Medical Physicist Skills Checklist
Answer Key
1. No Experience 2. Requires Supervision 3. Proficient 4. Can Teach Others
Age of Patients
*
Rows
1
2
3
4
Newborn/Neonate (birth to 30 days)
Infant (1 month to 1 year)
Toddler (1 year to 3 years)
Preschooler (3 years to 5 years)
School Age Child (5 years to 12 years)
Adolescents (12 years to 18 years)
Young Adults (18 years to 39 years)
Middle Adults (39 years to 64 years)
Older Adults (64 years to 79 years)
Elderly Adults (over 79+ years)
Experience
General Skills
*
Rows
1
2
3
4
Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Crash Carts
Defibrillators
Basic Clinical Skills in Radiotherapy
*
Rows
1
2
3
4
The Clinical Environment
The Clinical Environment
Clinical Conduct
Chart Checking
Record and Verify Systems
Basic Radiation Safety
Quality Assurance in Radiation Oncology
*
Rows
1
2
3
4
Linear Accelerator Quality Assurance
Acceptance Testing and Commissioning
Measurement Equipment QA
CT Simulator QA
Portal Imaging and kV X-Ray Imaging QA
Cone-Beam CT QA
PET-CT QA
HDR QA
Software Systems QA
Prevention of Technology-Related Errors
Treatment Planning
*
Rows
1
2
3
4
Prerequisites for Treatment Planning
Mark and Start Cases
3D-Conformal Planning
IMRT Planning
Protocols
Secondary Monitor Unit (MU) Checks
Block Cutting
Diodes/TLD
Beam Data Collection, Modeling, and Commissioning
Special Procedures
*
Rows
1
2
3
4
Radiosurgery
LDR Brachytherapy
HDR Brachytherapy
TBI Electrons and Photons
IGRT Methods
Rotational Therapy
Proton Therapy
Health Physics
*
Rows
1
2
3
4
Radiation Safety
Instrumentation for Health Physics Measurements
Shielding Calculations
Isotope Procedures
Certifications
*
Rows
Yes
No
American Board of Radiology
American Board of Medical Physics
The Canadian College of Physicists in Medicine
The American College of Science in Nuclear Medicine
The American Board of Health Physics
Undertaking
*
The Information I Provided is True & Accurate
Name
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
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