Australas Phys Eng Sci Med DOI 10.1007/s13246-015-0342-9

REVIEW

Brief histories of medical physics in Asia-Oceania W. H. Round1 • S. Jafari2 • T. Kron3 • H. A. Azhari4 • S. Chhom5 • Y. M. Hu6 • G. F. Mauldon7 • K. Y. Cheung8 • T. Kuppusamy9 • S. A. Pawiro10 L. E. Lubis10 • D. S. Soejoko10 • F. Haryanto11 • M. Endo12 • Y. Han13 • T. S. Suh14 • K. H. Ng15 • A. Luvsan-Ish16 • S. O. Maung17 • P. P. Chaurasia18 • M. A. Jafri19 • S. Farrukh20 • A. Peralta21 • H. J. Toh22 • A. C. Shiau23 • A. Krisanachinda24 • S. Suriyapee24 • S. Vinijsorn25 • T. C. Nguyen26

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Received: 10 February 2015 / Accepted: 30 March 2015  Australasian College of Physical Scientists and Engineers in Medicine 2015

Abstract The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socioeconomic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and

there is a danger than it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.

& W. H. Round [email protected]

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Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan

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School of Medicine, Sungkyunkwan University, Seoul, Korea

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The Catholic University of Korea, Seoul, Korea

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University of Malaya Medical Centre, Kuala Lumpur, Malaysia

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Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia

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Yangon General Hospital, Yangon, Myanmar

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B. P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal

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Pakistan Organization of Medical Physics, Karachi, Pakistan

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Atomic Energy Medical Centre, JMPC, Karachi, Pakistan

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Department of Health, Manila, Philippines

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Radiation Oncology Centre, Mount Elizabeth Hospital, Singapore, Singapore

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Department of Medical Physics, Koo Foundation Sun YatSen Cancer Center Hospital, Tapei, Taiwan

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Chulalongkorn University, Bangkok, Thailand

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Siriraj Hospital, Mahidol University, Bangkok, Thailand

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Unit of PET-CT and Cyclotron, Cho Ray Hospital, Ho Chi Minh City, Vietnam

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School of Engineering, University of Waikato, Private Bag 3105, Hamilton 3240, New Zealand

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Kabul Medical University, Kabul, Afghanistan

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Peter MacCallum Institute, Melbourne, Australia

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Department of Medical Physics and Biomedical Engineering, Gono Bishwabidyalay, Dhaka, Bangladesh

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Calmette Hospital, Phnom Penh, Cambodia

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Cancer Institute, CAMS, Beijing, People’s Republic of China Formerly Queen Elizabeth Hospital, Hong Kong Special Administrative Region, People’s Republic of China Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region, People’s Republic of China

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Medical Physics Division, Dr. Kamakshi Memorial Hospital, Chennai, India

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Physics Department, University of Indonesia, Kota Depok, Indonesia

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Physics Department, Bandung Institute of Technology, Bandung, Indonesia

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Keywords Medical physics  Hospital physics  Medical technology  History

The International Organization for Medical Physics in Asia-Oceania Kin Yin Cheung The medical physics profession in the Asia and Oceania region started as early as 1930s when the first hospital physicists were appointed to support radiology services in Australia and New Zealand. Since then the profession was gradually introduced in the clinics in other countries with different pace and scale as governed by the development of radiation medicine in the respective countries. Apart from those practicing in Australia and New Zealand, there was a lack of opportunity for interaction or communication amongst the medical physicists in the region. With very few exceptions, collaboration amongst the medical physicists from different countries was basically non-existent in the early years. The International Organization for Medical Physics (IOMP) brought some changes in the networking of medical physicists in the early 1980s. With the stimulation and guidance of IOMP, more medical physicists were forming their own national professional societies and became members of the Organization. Medical physicists in the region have established personal links through participation in IOMP organized activities such as the World Congress on Medical Physics & Biomedical Engineering (WC). WC 1991 which was held in Kyoto, Japan helped bringing together leaders of Asian medical physics and fostering the idea of forming a regional medical physics organization. The largest impact on promoting the collaboration of the medical physicists in the region came in year 2000 when the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) and South-East Asia Federation of Organizations in Medical Physics (SEAFOMP) were formed and became Regional Organizations of IOMP. For the first time, medical physicists in the region were formally linked-up and worked together on professional and scientific issues. Since then, a formalized collaborative framework has been established in raising the standard of practice and professional status of medical physicists in the region. They have established their own series of annual conferences in the region, which provide the platforms needed for interaction and sharing of scientific knowledge and experience amongst themselves. They support each other on education and training of medical physicists, including support of medical physicists from developing countries to attended conferences and training. In collaboration with IOMP, they are developing an international

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system for accreditation of medical physicist certification boards. Through IOMP, they have expanded their collaborative network to beyond Asia to work with medical physicists from different parts of the world in promoting our profession.

The South East Asia Organization for Medical Physics Anchali Krisanachinda The South East Asian Federation of Organizations for Medical Physics (SEAFOMP) is a regional chapter of the International Organization of Medical Physics (IOMP). It comprises of seven member countries, namely Indonesia, Malaysia, Philippines, Singapore, Thailand, Brunei and Vietnam. Medical physicists from the ASEAN region come under this organization with a mission to promote cooperation and communication between medical physics organizations in the region leading to advancement in status and standard of practice of the medical physics profession in this region [1–5]. SEAFOMP has been organizing a series of congresses to promote scientific exchange and mutual support. The South East Asian Congress of Medical Physics (SEACOMP) was held respectively in Kuala Lumpur (2001), Bangkok (2003), Kuala Lumpur (2004), Jakarta (2006), Manila (2007), Ho Chi Minh City (2008), Chiang Mai (2009), Bandung (2010), Bohol (2011), Chiang Mai (2012), Singapore (2013), Ho Chi Minh City (2014) and will be in Yogyakarta (December 2015). The education and training of medical physics is started in Thailand, Philippines, Malaysia, Indonesia and Vietnam respectively. The number of graduated medical physicists in 2014 was about 800. The clinical training of medical physicists under IAEA RAS 6038 started in 2007 in Thailand in radiation oncology, 2010 in Philippines in diagnostic radiology and 2011 in Thailand in nuclear medicine. Malaysia started radiation oncology medical physics training in 2012 and diagnostic radiology medical physics in 2013. SEAFOMP will develop accreditation for medical physics academic programs and clinical training in ASEAN region in the future.

