Medical Physicist Workforce Study - Health Workforce Australia

Medical Physicist 

Workforce Study 

September 2012

© Health Workforce Australia 

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ISBN: 978-0-9873201-8-6 

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Citation: Health Workforce Australia 2012: Medical 

Physicist Workforce Study

Contents 

1 Introduction ................................................................................................................................. 6 

2 Medical physicists – their role and responsibilities ................................................................. 7 

3 Workforce dynamics indicator methodology ........................................................................ 9 

4 Medical physicist workforce dynamics assessment ............................................................ 11 

5 Context for workforce assessment ......................................................................................... 22 

6 Potential paths forward ........................................................................................................... 28 

Appendix 1 – National Minimum Data Set ................................................................................... 31 

References ........................................................................................................................................ 32 

Medical Physicist Workforce Study 

iii

List of tables 

Table 1: Workforce dynamic indicators ........................................................................................................... 10 

Table 2: ROMPs and DIMPs – summary of workforce dynamics indicators .............................................. 12 

Table 3: Average age workforce dynamic rating assessment, ROMPs .................................................... 13 

Table 4: Average age workforce dynamic rating assessment, DIMPs ...................................................... 14 

Table 5: Training pathway, ROMPs ................................................................................................................... 15 

Table 6: Number of ROMPs intending to retire, 2009 .................................................................................... 15 

Table 7: Replacement rate workforce dynamic rating assessment, ROMPS ........................................... 15 

Table 8: Training pathway, DIMPs ..................................................................................................................... 16 

Table 9: Number of DIMPs intending to retire, 2011 ...................................................................................... 16 

Table 10: Replacement rate workforce dynamic rating assessment, DIMPs ........................................... 16 

Table 11: Vacancy rate, ROMPs, 2006 and 2009 ........................................................................................... 17 

Table 12: Vacancy rate workforce dynamic rating assessment, ROMPs ................................................. 18 

Table 13: Vacancy rate, DIMPs, 2006 and 2009 ............................................................................................. 19 

Table 14: Vacancy rate workforce dynamic rating assessment, DIMPs ................................................... 19 

Table 15: Origin of qualification by year of qualification, ROMPs .............................................................. 20 

Table 16: Dependence on ITPs workforce dynamic rating assessment, ROMPs ..................................... 20 

Table 17: Duration of training program workforce dynamic rating assessment, ROMPs and DIMPs .. 21 

Table 18: Employed ROMPs and DIMPs in Australia, 2006 and 2009 .......................................................... 22 

Table 19: Calculation of DIMP workforce trends with and without intakes .............................................. 26 


iv

List of figures 

Figure 1: Professions survey – ROMPs (including registrars), age by sex, 2008 .......................................... 13 

Figure 2: DIMPs, age by sex, 2011 .................................................................................................................... 14 

Figure 3: ROMPs (including registrars), average weekly hours worked by sex, 2008 .............................. 23 

Figure 4: ROMP workforce projections to 2019............................................................................................... 25 

Figure 5: DIMP workforce trends with and without intakes ......................................................................... 26 


v

1 Introduction 

In 2002, the Report of the radiation oncology inquiry: A vision for radiotherapy 1 was published. The 

aim of this inquiry was to ‘examine and make recommendations on Australia's usage of radiation 

therapy as a cancer treatment modality with reference to current capacity, international best 

practice, clinical efficacy, as well as other cancer treatment modalities’. Within this, the role of 

radiation oncology medical physicists (along with radiation oncologists and radiation therapists) 

was examined. For radiation oncology medical physicists, the inquiry found existing workforce 

shortages, with increasing attrition rates. Recommendations in relation to the workforce included 

better career paths, competitive remuneration and the introduction of a formal training pathway 

(which was subsequently established). 

Since then, concerns have continued in relation to the radiation oncology medical physicist 

workforce. For example, in 2009, a Department of Health and Ageing commissioned review of the 

radiation oncology workforce 2 confirmed a shortage of radiation oncology medical physicists. 

Then, in 2010, the Health Workforce Principal Committee also highlighted a concern about a 

shortage of medical physicists, particularly of diagnostic imaging medical physicists. It was agreed 

that Health Workforce Australia (HWA) would consider this matter. This occurred at the same time 

as the implementation of the cancer care initiatives announced in the 2009 Federal Budget. In 

addition, HWA is concurrently developing a broader National Cancer Workforce Strategy, and the 

radiation oncology medical physicist workforce is incorporated within this work. 

The purpose of this report is to examine the radiation oncology and diagnostic imaging medical 

physicist workforces and highlight if there is cause for concern. Firstly, this report provides an 

overview of medical physics and the specialties within the profession. To examine the medical 

physicist workforces, an assessment is conducted against five separate workforce dynamics 

indicators – the indicators are first described and then the assessment against each is presented. It 

should be noted HWA did not conduct a new data collection to be able to undertake the 

assessments. Rather, existing information about the workforces was used. The assessment is followed 

by information on other key factors to assist in interpreting the significance of the assessment results. 

Finally, potential paths forward are presented. 

1 

Report of the radiation oncology inquiry: A vision for radiotherapy, Commonwealth of Australia, 2002. 

Accessed at http://www.health.gov.au/internet/main/publishing.nsf/Content/health-roi-inquiry-report.htm. 

2 

HealthConsult. Radiation Oncology Workforce Planning. Final Report for Department of Health and Ageing. 

Sydney: HealthConsult, November 2009. 

Medical Physicist Workforce Study 6

2 Medical physicists – their role and responsibilities 

The medical applications of x-rays and radioactivity have given rise to the discipline of medical 

physics. Accordingly, medical physicists are health professionals with specialised training in the 

medical applications of physics. Their work involves the use of: x-rays; gamma rays; electron and 

charged particle beams; neutrons; and radiations from sealed and unsealed radionuclide sources 

in the diagnosis and treatment of human diseases. 

