Heather Patterson - Australia - RCA PANEL DISCUSSION HUMAN HEALTH 18th September 2012 Vienna Heather Patterson - Australia -

The goal of the IAEA programme in Human Health to enhance the capabilities in Member States to address needs related to the prevention diagnosis treatment of diseases through the application of nuclear techniques.

Introduction Most RCA Member States projects emphasis on: Early diagnosis and treatment infectious and non-communicable diseases - cardio-vascular disorders or cancer Nonhereditary and hereditary diseases Identification of nutritional deficiencies

RCA input: Collaborative Activities of Health Care Projects # participants Regional Training Courses 114 2,177 Regional Technical Workshops / Technical Meetings 50 440 Regional project Planning Meetings 43 592 Expert Missions to Member States 223

Main Categories: Activities: Nuclear Medicine and Diagnostic Imaging Applied Radiation Biology and Radiotherapy Dosimetry and Medical Radiation Physics Nutritional and Health-Related Environmental Studies Activities: Coordinated Research Projects Publications Guidelines Education and Training programs

Nuclear Medicine Cancer Joint & Bone disorders Medical Physics Radioimmunoassay Tissue Grafts The introduction of a program of clinical training to supplement academic qualifications has the dual purpose of providing skilled professionals for the developing country as well as providing standards that can be used to raise the recognition on medical physicists.

Radioimmunoassay: 4 projects 1986 - 97 Data processing: Train the Trainer Thyroid Hormones Hepatitis B diagnosis >600 scientists trained in bulk reagent methodology Clinical Applications: The teaching resources will be used for development of further education and training programs. The medical physicists trained will provide improved in-house capabilities to enhance services and allow future development.

Tissue Banking: project 1988 – 2002 Tissue banking operators trained through distance learning First curriculum of its kind Developed through RCA - then inter-regional ARCAL, AFRA and Europe 2003 Diploma course through National University Singapore - University of Buenos Aires (Spanish) Regional Meeting of National Trainers - PHI, 18-19 January: 2 day meeting of National Project Coordinators to Review the Status of Medical Physics in the Region. Manila. The National Project Coordinators presented updates on their work in the project. There was an enthusiastic response from the MSs. Expert Steering Group Meeting - CPR, 6-10 September: Beijing - reviewed the existing clinical training guide for radiotherapy physics in light of the experience of the pilot. Currently the clinical training guide is undergoing modification following the recommendations of that meeting. One result was the identification of common material shared by all three specialisation guides. This identification will allow residents to take a second specialisation if needed and is expected to help physicists in small departments with wide clinical responsibilities. Regional Meeting of National Trainers - BGD, 18-19 Oct : 2 day meeting of National Project Coordinators in Dhaka to brief counterparts on the clinical training program for medical physicists specialising in nuclear medicine. The National Project Coordinators presented updates on their work in the project.

Joint and Bone disorders: 3 projects 2003 – 2008 Nutritional and Health-Related Environmental Studies Joint and Bone disorders: 3 projects 2003 – 2008 Diagnosis of osteoporosis Prevention Treatment e.g. Radiosynovectomy for arthritis

Cancer related projects: 1984 /88 – ongoing Radiation Oncology Treatment Nuclear Medicine Diagnosis & Treatment Medical Physics Quality Assurance

Applied Science of Oncology (ASO) 1999 - ongoing To increase number of Radiation Oncologists – particularly in remote areas Level  Part 1 (theory) of a professional college Training materials supplied on CD Rom - 80 specialist modules animations, interactive , self assessment 2013 available on-line - download and install - adaptable for specific training programs Supplements clinical training MS in AFRA and ARCAL participated in a Pilot 2004 The aquaria picture of radioecology experiments (uptake & retention of radionuclides) on corals at the Phuket Marine Biology Centre – see the little coral ‘nubbins’ in the racks. Of course, use the ASPAMARD image – I use it many presentations & many people are impressed. The hotspot is a legacy of pre-1972 ocean dumping & the figure is a compilation of ‘all data’ from 1975-1999. It would be wonderful to be able to produce a more recent snapshot (every 10 years would be fantastic).

Medical Physics: Guidelines for clinical training - 3 publications Sub-specialities: Radiation Oncology Diagnostic Radiology Nuclear Medicine Medical radiation physics essential for Quality Assurance Dosimetry Safe Clinical Applications of Ionizing Radiation Review current practices and legislation in radiation medicine (radiation oncology, diagnostic radiology and nuclear medicine) in light of the newly published IAEA BSS. BSS = Basic Safety Standards

Radiation Oncology Treatment Planning Medical Physics Nuclear Medicine Radiology

Distance Assisted Training (DAT) for Nuclear Medicine Professionals 1994 – ongoing Initially developed for NM Technologists in RCA Recent additions more suitable for all in the profession 2009 introduced delivery on-line www.datnmt.org Curriculum: Basic Science to SPECT and PET/CT >900 hours of work-integrated study (16 modules) >800 participants RCA, ARCAL, AFRA and Europe Translated to Spanish, partially Chinese, Korean & French (Turkish in progress) Sustainable training established in many countries

DAT Implementation Introduction of DAT on-line

Key elements of successful training projects: Adaptability - integration with other programs Cost effective - benefits professionals, patients and medical service Sustainability - continuing programs (commitment) - maintaining reviews and updates e.g. meet needs of evolving technology Local Team Management and Support - essential Recognition of achievements - rewards, career enhancement, motivation

Summary: 24 RCA projects in Health Sector since 1984 Distance Learning programs show continuing growth - Tissue Banking - Applied Science of Oncology - Distance Assisted Training in Nuclear Medicine Projects vs Programs - Projects have an end (4 – 5yrs) - Programs ongoing to meet evolving needs and train more people Need for Government and Education Institutional support - successful programs have already shown sustainability - consider integration to current indigenous programs - ‘fill any gaps’ - need for professional recognition as incentives and motivation