The Asia-Oceania Federation of Organizations for Medical Physics Adapted from AFOMP web site The AFOMP was founded on May 28, 2000. IOMP, particularly with the initiatives of Professors Colin Orton and Gary Fullerton and members of its Science Committee

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played an important role in promoting the formation of its Asian regional chapter. On October 5, 1999 during the International Conference on Medical Imaging, Medical Physics and Precision Radiation Therapy in Guangzhou, China, Dr. Ito and Dr. Kwan Hoong Ng (Malaysia) organized a meeting with representatives from China, Hong Kong, Japan, Korea, Malaysia, and Thailand to exchange ideas on scientific collaboration and on the possibility of formation of a regional medical physics organization. The second meeting of the physicist representatives in the Asia and Oceania regions was held on May 28, 2000 during the 2nd Beijing International Congress on Medical Radiation Physics in Beijing. The meeting was attended by representatives from Australasia, China, Hong Kong, Indonesia, Korea, Singapore, and Taiwan. The meeting voted unanimously in favour of forming a regional medical physics federation and the name chosen was Asia-Oceanic Federation of Medical Physics Organizations. Shortly after the Beijing meeting the medical physics organizations in Bangladesh, Philippines, Japan, Malaysia, and Thailand also became members of the Federation. During the Chicago World Congress in 2000, the Medical Physics Association of India also became a member, and the Federation held its first Council Meeting. The meeting elected Dr. Kin Yin Cheung as President of the Federation, Barry Allen the Vice-President, Akira Ito the Secretary General, and Anchali Krisanachinda (Thailand) the Treasurer. The meeting also adopted a new name for the Federation, namely The AFOMP. On July 26, 2000 at its Council Meeting in Chicago IOMP officially admitted AFOMP to be one of its Regional Chapters. AFOMP is charged with the important task of promoting medical physics in the Asia and Oceania regions. The Federation has been and will continue to working closely with its member organizations, IOMP and other national and international organizations on matters such as development of professional status and standard, medical physics service and service standard, education and training of physicists, and scientific meetings and exchanges. AFOMP, at its second AFOMP Annual Council Meeting held in November 2001 in Bangkok during the 1st Asia-Oceania Congress of Medical Physics, established three committees namely Professional Development Committee, Education & Training Committee and Scientific Committee to work on these important tasks. Among their first tasks were drafting of a set of common regional definitions and standards on the roles and responsibility of a medical physicist, professional and quality standards, manning scale and manpower requirements, and the organization and support of training events and training development.

Afghanistan Shakardokht Jafari Medical physics in Afghanistan started in 1967, when a cobalt-60 radiotherapy unit was installed with the support of International Atomic Energy Agency (IAEA) with the presence of Paul Luzinci and Estrofski at Aliabad Teaching Hospital in Kabul. The radioactive source (5000 curies) was provided by the IAEA. Dr. Abdul-Rahman Salim, a radiologist who graduated in France, Dr. Malik Asghar and Eng. Abdul-Malik Malik were the core of an expert team. In 1991, a set of brachytherapy needles was brought from the Bhaba Atomic Research Centre in India, for the treatment of gynaecological cancers. But, in 1992, an unwanted war destroyed the health infrastructure including the Cobalt Therapy Center in Afghanistan (Fig. 1a). In 2002, IAEA managed to secure the abandoned cobalt-60 source [6–11]. However the brachytherapy sources were still left in the ruins of the hospital and were later secured in 2007 by another IAEA mission. Afghanistan resumed the connection with IAEA in 2003 and in 2005 a mission from IAEA visited Kabul and invited a delegation from Kabul Medical University (KMU) to Vienna. As a result, a project entitled ‘‘Establishment of Radiation Oncology Center in Kabul Medical University (AFG/6/012)’’ was approved to be funded by the IAEA. In August 2007, an IAEA mission that included Dr. Farshid Farhan (an oncologist), Mr. Ramin Jaberi (a medical physicist) and Junous Balla (an engineer) visited KMU to evaluate the reconstructed radiotherapy building (Fig. 1b) and interview nominated candidates for training. Mrs. Shakardokht Jafari, an assistant lecturer in the Radiology Department, participated in this mission as a KMU counterpart to this project. For this mission, 11 trainees were selected and have been sent for training as follows: • •

• •

Four radiation oncologists were sent to Turkey and Egypt for a full postgraduate program. Three medical physicists (Mr. Qasem Sadeqi, Mr. Musa Joya and Mrs. Shakardokht Jafari) were sent to UK to do an MSc medical physics program follow by a 9-month hospital placement in the UK and Turkey. Three radiographers were sent to Turkey and Iran for hospital placements and BSc courses. One biomedical engineer went for training at Seibersdorf Radiation Laboratories for 6 months.

The good progress of this project led to the approval of two further projects under title ‘‘Establishing a Radiology Diagnostic Centre for Ali Abad Teaching Hospital & Establishment of Brachytherapy’’.

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Fig. 1 a Old Kabul 60Co bunker in 2005. Traces of bullets are visible on the wall (left side of photo) b Refurbished building in 2008

All three medical physicists commenced their training program with the MSc. in Medical Physics at the University of Surrey, UK, in the 2010–2011, academic year and all graduated with Distinction. After the MSc. program, Mrs. Jafari was awarded an overseas research scholarship for a Ph.D. program from the Medical Physics Department of University of Surrey and stayed in the UK to accomplish her further education and hospital placement in the Radiotherapy Department of Royal Surrey County Hospital. She is currently in final year of her study. Mr. Sadeqi and Mr. Joya both received clinical medical physics training in the Radiotherapy Department of the Ege University Hospital, Turkey, and both returned to KMU in November 2012. At the moment they are employed by KMU and helping with the teaching and radiotherapy infrastructure preparation.

