needs for radiation professionals are pretty secure for at least the next 10 y; they think they can keep up with the increased demand. One of the problems is that the acronym “RP” is used for “radiation protection,” but it can be also for “radiation professional,” and the latter is much broader than radiation protection. The critical need (no pun intended) is more on the HP (health physics) side.

J. Williams: I think I'd argue that one. As a radiation biologist, and one of the few in the room, I think you're going to find that the crisis has arrived for radiation biology and, I'm really sorry, but this is not simply with respect to the teaching of the discipline. The fundamental effects of radiation on biology are the basis of health physics and medical physics. How to apply the observed effects to radiation protection comes from the biology.

Q

Is incorporation of radiation sciences in STEM too specialized at an early stage in education?

R. Toohey: I don’t think so. Being born at the beginning of the atomic age, I was hooked on the subject in grade school; remember “Our Friend the Atom” on the “Disneyland” TV show in 1957? It is especially important to reach under-represented populations early in their education, before social pressures convince them they don’t have a future in this area.

Q

Who wakes the bugler? Is there any initiative to support the university teaching programs most critical in maintaining radiation professionals?

R. Toohey: It is somewhat of a chicken-and-egg problem. You can’t teach students without the programs, but you can’t support the programs without students and research grants. This is why the WARP statement includes a call for government support of training programs, as was previously done for other national needs, such as the “missile gap” and “space race” in the 60s and 70s.

Q

Please comment on whether more radiation safety is being done by RSO (radiation safety officers) following prescribed requirements that do not need professional HPs.

R. Toohey: As my friend and colleague, Barbara Hamrick, likes to say: “It depends.” In a really well-defined situation, you may not need a professional health physicist in attendance; however, you’d better have one on call for an off-normal occurrence. In non-routine operations, such as basic research, decontamination and decommissioning, and radiological emergency response, HP professionals absolutely have to be available.

Requiring a CHP (Certified Health Physicist) credential for RSOs would be a big mistake. There are far too may facilities that have an RSO, especially medical facilities, where the RSO is often a radiologist or radiation oncologist. For smaller community hospitals, it is unrealistic to expect them to hire a CHP. I would hate to see us recommend that and the NRC adopt it.

Q

Research budgets are shrinking for all fields. Is the shrinkage proportional or is radiation disproportionally affected?

R. Toohey: I believe it is the latter. As evidence, I submit the reprogramming of funds intended for the low-dose radiation effects program to “green” energy research.

Q

Particularly relevant as HP programs and related professions fight for scarce resources, how do we articulate our impact to decision makers and resource providers when our success means nothing happens (i.e., people are safe)?

R. Toohey: This is the old problem of paying for the fire department in between fires, or paying for insurance that you don’t think you are likely to need. If we are ever successful in implementing a real radiation protection culture in industry, research, and other radiological operations, the problem could resolve itself. However, in my experience, we are a very, very long way from that situation. Unfortunately, the only way to demonstrate our value is to use radiation accident history to demonstrate what can happen when radiation protection is not emphasized; however, and again because of lack of a proper safety culture, management reaction is often: “Well, that can’t/won’t happen here.”

Q

Where are the jobs? How many positions open per year? At what level (tech associate, BS, MS, PhD)?

R. Toohey: This is something CC 2 will be tracking. My academic contacts tell me that current graduates typically have several job offers. However, one disconnect is that as we “senior professionals” really do retire, we cannot be replaced by new graduates; there is something to be said for experience. I do think that new graduates, once they have a job, are going to have to go to extraordinary efforts to continually improve and broaden their skills to meet the radiation protection needs of the future.

Panel

Q

Should the various organizations, societies, NCRP, etc. join forces to propose a radiation corps, modeled after the Peace Corps, to focus on gap filling by sponsoring internships, etc.?

J. Williams: I think this is one of the suggestions for us all joining together and trying to work out a solution. Earlier on, when I was talking to Wayne [Newhauser] and I was discussing his talk, he said that it's interesting that, when you're in the Wild West and there's a problem, you all circle the wagons and all join together. He said what seems to be happening in the radiation professions is that we're circling the wagons, but we're shooting inwards not outwards. I'd really like to suggest that the one thing that we really need to accomplish as a community is to all join together, because a rising tide raises all ships. If there's only one ship being raised, everybody else gets washed out to sea and you've got a boat sitting on a rock.

