Part I (written exam) – General Medical Physics

Last Modified – Jan 2018

Contents

Exam Description

The Part 1 – General Medical Physics written exam is intended to test the general knowledge of the basic principles of medical physics.  These are the principles with which all medical physicists should be familiar, regardless of their specialization. Questions will be restricted to basic principles only. The General Medical Physics exam can be taken to satisfy the Part 1 requirement for either the MRI Physics sequence, or the Medical Health Physics sequence.  Detailed questions appear in the appropriate Part II examinations.

The questions in the examination are apportioned by topic as follows.

Examination Content Outline

Note: Under the major headings, bullet points represent examples of topics which may be found in the exam. However, the exam content may not be limited to those topics alone.

Radiological Physics 25%
Radiation Detection and Survey Instrumentation 18%
Biology and Radiobiology 10%
Radiation Protection 20%
Imaging and Other Diagnostic Studies 20%
Radiographic Anatomy 7%

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Radiological Physics (25%)

  1. Radiation Units
    • SI system of units
    • Exposure
    • KERMA
    • Absorbed dose
    • Equivalent dose
    • Effective dose
    • Radioactivity
  2. Atomic and Nuclear Structure
    • Bohr model
    • shell structure
    • electron transitions
    • electron binding energy
    • ionization and excitation
  3. Electromagnetic Radiation
    • electromagnetic spectrum
    • properties of non-ionizing radiation
    • properties of ionizing radiation
  4. Ultrasound
    • Basic principles
  5. Radioactivity
    • mathematics of decay
    • parent-daughter relationships
    • exposure rate constant
    • isotope production
    • modes of decay
  6. Production of diagnostic X-Rays
    • x-ray spectrum
    • x-ray tube
    • x-ray generators
    • modification of the x-ray beam
    • technique factors
  7. Interaction of Photons with matter
  8. Interactions of Charged Particles with Matter
    • collisional
    • radiative
    • range
    • stopping power
    • LET
    • Bragg peak
  9. Neutron Interactions

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Radiation Detection and Survey Instrumentation (18%)

  1. Fundamentals of Radiation Detectors
    • General principles of operation
    • Ion chambers
    • Geiger-Mueller
    • Scintillation
    • Gamma well detectors
    • Other
  2. Dose Measurements
    • general Bragg-Gray theory and principles
    • stopping power ratio principles
  3. Dosimeters
    • TLD
    • OSL
    • self-reading dosimeters
  4. Principles of Bioassay

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Biology and Radiobiology (10%)

  1. The Cell
    • basic structure
    • function
    • proliferation
      1. phases of cell cycle
      2. cell cycle time
      3. enzymes
      4. sensitivity
  2. Chromosomes
    • DNA and replication
    • chromosomal aberrations
  3. Basic Genetics
    • genes
    • genetic mutations
  4. Radiation Chemistry
    • direct / indirect actions
    • protectors and sensitizers
  5. Cell Survival Curves
    • basic target and L-Q theories
  6. Dose Response
    • statistical nature of dose-response curves
    • sublethal damage and repair
  7. Acute Radiation Syndrome
    • hematopoietic
    • LD50
    • gastrointestinal
    • latent period
    • CNS syndrome
  8. Radiation Carcinogenesis
    • human data
    • relative and absolute risk models
    • latent period
    • BEIR reports
  9. Radiation Cataractogenesis
    • ocular lens
    • dose response
    • cataracts
  10. Radiation Effects on Embryo/Fetus
    • gestational age versus time of exposure
    • teratogenesis
    • radiation carcinogenesis

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Radiation Protection (20%)

  1. Sources of Human Exposure
    • natural sources
    • medical and other sources
  2. Regulatory Agencies
    • NRC
    • EPA
    • Agreement states
    • FDA
  3. Non-governmental standards and organizations
    • TJC
    • NCRP
    • ICRP
  4. Radioactive Sources
    • storage and transportation
    • leak testing
  5. Surveys
    • basic methodology
  6. Principles of External Radiation Protection
    • time
    • distance
    • shielding
  7. Internal Radiation Protection
    • internal radiation hazards
  8. Hazards of Non-Ionizing Radiation
    • Lasers
    • MRI hazards
  9. Statistics
    • Samples, sample surveys
    • Observations
    • Random Sampling
    • Frequency Distributions
    • Mean, Standard Deviations
    • Normal (or Gaussian) Distributions
    • Test of Hypothesis
    • Binomial and Poisson Distributions
    • Regressions

