Shelley Waugh - Medical Physicist - NHS Tayside
From undergraduate to trainee to qualifed clinical scientist
The first year of training was spent studying an intensive MSc course in Medical Physics at the University of Aberdeen. It covered the theoretical background of various topics such as nuclear medicine, instrumentation, medical computing, ultrasound, Magnetic Resonance Imaging (MRI) and radiation etc. Professional topics such as statistics and ethics were tackled as well as a rigorous course in anatomy…something alien to a physicist! The course finished with a three month research project on the use of functional Magnetic Resonance Imaging and visualisation of the auditory cortex, which I undertook at Ninewells Hospital in Dundee.
After successfully completing the taught course in September 2005, I began vocational training with NHS Tayside, based at Ninewells Hospital in Dundee. This covered three specialist areas: Magnetic Resonance Imaging (MRI), radiation protection and radiotherapy; and consisted of shadowing work colleagues, carrying out practical projects and performing supervised tasks to gain a flavour of the work carried out by medical physicists in healthcare.
Assessment was via written portfolios created during each placement and an oral examination focusing on ability and understanding of the work performed during placements. After successful completion of basic training in 2006, it was time to embark on my final two years of training. These would ultimately lead to state-registration, a required qualification for medical physicists working in the NHS.
MRI as a specialty
My chosen speciality was in MRI. I was drawn to it because of the clinical involvement and expertise that MRI physicists have, as well as the potential opportunity to become involved with clinical development and research.
MRI physicists at our institution are an integral part of the clinical service. Their involvement includes performing all safety assessments of implants prior to MRI examinations, supervising and analysing various clinical examinations for inclusion in patient clinical reports and playing a key role in MRI service development such as aiding the expansion and introduction of new clinical examinations and techniques.
I initially carried out these roles under close supervision then gradually performed them more independently, although still under the supervision of a state-registered physicist.
The most rewarding part of my higher training was my involvement in setting up a Breast MRI service in NHS Tayside. It would serve patients with a predisposed high risk of developing breast cancer and also symptomatic patients to aid clinical decision making. The service later expanded to include breast implants assessment and the monitoring of patients undergoing neoadjuvant chemotherapy for inoperable or locally advanced breast cancer. This was in order to identify patients not responding to treatment and aid earlier management decisions. As physicists, we were responsible for setting up imaging protocols and devising quantitative measures for inclusion on patient reports - work which has led to a service that now benefits over 250 patients per year.
Physicists have many and varied tasks in the MRI environment, and my training required me to become competent in all of these, including teaching medical students, radiographers, other physicists and clinicians.
Training around hardware knowledge, including quality assurance, problem solving, scanner procurement and acceptance testing all formed essential key aspects of my two year placement. I was also supported to attend conferences to improve my communication skills and gain a wider context for the work in which I was becoming progressively more involved.
In December 2008 I secured a permanent position in Dundee and became a state-registered clinical scientist in February 2009.
Working in MRI involves a great degree of clinical development and input into clinical research, and for these reasons I had always been keen to obtain my final qualification.
In October 2009, I began a part time PhD in ‘The Use of Texture Analysis in Breast MRI’. Since I had been so heavily involved in the introduction of the Breast MRI service, the topic of cancer imaging was close to my heart. It involved the analysis of lesion heterogeneity in lesion classification and treatment response assessment, purely based on imaging alone.
I successfully completed my research this year and earned my doctorate. In the course of my research I was again fortunate through forging links with our breast cancer research programme and highlighting the usefulness of physics input in MRI research studies.
The NES training scheme started me on my path from new graduate and guided me through to state-registration. The training was broad and intensive, instructive yet flexible and provided an invaluable opportunity that led me towards a career that is varied, ever-changing and very rewarding.