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Training, Education, & Staffing: Focus on low & m iddle-incom e countries
( I ndia as a case exam ple)
KA Dinshaw , T.Gupta
& S K Shrivastava
Professor & Head, Departm ent of Radiation Oncology Tata Mem orial Centre, Mum bai, I NDI A
Training, Education, & Staffing: Focus on low & m - - PowerPoint PPT Presentation
Training, Education, & Staffing: Focus on low & m - - PowerPoint PPT Presentation
Training, Education, & Staffing: Focus on low & m iddle-incom e countries ( I ndia as a case exam ple) KA Dinshaw , T.Gupta & S K Shrivastava Professor & Head, Departm ent of Radiation Oncology Tata Mem orial Centre, Mum bai,
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Projections for future (2015-2020)
Doubling of the cancer incidence in next 15 years (WHO) Ageing population with consequent increase in cancer incidence & prevalence (WHO; ICMR; NCRP) Huge shortage of RT infrastructure (equipment and human resource) to meet recommended norms (IAEA; WHO)
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50 100 150 200 250 300 1960 1980 1985 1990 1995 2000 2005 2008
Co-60 LA
U N I T S Co-60 : 2 7 9 LA: 1 1 4
Growth of teletherapy infrastructure in India over the years
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Barton et al, Lancet Oncol 2004
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Radiation Oncology Infrastructure
Gap between demand and supply
Parameter Current Existing Ideal Scenario* (international norms) Practical Recommendation Shortfall
Equipment Tele-density 0.33 per million population 2 per million population 0.5 per million population 0.17 per million Tele-units 393 teletherapy units 2400 600 207 units Personnel Radiation Oncologist 800 (1 per 825 patients annually) 2640 (1 per 250 patients annually) 1320 (1 per 500 patients annually 520 Medical Physicist 550 (1 per 1200 patients annually) 1650 (1 per 400 patients annually) 1320 (1 per 500 patients annually) 770 Dosimetrist Nil 660 (1 per 1000 patients annually) 1 per RT centre 660 RT Technologist 750 (2 per MV unit) 9600 (4 per MV units) 1800 (3 per MV unit) 1050 * I deal scenario ( ACR guidelines) 8 w orking hours per day; 2 5 -3 0 patients per day per teletherapy unit Average: 5 w eeks of XRT treatm ent ( radical & palliative) ; 5 0 w orking w eeks/ year 2 5 0 -3 0 0 patients per teletherapy unit per year; 6 6 0 ,0 0 0 patients need RT every year
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Current RT training infrastructure in India
- Number of recognized MD (Radiation Oncology) seats: 52 per year
- Total number of active/practising Radiation Oncologists: 800 approximately
- Number of Diploma in Radiological Physics pass-outs: 16 per year (average)
- Number of MSc in Medical Physics pass-outs: 17 per year (average)
- Total number of practising medical physicists: 550 only
- Number of seats for training in RT technology: 60 per year
- Number of seats for RT dosimetrists; NIL
- Total number of practising RT Techs: 750 approximately
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Radiation Oncologists
Increase number of centres offering MD-Radiotherapy (secondary & tertiary level) Increase the number of MD-Radiotherapy seats in existing tertiary referral centres Stop running MD-Radiotherapy courses in centres not fully equipped
Medical Physicists
Increase post MSc DRP seats Mandatory 6-month internship for DRP students in tertiary referral centres Introduce and promote PhD courses at tertiary referral centres
Radiotherapy Dosimetrists/Technologists
Increase number of seats in exclusive training courses for RT technologists Introduce training courses for dosimetrists Mandatory 3 mth internship for all RT technologists/dosimetrists in clinical radiotherapy department at either a secondary or tertiary level centre
Manpower: Capacity Building
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Prim ary Referral RT centre Secondary Referral RT centre Tertiary Referral RT centre
Equipment/Infrastructure
Proposed 3-Tier Network
Networking via Tele-Medicine
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Summary for improving radiotherapy infrastructure
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