2.89.
In medical uses of ionizing radiation, the prime responsibility for radiation protection and safety rests with the person or organization responsible for the medical radiation facility, normally referred to as the registrant or licensee. Almost all the requirements of GSR Part 3 [3] applicable to a medical radiation facility for ensuring radiation protection and safety in medical uses of ionizing radiation place the responsibility on the registrant or licensee (and on the employer, in the case of occupational radiation protection).
2.90.
However, medical uses of ionizing radiation involve a multidisciplinary team led by a health professional who often is not the registrant or licensee of the authorized medical radiation facility. Because of the medical setting in which such exposures occur, primary responsibility for radiation protection and safety for patients lies with the health professional responsible for the radiological procedure, who is referred to in GSR Part 3 [3] and in this Safety Guide as the radiological medical practitioner. The term ‘radiological medical practitioner’ is the generic term that GSR Part 3 [3] uses to refer to a health professional with specialist education and training in medical uses of radiation, who is competent to perform independently or to oversee procedures involving medical exposure in a given specialty. Health professionals that could take on the role of the radiological medical practitioner, depending on the particular use of radiation and on the laws and regulations in a State, include radiologists, nuclear medicine physicians, radiation oncologists, cardiologists, orthopaedic surgeons, other specialist physicians, dentists, chiropractors and podiatrists. More guidance on the health professionals who could be radiological medical practitioners is given in Sections 3–5 and in paras 2.124 and 2.125 on education and training.
2.91.
The net effect of paras 2.89 and 2.90 is that, for medical exposure, the registrant or licensee should ensure all requirements are applied. This normally requires that the radiological medical practitioner ensure a given set of actions take place, usually with the involvement of further health professionals, mainly medical radiation technologists and medical physicists (see paras 2.92 and 2.93, respectively). The medical exposure subsections of Sections 3–5 provide guidance on meeting the many requirements that come under the responsibility of the radiological medical practitioner.
2.92
The term ‘medical radiation technologist’ is used in GSR Part 3 [3] and this Safety Guide as the generic term for a second group of health professionals. A wide variety of terms are used throughout the world for such health professionals, such as radiographer, radiological technologist, nuclear medicine technologist and radiation therapist. In GSR Part 3 [3], a medical radiation technologist is a health professional with specialist education and training in medical radiation technology, competent to perform radiological procedures, on delegation from the radiological medical practitioner, in one or more of the specialties of medical radiation technology (e.g. diagnostic radiology, radiation therapy and nuclear medicine). The medical radiation technologist is usually the interface between the radiological medical practitioner and the patient, and his or her skill and care in the choice of techniques and parameters determines to a large extent the practical realization of the optimization of radiation protection and safety for a given patient’s exposure in many modalities. The medical radiation technologists may also have a role in education and training. More guidance on the roles and responsibilities of medical radiation technologists is given in Sections 3–5 and in paras 2.126 and 2.127 on education and training.
2.93
In GSR Part 3 [3], a medical physicist is a health professional with specialist education and training in the concepts and techniques of applying physics in medicine and competent to practise independently in one or more of the subfields (specialties) of medical physics (e.g. diagnostic radiology, radiation therapy and nuclear medicine). The medical physicist provides specialist expertise with respect to radiation protection of the patient. The medical physicist has responsibilities in the optimization of radiation protection and safety in medical exposures, including source calibration, clinical dosimetry, image quality and patient dose assessment, and physical aspects of the programme of quality assurance, including medical radiological equipment acceptance and commissioning. The medical physicist is also likely to have responsibilities in providing radiation protection and safety training for health professionals. In addition, he or she may also perform the role of the RPO, whose responsibilities are primarily in occupational and public radiation protection. More guidance on the roles and responsibilities of medical physicists is given in Sections 3–5, in Ref. [26], and in paras 2.128 and 2.129 on education and training.
2.94.
There are other health professionals with responsibilities for radiation protection of the patient. These include, for example, radiopharmacists, radiochemists, dosimetrists and biomedical or clinical engineers. Detailed guidance is given in Sections 3–5.
2.95.
For a medical radiation facility, the radiation protection and safety responsibilities outlined above for the radiological medical practitioner, the medical radiation technologist, the medical physicist and other health professionals with responsibilities for patient radiation protection should be assigned through an authorization (or other regulatory means) issued by the radiation protection regulatory body in that State.
2.96.
The RPO is: “A person technically competent in radiation protection matters relevant for a given type of practice who is designated by the registrant, licensee or employer to oversee the application of regulatory requirements” [3]. For a medical radiation facility, the RPO oversees the application of requirements for occupational and public radiation protection, and may provide general radiation protection advice to the registrant or licensee. The RPO has no direct responsibilities or roles with respect to patient radiation protection. An RPO, unless he or she has recognized competence in medical physics, cannot perform the role of a medical physicist with respect to medical exposure.
2.97.
In addition, all health professionals involved in medical uses of ionizing radiation have responsibilities with respect to occupational and public radiation protection. (See the occupational and public radiation protection subsections in Sections 3–5).
2.98
Medical radiation facilities, as they increasingly utilize digital technologies, should ensure access to an IT specialist11 who, through specialized training and experience, has competence in the maintenance and quality control of IT software and hardware. The correct functioning of these systems is crucial for radiation protection and safety.