Effort of strengthening Medical Physics in Indonesia Djarwani S. Soejoko Department of Physics Faculty of Mathematics and Sciences University of Indonesia

Radiotherapy There are 19 centers 10 centers with 15 linacs 10 centers with 15 linacs 14 Co-60 units 14 Co-60 units 13 brachytherapy units (HDR, MDR) 13 brachytherapy units (HDR, MDR)

continued Man power 36 radiation oncologists 36 radiation oncologists 38 medical physicists 38 medical physicists 6 dosimetrists 6 dosimetrists 125 RTT 125 RTT 60 nurses 60 nurses

Medical physicists 4 persons with master degree in 2 centers 4 persons with master degree in 2 centers rests are bachelor degree (S1), some are RTT plus 1 – 2 years additional physics courses rests are bachelor degree (S1), some are RTT plus 1 – 2 years additional physics courses

Diagnostic Radiology > 5100 X ray units > 5100 X ray units Small hospitals, conventional radiography and some with fluoroscopy Small hospitals, conventional radiography and some with fluoroscopy Hospitals (government and private) in big city, equipped with different types of x ray units (conventional radiography and fluoroscopy, mammography, interventional radiology, helical and multi-slice CT, CR) Hospitals (government and private) in big city, equipped with different types of x ray units (conventional radiography and fluoroscopy, mammography, interventional radiology, helical and multi-slice CT, CR)

Continued Man power radiologists and technician are at reasonable amount, even is not yet sufficient radiologists and technician are at reasonable amount, even is not yet sufficient medical physicists, almost all with S1 degree, the number at hospitals is still limited medical physicists, almost all with S1 degree, the number at hospitals is still limited physics service is not yet implemented physics service is not yet implemented

Nuclear Medicine < 10 centers < 10 centers SPECT, SPECT and CT, PET (starting to be installed) SPECT, SPECT and CT, PET (starting to be installed) Number of doctor in Nuclear Medicine is still limited Number of doctor in Nuclear Medicine is still limited Number of medical physicists is still limited (with S1 degree) Number of medical physicists is still limited (with S1 degree)

Effort to strengthen medical physics Education with good standard Education with good standard Collaborate with BATAN (Nuclear Energy Agency) Collaborate with BATAN (Nuclear Energy Agency) Contribute in preparing regulations (BAPETEN, Nuclear Energy Regulatory Body) Contribute in preparing regulations (BAPETEN, Nuclear Energy Regulatory Body) Collaboration with Ministry of Health, hospitals Collaboration with Ministry of Health, hospitals

Education Department of Physics, Fac. Math. and Sciences, Univ. of Indonesia, sponsored by BATAN Open undergraduate study 1998 Open undergraduate study 1998 Open graduate study 2002 Open graduate study 2002 To increase the number of medical physicists with master degree (at least). Currently critical mass (for development) has not been reached.

Medical physicist career Hospitals (radiotherapy, diagnostic radiology, nuclear medicine) Hospitals (radiotherapy, diagnostic radiology, nuclear medicine) Research institutes (BATAN, LIPI) Research institutes (BATAN, LIPI) Regulatory body (BAPETEN, Ministry of Health) Regulatory body (BAPETEN, Ministry of Health) Vendors Vendors

Clinical Training (career at hospital) not yet been started To increase number of medical physicists at hospitals with master degree. To increase number of medical physicists at hospitals with master degree. To prepare supervisor candidates (master degree + > 3 – 5 years experience). Expected 2008 – 2009, 7 persons available. To prepare supervisor candidates (master degree + > 3 – 5 years experience). Expected 2008 – 2009, 7 persons available. To prepare hospitals where clinical training will be enrolled, collaboration with ministry of Health To prepare hospitals where clinical training will be enrolled, collaboration with ministry of Health

Collaboration with BAPETEN Preliminary project investigation (QA and inventory) for several radiotherapy, conventional radiology, and nuclear medicine equipment in the country (2003 – 2004) Preliminary project investigation (QA and inventory) for several radiotherapy, conventional radiology, and nuclear medicine equipment in the country (2003 – 2004) To contribute in preparing regulation (to match with IAEA recommendation, TECDOC 1040, with 7 years transition time ) To contribute in preparing regulation (to match with IAEA recommendation, TECDOC 1040, with 7 years transition time )

Collaboration with Ministry of Health, hospitals 2007 recognition of medical physics professional 2007 recognition of medical physics professional Short plan (to have medical physicists at hospitals match with IAEA recommendation) Short plan (to have medical physicists at hospitals match with IAEA recommendation) To establish network for medical physics external audit throughout the country To establish network for medical physics external audit throughout the country Hospitals, practical works and research Hospitals, practical works and research

Collaboration with BATAN Sponsor in education funds (fellowships S1 students, operational) funds (fellowships S1 students, operational) Lab. for practical work Lab. for practical work IAEA projects (RCA – RAS/6/038, and INS/6/013) IAEA projects (RCA – RAS/6/038, and INS/6/013)

Project RAS/6/038 Recent activities, Bangkok IAEA Regional meeting, 25 – 26 June 2007 IAEA Regional meeting, 25 – 26 June 2007 workshop on 27 – 28 June 2007 workshop on 27 – 28 June 2007

Response As a report to government 1. Medical physicists should match with IAEA recommendation. Department of Physics FMIPA UI, has contributed in academic education to produce candidate medical physicists (up to master degree

Continued 2. To prepare clinical training (training for supervisor candidates, fulfill equipment requirement). 3. To propose either Ministry of Health or hospitals to provide scholarships for residents during clinical training

Comment on Clinical Training Guide 1. Several countries still use Co 60 unit for external radiotherapy. It will appreciate it if the guide includes materials related with the use of gamma radiation (Co 60) 2. Not all guides suitable for all countries, therefore every country is permitted either to modify or to reduce these materials.

Other comments It is nice to hear that clinical training guidelines for Diagnostic Radiology is already available. Even though IAEA is only concern with ionizing radiation, it will be very helpful if the guidelines is also included MRI and USG It is nice to hear that clinical training guidelines for Diagnostic Radiology is already available. Even though IAEA is only concern with ionizing radiation, it will be very helpful if the guidelines is also included MRI and USG We are waiting the IAEA clinical training guidelines on nuclear medicine. We are waiting the IAEA clinical training guidelines on nuclear medicine.

Thank You