There are three medical physicist specialties – radiation oncology, radiology and nuclear medicine. 

Radiation oncology medical physics pertains to the: 

• therapeutic application of x-ray, gamma rays, electron and charged particle beams, 

neutrons and radiations from sealed radionuclide sources 

• equipment associated with their production, use, measurement and evaluation 

• proper calibration and quality control of equipment used for therapeutic purposes and 

radiation dosimetry. 

Radiation oncology medical physicists (ROMPs), that is, people who practice radiation oncology 

medical physics, design and implement the quality assurance program in radiation oncology. Their 

primary roles are to ensure: therapy radiation doses are delivered accurately; radiation safety of 

patients, staff and the general public; and compliance with relevant regulations and standards. 

Radiology medical physics pertains to the: 

• diagnostic application of x-ray, gamma rays from sealed sources, ultrasound, radio 

frequency radiation and magnetic fields in medical imaging 

• equipment associated with the use of radiation for diagnostic imaging 

• quality of images and radiation dose associated with the use of imaging equipment. 

Nuclear medical physics pertains to the: 

• therapeutic and diagnostic application of radioactive isotopes for medical purposes 

• equipment associated with the production, use, measurement and evaluation of 

radioactive isotopes 

• quality of images and patient dose resulting from the use of radioactive isotopes. 

Collectively, radiology medical physicists and nuclear medical physicists are referred to as 

diagnostic imaging medical physicists (DIMPs). DIMPs play an important role in the quality 

assurance of imaging equipment and ensuring optimum image quality 3 , with the diagnostic 

parameters derived from images paramount in the management of patients’ treatment. 4 DIMPs 

also ensure that radiation exposure from radioactive sources, x-rays and other radiation emitters is 

measured or calculated appropriately for dosimetric and safety purposes. As with ROMPs, the role 

of DIMPs also encompasses the radiation safety of patients, staff and the general public, and 

ensuring compliance with relevant regulations and standards. 

Regulatory responsibilities 

The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) is responsible for 

protecting the health and safety of people, and the environment, from the harmful effects of 

ionising and non-ionising radiation. ARPANSA developed the Code of Practice for Radiation 

3 

For further detail see www.acpsem.org.au. 

4 

Personal communication, John Cormac, September 2011. For further detail see 

www.chemphys.adelaide.edu.au/ medicalphysics. 


Protection in the Medical Applications of Ionizing Radiation (2008) (the Code), a regulatory 

document that covers the practices of radiotherapy, diagnostic and interventional radiology and 

nuclear medicine. The Code identifies that all health facilities using radiation must have access to a 

‘qualified expert’, this being a qualified medical physicist. Specifically, the qualified expert is 

defined as a person who: 

• is qualified in the application of the physics of therapeutic or diagnostic uses of ionizing 

radiation, and 

• has been recognised by the relevant regulatory authority as being able to perform the 

dosimetric calculations, radiation measurements and monitoring relevant to the person’s 

area of expertise. 5 

The qualified expert needs to be available for consultation on optimisation, dosimetry and quality 

assurance; and to give advice on matters relating to radiation protection in medical exposure. In 

addition, for radiotherapy the Code outlines that calibration, dosimetry and quality assurance 

requirements are conducted by, or under the supervision of, a qualified expert. This means each 

health facility using radiation must have access to a medical physicist who ensures that the 

radiation exposure from radioactive sources, x-rays and other radiation emitters is measured or 

calculated appropriately for dosimetric and safety purposes. 

5 

Australian Radiation Protection and Nuclear Safety Agency, 2008. 


3 Workforce dynamics indicator methodology 

HWA has adapted Health Workforce New Zealand’s (HWNZ) medical discipline vulnerability ranking 

method to highlight aspects of the current workforce that may be of concern now and into the 

future. In this method, HWNZ use a traffic light approach to score workforces against four indicators 

(age and trainee numbers, dependence on general registrants, dependence on international 

medical graduates and level of vacancies). Scores against each indicator are then combined into 

an overall rating to demonstrate the vulnerability of the workforce. HWA renamed the method 

‘workforce dynamics indicator’ as the term ‘vulnerability’ has an implied meaning which was not 

appropriate for the assessment being made, and selected the following indicators for scoring. 

• Average age – workforces with a higher average age are of more concern due to the 

potential for higher exit rates (through retirement). 

• Replacement rate – this item calculated the ratio of newly accredited medical physicists to 

workforce exits in a given year. This indicates whether the number gaining accreditation is 

sufficient to replace those presently leaving the workforce. Note: this is an indicator for 

workforce dynamics assessment purposes only and is not intended to guide training 

numbers for the future. 

• Vacancy rate – workforces with a higher percentage of vacancies are of more concern 

due to the inability to fill existing workforce positions. 

• Dependence on internationally trained professionals (ITPs) – workforces with high 

percentages of ITPs are of greater concern due to their dependence on a less reliable 

supply stream (for example, changes in immigration policy may impact on supply, migrants 

may choose to settle in other countries). 

• Duration of training program – the greater the duration of training, the longer it takes to train 

a replacement workforce. 

The indicator range boundaries were selected as an extension of the HWNZ ranking method. In this 

initial development of the workforce dynamics indicator, the ranges for each indicator rating were 

set to be relatively equal, rather than being established using a statistical base. 

Unlike HWNZ, an overall rating is not generated in HWA’s scoring. This reflects the view that the 

focus should be on each individual indicator, and understanding the drivers of the results for those 

indicators, rather than on an amalgamated rating. 

To be able to score against the workforce dynamics indicators, an extensive range of data is 

required. Where a score cannot be allocated due to insufficient data, the indicator is not assessed. 

It should be noted this is a first iteration of the workforce dynamics indicator within HWA. The 

indicators used are basic measures only – ideally as data availability improves, more sophisticated 

measures can be developed. 


Table 1 summarises the workforce dynamics indicator and the score ranges. 

