As a medical physicist, I apply physics methods and concepts to medicine and healthcare, such as radiotherapy, X-ray imaging, and nuclear medicine (the use of radiation to diagnose and treat disease). My duties include performing quality assessments on radiation equipment, conducting risk assessments, and developing standard protocols in Radiotherapy, Diagnostic Radiology, and Nuclear Medicine. I am also responsible for the designs and evaluation of radiation room shielding, the management of radioactive waste, performing radiotherapy treatment plans for patients receiving radiotherapy, and ensuring the radiation protection of patients, hospital staff, and members of the general public.
Currently, there are many shortfalls in radiation medicine in the Caribbean. These shortfalls are mainly due to the lack of regulations and legislation regarding the safe use of ionising radiation (the energy produced from natural and man-made radioactive materials), outdated imaging and treatment equipment, a lack of quality assurance programmes, and an absence of clinically trained medical physicists, partly as a result of brain drain. Across the region, there are only a handful of medical physicists, most of whom only work in radiotherapy. In Barbados, I am one of only two medical physicists specialising in nuclear medicine, with the other providing treatment privately. The quality, safety, and efficiency of patient care are affected negatively due to these shortfalls and thus require urgent attention.
Strengthening human capacities
Over the past two years, I have been working with the International Atomic Energy Agency (IAEA) to improve the current situation of radiation medicine in the Caribbean. I was nominated by Barbados to be a counterpart for one of the IAEA’s regional projects, ‘Strengthening Human Capacities of Caribbean Countries in Radiation Medicine’. The four-year project (2018-2021) aims to build capacity in radiation medicine in Caribbean countries through enhancing continuous professional education and creating and strengthening training programmes for current and new staff. The project focuses on diagnostic radiology, nuclear medicine, and radiotherapy as important tools for the diagnosis, treatment, and management of major illnesses, including non-communicable diseases. As a counterpart for the project, I am responsible for assisting in the design of the project work plan, informing and coordinating changes to current healthcare practice, and working with national institutions at the country level to identify suitable participants for the training. Since the implementation of the project, participants have been involved in expert missions carried out by the IAEA to assess the status of radiation medicine in some Caribbean countries to identify areas for development.
As a result of these missions, the project includes the ongoing identification of sub-regional centres which can be strengthened and transformed into reference centres, which will provide clinical and human resources in radiation medicine and increase the number of patients able to access this type of treatment. As part of the development of sub-regional centres, I have coordinated the development and delivery of regional training courses and workshops to enhance the skills, knowledge, and competencies of radiologists, oncologists, medical physicists, and radiographers, who all play important roles in the safety, quality, and efficiency of patient diagnosis and treatment. Between 2018-2019, three workshops were delivered and provided training to over 65 personnel in IAEA member states within the region. These individuals are now disseminating this knowledge through institutional training, as well as updating and/or implementing standard protocols and policy governing quality, safety, and efficiency in radiation medicine.
I am currently in the process of developing a questionnaire in combination with a tool from the IAEA to assess the status of medical physics in the Caribbean. The results will provide data on the ongoing impact of the project and much-needed data specific to the region.
Key future outcomes
For the remaining two years, further training courses and expert missions are planned to encourage ongoing professional training for current and new staff and assess the impact of this work in delivering quality and safe diagnosis and patient care. Additionally, through the project many hospitals in the region will be presented with quality assurance test equipment to assist in the development of quality control programmes.
Another key outcome of the project within the next two years will be to establish clinical training programmes for medical physicists in nuclear medicine, radiotherapy, and diagnostic radiology. These programmes will ensure the Caribbean region meets the demands of clinically trained medical physicists and enable them to contribute to the enhancement of quality patient care.
While the lack of ionizing radiation regulations and legislation throughout the Caribbean is concerning, the development of radiation safety cultures and best practices will greatly accelerate the improvement of sustainable quality patient care. It is my firm belief that this current IAEA regional project will catapult the Caribbean region in meeting international standards and best practices in the field of radiation medicine.