The 4th action of the Bonn Call for Action [1] aims to “strengthen radiation protection education and training of health professionals”.
This action is subdivided in several subactions:
Fig. 1: 4th Bonn call for action. Joint Position Statement by the IAEA and WHO
References: Bonn call for action (2012). Joint Position Statement by the IAEA and WHO
In Spain nearly all the medical specialties include in their curricula a compulsory training in radiation protection (RP) [2].
This training aims to the acquisition by the residents of a basic knowledge and competence in radiation protection following the principles settled in the 116 Radiation Protection publication of the European Commission on Guidelines on education and training in radiation protection for medical exposures [3].
Training must be provided by a RP Department.
The requirements of training depend on the specialty.
Medical specialties are classified in three groups:
Includes the specialties which use Radiology as referrers.
Those specialists that request explorations but do not directly use ionizing radiations.This group is formed by: Anaesthesiology,
Surgery,
Oro-maxillo-facial Surgery,
Paediatric Surgery,
Plastic Surgery,
Dermatology,
Endocrinology,
Hospital Pharmacy,
Immunology,
Family Medicine,
Occupational Medicine,
Forensic Medicine,
Laboratory Medicine,
Public Health Medicine,
Neurology,
Ophthalmology,
Medical Oncology,
Otorhinolaryngology and Paediatrics
Includes the specialties that use Radiology not only as referrers,
but also independently perform techniques or procedures that use ionizing radiations as a guidance.
This group is formed by: Vascular Surgery,
Gastroenterology,
Cardiology,
Cardiac Surgery,
Orthopaedics,
Thoracic Surgery,
Neurosurgery,
Gynecology and Obstetrics,
and Urology.
Includes the Imaging specialties: Nuclear Medicine and Radiology [4].
Regulations require that residents of all groups follow during their first year of residency a training program of 6-10 hours including the following topics:
- The atomic structure and interaction of radiation
- Nuclear structure and radioactivity.
- Radiological quantities and units.
- Physical characteristics of X-ray machines.
- Fundamentals of radiation detection.
- Fundamentals of radiobiology: cell,
systemic and whole body responses.
- Radiation protection.
General criteria.
- Quality control and quality assurance.
- Spanish and European regulations and standards.
Groups B and C residents must follow an additional training program of 2-4 hours along the rest of their residency including the following topics:
- Operational radiological protection.
- General RP aspects in diagnostic radiology
- Particular aspects of patient and staff RP
Group C residents receive additional training also.
Problems appeared from the start after the implementation of this regulation in the specialties training curricula.
Many of the postgraduate training units,
especially those located in small hospitals and Primary Care centres lack a PR Department to provide this training.
Residents,
and also the specialists of the training centres,
were not very aware of the interest that RP had for them,
especially in the Group A specialties.
Enforcement of the regulation has not been carried out also,
and in fact the absence of this training is not considered as important in the audits of the Health Ministry.
As a result,
many training units in Spain lack the mandatory training program in RP.
In some cases,
a regional training program has been organized by regional Healthcare authorities,
but the residents frequently fail to attend due to their tight working schedule and the need to travel to another city for the course.
Thus,
education in RP is in general poor among Spanish physicians.