Table 1: Workforce dynamic indicators 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Average age of existing workforce

4 Medical physicist workforce dynamics assessment 

In this section, the ROMP and DIMP workforces are assessed against each workforce dynamic 

indicator. As noted earlier, HWA did not conduct a new data collection to obtain information on 

these workforces. Rather, the assessments have been based on existing information. 

For ROMPs, two key data sources were used. 

1. The Radiation Oncology Workforce Planning Final Report (prepared by HealthConsult in 

2009). This was a review of the radiation oncology workforce commissioned by the 

Department of Health and Ageing, and included both primary data collection (with 80 

percent coverage of the ROMP workforce) and consultations with key stakeholders. 

2. The 2006 and 2009 Round Survey of the Australasian clinical medical physics and 

biomedical engineering workforce, which reviewed the profile, salary levels and number of 

vacant positions in the surveyed workforces. 

For DIMPs, the Round surveys were also key data sources, along with data made available to HWA 

from the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM). 

Summary of indicator results 

A summary of the indicator results for ROMPs and DIMPs is provided in Table 2. Reflecting the fact 

that data availability is greater for ROMPs, each indicator for ROMPs was able to be assessed. This is 

because of the greater focus on the ROMP workforce stemming from the 2002 Report of the 

radiation oncology inquiry: A vision for radiotherapy. 

The ROMP workforce has a low average age (less than 40) and more ROMPs being accredited 

than leaving the workforce (with retirement intentions used as a proxy for exits). Consequently both 

these indicators received the lowest rating in the workforce dynamics assessment, that is, they are 

areas of minimal concern. ROMPs had a vacancy rate of more than 10 percent (receiving the 

highest rating for this indicator, and therefore an area of significant concern), and a medium rating 

for dependence on internationally trained professionals (with approximately 40 percent of ROMPs 

receiving their qualification overseas). 

For DIMPs, one indicator (dependence on ITPs) was not assessed due to data availability. This 

suggests improved data collection is an area for future improvement for this workforce. Of the 

assessed indicators, the replacement rate received the highest rating (and is an area of significant 

concern), with no DIMP accreditations over the period 2006 to 2011. The average age (44 years) 

and vacancy rate (approximately seven percent) indicators both received medium ratings. 

With the majority of the workforce dynamics indicator assessments falling within the medium rating, 

this suggests areas of concern for both the ROMP and DIMP workforces. 


Table 2: ROMPs and DIMPs – summary of workforce dynamics indicators 

ROMPs 

DIMPs 

Average age of existing workforce 

Ratio of accreditations to workforce exits 

Vacancy rate 

Dependence on ITPs 

(ITPs as a percentage of employed practitioners) 

n.a.* 

Duration of training program (years) 

*n.a. not assessed 

As noted earlier, an extensive range of data is required to be able to conduct the indicator 

assessment. With one indicator not able to be assessed for DIMPs, the replacement rate indicator 

using a proxy data item (retirement intentions rather than actual exits) and key data sources for the 

ROMP and DIMP workforces being collected on a different basis, with different data items, there is 

scope for improved data collection. Improvements in data collected would allow for more robust 

and comparable assessments, as well as monitoring and planning. For information, Appendix 1 

contains the Australian Health Ministers’ Advisory Council endorsed national minimum data set 

items along with a proposed data dictionary for medical physicists. 

Average age 

ROMPs 

Average age information was not directly available from either of the ROMP key data sources. 

However, the 2009 HealthConsult report provided an age and sex distribution of the ROMP 

workforce (Figure 1). This showed ROMPs have a relatively young age profile – more than half (54 

percent) were aged less than 40 years, with only 11 percent aged more than 55 years. 

On the basis of the age distribution, the average age of ROMPs in 2009 can be estimated to fall 

within the 35 to 39 year age bracket (the lowest range in the workforce dynamics indicator score, 

Table 3). 


40 

35 

30 

Male 

Female 

Number 

25 

20 

15 

10 

5 

0 

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ 

Age Group (years) 

Figure 1: Professions survey – ROMPs (including registrars), age by sex, 2008 

Source: HealthConsult, 2009 

Table 3: Average age workforce dynamic rating assessment, ROMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 


Number 

10 

9 

8 

7 

6 

5 

4 

3 

2 

1 

0 

Male 

Female 

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ 

Age Group (years) 

Figure 2: DIMPs, age by sex, 2011 

Source: Unpublished data, ACPSEM, November 2011 

With an average age of 44 years, the DIMP assessment for average age falls within the second 

rating. 

Table 4: Average age workforce dynamic rating assessment, DIMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 


ROMPs 

Number of trainees and accreditations 

Table 5 provides an overview of the TEAP training pathway from 2006 to 2011 for ROMPs. New TEAP 

enrolments occurred each year over the period, along with an increasing (but relatively small) 

number of new accreditations. These data are consistent with the funding of fifteen ROMP registrars 

commencing their first year of training in 2010-11 under the Department of Health and Ageing 

Strengthening Cancer Care budget measure. 

Table 5: Training pathway, ROMPs 

2006 2007 2008 2009 2010 2011 

New TEAP enrolments 12 16 18 23 15 15 

Accreditations 0 0 3 2 8 6 

Source: Prof Eva Bezak, Personal communication October 2011 

Workforce exits 

As noted above, exit information was not available for the ROMP workforce. However, the 2009 

HealthConsult survey collected data on ROMPs’ intention to retire, and in the absence of other 

information this measure is used as a proxy. Table 6 shows that at the time of the survey, 16 ROMPs 

(eight percent) intended to retire between 2009 and 2013, with a further 18 (or nine percent) 

intending to retire between 2014 and 2018. Assuming the retirements occur at an equal rate across 

those years, this equates to approximately three people exiting per annum. 