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Imaging and Other Diagnostic Studies (20%)

  1. Resolution and Contrast
    • modulation transfer function
    • line spread function
    • film contrast
    • line pairs
    • basic principles of MTF & LSF
    • phosphors
  2. Screens
    • resolution
    • modification of H&D curves
    • effect on image quality and dose
    • mottle
  3. Noise
    • signal-to-noise ratio
    • model structured and statistical grids
    • scatter
  4. Image Formation – subject contrast as related to:
    • density
    • atomic number
    • energy spectrum
  5. Fluoroscopy
    • basic principles of digital systems
    • basic principles of luminescences
    • Image Intensification
      1. design
      2. brightness
      3. flux gain and minification
      4. dose
  6. Radiography
    • general equipment
    • imaging considerations
  7. Basic Principles of:
    • angiography
    • Computed Tomography (CT)
    • tomography
    • mammography
  8. Nuclear Medicine
    • basic principles
      1. uptake
      2. scanning
      3. emission tomography
      4. radionuclides
    • instrumentation and basic performance checks
    • applications
    • hazards
  9. Magnetic Resonance (Imaging and Spectroscopy)
    • basic principles
      1. nuclear magnetic resonance
      2. relaxation times
      3. chemical shifts
    • instrumentation
    • applications
    • hazards
  10. Clinical Ultrasound
    • basic principles
      1. propagation of sound
      2. generation and detection
      3. interactions in tissues
      4. uses of Doppler shift
    • instrumentation
    • applications
    • hazards

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Radiographic Anatomy (7%)

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Sample Questions (of Types A, B, K, and S)

TYPE A

The average annual collective dose equivalent in mSv from natural sources (excluding radon) to the population in the USA is about:
A. 0.1
B. 0.5
C. 1.0
D. 2.0
E. 3.0

TYPE B

Match the property (1-4) with the appropriate particle (A-E):
A. Proton
B. Neutron
C. Electron
D. Neutrino
E. Pion

(B) 1. Has the greatest mass
(E) 2. Has rest mass of 140 MeV
(B) 3. Has no charge and rest mass of 939 MeV
(A) 4. Electron capture reduces the number of these in the nucleus

TYPE K

Within hours of receiving a nearly lethal whole body dose of radiation an individual is likely to experience acute radiation syndrome symptoms which include:

1. nausea and diarrhea
2. convulsive seizures
3. severe fatigue
4. loss of hair

A. (1,2,3 only)
B. (1,3 only)
C. (2,4 only)
D. (4 only)
E. (All are correct)

TYPE S

A variable X is determined by making a series of measurements of two independent variables Y and Z with variances 10 and 5 and mean values 100 and 50, respectively.

1. If X=Y+Z, then the variance of X is:
A. 5
B. 7.5
C. 15
D. 75
E. 125

2. If X=Y-Z, then the variance of X is:
A. 5
B. 7.5
C. 15
D. 75
E. 125

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Suggested References

Textbooks

  1. Allisy-Roberts, P., Williams, J., Farr’s Physics for Medical Imaging, Elsevier, 2nd edition, 2007, ISBN 978-0702028441
  2. Bushberg, Seibert, Leidholdt and Boone, The Essential Physics of Medical Imaging, Philadelphia: Lippincott Williams & Wilkins, 3rd Edition, 2013, ISBN: 978-0781780575
  3. Cherry, S.R., J.A. Sorenson, and M.E. Phelps, Physics in Nuclear Medicine, Philadelphia: Elsevier Saunders, 4th edition, 2012. ISBN 978-1416051985
  4. Huda, W., Review of Radiologic Physics, Philadelphia: Lippincott Williams & Wilkins, 4th edition, 2016, ISBN 978-1496325082

