Radiation Safety and Diagnostic Radiology – 2025 review results

Current priority areas

• 10 Year Health Plan for England: fit for the future
• Science in healthcare: Delivering the NHS Long Term Plan – The Chief Scientific Officer’s strategy

Stakeholder feedback

Feedback collecting through the Curriculum Library survey collected between January 2024 and November 2025. All stakeholder feedback is presented verbatim.

Programme

• Overall, I think the training activities reflect the work of a qualified clinical scientist quite well. I think the expectation level of how much a trainee can do is handled well in the sense of some training activities eg. “contribute to a complex design” rather than “do a whole linac design” which would be unrealistic. I think some competencies do not lend themselves to reflective practice – I disagree with having to reflect on every single training activity, especially in a specialism which is largely non-clinical/not doing case by case training. For example, it is easy to reflect on a QA fail and how that learning shapes future practice, but this doesn’t align with every competency. Also in Radioactive Materials, there is a typo :”Critically appraise a healthcare facilities best svailable techniques statement and make recommendations”. There are a few ETAs which I think do not need to be repeated – for example “Perform a sealed sources wipe test and assist with accounting procedures”. This is a good example of a practice which is not performed frequently enough to be able to repeat it several times.
• I think that Diagnostic Radiology (together with the radiation protection and governance issues associated directly with diagnostic radiology) is a broad enough topic and career direction that there should be an option to follow this path without inclusion of the radioactive materials module and without the radiation protection elements within other modules relating to Radiotherapy and non-ionising radiation. One solution may be to deliver separate speciality in Radiation Protection (which could include a broad range of radiation protection issues including for diagnostic radiology, radiotherapy, nuclear medicine, radioactive materials and non ionising) and a separate speciality in Diagnostic radiology. Another solution could be to make the specialty truly modular, such that trainees could choose from a larger pool of suitable modules (with the guidance and approval of the training centre) such that they can develop skills in areas that would be relevant to their preferred career path or the needs of the department in which they are training. As a senior Diagnostic radiology physicist and MPE in diagnostic radiology with over 20 years of service, I have had no cause to deal with radioactive materials or provide advice in relation to the topics in the radioactive materials module. In departments such as the one I work in, inclusion of the radioactive materials module and radiation protection elements not related to diagnostic radiology just makes it more difficult to deliver the training. I acknowledge that both of my suggested ways forward would result in additional work for content creators/module editors and may make examining more challenging.
• There are no considerations or training activities that specifically mention or discuss sustainability. I think this is a missed opportunity because as clinical scientists we can play a large role in shaping our department
• AI is an emerging technology with increasing applications across the whole of diagnostic radiology. Under the 2024 amendments to IRMER, software tools which are used in clinical evaluation are now considered as equipment. There is also a requirement for MPE input into the commissioning and routine quality assurance of equipment. Therefore, there is a requirement for Clinical Scientists supporting imaging and treatment using ionising radiation to have an understanding of the application of AI and to be able to advise clinical users on this. I would strongly advocate for AI to be included in the curriculum going forwards. However, I understand that not all sites will be able to support this in terms of local expertise. It may therefore be more appropriate to require input from the academic component of training.
• The inclusion of optical radiation in both radiation safety and diagnostic radiology and imaging with non-ionising radiation makes no sense. This is occasionally performed by radiation safety clinical scientists but more frequently by non-ionising radiation clinical scientists. These areas are hard for may trainees to complete as they don’t have LPA on site and may not have a non ionising team in their center. If it is included in both it should be that they are required to complete the same training activities for these areas which is not currently the case
• You need to start looking to take Radiation Safety out or make it a common theme.  FIrst off, you need to have Radiation Protection in all areas of ionising radiation – radiology, interventional, nuclear medicine, and radiotherapy. There is no sense in stating it ‘explicitly’ in this speciality as they will not cover enough to make a proper career path in – say – the RWA channel. Cut this right down and focus on the imaging The move towards Medical Physics 3.0 will also change how people in this area work, you need to start adapting the training for what they will be doing in 5 years time, not what they did 20 years ago