Table 6: Number of ROMPs intending to retire, 2009 

2009-2013 2014-2018 2019 and beyond 

Australia 16 18 143 

Note: Excluding registrars. Source: HealthConsult, 2009 

Using an average of the accreditations over the period 2009 to 2011, the ratio of accreditations to 

workforce exits for ROMPs falls into the lowest rating bracket on the assessment scale (Table 7). 

Table 7: Replacement rate workforce dynamic rating assessment, ROMPS 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Proportion of accreditations to 

workforce exits 

130+% 

110- 

DIMPs 

Number of trainees and accreditations 

For DIMPs, there have only been a small number of nuclear medicine TEAP enrolments in recent 

years, with no enrolments for radiology. There have been no accreditations for DIMPs over the 

period 2006 to 2011 (Table 8). 

Table 8: Training pathway, DIMPs 

New TEAP enrolments 

2006 2007 2008 2009 2010 2011 

Radiology 0 0 0 0 0 0 

Nuclear medicine 2 0 0 4 2 1 (a) 

Total DIMPs 2 0 0 4 2 1 (a) 

(a) Enrolled in Diagnostic Imaging under the TEAP for DIMPs. Source: Prof Eva Bezak, Personal 

communication October 2011 

Workforce exits 

Table 9 provides information on DIMPs’ intentions to retire – with 11 DIMPs intending to retire in the 

next two years (from the time of the survey) and a further three in the next five years. Using the 

same process as was used for ROMPs, that is, assuming the retirements occur at an equal rate 

across those years, this equates to approximately three people exiting per annum. 

Table 9: Number of DIMPs intending to retire, 2011 

In the next 2 years In the next 5 years In the next 10 years 

Australia 11 3 1 

Source: Unpublished data, ACPSEM, November 2011 

With no accreditations, the replacement rate indicator is assessed at the highest rating bracket on 

the assessment scale (Table 10). 

Table 10: Replacement rate workforce dynamic rating assessment, DIMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Proportion of accreditations to 

workforce exits 

130+% 

110- 

ROMPs 

Table 11 provides the vacancy rate for the ROMP workforce. Nationally, there was a relatively high 

proportion of vacancies for ROMPs in both 2006 (14 percent) and 2009 (11 percent). The vacancy 

rate varied substantially across states and territories, ranging from a low of approximately six 

percent in Western Australia to a high of 27 percent in the Australian Capital Territory in 2009. 

Large variability in vacancy rates occurred within states and territories across survey years. For 

example, in the Australian Capital Territory the vacancy rate increased from zero in 2006 to 27 

percent in 2009. This is because of the size of the ROMP workforce, where only a small change in 

the number of vacancies has a large percentage impact. 

ROMP services are provided remotely to the Northern Territory. This is reflected in Table 11 with the 

Northern Territory having no vacancies or positions. 

Table 11: Vacancy rate, ROMPs, 2006 and 2009 

2006 2009 

Vacancies 

Total 

positions (a) 

Vacancy 

rate 

Vacancies 

Total 

positions (a) 

Vacancy 

rate 

State/Territory FTE FTE % FTE FTE % 

NSW 17.0 100.0 17.0 12.0 116.7 10.3 

Vic 7.0 48.3 14.5 4.0 55.6 7.2 

Qld 4.0 31.9 12.5 6.0 44.4 13.5 

SA 0.0 17.8 0.0 3.5 26.5 13.2 

WA 2.0 15.4 13.0 1.0 17.4 5.7 

Tas 1.0 6.1 16.4 0.9 5.9 15.3 

ACT 0.0 4.5 0.0 2.0 7.3 27.3 

NT 0.0 0.0 –– 0.0 0.0 –– 

Australia 31.0 223.9 13.8 29.4 273.8 10.7 

(a) Including vacancies. Source: Round, 2007 and 2010 


As an average across the two survey years, the ROMP vacancy rate was approximately 12 

percent. This falls into the highest range on the workforce dynamic rating scale (Table 12). 

Table 12: Vacancy rate workforce dynamic rating assessment, ROMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Vacancy rate

Table 13: Vacancy rate, DIMPs, 2006 and 2009 

2006 2009 

Vacancies 

Total 

positions (a) 

Vacancy 

rate 

Vacancies 

Total 

positions (a) 

Vacancy 

rate 

State/Territory FTE FTE % FTE FTE % 

NSW 2.0 26.3 7.6 1.0 24.7 0.4 

Vic 0.0 7.1 0.0 0.0 9.5 0.0 

Qld 0.0 15.3 0.0 1.0 16.9 5.9 

SA 0.0 5.4 0.0 2.3 7.9 29.1 

WA 1.0 13.3 7.5 1.0 15.3 6.5 

Tas 0.1 0.7 14.3 0.0 0.0 –– 

ACT 1.0 1.1 90.9 1.1 1.7 64.7 

NT 0.0 0.0 –– 0.0 0.0 –– 

Australia 4.1 69.0 5.9 6.4 76.0 8.4 

(a) Including vacancies. Source: Round, 2007 and 2010 

As an average across the two survey years, the DIMP vacancy rate was approximately seven 

percent. This falls within the third bracket on the workforce dynamics rating scale (Table 14). Please 

note, advice from ACPSEM was that this rating should be at the highest level. They suggested longterm, 

unfilled positions have fallen off the vacancy list, leading to an under-estimation of the 

number of vacancies (and consequently a lower workforce dynamics indicator rating). They also 

suggested there is a shortfall in existing workforce numbers required to provide an appropriate 

quality service. 

Table 14: Vacancy rate workforce dynamic rating assessment, DIMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Vacancy rate

Dependence on internationally trained professionals 

ROMPs 

The HealthConsult survey identified that approximately 40 percent of ROMPs received their 

qualification overseas (Table 15). This proportion was relatively consistent across ROMPs regardless 

of workforce entry year. This indicates there is reliance in the workforce on internationally trained 

professionals. 