NATIONAL COUNCIL ON RADIATION PROTECTION & MEASUREMENTS (NCRP) REPORTS

  1. NCRP Report 116 – Limitation of Exposure to Ionizing Radiation, Bethesda, MD: NCRP (1993)
  2. NCRP Report 147 – Structural Shielding Design for Medical X-Ray Imaging Facilities, Bethesda, MD: NCRP,  (2004)
  3. NCRP Report 149 – A Guide to Mammography and Other Breast Imaging Procedures, Bethesda, MD: NCRP,  (2004)
  4. NCRP Report 155 – Management of Radionuclide Therapy Patients, Bethesda, MD: NCRP, (2006)
  5. NCRP Report 160 – Ionizing Radiation Exposure of the Population of the United States, Bethesda, MD: NCRP, (2009).
  6. NCRP Report168 – Radiation Dose Management for Fluoroscopically-Guided Interventional Medical Procedures, Bethesda, MD: NCRP, (2010)
  7. NCRP Report 174 –  Preconception and Prenatal Radiation Exposure: Health Effects and Protective Guidance, Bethesda, MD: NCRP, (2013)
  8. National Council on Radiation Protection and Measurements. Program Presentations No.43 – Advances in Radiation Protection in Medicine (2007). https://www.ncrppublications.org/index.cfm?fm=Product.ViewPDF&pdf=2007%20Annual%20Meeting%20Presentations.pdf&type=free
  9. National Council on Radiation Protection and Measurements. Program Presentations No. 48 – Emerging Issues in Radiation Protection in Medicine, Emergency Response, and the Nuclear Fuel Cycle (Medical Section only) (2012). https://www.ncrppublications.org/index.cfm?fm=Product.ViewPDF&pdf=2012%20Annual%20Meeting%20Presentations.pdf&type=free

OTHER REPORTS & GUIDANCE DOCUMENTS

  1. American College of Radiology, Disaster Preparedness for Radiology Professionals, Response to Radiological Terrorism: A Primer for Radiologists, Radiation Oncologists and Medical Physicists, version 3, 2006.  https://aapm.org/pubs/reports/DisasterPreparednessV3.pdf
  2. American College of Radiology, ACR Practice Guideline for Imaging Pregnant or Potentially Pregnant Adolescents and Women with Ionizing Radiation, 2013.  https://www.acr.org/-/media/ACR/Files/Practice-Parameters/pregnant-pts.pdf
  3. American Association of Physicists in Medicine. AAPM Report 181: The Selection, Use, Calibration, and Quality Assurance of Radionuclide Calibrators Used in Nuclear Medicine. College Park, MD: AAPM, 2012 . https://www.aapm.org/pubs/reports/RPT_181.pdf
  4. Applying Radiation Safety Standards in Nuclear Medicine.   http://www-pub.iaea.org/books/IAEABooks/7116/Applying-Radiation-Safety-Standards-in-Nuclear-Medicine
  5. Code of Federal Regulations (CFR): Title 10 CFR Parts 19, 20, 35  https://www.nrc.gov/reading-rm/doc-collections/cfr
  6. Communicating Radiation Risks in Pediatric Imaging: Information to Support Healthcare Discussions about Benefit and Risk –  http://www.who.int/ionizing_radiation/pub_meet/radiation-risks-paediatric-imaging/en/
  7. Diagnostic Radiology Physics: A Handbook for Teachers and Students (Chapters 1-3, 15.6, 20-22, 24) – http://www-pub.iaea.org/MTCD/Publications/PDF/Pub1564webNew-74666420.pdf
  8. Federal Guidance Report No. 14 Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures, November 2014.  https://www.epa.gov/sites/production/files/2015-05/documents/fgr14-2014.pdf
  9. Nuclear Medicine Physics: A Handbook for Teachers and Students (Chapters 1-6, 20)  – http://www-pub.iaea.org/MTCD/Publications/PDF/Pub1617web-1294055.pdf
  10. Radiation Protection in Medicine: Setting the Scene for the Next Decade –  http://www-pub.iaea.org/MTCD/publications/PDF/Pub1663_web.pdf
  11. US Nuclear Regulatory Commission, NUREG-1556. Consolidated Guidance about Materials Licenses. Volume 9, Program-Specific Guidance about Medical Use Licenses. Revision 2.   https://www.nrc.gov/docs/ML0734/ML073400289.pdf
  12. U.S. Nuclear Regulatory Commission, Washington, DC, January 2008.US Nuclear Regulatory Commission, Safety Culture Policy Statement, NUREG/BR-0500, March 2015.  https://www.nrc.gov/docs/ML1506/ML15062A478.pdf