S-DR-R1 Introduction to Radiation Safety and Diagnostic Radiology

Training activities

• 2 – Considerations – The considerations say to consider the role of RPA and MPE, which are applicable, but then also LPA and other non-ionising specialists. The LPA and non-ionising components are covered in the Rotation “Introduction to Non-Ionising Radiation” which must be completed by ANY trainee undertaking Medical Physics (undefined) or if they already have a defined specialism within Medical Physics (RSDR, INIR, RT, NM) therefore the addition of LPA/non-ionising in this consideration is not required and should be removed
• 3 – Yes the radiation department will work with the legislative side of this but this has to be completed within either the radiotherapy department or nuclear medicine department and would make more sense within the nuclear medicine rotation. In most cases they are the experts on many of the attributes that are being assessed in the competency
• 4 – There weren’t many big technological advances in DR & RP to choose from, aside from photon counting CT. However, this won’t have an impact on most trusts which do not have one.

I think changing this from a technological advance to a “new development” in DR & RP. This could be a new / repurposed X-Ray room, CDC, hospital, dental, vet centre etc and to reflect on the role of clinical scientists.

I believe looking at real life projects associated with DR & RP will give trainees a better idea and application of what clinical scientists of different seniorities do, and how they all work together to achieve a common goal. It would also give trainees a better idea of what MPEs, RPAs and RWAs do.

In my radiotherapy/mri/nuclear medicine modules I could clearly see how an innovation/technological advance could clinically affect their practice, but for DR & RP this was more unclear (I ended up doing this TA on the QA of AI). Technological advances are not implemented as regularly in my area of medical physics. Changing this module to a new development would give trainees a better idea of the role of DR & RP and how it impacts projects and patients.

I understand that TA2 of this module is meant to teach trainees the role of the clinical scientist in radiation safety, but having a real-life application/example for them would really help for putting things in perspective. For me, I didn’t really understand what senior clinical scientists  did until I attended a delivery team meeting. Here, I learn’t about how the team of scientists work together to solve the radiation protection / imaging related isses of a large NHS trust.

My suggestion could also give trainees a flavour of shielding calculations, incidents, radioactive substances, how DR & RP work with other medical physics departments, role of RPA/MPE and monitoring. It really allows for 1st year trainees to get a real sense of what they can do in our specialty, which, after asking my STP colleagues, I think is lacking, and may be why DR & RP isn’t as popular for undefined trainees.

• 5
  • Task – This is a key principle that should be included in the rotation.
  • Considerations – The requirement to reflect at multiple points in time doesn’t make sense for this competency. It is something that will be reflected on and have changing viewpoints if you are in the specialism for larger periods of time. Within the timeline that would occur to write up a rotational competency there won’t be any significant difference from reflecting at multiple points in time. It will just lead to people writing reflections they think they should write rather than actual reflections on the principles they are looking at
• 6 – An instantaneous dose rate survey are not always completed within a typical rotation length. Instead this could just discuss environmental surveys and the types included as one of the considerations

Direct Observation of Practical Skills (DOPS)

• “Perform simple scan of a phantom or patient”- This seems significantly simpler than similar DOPS in other rotational modules. Due to the wide range of equipment that could be used to perform a scan it is very varied as to how this could be used in practice. If this was made to be a little more specific it would be more comparable to other DOPS on the other rotations.