X-ray images in the big city of Melbourne (Professor Thomas Rankin Lyle at University of Melbourne), the industrial town of Newcastle (railway engineer Walter Drowley Filmer) and the country town of Bathurst (Father Joseph Slattery) [12]. Their discoveries and developments were honoured in a stamp by Australia post in 1996 (Fig. 2). The further history of applications of ionising radiation in medicine had its ups and downs, as everywhere in the world, with the first ‘hospital physicists’, Wellington (Melbourne) and Harper (Sydney) being employed in 1935. The medical physics community grew and was for many years closely associated with the UK Hospital Physics Association. In 1977, the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM, http:// www.acpsem.org.au/) was founded with Kenneth Clarke as Foundation President [13]. Since then the organisation and medical physics has grown considerably and ACPSEM represents now about 500 medical physicists working in Australia and New Zealand. An important milestone was the introduction of an accreditation scheme for medical physicists more than 20 years ago which by now has developed into a full training and education program in radiotherapy and diagnostic imaging physics. Other achievements are the publication of a professional journal (Australasian Physical and Engineering Sciences in Medicine) which started more than 30 years ago and the holding of annual scientific conferences (Engineering and Physical Sciences in Medicine) which attract regularly 300 or more attendees. Medical physicists in Australia are mostly employed in hospitals and provide a wide range of services to radiation oncology, diagnostic radiology, nuclear medicine and other areas. There are several active research groups and six universities in Australia are offering a masters program in medical physics. While the challenges of professional

Australia Tomas Kron X-rays have been used in Australia since 1896 when three persons from very different background commenced taking

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Fig. 2 Australia Post stamp depicting three X-ray pioneers in Australia

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recognition remain, medical physicists in Australia find themselves in a good position to provide and improve services to patients and develop new applications for physics in medicine.

Bangladesh Hazin Anupama Azhari In Bangladesh, medical physics education started in 1994 at the Physics Department of the Bangladesh University of Engineering and Technology (BUET). In 1996, promotion of and seminars in medical physics were started in Bangladesh with the cooperation of the Task Group 16 ‘‘Medical Physics in the Developing Countries’’ of the German Society for Medical Physics (DGMP). Five seminars/workshops were organized from 1996 until 2000 (Fig. 3), involving 70–80 participants each year. A major purpose of these seminars was to inform and to motivate the physicists to become medical physicists. As a result, the Bangladesh Medical Physics Association (BMPA) was founded in 1998. In 2009, another medical physics professional organization, the Bangladesh Medical Physics Society (BMPS), was formed. The first impetus to start a medical physics department in Bangladesh came from the time that BMPA was founded. In 2000, the Department of Medical Physics and Biomedical Engineering (MPBME) was founded at Gono Bishwabidyalay (University) in Savar, Dhaka. It was founded by Professor Dr. Golam Abu Zakaria, a Bangladesh-born medical physicist living in Germany and also the initiator of the above seminars. This was the first attempt to establish masters and bachelors courses in medical physics and biomedical engineering. Up to now it is the only fullyfledged department in Bangladesh. The syllabus of these courses is based on the documents of DGMP, AAPM and

Fig. 3 Participants in the Medical Physics Seminar in 1999

IAEA and covers all important aspects of medical physics [14, 15]. A collaboration program between Gono University and Heidelberg University was implemented in June 2002. With the financial support from the German Academic Exchange Service (DAAD) about 20 students and teachers have received education and training in the Department of Medical Radiation Physics at the German Cancer Research Centre (DKFZ) in the years 2003 to 2006. These trainees are considered the pacemakers of cancer treatment in Bangladesh. The Department of MPBME provides a highstandard education in medical physics and biomedical engineering in collaboration with many renowned national and international institutes and radiotherapy hospitals. Presently 150 students are registered. A good number of students have already passed with masters or bachelors degrees. The graduates are working either as medical physicists in radiotherapy departments of most public and private cancer hospitals, or in teaching and medical-technical companies. The establishment of medical physics and biomedical engineering education in Gono University is a successful and directive story for Bangladesh. Just recently, in 2013, another new department was started in the Bangladesh University of Heath Sciences in Dhaka.

Cambodia Sakborey Chhom The first radiotherapy department was established on 2003 at the Khmer-Soviet Friendship Hospital in Phnom Penh. It was equipped with a second hand Co-60 unit, an LDR brachytherapy unit, a second hand simulator and a second hand 2D treatment planning system and some physics tools for quality assurance. The physics staff involved in the establishment of the department were Daniel Taisant, Piere Aletti, Sakborey Chhom and Um Kosal. Initially France provided assistance to set up radiotherapy through Cancerologue Sans Frontie`re and Physicien Me´dical Sans Frontie`re, and Sakborey Chhom and Um Kosal were trained in radiological and medical physics in France. Now there are four physicists: Sakborey Chhom and Um Kosal are still at the radiotherapy centre while Ath Vannyath is training in Malaysia and Sann Chanthou Bopha is training in France. Currently the National Cancer Center is being established in Calmette Hospital in Phnom Penh. The construction of the oncology building will be finished by mid2015 where 3 linear accelerators, a simulator, an HDR brachytherapy unit, a PET/CT, a gamma camera and a SPECT unit will be installed. However, in order to move

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from 2D to 3D CRT, IMRT, IGRT and Cyberknife, the radiation therapy team needs further training in advanced technology and techniques in radiotherapy process as well as nuclear medicine.

Peoples’ Republic of China Yimin Hu Diagnostic X-ray imaging was introduced to China shortly after the discovery of X-rays by Roentgen [16] (Fig. 4). Later, in the early 1930s, radiation treatment centres were established almost simultaneously in Beijing, Guangzhou and Shanghai. The Sino-Belgian Radium Institute was the most prominent having had two 180 kV X-ray units installed as well as having 1 g of radium tubes and needles available [17]. Chinese medical physics was pioneered by Professor Xu Haichao who worked with an American medical physicist, Professor Marvin Williomus, in the 1940s in the Peking Union Medical College (PUMC) by using a 400 kV X-ray unit to treat cancer patients. Until 1964 and after, there was a move by the Ministry of Higher Education to assign postgraduates from physics and physics-related science departments of comprehensive universities to the radiotherapy centers in hospitals in China to meet the big demand for cancer patients’

treatments. Medical instrumentation was also being developed at this time (Fig. 5). In 1981, Professor Kuang Hua-chun and co-workers in medical physics at Liu Pu advocated the establishment of China Society of Biological Engineering Medical Physics Branch [18]. The Medical Physics Branch became China’s national member organization of IOMP in 1986. It started to published a journal, Medical Physics, which became the China Medical Physics Journal in 1993. Modern medical physics development was expanded by sending hospital physicists to the USA and Europe for academic exchanges, and by organizing national and international medical physics conferences, seminars and medical physics training programs, etc. Training of medical physicists has improved with Beijing University, Tsinghua University and Wuhan University and other colleges and universities setting up medical physics graduate education programs. But education and training must now be enhanced by setting up medical physics residency programs and more graduate programs in larger centers, and for that a strict accreditation system needs to be set up. In 2011, the Ministry of Education and the State Council of China recognized the medical physicist as a professional. This will further speed-up the development of medical physics in China.