Table 15: Origin of qualification by year of qualification, ROMPs 

Workforce entry year 

Before 2000 2000-2004 2005-2009 Total 

Place of qualification no. % no. % no. % no. % 

Australia 51 63.8 24 57.1 29 56.9 104 60.1 

Overseas 29 36.2 18 42.9 22 43.1 69 39.9 

Total 80 100.0 42 100.0 51 100.0 173 100.0 

Note: Excludes registrars and 20 origin of qualification not stated. Source: HealthConsult, 2009 

Based on the information in Table 15, the ROMP workforce falls within the third bracket on the 

workforce dynamics rating scale for dependence on ITPs (Table 16). 

Table 16: Dependence on ITPs workforce dynamic rating assessment, ROMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Dependence on ITPs 0-14% 15-29% 30-44% 45-59% 60+% 

DIMPs 

Information was not available on ITPs for the DIMP workforce, therefore this indicator was not 

assessed. ACPSEM suggested this indicator would fall within the middle assessment ranges based 

on their workforce modelling. 


Duration of training program 

To become a medical physicist, a person must: 

• complete an undergraduate degree with a major in physics 

• obtain a training position at a clinical department 

• apply for a place as a registrar in the TEAP in one of three specialty areas (upon obtaining a 

training position), and 

• complete a post-graduate degree in medical physics, normally at Masters level 

(undertaken concurrently with TEAP completion). 7 

Upon successful completion of the above steps, the ACPSEM accredits a person as a medical 

physicist. 

For the purpose of this indicator, the assessment is based on the post-graduate training time (that is, 

the TEAP), not the entire training pathway. TEAP initially commenced for ROMPs in 2003. It was first 

developed as a response to the 2002 Report of the radiation oncology inquiry: A vision for 

radiotherapy, which recommended the introduction of a formal five-year training program for 

ROMPs. The program was expanded to encompass radiology and nuclear medicine (DIMPs). The 

ACPSEM website notes the TEAP ‘standard program is expected to take four to five years’. For this 

assessment the longest training time is assumed. Therefore, both the ROMP and DIMP rating falls in 

the third bracket on the assessment scale for this indicator. 

Table 17: Duration of training program workforce dynamic rating assessment, ROMPs and DIMPs 

Minimal 

concern 

Significant 

concern 

1 2 3 4 5 

Duration of training program (years)

5 Context for workforce assessment 

While the assessment in chapter 4 highlights a number of areas of concern in both the ROMP and 

DIMP workforces, it is important to understand other factors that may influence the interpretation of 

the assessment. Three additional aspects are presented for information in this chapter: 

• Size and other characteristics of the workforces 

• Demand for ROMPs and DIMPs 

• Workforce projections. 

Size and other characteristics 

Size 

The absolute size of a workforce is not necessarily a measure of concern in itself – how would the 

threshold below which a workforce is considered vulnerable be determined However, when 

combined with other indicators the size of a workforce can contribute to areas of concern. Table 

18 presents the size of the ROMP and DIMP workforces. ROMPs accounted for the majority of 

employed medical physicists in 2009 (78 percent or 244.4 FTE), with DIMPs accounting for the 

remaining 22 percent. The DIMP category was split almost equally between radiology medical 

physicists (32.4 FTE) and nuclear medicine medical physicists (37.2 FTE). 

As can be seen, both workforces (particularly the DIMP workforce) are very small. This means they 

are likely to be more affected by areas of significant concern (highlighted by the workforce 

dynamics indicator) than larger workforces. For example, the ROMP workforce has a high vacancy 

rating. In a sustained period of high vacancies, the impact on the ROMP workforce could be 

expected to be more significant when compared with a larger workforce. This is because the larger 

workforce would have some capacity to absorb high vacancies in the short-term, while 

interventions could be established. 

Table 18: Employed ROMPs and DIMPs in Australia, 2006 and 2009 

Employed (FTE) 

2006 2009 

Radiation Oncology (ROMPs) 192.9 244.4 

Diagnostic imaging medical physicists 

Radiology 25.4 32.4 

Nuclear Medicine 39.5 37.2 

Total DIMPs 64.9 69.6 

Total medical physicists 257.8 314.0 

Source: Round, 2007; Round, 2010 


Average hours worked and gender distribution 

ROMPs 

Figure 3 presents average weekly hours worked by gender for ROMPs. The majority of ROMPs 

worked between 40-49 hours per week, with only small proportions working 50 or more hours per 

week (eight percent) and less than 30 hours per week (six percent). Almost half (49 percent) of 

female ROMPs worked less than 40 hours per week, compared with approximately one-third (32 

percent) of males. 

Figure 1 earlier in this report showed there are approximately equal numbers of male and female 

ROMPs in the younger age groups, with the older age groups dominated by males. Combined with 

the average hours worked results, this will likely have an impact on ROMP supply. 

100 

90 

80 

70 

Male 

Female 

Number 

60 

50 

40 

30 

20 

10 

0 

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70+ 

Average Weekly Hours Worked 

Figure 3: ROMPs (including registrars), average weekly hours worked by sex, 2008 


DIMPs 

Average hours worked information was not available for DIMPs, however it can be assumed that a 

similar pattern of female and male average hours worked would exist, that is, female average 

weekly hours worked are lower than males. Similar to ROMPs, there are also approximately equal 

numbers of male and female DIMPs in the younger age groups (Figure 2, earlier in this report, noting 

also the very small numbers). A similar effect as described above may be expected, with an 

impact on DIMP workforce supply. 

So, being small workforces with increasing female participation (that may impact average weekly 

hours worked), the areas of concern highlighted by the workforce dynamics indicator could be 

expected to affect the ROMP and DIMP workforces more than workforces with greater absolute 

numbers. 