Q

Younger professionals seem to move around from job to job with greater regularity. Older professionals seem to stay in the same company or agency for 10–20 y. Are the younger professionals looking for upward mobility? Do they see a greater path in the radiation fields?

J. Williams: I think this is what we were saying earlier, is that there is not a clear path for the younger professionals.

W. Newhauser: At least on the medical physics side, you have to move around. You go somewhere else to do your residency. After the residency, although you could stay, typically people will go somewhere for their entry level job. A few years later, after they pass their board examination and are certified, they can either stay, underpaid to the tune of a couple of tens of thousands of dollars year after year, or they can change jobs again and get the raise that the market will pay. So the incentives are just set up for them to do that. I don't think it's necessarily a preference or a lifestyle choice; it's just a fact of life with young folks.

R. McBurney: We're also seeing, in state government, that the young people, if they are in a position where there is an opportunity to move up, they will do so. Also, if they see no opportunity for change, then they're likely to move on to another place. Most of the state health physicists I've seen actually join that group because it's where they want to live. There are pretty good benefits. Maybe the salary's low, but the benefits and the location are what they're looking for.

M. Cervera: I just wanted to throw in a perspective about that. I went to an interagency big tabletop which included a whole bunch of states, and I was talking to a person from a state that will remain nameless. They had just posted a job posting where they wanted a health physicist with 10 y of experience and a CHP, and they were paying $17 an hour. I wouldn't take that job because that's not entry level; but you could go to work for that state, you could get all the training, and then you'd get the heck out of there. Who's going to work for $17 an hour? You wouldn't be able to pay your student loans. This is really important; even being young and a little bit more mobile and willing to go, I also can't live on that salary.

Q

What is the level of job satisfaction for health physics and for medical physics? Do people leave the field for reasons other than retirement?

R. McBurney: As I mentioned earlier, it's pay. You want to earn a living wage, and so it's a good training ground. I know on the x-ray side, not a lot of states get radiological technologists who have bachelor's degrees that want to get out of the clinical setting and into the regulatory side. And we train them on x-ray inspections and so forth, and then gradually they may want to go into radioactive materials, but for the most part they stay in x ray. For HPs, it's a good training ground, but as they see more opportunities outside, then they leave in a lot of cases. It's hard to retain them.

W. Newhauser: There have been some surveys of this. I don't have the figures in my head, but I think maybe it was NIOSH (National Institute for Occupational Safety and Health) did a survey and asked about things like job satisfaction and so forth. I'd say for medical physics, most are happy. There are certain things that tend to make them a little bit happier, which is having colleagues (not being in sole practice) and also having some connection to research and teaching. It just keeps life more interesting. But, by and large, I think they're happy. They're certainly not leaving the field in droves.

Q

Is there information out there about where people who actually graduate with radiation related-degrees are employed? Are there enough people graduating?

J. Williams: As a past membership chair of RRS, I can comment that the Society has a very active Scholars-in-Training program, but very few actually graduate from Scholars-in-Training to the membership. Is that a matter of they get the degree and there are no jobs?

R. Toohey: Again, what we've been seeing is that this is very widespread. Some graduates have multiple job offers and others may go a couple of years before getting a job. The problem has always been, when you're starting your academic program and you're looking 4–6 y in the future, you have to guess what specialization is going to be hot at the time you need to find a job. Right now it's things like waste management, TENORM (technologically enhanced naturally occurring radioactive material) is certainly going to be emerging, and things like that. But nuclear power plant operations, not so much. In fact, the American Board of Health Physics used to offer a certification specialty in nuclear power operations and that was dropped a number of years ago. You need a crystal ball to manage that better.

L. Dauer: Just another related point on when those facilities and programs decline, it also affects whether or not you'll encourage one of your own mentees into a program. I was speaking with a radiobiologist at one point who said, “How could I ethically produce a new PhD radiobiologist who I know isn't going to be able to get a job because those programs just aren't there? I can barely keep enough funding for my own program to move forward.” I think it really depends on what area the person is graduating in as well. This issue needs a global focus.

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