Revision History


Role

Personnel Requirements/Recommendations

Medical Director

Each program must have a medical director who is a radiation oncologist as described below. He/she is responsible for oversight of the department, including policies, procedures, and personnel. He/she is also responsible for instituting and supervising the CQI program through direct or delegated leadership.

Radiation Oncologist (one of these)

Board Certified in Radiology or Radiation Oncology:

ABR certification in radiology (for a physician who confines his/her professional practice to radiation oncology) or certification in radiation oncology or therapeutic radiology by the ABR, AOBR, RCPSC or CMQ is considered proof of adequate qualification. Radiation oncologists with time-limited board certification must be enrolled in the certifying board’s MOC program and must satisfactorily renew certification in a timely fashion. Those with non-time-limited certificates are strongly encouraged to voluntarily participate in the MOC program.

Board Eligible:

Satisfactory completion of a radiation oncology residency program approved by the ACGME, RCPSC, CMQ, or AOA. For those who are eligible but not yet certified by the date of initial employment, a pathway and timeframe would be defined

 by the individual for him/her to become licensed and certified in accordance with the requirements for board certification at left.

Qualified Medical Physicist

The ACR strongly recommends certification in therapeutic medical physics by the ABR, CCPM or ABMP. Previous medical physics certification categories, including radiological physics and therapeutic radiological physics, are also acceptable.

Radiation Therapists & Simulation Staff

Should fulfill state licensing requirements and be certified or eligible for certification by the ARRT in radiation therapy (radiation therapists or simulation staff) or diagnostic imaging (simulation staff).

Dosimetrist

Should fulfill state licensing requirements and be certified or eligible for certification in medical dosimetry by the MDCB.

Patient Support Staff

Should have appropriate nursing credentials (oncology nursing certification is encouraged), appropriate experience in the care of radiation therapy patients, and access to qualified nutritionists or social workers.

Physician Assistant

Has completed postgraduate education, is currently certified by NCCPA, and has obtained specified licensure in accordance with the state(s) in which he/she practices. CME should be in accordance with NCCPA and state

 guidelines. 

Nurse Practitioner

Has completed postgraduate education in nursing; currently licensed/certified as a nurse practitioner in accordance with the state(s) in which he/she is practicing.

Administrative Support

Administrative staff are valuable for budgeting and managing resources that enable the facility to acquire and maintain the equipment needed for standard treatment practices and QA procedures, and to achieve and sustain clinical staffing levels that assure a safe and effective treatment environment. 

Explanation of Acronyms

ABR: American Board of Radiology                                                                                       

ABMP: American Board of Medical Physics

ACGME: American Council of Graduate Medical Education                                                  

AOA: American Osteopathic Association

AOBR: American Osteopathic Board of Radiology                                                                 

ARRT: American Registry of Radiologic Technologists

CCPM: Canadian College of Physicists in Medicine                                                              

CME: Continuing Medical Education

CMQ: Le College des Medecins du Quebec                                                                          

CQI: Continuous Quality Improvement

MOC: Maintenance of Certification                                                                                         

MDCB: Medical Dosimetrist Certification Board

NCCPA: National Commission on Certification of Physician Assistants                                 

QA: Quality Assurance

RCPSC: Royal College of Physicians and Surgeons of Canada


If the practice site’s medical director, president/CEO or owner changes, the site must submit a new Personnel Summary List and a new Survey Agreement to the ACR.


Staffing Levels

In the final report, the facility’s staffing levels for radiation oncologists, physicists, radiation therapists, and dosimetrists are compared to the accredited facility averages and averages for the facility’s stratum as defined in the following table (updated 7-3-2019). The table allows facilities to identify personnel and equipment utilization issues. Staffing recommendations may be part of the final report; however, variations from these levels generally do not result in the withholding of accreditation unless inadequate staffing levels result in non-compliance with ACR Practice Parameters and Technical Standards and/or compromise patient safety.


While this comparison may be instructive, note that these data are incomplete in some important aspects. The data do not account for other staff duties (e.g. simulation for therapists) nor are the data scaled for complexity or the proportion of different pathologies treated at any given clinic. Each facility should, when comparing their staffing data to stratum and national averages, consider their patient population, range, and complexity of services provided, and any staff duties outside of those assumed in this table.



New Patients Per:

FTE Therapists
Per
Treatment Machine


FACILITY STRATUM

Radiation Oncologist

Physicist

FTE Dosimetrist

FTE Therapist

Treatment Machine

All Accredited Facilities

208

256

259

82

226

3.1

Academic/Comprehensive Cancer Center/Main Teaching Hospital of a Med School

190

195

262

77

281

4.1

Hospital-Based

600 or more patients

272

297

314

100

303

3.1

201-599 patients

222

256

255

82

225

2.9

200 or fewer patients

139

211

186

65

145

2.6

Free-Standing

600 or more patients

300

298

345

101

327

3.4

201-599 patients

230

305

306

94

255

3.0

200 or fewer patients

144

238

212

71

143

3.8



Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

4-1-2020
Staffing Levels
Updated data as of July 3, 2019
7-22-20Staffing Levels
Updated data as of July 2020



Next: QC/QA: Radiation Oncology