Observed Communication Events (OCE)

• “Gather a patient history relevant to the specialty from a patient, patient representative, or another member of the multidisciplinary team” and “Present a patient history relevant to the specialty to another member of the multidisciplinary team” – These are not possible for trainees to carry out – we simply do not encounter patients in this way in this specialism. I would like to suggest that the above OCEs are removed, or replaced with something that is achievable for the trainees and specifically worded for this specialism.
• “Gather a patient history relevant to the specialty from a patient, patient representative, or another member of the multidisciplinary team”- This is not a task regularly completed by scientists within Radiation safety so it makes no sense to include it as a OCE in this rotation

S-DR-S1 Radioactive Materials

Training activities

• 5 – I don’t think this is applicable to a DR and safety trainee. The theory should be covered in the MSc component but in practice, the Nuclear Medicine department would likely have routine involvement in doing this rather than a DR and safety team. This is something that I used to do when working as an Assistant Technologist in Nuclear Medicine though I appreciate teams will work differently in different Trusts

S-DR-S2 Radiation Protection Culture and Governance

Training activities

• 1
  • Task – Radiation protection is a waste of post graduate physicist skills – in other industries it is not made out to be anything more than it is. The sooner this is just glossed over and handed to the MTO/CTO who do it much better then we can actually focus on training the STP candidates in the real skills such as Task Based Imaging assessment, image processing, quantitative image analysis and (dare it raise its head again)  hybrid imaging where the real skills gaps lie
  • Type – Lectures on the bases for radiation protection are essential but that is all that they need
  • Considerations- Cut most of this out – it is only there because of legacy not because they need it OR if you are wanting to keep it – do it properly, not just the stuff that someone has in handed down slides
• 10
  • Task – The wording of this training activity is incredibly vague and in discussing it with other trainees, we have interpreted it completely differently so taken very different approaches.
  • Considerations – These are just as vague as the wording of the TA and feels like there is a lot of overlap with other training activities so it makes it hard to know how much to write about.

Direct Observation of Practical Skills (DOPS)

• “Audit compliance against employer’s procedures.”- If you are in a dept where they have moved to QSI then the radiology dept should be doing all this so what is the point of teaching the staff of the future how to do something that is stuck in the past

Observed Communication Events (OCE)

• “Share improvements to practice with other healthcare professionals”. – Generally, I have found with any OCE involving other healthcare professionals, it is very impractical to organise a meeting with other healthcare professionals at a time where an assessor is available to observe and assess the OCE due to understaffing as staff tend to have a large workload and are therefore scarcely available. Additionally, healthcare professionals who are unfamiliar with the STP don’t tend to understand the concept of an OCE making it difficult to follow NSHCS guidelines. I have ended up doing more DOPs than OCEs as a result of this, and the OCEs that I have performed have only loosely followed the NSHCS guidelines as per the reasons above.
• “Deliver training to clinical staff on radiation risks” – This must not be an excuse to make the STP candidate to the talks that are essential to the H&S training of staff within the dept. You have to ensure that the centres keep a proper trail from staff training to competence; this is a potentially dangerous OCE on the grounds that i know of at least 3 centres who do not do it properly, let alone well

Work-based learning outcomes

• 1 – When the student has been placed in a dept where they do not have a reputation for good practice nor the respect of their clinical colleagues, you are not passing on anything that we want in the NHS in the future there needs to be better independent assessment of the departments where students are sent and not just ‘mates helping out’ to get an extra cheap body in the trust

Clinical experiences

• 4 – THis is really not a relevant experience for someone in training – I know people who have worked ‘post registration’ for 10 years without having to interact with PPI and normally you don’t want to have anyone but those training up for MPE to get involved with Research Panels. This is another case of trying to put ‘everything we can think of’ in to what is supposed to be a basic competence training package

Academic learning outcomes

• 5 – Again – if the dept are not doing anything to keep up with the current trends in radiation safety, why are you training the STP to think that this current poor practice is what we want to keep going in the future

Academic indicative content

• There needs to be a lot more content on the background and development of things like the radiation safety framework – the fact that we have STP students who have never heard of the Basic Safety Standards after 14 months in the programme is very worrying.