Demand for ROMPs and DIMPs 

If demand for the ROMP and DIMP workforces is not expected to continue, high workforce 

dynamics indicator ratings may be of less concern than if demand is expected to continue or 

grow. In the latter instance, high workforce dynamics ratings may indicate a need for workforce 

intervention. There are two key factors influencing the demand for the ROMP and DIMP workforces 

– increasing incidence of cancer and increasing cancer care infrastructure. 

Incidence of cancer 

According to the Australian Institute of Health and Welfare, the number of new cancer cases more 

than doubled between 1982 (47,350 new cases) and 2007 (108,368 new cases). 8 The incidence rate 

for all cancers combined also increased (by 27 percent) – from 383 cases per 100,000 people in 

1982 to 485 cases per 100,000 people in 2007. 9 

Further to this, Cancer Australia noted in their 2010-11 Annual Report: ‘In 2010 about 115,000 

Australians were expected to be diagnosed with cancer, and by the age of 85 years, one in two 

men and one in three women will have been diagnosed with cancer in their life. Cancer is 

estimated to be the leading cause of burden of disease in Australia, accounting for approximately 

19 per cent of the total disease burden in 2010’. 

Similar concern over the demand for services has been expressed by Victoria with an expected 

increase of over 20 percent in cancer incidence over the next decade 10 . 

From such statements, it can be expected the incidence of cancer will continue, and 

consequently there will be a continuing, if not growing, demand for ROMP and DIMP services. 

Infrastructure 

The 2009-10 Federal Budget included a number of initiatives related to the Cancer Care System. 

New infrastructure announced included national centres at the Royal Prince Alfred Hospital in 

Sydney, the Parkville Comprehensive Cancer Centre in Melbourne and an expansion of the 

Garvan St Vincent’s Cancer Centre in Sydney, plus the building of a network of regional cancer 

centres. This increase in infrastructure will particularly impact on the demand for ROMPs, whose role 

encompasses ensuring that therapy radiation doses are accurately delivered. The impact on DIMPs 

will not be as great, however some increase in demand is expected, reflected in the funding of 

fifteen additional diagnostic imaging training positions. 

Workforce projections 

Workforce projections are a tool to assist with workforce planning. In the context of this report 

workforce projections can be used to highlight any significant anticipated changes to the future 

workforce that may impact on the workforce dynamics assessment. 

ROMPs 

In the 2009 HealthConsult report, a workforce projection was conducted using 2009 as the baseline 

(by age profile), with expected recruitment and estimated attrition rates. Parameters and 

assumptions in the projection included: 

• there would be 97 new registrars in each five year period of the projections 

• 38 percent of Australian patients diagnosed with cancer received radiation treatment (per 

the 2002 Report of the radiation oncology inquiry: A vision for radiotherapy) 

8 

http://www.aihw.gov.au/cancer/. Accessed 2 May 2012. 

9 

Ibid 

10 

Victorian Government. Department of Human Services, Victorian Radiotherapy Service Plan, July 2007. 


• a moderate target to aim to achieve was 45 percent treatment 

• the desired, or best practice treatment rate was 52.3 percent rate. 

Figure 4 presents the supply projection and estimated demand scenarios. In the short to medium 

term, the level of supply remained at the ’no change’ demand level of meeting approximately 38 

percent receiving treatment. This is substantially less than the moderate (45 percent) or best 

practice (52.3 percent) levels of treatment. In the longer term, the projection showed that 

workforce supply, with expected recruitment and estimated attrition, would be sufficient to meet 

the moderate level of treatment (but still below the best practice level of treatment). 

ROMP Workforce Projection 

500 

450 

400 

350 

300 

250 

Supply of ROMPs 

200 

Demand: Best Paractice (52.3% treatment) 

150 

Demand: Moderate (45% treatment) 

100 

50 

Demand: No change (38% treatment) 

0 

2009 2014 2019 

Figure 4: ROMP workforce projections to 2019 


DIMPs 

For DIMPs, a projection series was prepared (Cormack 2011) which provided a workforce supply 

trend if no intake is initiated, and the level of intake that would be required to increase the DIMP 

workforce to a fixed level. The tabulation used and the graphical presentation published in 2011 

are provided in Table 19 and Figure 5. 

This illustrative approach to projecting workforce supply to meet a fixed demand provides an 

indication of the magnitude of the injection of new registrars required (assuming nothing else 

changes). This assists in providing short and medium term directions in the estimation of the number 

of new registrars. 


Year 

Table 19: Calculation of DIMP workforce trends with and without intakes 

Effective 

workforce 

(current 

trend) 

Workforce 

(required) 

Effective 

workforce (a) 

Effective 

registrar 

contribution 

intake 1 (b) 

Effective 

registrar 

contribution 

intake 2 (c) 

Effective 

registrar 

contribution 

ongoing (d) 

Intake of 

experienced 

DIMPs 

2010 64 104 68 4 

Attrition 

Rate 

2011 60 104 68 4 6.5% 

2012 56 104 74 7 4 6.5% 

2013 52 104 87 7 6.33 4 6.5% 

2014 49 104 98 7 6.33 4 6.5% 

2015 46 104 104 6.33 1.33 4 6.5% 

2016 43 104 102 2.66 4.0% 

2017 40 104 102 4 4.0% 

2018 37 104 102 4 4.0% 

2019 35 104 102 4 4.0% 

2020 33 104 102 4 4.0% 

(a) Effective workforce (with recruitment and training strategy) 

(b) Effective registrar contribution intake 1: 21 registrars, starting 2011 

(c) Effective registrar contribution intake 2: 20 registrars, starting 2012 

(d) Effective registrar contribution (ongoing): 4 new registrars per year, starting 2014 

Source: John Cormack, Personal communication May 2011 

Figure 5: DIMP workforce trends with and without intakes 

120 

Required level 

Effective workforce 

100 

80 

60 

40 

20 

With recruitment/training 

strategy 

Current trend 

0 

2008 2010 2012 2014 2016 2018 2020 2022 

Source: Cormack, 2011 

Limitations in the DIMP illustrative projections 

The projection series prepared by Cormack (2011) demonstrated a widening gap between the 

demand and supply of DIMP services. However there are a number of additional factors to 

consider in interpreting the projection series. 