Hong Kong Geoffrey Mauldon and Kin Yin Cheung The first recorded installation of an X-ray machine in Hong Kong was in 1910 at the private Nethersole Alice Ho Mui Ling Hospital.

Fig. 4 The first Siemens X-ray machine installed in China 1899

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Fig. 5 A B-mode ultrasound scanner produced in Wuhan, China in the early 1960s

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The first radiotherapy machine installed was a 400 kVp Maximar located at the Queen Mary Hospital (QMH) in 1938 and brought into service in early 1939. The radiologist in charge at QMH was Dr. F. J. Farr from the UK. The first medical physicist in Hong Kong was Mr. G.F. Mauldon who was on temporary and later became permanent secondment from the Peter MacCallum Clinic (now a hospital) in Melbourne, Australia (Fig. 6). Diagnostic and therapeutic nuclear medicine procedures were introduced within two years of Mr. Mauldon’s arrival. Six medical physicists were later added to the department over a period of time. Training of medical physicists in the early days was mainly carried out informally on an in-house arrangement. Some of them were sent to the UK for more comprehensive training. The second major hospital, the Queen Elizabeth Hospital, was opened in 1963 while the radiotherapy service commenced in 1964 with two 6 MeV linear accelerators and one 35 MeV betatron (Asklepitron) (Fig. 7) and five medical physicists. Medical physics continued to develop as the number of radiology and radiotherapy centres grew. Hospital medical physicists were also responsible for legislative enforcement of the radiation ordinance and territory-wide personal radiation dose monitoring until the 800 s when the Radiation Health Unit (RHU) was established. Currently there are 11 radiotherapy centres in Hong Kong with 6 of them operated by government funding and the rest operated by private hospitals and a total of about 80 active clinical medical physicists. Two medical physicist societies have been formed, one in 1985 and one in 2012 mainly for the purpose of promoting medical physics in different sectors of radiation medicine and training of medical physicists, including professional certification and continual professional development.

Fig. 6 Hong Kong’s first medical physicist, Geoffrey Mauldon

Fig. 7 Hong Kong’s 35 MeV betatron

India Thayalan Kuppusamy The medical use of radiation had started in India, soon after the discovery of X-rays. The first X-ray tube came to Madras (1900) to the Government General Hospital (GGH). The X-ray department was headed by Rao Sahib M. Govindarajulu Naidu (1909), and later by Capt. T.W. Barnard (1920), who started The Madras Government Institute of Radiology in 1934 (Fig. 8). They initiated the first cancer treatment in 1924 with a 200 kV, X-ray unit at Chennai. This center offered the first postgraduate diploma in radiology (DMR) and the first one-year certified radiological assistant (CRA) course for technologists (1936). In 1913, Col Vaughan used radium in Ranchi, which was made as Radium Institute (1920) and then shifted to Patna Medical College (1928). The first medical physics department was started (1956) at the Cancer Institute, Adyar, Chennai, which acquired the first telecobalt unit (1956, Eldorado A) and the first linear accelerator (1976, Clinac 4). Arthur Ponnaiah (1934) served as first physicist at the GGH, Chennai. Dr. Ramaiah Naidu (1936) served as chief physicist at the Tata Memorial Hospital, Mumbai (Fig. 9). This was followed by Dr. Cyril Jayachandran (1955) at the Christian Medical College, Vellore and Dr. K. S. Chandrasekar at the Cancer Institute, Chennai, as physicists. The first radiological measurement laboratory, headed by Mr. P. N. Krishnamoorthy (1959), was established, under the Atomic Energy Establishment at Mumbai, to ensure radiation protection on a country-wide basis. It offered services including, personnel monitoring, surveying of medical X-ray units and development of measuring devices. Later it was reorganised as Directorate of Radiation Protection (DRP) in 1963 and the Atomic Energy Regulatory Board (AERB) in 1983.

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started a 2-year M.Sc. Medical Physics course in collaboration with the Cancer Institute, Adyar, Chennai. As of today there are about 20 centres offering such programs. A one-year internship was made compulsory for medical physicists (2013) and the RSO examination is conducted by the Radiological Physics and Advisory Division (RPAD), BARC, duly certified by the Atomic Energy Regulatory Board (AERB). The Association of Medical Physicists of India (1976) and the College of Medical Physics of India (2008) are working together to uplift the status of medical physics in India. One of our members, Dr. U. Madhavanath served as president of IOMP. To date there are about 350 cancer centres with about 260 linear accelerators, 237 telecobalt units, and 265 HDR brachytherapy units, with 800 medical physicists. Still the number is inadequate for the Indian population of 1.2 billion. The present momentum and growth rate reveals that we are not far away to reach our goal.

Indonesia Fig. 8 The Barnard Institute of Radiology (Madras Government Institute of Radiology), 1934

Fig. 9 Dr. Ramaiah Naidu, Tata Memorial Hospital, Mumbai

The first radiological physics training program was started (1962) at the Bhabha Atomic Research Centre (BARC), Mumbai, as a postgraduate diploma, under a collaboration with WHO. It was later (1972) affiliated to the University of Bombay. In 1981, the Anna University

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Supriyanto Pawiro, Freddy Haryanto, Lukmanda Lubis and Djarwani Soejoko A medical physics service started in 1950s with the first cobalt machine at the National General Hospital, by Dr. Cipto Mangunkusumo, Jakarta. At the time, the medical physics service was provided by the National Atomic Energy Agency (BATAN). In the 1980s, linear accelerator and brachytherapy machines were installed in Indonesia. To answer the need for medical physicists in hospitals, the Ministry of Health together with Diponegoro University set up extension program to train radiographers to become medical physicist in 1985. Formally, medical physics education in Indonesia started with an undergraduate program in physics majoring in medical physics at the University of Indonesia in 1998. The program was extended with a Master of Medical Physics program in 2002. Nowadays, five universities offer a Bachelor of Medical Physics program and 3 universities offer a Master of Medical Physics program. Medical physics in Indonesia was formally recognized by a Decree of the Ministry of Health in 2007 and endorsed by the government in 2008. Now, most medical physicists are radiation oncology medical physicists servicing 23 radiotherapy centres with 20 linac machines, 16 cobalt units, and 1 Gamma Knife machine. Most medical physicists in hospitals is have a bachelor degree in physics and only 12 medical physicists hold a master degree in medical physics. A few medical physicists serve in diagnostic radiology and nuclear medicine departments. Unfortunately most diagnostic radiology departments do not have a medical physics

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infrastructure, but the National Nuclear Regulatory Agency has released a regulation that diagnostic radiology departments the operate CT scanners and interventional radiology should have a medical physicist.

