The scope of practice document has been developed with an eye to a future state under certified national board registration. Whilst this does not impact the content of the clinical competencies and their enabling components, it does influence the scope of the document and the way it is set out. A full scope of practice for the purpose of national registration must include; minimum standards for entry into a training program, a robust training program or assessment methodology for grandparenting/international graduates, a minimum or ‘core’ scope of practice for registered entry into the profession, additional scope of practice that requires further education or credentialling, recency of practice requirements, and clear policy for ongoing professional development to retain registration.
To date, the scope of practice document only includes a minimum scope of practice for registered entry into the profession. Whilst many of the other components are either developed or under development, they have not yet been included into the framework. Further consultation opportunities will be available once the full framework is complete.
Under the National Health Law, AHPRA has several defined categories of registration that are broken into three distinct categories: medical (specialty and general), nursing (RN and EN), and allied health. Under allied health, professions are groups under the management of National Boards. It is anticipated that any future registration of medical physicists, would be placed under the management of the Medical Radiation Practice Board. It is well noted that this Board would need to expand to accommodate the significantly varied needs of our profession. This assumption has been made based on the similarities across areas of work, the small size of our workforce, the fact medical physicists would fall into the defined category of allied health, and the cost associated with the development of a completely new board.
Our scope of practice has been broken into foundational skills that are deemed crucial for the general registration of a medical physicist, and three specialty areas of skills that would allow for extended registration (Radiation Oncology, Radiology and Nuclear Medicine). Extended specialty registration would require both foundational (general) and specialty competencies to be assessed and met through a designated authority using accredited, published policy and process. This separation has been carefully considered and designed to ensure that general registration is possible for our colleagues with diverse professional skill sets that may not specifically fall into the current three defined and assessable training programs.
The newly updated and published ACSPEM curriculums have been used (ROMP/DIMP) in the development of both the foundational and specialty scopes of practice. Foundational competencies were developed using methodology that included core skills identified across the curriculums, and a variety of learning outcomes defined by accredited Australian university medical physicist Masters programs.
It has been noted by Members that the scope of practice includes professional skills outside of the clinical and scientific skills, such as communication, advocacy, leadership and being an educator. These additions have been a strategic inclusion by the ACSPEM Board and PSB. The new curriculums have incorporated the CansMED model of training and assessment, that prioritises professional skills being paramount to the future of health practitioners providing safe, high-quality care. Whilst there are varying degrees of public-facing interactions across the medical physicists’ scope of practice, it was agreed that these skills are integral to the future of the profession and the changing role medical physicists may hold in a multi-disciplinary environment.
All registered professions (including medical specialists) have detailed requirements for professional skills. Typically, allied health scope of practice includes these in their published documents, however medical specialists have a separate and detailed code of conduct that details these in addition to the clinical scopes defined by their medical colleges.
In an inclusive scope of practice document, any role that a medical physicist has (whether public facing or working within a team environment that provides public care) must include the minimum professional competencies expected. It is understood, that for those who are never public facing, there may be expected competencies that are not part of your daily work. This can be said for any of the competencies in the document. The ideology behind the minimum competencies is that at the point of registration, the medical physicist has the skills and capability to meet them.
The new curriculums, which include domains of learning across professional skills, have been mapped to assessments that evidence these competencies. Much work has also been done within ACSPEM on a future grandparenting process to allow for the current workforce to have their professions recognised and registered. ACER (the Australian Council for Education and Research) has been working with the College for some time, providing professional leadership for assessment development across both clinical and professional skills. The College will engage with Members regarding proposed grandfathering processes as it progresses towards its goal of national registration.
A core scope of practice is limited to the minimum skills required into registered entry to the profession. This registration allows for unsupervised practice of those skills that can be indemnified. The registration body requires evidence that at point of registration, a medical physicist has been assessed and deemed competent by the accredited authority. As such, the drafted scope of practice is directly linked to the learning outcomes of the new ACPSEM curriculums.
It is understood that the scope of a medical physicist can be far wider and include additional expert skills that may require a combination of education, training, experience and or supervision. These additional skills can be credentialed as either endorsed registered competencies, or credentialled within hospitals using national guidelines.