• The impact of the number of new TEAP recruits on the existing workforce. Two major intakes 

of registrars included in the projection would have a major impact of the need for 

supervision from the reducing pool of experienced DIMPs. This would impact on the 

provision of DIMP services. 

• The impact in the changing proportion of female DIMPs. With approximately equal numbers 

of male and females in younger age groups, it can be anticipated that the FTE DIMP 

workforce would fall (due to females historically working less hours than males). 

• The assumption of a fixed level of demand. From recent studies it is evident that demand 

will increase with the expected increase in incidence of cancer and the increase in 

infrastructure. In addition, with changing technology it can be expected that there would 

be an increase in DIMP workload to both implement and maintain these new technologies. 

HealthConsult (2009) identified that more complex technologies will require more staff. 

Notwithstanding the limitations outlined above, the projections suggest that the ROMP and DIMP 

workforces will not increase significantly – the ROMP projections suggest no change in the short to 

medium term and the DIMP projections suggest falling workforce numbers. This indicates the 

workforce dynamics indicator assessment conducted in this report are not likely to be impacted. 

That is, the areas of significant concern are not likely to reduce in the future compared with current 

with the current assessment. 


6 Potential paths forward 

The workforce dynamics indicator assessment, combined with the additional contextual 

information, suggests areas of concern now and into the future for both the ROMP and DIMP 

workforces. As such, consideration of future paths forward for the workforces is appropriate. In 

considering the future pathway, it is important to recognise what is sustainable, and to examine a 

range of options. Applying the response framework adopted for Health Workforce 2025 11 , there are 

four areas of consideration: 

1. Workforce reform and innovation 

2. Reform of training pathways 

3. Increased supply through immigration 

4. Increased supply through domestic training. 

It is likely a combination of all these areas would be required to sustainably move forward. 

Workforce reform and innovation 

Workforce reform and innovation can be used to improve flexibility, productivity and retention. The 

ROMP and DIMP workforces are small and highly specialised professions with a long training 

pathway. As such, it is important they are employed as far as possible on tasks for which only they 

have the training and capability to perform. Other tasks can be safely undertaken by less 

specialised workers, under appropriate guidance and supervision. 

In the case of the medical physicist workforces there is an existing model of this approach – DIMP 

services in Tasmania and the Northern Territory are provided by interstate-based DIMPs, who visit 

regularly to conduct quality control and audit on site technicians 12 . There are also some centres in 

Australia employing medical physics technicians to undertake defined tasks, with discussions also 

occurring more broadly on the role medical physics assistants or medical physics technicians could 

play in easing workforce issues. 13 This suggests there is scope to look at alternative models of 

workforce deployment (also enabled by an existing nationally consistent training program). This 

could reduce the need for the profession to directly undertake tasks, rather, enabling the 

professions to supervise an assistant workforce. 

Such alternative models could have a large potential impact on the requirement for ROMPs and 

DIMPs, and hence on their workforce dynamics rating assessment. 

There is also a high degree of specialisation within such a small overall workforce, with three distinct 

sub-specialties (radiation oncology, radiology and nuclear medicine). An examination of whether 

this degree of specialisation is required may be appropriate. An option could be a more generalist 

medical physicist role, which may be particularly applicable in an environment where the role of 

the medical physicist may be more supervisory than operational. 

The suggestions above encompass both the ROMP and DIMP workforces. The Radiation Oncology 

Reform Implementation Committee (RORIC), responsible for advising on reform initiatives to support 

sustainable access to radiotherapy services, has developed the RORIC Workforce Reform 

Framework. This framework is specific to radiation oncologists, radiation therapists and ROMPs. The 

framework specifies four key areas of reform, one of which is Workforce reform for more effective, 

efficient and accessible service delivery. This is focused on ‘improving the efficient and effective 

utilisation of available workforce, through business process improvements, effective application of 

11 

Health Workforce Australia 2012: Health Workforce 2025 – Doctors, Nurses and Midwives – Volume 1. 

12 

Personal communication, John Cormack, April 2012. 

13 

Communication with HWA, ACPSEM, May 2012. 


new technology, clinical practice improvements and role redesign.’ While there are no specific 

reforms outlined for ROMPs within this, proposals include more actively engaging with stakeholders 

to inform best practice models of care, and that innovative approaches are shared across 

jurisdictions. 

Under the Workforce capacity building and skills development area of reform, advanced practice 

and extended scope of practice are promoted as ways to expand workforce numbers – creating 

positions to perform less specialised tasks currently undertaken by skilled professionals. This is 

consistent with HWA’s suggestion above, and while the framework does not suggest specific 

reforms, it proposes RORIC will provide information on job redesign potential and examine the 

feasibility of the concept (if the proposal is supported). One example already in existence is 

advanced roles for radiation therapists, which included the development and evaluation of a 

radiation engineering assistant role (with the evaluation report currently being written). 

Reform of training pathways 

In line with an approach of a more generalist workforce as outlined above, the existing training 

pathway for medical physicists could be examined – particularly in terms of training posts which are 

currently specific to ROMP and DIMP roles. It should be noted some amalgamation of nuclear 

medicine and diagnostic radiology is already occurring, with the design of the DIMP TEAP taking 

this into account. 

The four to five year training pathway for medical physicists is also relatively long. In a situation 

where the profession is identified as potentially vulnerable it may be appropriate to examine 

whether it is possible to streamline training to reduce the overall length, while maintaining 

appropriate quality standards. 

This is consistent with the RORIC Workforce Reform Framework, which specifically mentioned 

streamlining existing training programs, and for the ROMP workforce in particular, it promoted the 

Queensland approach to training, which reduces the traditional ROMP training time by one year. 