Japan Masahiro Endo Soon after the discovery of X-rays in 1895, Japanese industry started to manufacture X-ray equipment and introduced them to hospitals around 1900. The medical physics profession started to develop in 1934 when the Cancer Institute obtained 5 g of radium with a donation of one million yen (approximately ten billion yen the current prices). The Institute employed physicists at first in parttime and later in full-time roles. After the World War II, the application of radiation to medicine progressed with new technologies such as the cobalt-60 teletherapy unit and the scintiscanner being introduced. Physicists started working in radiology to solve problems with regard to these new technologies [19] (Fig. 10) and founded the Japan Society of Medical Physics (JSMP) in 1961 as a sub-organization of Japan Radiological Society (JRS) [20]. At first, Japanese medical physicists introduced new technologies, and established a traceability system of absorbed dose standards for high-energy radiation therapy. Later, as well as introducing western technologies, several original technologies, such as a large-field-of-view scintillation camera, were developed. The number of medical physicists grew to about 700, and JRS and JSMP started to certify physicists in 1987. Medical physicists then concentrated on basic research and development because they mainly belonged to universities and research institutes. In this period, intensive research on particle therapy and PET was undertaken, which resulted in the construction of the HIMAC (Heavy Ion Medical Accelerator in Chiba) (Fig. 11), several proton therapy facilities and commercial PET devices. However, during this time research medical physicists did not have a close relationship with clinical practice. With the development of high-precision radiotherapy such as IMRT, the number of clinical medical physicists increased rapidly and strengthened the relationship between basic research and clinical practices. Intensive 4D imaging and therapy research was carried out, resulting in Toshiba’s Aquillion One (Area Detector CT) and Mitsubishi’s Vero4DRT in collaboration with the manufacturers. Several guidelines were published to carry out QA for high-precision radiotherapy.

Fig. 10 An Aloka B-mode ultrasound scanner, 1960

Japanese medical physicists will continue not only to develop new modalities for radiation diagnosis and therapy in collaboration with manufacturers, but also to make best use of new technologies in clinical practice in the future Fig 12. JSMP has been independent from JRS since 2000. Since then the number of members has grown rapidly to approximately 2100. There are several reasons for rapid growth in the last decade. One reason is that importance of medical physics has been recognized because the several radiotherapy accidents occurred due to lack of QA around the year 2000. In 2009 JSMP organized the Japanese Board of Medical Physics (JBMP) with JRS, where JBMP is the new organization certifying medical physicists in Japan. JSMP publishes the Japanese Journal of Medical Physics (JJMP) four times a year. Because JJMP is published mainly in Japanese, JSMP has published Radiological Physics and Technology (RPT) in English since 2008 with the Japanese Society of Radiological Technology (JSRT) twice a year.

Korea Youngyih Han and Tae-Suk Suh The Korean Society of Medical Physics (KSMP) was founded in 1990. Over the last 20 years, KSMP has extended to have several sub-organizations such as the Korean Society of Medical Physics for Radiosurgery, the Korean Council of Nuclear Medicine Imaging and

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Australas Phys Eng Sci Med Fig. 11 The HIMAC at Chiba

Fig. 12 Korea National Cancer Center, Proton Therapy Facility [21]

Instrument etc. KSMP publishes its quarterly official journal, Progress in Medical Physics. The KSMP administers an accreditation program for medical physicists based on the standard of internationally well-established organizations. As for the education program in Korea, there are more than 6 universities that offer postgraduate medical physics programs. After completion of a postgraduate education, clinical training can be obtained through a hospital-based residency. Currently, there are only two KSMP-accredited

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medical physics residency programs while some other programs are under review for KSMP approval. Since 1991, the Certifying Examination Committee for Medical Physics of KSMP has administered the certification examination for medical physicists. The certification examination consists of written, practical and oral sections. As of 2013, there are 70 certified medical physicists. Most are in the field of therapeutic radiological physics (63), with small numbers in diagnostic radiological physics (3) and nuclear medicine physics (3). The certification of medical physics has not yet been officially recognized by the government. Therefore, the objective of KSMP is to get endorsement of certification from the government. Medical physics in Korea continues to grow rapidly, in both members and mission. One of major roles of KSMP is to support collaboration with international organizations of medical physics in the Asia-Oceania region, North America and Europe. Since the establishment of KSMP, it has been making an effort to improve the status of medical physicists in Korea, and to develop the collaboration with related organizations. Since 1996, the Korea-Japan Joint Meeting on Medical Physics has been held six times triennially in Korea (3 times) and Japan (3 times). The past six Joint Meetings were successful and have made a significant contribution to promote research activities in

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medical physics among two societies, while offering a great opportunity of cultural exchange between KSMP and JSMP. Furthermore, KSMP organized the AOCMP (AsiaOceania Congress on Medical Physics) twice (2002, 2006) and the World Congress on Medical Physics and Biomedical Engineering (2006) in Korea. KSMP will strengthen the educational, training and professional development of medical physicists by addressing legislative and regulatory issues. Another important strategy to promote the professional status of medical physicists is to enhance research opportunities and research funding. The final important mission is strengthening the relations with other nations’ medical physics organizations. Increased exchange of knowledge and information with other countries will promote the advancement of medical physics in each country.

Malaysia Kwan-Hoong Ng Just as in many other developing countries, medical physics started with a few physicists serving in radiotherapy and nuclear medicine. The 60s was a humble beginning with a handful of physicists and now more than 50 medical physicists have been trained. Recognition of the profession was almost non-existent then. However situation has improved considerably. In 1991, the Malaysian Institute of Physics, Radiation and Medical Physics Subgroup, was officially accepted as a member of IOMP during the 16th World Congress on Medical Physics and Biomedical Engineering held in Kyoto, Japan. The inaugural SEACOMP (South-East Asian Congress of Medical Physics) was successfully held in Kuala Lumpur, April 2001. In September 2004 Kuala Lumpur hosted the 3rd SEACOMP and 4th AOCMP (Asia-Oceania Congress of Medical Physics). The growth and expansion of medical physics was spurred by more students graduating from the two masters courses run by the University of Malaya and the Universiti Sains Malaysia. It should be pointed out that there two other associations have been formed to serve different needs. Furthermore, the introduction of advanced and complex medical technology, development of regulations, along with training provided by the IAEA have also contributed to the progressive expansion, upgrading and recognition of medical physicists.