Increased supply through immigration 

The ROMP workforce is already relatively reliant on ITPs (with no information available for the DIMP 

workforce). The continued or increased targeting of overseas supply may be useful in the short-term 

to fill supply gaps, while workforce and domestic training reforms are established. The medical 

physicist occupation is currently included on the general skilled migration skilled occupation list, 

which means overseas medical physicists can apply for a permanent visa in Australia without 

employer sponsorship, and it is also on the employer nomination scheme occupation list. By 

appearing on both these lists, the immigration of medical physicists into Australia is better enabled. 

Increased supply through domestic training 

For ROMPs, the replacement rate indicator is at the lowest workforce dynamics rating level, that is, 

of minimal concern. However for DIMPs, this indicator was at the highest workforce dynamics rating 

level (of significant concern). Therefore it may be appropriate to examine whether additional 

training positions should be created to meet long-term supply issues. Any increase in domestic 

training should only be considered in combination with the options outlined above. This is to ensure 

the opportunity for appropriate reform is not lost by simply taking a ‘more of the same’ approach, 

and that the option (or combination of options) chosen, results in a sustainable workforce and 

training pathway. 

Improved data collection 

In addition to the potential paths forward outlined above, there is scope for improved data 

collection on the medical physicist workforces, particularly for DIMPs. Reflecting the greater focus 


on the ROMP workforce as a result of the 2002 Report of the radiation oncology inquiry: A vision for 

radiotherapy, all indicators for ROMPs were able to be assessed (recognising retirement intentions 

were used as a proxy for exits). A key data source on the ROMP workforce was a detailed data 

collection conducted as part of the 2009 HealthConsult review of the radiation oncology 

workforce. However for DIMPs, no such data source exists and one of the five workforce dynamic 

indicators was not assessed due to data limitations (again also recognising retirement intentions 

were used as a proxy for exits). With key data sources for the ROMP and DIMP workforces also 

being collected on a different basis, with different data items, this indicates there is a need to 

improve the evidence base. Improved data collection would enable monitoring and planning, 

and a collection based on national health workforce data items (refer Appendix 1) would also 

enable comparability with other health professions. 


Appendix 1 – National Minimum Data Set 

The table below provides the Australian Health Ministers’ Advisory Council endorsed national 

minimum data set items. A proposed data dictionary for medical physicists for each of these data 

is included. 

Data item Collection Proposed Data Dictionary 

Sex One-off Male/ female 

Age Derived Month and year of birth 

State/Territory of birth One-off If Australian born 

Country of birth One-off If overseas born, SACC (4 digit code) (a) 

Indigenous status One-off For Australian born 

Residential address Annual Postcode, suburb/ locality 

Permanent residency status Annual If overseas born, No/Yes 

Visa type 

Annual 

1 st qualification One-off 

Year of 1 st qualification 

One-off 

If not permanent resident, category of Visa (or travel 

authority) 

First post-secondary qualification that enables working as 

Medical Physicist 

Country of 1 st qualification One-off If overseas trained, SACC (4 digit code)* 

State/Territory of 1 st qualification One-off If Australian trained 

Additional qualification 

Labour force status 

Hours worked by work location 

Hours worked by work sector 

Hours worked by principal area 

Hours worked by specialty area 

Annual 

Annual 

Annual 

Annual 

Annual 

Annual 

Employed in MP (including on leave for less 3 months) 

Employed in MP but on leave for 3+ months 

Not working in MP – o/s in MP/other employment 

Not working - unemployed /retired 

(If not working in MP in Australia) 

Looking for work in MP in Australia – Yes/No 

Work location – main / 2 nd Annual State/postcode/ suburb/ locality 

Work sector – main / 2 nd Annual Public/ private 

Principal role – main / 2 nd Annual Clinician/ Administrator/ Teaching/ Research 

Specialty area – main / 2 nd Annual Radiation oncology/ Radiology/ Nuclear medicine 

Work setting – main / 2 nd Annual Classification to be determined in consultation with ACPSEM 

Number years worked in MP 

Years intended to remain in in MP 

Annual 

Annual 

(a) ABS. Standard Australian Classification of Countries, Second Edition. Cat. No. 1269.0: 2011 


References 

Australian Radiation Protection & Nuclear Safety Agency. Radiation Protection Series No. 14. Code 

of Practice: Radiation Protection in the Medical Applications of Ionizing Radiation, 2008. 

Baume P. A Vision for Radiotherapy. Report of the Radiation Oncology Inquiry. Canberra: 

Department of Health and Ageing, June 2002. 

Cancer Australia. Cancer Australia Strategic Plan 2011-2014. Sydney: Cancer Australia, 2011. 

 

Cormack J. Editorial: the ACPSEM diagnostic imaging TEAP project. Australasian Physical & 

Engineering Sciences in Medicine 2011; 34: 173-8. 

HealthConsult. Radiation Oncology Workforce Planning. Final Report for Department of Health and 

Ageing. Sydney: HealthConsult, November 2009. 

Health Workforce Australia. Health Workforce 2025 – Doctors, Nurses and Midwives – Volume 1. 

Adelaide: HWA, 2012. 

Radiation Oncology Reform Implementation Committee. Radiation Oncology Reform 

Implementation Committee (RORIC) Workforce Reform Framework. Canberra: Department of 

Health and Ageing, 2011. 

Round WH. A survey of the Australasian clinical medical physics and biomedical engineering 

workforce. Australasian Physical & Engineering Sciences in Medicine 2007; 30: 13-24. 

Round WH. A 2009 survey of the Australasian clinical medical physics and biomedical engineering 

workforce. Australasian Physical & Engineering Sciences in Medicine 2010; 33: 153-62. 

Victorian Government. Victorian Radiotherapy Service Plan, July 2007. Victoria: Department of 

Human Services, 2008. < http://www.health.vic.gov.au/radiotherapy/radiotherapy-serviceplan06-11.pdf> 


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