Mongolia Ajnai Luvsan-Ish Until the 19900 s, Mongolian medical technical engineers were mostly trained by the former Soviet Union. In addition, the Mongolian National Technical University trained some medical engineers under its electrical engineering degree program, and the Mongolian Medical College had an associate degree for radiology technicians. Today, seven large universities are run by the state in Mongolia. Graduates of three of these universities work as medical equipment engineers, medical IT specialists, radiologists and other health-related technical specialists. The Health Sciences University of Mongolia offers a bachelors degree in Health Information Technology. The Mongolian University of Science and Technology offers a Bachelor’s degree in Medical Equipment Engineering. The National University of Mongolia offers a Bachelor’s degree in Nuclear Physics. The nine largest hospitals that are run by the state have their own Technical and Engineering Departments. These departments employ medical equipment engineers and medical IT engineers. There is no official position for medical physicists in hospitals. Medical doctors, researchers, radiologists, medical equipment engineers and medical IT specialists cooperatively share the role of medical physicists. Mongolian Society of Medical Physics and Informatics was established in 2003 and became a member of the IOMP and the AFOMP. Today, our society has nineteen members. Our delegates participated in the 2003 Sydney and the 2006 South Korea World Congresses on Medical Physics and Biomedical Engineering. Society members periodically receive the Medical Physics World journal. In Mongolia, medical doctors, pharmacists, and nurses get licenses after passing licensing board exams. We are planning to prepare and license professional medical physicists from medical doctors, medical equipment engineers and medical IT specialists. So, it is important for us to send our specialists for short and long-term studies to developed countries, especially member countries of the Asia-Oceania Federation of Organizations for Medical Physics. Also, we need to bring professionals to teach and lecture to our specialists. In order to officiate and license medical physicist specialists in Mongolia, we will convey knowledge, discussion and experience gained from congresses to our State Health Department and other government officials.

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Myanmar Soe Oo Maung Medical physics in Myanmar started with the establishment of the Radiotherapy Department at the Yangon General Hospital in 1958. The sole treatment machine was a Co-60 Theratron Junior. Initially the staff consisted of two oncologists (Drs Cunningham and Bennett), a physicist (Ray Dash) and a technologist (J. Goodall). But from 1960 the Department had its own local staff. The first local Myanmar physicist was Ku Aung Gyi who trained in Canada and Germany. He was followed by other Myanmar physicists trained in Canada, U.K, Germany and India as there was no local medical physicist training in Myanmar. They had bachelor or master degrees in physics from the local university. Currently, there are only 4 physicists in Myanmar—one in each of the Myanmar’s radiotherapy centres. All of them had short-term overseas training sponsored by the IAEA. Currently the treatment facilities in Myanmar are limited to a linac and two Co-60 units in Yangon (Fig. 13), a linac and two Co-60 units in Mandalay, a linac in Naypyitaw, and a Co-60 unit in Taunggyi.

Nepal Pradumna Prasad Chaurasia The need for a medical physicist post in Nepal was first identified when a decision was made to start a radiotherapy service in 1990 at the Bir Hospital Kathmandu. Nepal started using ionizing radiation for cancer treatment in 1991 with the installation of the first telecobalt machine. Now there are 4 radiotherapy centres with a total of 3 telecobalt machines, 3 linear accelerators, 2 simulators and 4 HDR brachytherapy machines in Nepal. The B.P. Koirala Memorial Cancer Hospital (BPKMCH) is a national cancer center where 2D, 3DCRT, IMRT and HDR brachytherapy are done. In 2012, about 4200 patients received radiotherapy in Nepal. According to the WHO–IARC Globocan, there is a need for 11,200 new patient treatments. Now there are 8 medical physicists in hospitals and one in a diagnostic radiology teaching faculty. As yet, there are no female medical physicists in Nepal. The Nepalese Association of Medical Physicists (NAMP) was formally registered in 2009 to promote the medical physics profession. Nepalese medical physicists have participated in many colleges on medical physics organized by the Abdus Salam International Center of

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Fig. 13 Opening of the Varian iX accelerator at Yangon General Hospital

Theoretical Physics in Italy. It also associates with the Association of Medical Physics of India and the BMPS. NAMP successfully organized a Symposium on Medical Physics on the occasion of International Day of Medical Physics in 2013. There is a trend to appoint MSc physics or medical physics graduates and train them to be medical physicists. It is high time to start a formal postgraduate medical physics course or accredited residency in Nepal to meet the national demand. Professional recognition and accreditation is essential. Justification of the uses of ionizing radiation in human health, abreast with new advanced technologies in therapeutic and diagnostic imaging clinical application are challenging in Nepal. Only doing clinical routine medical physics work will not be enough, and research and education is also important. The IOMP accepted the application of P. P. Chaurasia to represent Nepal in IOMP functions in 1998. Nepal became a member of the IAEA in 2008, but still there is no regulatory body in Nepal. Self-regulation based on best practices developed internally is the key to successful integration of technology by ensuring highest quality without compromising on safety. Radiology departments with techniques such as CT and MRI, nuclear medicine facilities and radiology teaching departments must appoint a medical physicist.

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New Zealand Howell Round Medical radiation was introduced to New Zealand in 1896 when a doctor, William Hosking, imported X-ray equipment shortly after Roentgen discovered X-rays [22] (Fig. 14). He later imported some radium to treat his wife’s breast cancer. His poor radiation protection practices lead to his death. By 1930, four radiotherapy departments had opened, and a radon plant was set up at Wellington Hospital, but no physicist was employed. In 1933, the first medical physicist, John Strong, was employed, based at Victoria University in Wellington, to quality assure all of the medical X-ray equipment in New Zealand. He joined the British radar research team during World War Two, and unfortunately was killed in an air accident while testing equipment. Following World War Two, the first hospital physicist to be appointed was Warren Sinclair in Dunedin. He was eventually sent to the UK for further training, but did not return to New Zealand. Over the next two decades physicists were appointed in all six of the major government hospitals where radiotherapy and nuclear medicine services were established [23]. Over the last decade three private radiotherapy centres have also been established, each of which employs medical physicists. In 1983 an MSc degree in Medical Physics was offered by Otago University in Dunedin, but it eventually was discontinued. An MSc in Medical Physics at Canterbury University, Christchurch, was established and accredited in 2003 as the first MSc degree in the Australasian College of Physical Scientists and Engineers in Medicine’s new Training, Education and Accreditation Program.

Fig. 14 An early X-ray set in Palmerston North, New Zealand, circa 1914. Shielding? What shielding? What do you need that for?

There are now approximately 80 clinical medical physicists practicing in New Zealand. They were initially represented by the NZ Hospital Physicists Association and eventually by the Australasian College of Physical Scientists and Engineers in Medicine.

Pakistan Mishkat Ali Jafri and Salman Farrukh The Pakistan Atomic Energy Commission (PAEC) pioneered nuclear medicine in Pakistan, starting its first nuclear medicine centre in 1960 in Karachi where, apparently, no medical physicist was available at that time. Later, in 1962, Pakistan’s first radiotherapy unit was installed in the Jinnah Postgraduate Medical Centre Karachi. In 1963, other nuclear medicine diagnostic centre was established at Lahore and, in 1965, a nuclear medicine/ radiotherapy centre was established at Jamshoro. With the emergence of other nuclear medicine and radiotherapy centres, the Centre of Nuclear Studies, Islamabad (currently known as Pakistan Institute of Engineering and Applied Sciences–PIEAS) arranged post graduate courses in medical physics in late 1970s, mid-1980s and mid1990s. The era of linacs in Pakistan was started with the installation of a Varian linac at NORI Hospital in Islamabad in 1985. Various new medical centres were developed in the public and private sectors with the latest and advanced modalities throughout the country from that time. In 2001, PIEAS initiated a two-year postgraduate program in medical physics which is recognized by the IAEA and IOMP. The program is composed of lectures, lab demonstrations and hands-on training on medical equipment like LINACs, simulators, TPSs, etc. PIEAS also offers a PhD program in medical physics. A medical physics graduate program has not been available at any other university. However, a few universities have occasionally offered special courses in medical physics. Until late 2009, when there was a growing number of medical physicists as well as the addition of new modalities, the physicists wanted to have recognition as competent professionals. Also the medical physicists who wished to apply for international training/educational program were facing the problem that there was no such platform for them to help or channel such activities. It’s never too late, so to the foundation of medical physics forum was done with the name of ‘‘Pakistan Organization of Medical Physicists (POMP)’’ on 12th June, 2010 when a group of physicists of 05 Medical Centers met at Sindh Institute of Urology and Transplantation (SIUT), Karachi. Soon after its formation, POMP actively worked on its

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mission to advance medical physics in Pakistan by disseminating scientific and technical information; fostering educational and professional development of medical physicists. Pakistan now has very wide range of old and modern equipment, from planar gamma cameras, Co-60 units, 2D treatment planning systems up to PET cyclotrons, a Gamma Knife, a Cyber Knife, IMRT and IGRT modalities. As far as medical physics education in concerned, few medical centres have in-house training programs for newly-recruited medical physicists. Furthermore, short training courses are also being conducted for medical physicists’ professional development. More than a dozen training courses were conducted in 2012–2013. A structured training program and CPD in medical physics has yet to be established.

Philippines Agnette Peralta Radiation oncology medical physics (ROMP) began in the Philippines in 1963 when the IAEA sent a British medical physicist, Dr. Harold Cook, to the Philippine General Hospital because the hospital had acquired a cobalt 60 radiotherapy unit. He trained on-the-job Mr. Luciano Niguidula, considered to be the first Filipino medical physicist. Afterwards, three Filipinos were sent overseas to study medical physics but only one of them, Eulinia Valdezco of the then Philippine Atomic Energy Commission (PAEC), returned for good to the country. In 1974, the Radiation Health Office was created in the Department of Health (DOH). Its first director, Dr. Celia Anatalio, who is considered the ‘Mother of Medical Physics’ in the Philippines, was crucial in the establishment in the University of Santo Tomas Graduate School (USTGS) of the master’s degree program in medical physics in 1981. It was established as a joint project of the DOH, the PAEC, and the USTGS with technical assistance from the IAEA. The program has produced more than a hundred graduates, majority of whom have remained in the country. In 2010, the Philippine Board of Medical Physics, Section of ROMP, held the first certifying board examination in ROMP. The second ROMP board examination was given in 2012. The first diagnostic radiology medical physics DRMP certifying board examination was held in October–November 2013. The Philippines recently participated in the pilot implementation of the IAEA clinical training modules in ROMP and in DRMP. The first batch of ROMP residents graduated from this program in 2011. A second batch of

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ROMP residents is undergoing residency. The first batch of DRMP residents completed their residency in August 2013.

Singapore Hong Jin Toh The history of medical physics in Singapore is closely related to the development of the diagnostic and therapeutic radiology. Use of diagnostic X-rays started as early as 1913 in Singapore. Records show that the use of X-ray therapy started in 1923 and radium needles/tubes were acquired in 1930 for therapeutic purposes [24]. A radiotherapy department was started in Singapore in 1949 with a G.E. 400 kV X-ray machine followed by the installation of a 140 kV superficial unit. The first hospital physicist was employed in around 1953. The department operated in a few rooms in the X-ray block of the Singapore General Hospital (SGH). The department moved to a new separate building in 1967 with 2 cobalt machines and one caesium machine installed. A diagnostic X-ray machine was used as a simulator. Dr K C Tsien was the IAEA consultant who helped with the dosimetry and planning work. The dose measurements were done with a Victoreen R-meter and a Baldwin Farmer dosimeter. By the early 1970s, there were four physicists employed by the radiotherapy department. They were all local graduates with honours degrees in physics who received on-thejob training in renowned radiotherapy centres in the UK and the USA. The IAEA/WHO helped with the funding for the training. The physicists also covered the nuclear medicine service which was then under the charge of the head of the radiotherapy department. There were a Picker rectilinear scanner and a few Geiger and scintillation counters used by nuclear medicine. The first gamma camera, an Ohio Nuclear, was later acquired in 1975. The physicists also helped in the QA of machines in the diagnostic X-ray departments. During this period, IAEA and WHO provided equipment and technical support to set up a Secondary Standard Dosimetry Laboratory as part of the IAEA/WHO SSDLs Network. The Radiation Protection Inspectorate was established in 1972 to regulate the use of radioactive materials and radiation equipment. Two physicists were employed and trained in the UK. Megavoltage X-ray machines were introduced in 1980s. Three Siemens accelerators, Mevatron 20, were installed and commissioned in 1980 when a new department in the new premises of the SGH building was completed. The

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nuclear medicine department also moved to the new building and was then separated from radiotherapy to become an independent department. New gamma cameras with image processors were acquired. The physicists from the radiotherapy department continued to cover the nuclear medicine service. The first radiotherapy centre in private hospital was started in 1989 and a physicist from SGH left to join that hospital. Three more physicists were employed by SGH in that year, one of them worked full-time in the nuclear medicine department. Three more radiotherapy departments started during the following years, one in a private and two in the public hospitals. Also, a few nuclear medicine centres were established in both the public and the private hospitals. In 1998, the Society of Medical Physicists (Singapore) was formed and registered with ten founding members working in the various specialties of medical physics. Fast forwarding to the present, there are now over 30 hospital-based physicists covering the specialties of radiation oncology, nuclear medicine, MRI and other diagnostic imaging modalities. A few more physicists are working in the Centre of Radiation Protection, equipment suppliers and the research centres (A-Star and CIRC).

in August 24, 1996, and the organization was approved by Ministry of The Interior in December of 1996. The missions of CSMPT are to strengthen academic communication and to enhance medical applications of radiation physics and its related techniques. There are now 250 members consisting of clinical medical physicists, radiation oncologists, students and faculties of radiology and relative departments, and radiology research units. Medical physics, as a profession, is very active in Taiwan. CSMPT holds an annual members meeting together with academic symposia. Domestic and international professionals are invited to speak on designated subjects. For professional matters, CSMPT has established licensure examinations both for radiotherapy and imaging physicists. One that passes the evaluation will be issued a certificate by CSMPT and whose qualification will be put on record with both the authorities and CSMPT. A certificate is valid for 5 years and can be prolonged for another 5 years by earning credits before expiration through attending academic activities or continuing education. A certified medical physicist or dosimetrist who obtains the certification from radiological or radiological physics society outside Taiwan is entitled for one-time exchange of CSMPT certificate with the approval of evaluation committee.

Taiwan Thailand An-Cheng Shiau Radiation therapy in Taiwan was initiated as early as in 1911 at the Taiwan Governor ‘s Hospital. In March 1958, National Taiwan University Hospital operated the first Co60 therapy unit in Taiwan. Dr. Zheng Tianyou, who now is the academician of Academia Sinica, was the first radiotherapy physicist in Taiwan. In 1961, with the assistance of Dr. N.M. Strandjard from the University of Chicago, the Radiotherapy Department of the Taipei Veterans General Hospital began to operate with two Co-60 and one Cs-137 therapy machines. In 1979, Radiotherapy Department of Chang Gung Memorial Hospital was established when M.D. Fang-Jen Lin came back from the New York Memorial Sloan-Kettering Cancer Center. One Co-60 machine and in the same year one 10 MV Varian Linac were installed at CGMH. Through an arrangement by Dr. Lin, medical physicist education and training programs were provided at CGMH by inviting foreign physicists to come or by sending physicists overseas. Professor Clifton Lin was one of the medical physicists who came to Taiwan and greatly helped medical physicists. In Taiwan, medical physicists are represented by the Chinese Society of Medical Physics, Taipei (CSMPT). Its bylaws were agreed at the first annual membership meeting

Anchali Krisanachinda, Sivalee Suriyapee and Surat Vinijsorn Medical physics started in Thailand in 1959 in radiotherapy at Siriraj Hospital. The education and training of Medical physicists began in 1971 at Ramathibodi Hospital. The Faculty and graduates from this program set up Medical Physics Club of Thailand in 1978. In 2001, Thai Medical Physicist Society was established at King Chulalongkorn Memorial Hospital. There are 150 members all over Thailand. As the technology of medical physics has developed rapidly, there are needs for medical physicists in several centres in Thailand such as university hospitals, cancer centres, major hospitals of the Ministry of Public Health, Ministry of Defence and private hospitals. The education and training of medical physicists is increasing from one to four programs in Thailand, there are 306 graduates from these programs. The clinical training of medical physics in radiotherapy, diagnostic radiology and nuclear medicine started in 2006, 2009 and 2011 respectively using the IAEA curriculum for training and assessment. Medical physicists play an important role in healthcare services, research and development of healthcare

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technologies and clinical techniques, and teaching and training of healthcare professionals. There are 37 radiotherapy centers in Thailand with 85 medical physicists, 59 linear accelerators and 205 treatment planning systems and workstations. 29 brachytherapy remote after loading units of LDR, MDR and HDR are available in Thailand. There are 26 nuclear medicine centers with 40 nuclear medicine medical physicists, 10 PET/CT, 3 cyclotrons, 15 SPECT/ CT and 45 SPECT systems. 20 diagnostic radiology medical physicists work mostly at university hospitals.

Vietnam Nguyen Tan Chau The history of medical physics in Vietnam can be divided into two periods. In the first period, in 1969, the Radioactive Technology Department was established at ‘‘Central K’’ Hospital. In 1971, the first Nuclear Medicine Unit at Bachmai Hospital-Hanoi Medical University was established and later in 1978 that became the first Nuclear Medicine Department there. These two facilities are located in the northern part of Vietnam. Meanwhile, in the southern part of Vietnam, the first Nuclear Medicine Department was established at Choray Hospital–Saigon Medical University in 1962. After that the Ho Chi Minh Cancer Center was established in 1975. In this period, the people who responsible for medical physics-related work in hospitals were graduates of the Technology University or the University of Natural Sciences. They were called biophysics engineers. In the second period, when medical physics grew rapidly, the first linear accelerator for radiotherapy was put into operation at ‘‘Central K’’ Hospital in 2000. Then two more linacs were installed in Choray Hospital in 2002 and in the Ho Chi Minh Cancer Central in 2005, and in other hospitals few years later. The major historical event in the development of Vietnam’s medical physics was the foundation of the Vietnam Association for Medical Physics (VAMP) in 2008 where we were the host country of the 8th AOCMP/6th SEACOMP congress for the first time at Choray Hospital. At the moment, there are approximately 80 medical physicists officially working in hospitals in the whole country, but most are concentrated in three major cities: Hanoi, Ho Chi Minh and Da Nang. Finally, the medical physicist profession was officially recognised, but certification by the government is not yet available. Despite this, the number of medical physicists is growing rapidly.

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