S-DR-S3 Diagnostic Radiology Physics

Training activities

• 3 – The feedback is applicable to TA3 and TA4. There is a significant amount of overlap with the TAs and the DOPs ‘Perform tube and generator tests for a general x-ray unit or fluoroscopy system’ and ‘Perform image quality tests for a general x-ray unit, fluoroscopy system or CT scanner’. In doing these TAs and DOPs, I struggled to determine what I needed to do differently other than fill in a DOP form so it felt very repetitive and that there is a missed opportunity for there to be different approaches taken.

In moving Trusts following my training, it has also become very apparent how the approach to training can vary immensely. I was lucky that my training was very flexible and I was encouraged to get involved in whatever I could, and that, while supported, the way in which I wanted to meet different TAs was driven by me. However, training feels much more structured in other centres and   while I can see that this may be due to there being more trainees or staffing levels, I feel that some trainees then have opportunities that others may not.

S-DR-S4 Practical Radiation Protection

• no feedback received

Changes made

Module level changes

Programme level changes

• no changes made

Periodic review

This specialty curriculum requires significant change beyond the scope of an annual review.

Response – no

Rationale

Please provide an overview of the rationale for why the proposed changes are needed or why changes were not needed, with reference to stakeholder feedback.

Response

General

This curriculum covers both diagnostic radiology and radiation safety. We therefore feel that it is important that trainees completing the programme have a grounding in radiation safety principles as applied to radioactive materials and non-ionising radiation, in addition to x-ray. These elements have therefore been retained in the curriculum. It is entirely acceptable for trainees to carry out some of their training in, say, the nuclear medicine department, according to local service design.

The curriculum is designed to be flexible, and may be interpreted differently in different centres, depending on individual circumstances.

Reflection is an integral part of the STP curriculum, and the requirement for this has been retained. The NSHCS has provided resources for trainees and assessors.

We support the inclusion of sustainability issues and suggest that this is included within the core curriculum.

AI has not been included explicitly in this review. Inclusion of AI technologies within the curriculum will be considered at future review.

DOPS and OCEs – trainees are not expected to carry out all DOPS and OCEs, but rather, to choose those which are most appropriate for their situation. When carrying out activities, trainees are expected to be under the supervision of qualified staff.

Clinical experiences – are suggestions, not requirements, and again will depend on the local training centre.

Concerns with the quality of training delivered by individual training centres should be raised with the NSHCS accreditation team.

S-DR-R1 Introduction to Radiation Safety and Diagnostic Radiology

The curriculum is intended to form the minimum expectations for a trainee rotating through radiation safety. It is encouraged that trainees will get involved in the work of the department to the extent that the department is able to facilitate that. This will give them a more rounded view of the role of a clinical scientist within RS/DR, beyond the minimum requirements of the rotational curriculum.

Training activities – the wording of a number of activities has been improved to make these easier to complete in a short rotation. TA3 – follow the journey of a radioactive substance through the hospital – has been replaced to bring it more in line with the training activities of other rotations – ‘Follow the pathway of a patient undergoing a diagnostic imaging procedure, and reflect on the journey’.

DOPS – the DOPS on carrying out QC testing has been simplified as rotational trainees will only be expected to carry out parts of a QC procedure, under supervision.

OCE – we acknowledge that gathering and presenting patient histories is not usually appropriate in this specialty. The wording of these OCEs has been updated across all rotational modules in order to broaden their scope. Trainees are only required to carry out ONE DOPS or OCE.

S-DR-S1 Radioactive Materials

Training activities – new TA around the handling of radioactive waste, as we believe this is an important aspect of radiation safety that was not explicitly covered under the current curriculum.

DOPS – new DOPS on sealed source wipe test, which replaces the TA on this.

S-DR-S2 Radiation Protection Culture and Governance

We believe that it is key for a radiation safety scientist to understand the governance framework in which they work.

Training activities – TA8 (DRL review) was similar to S-DR-4 TA9 (patient dose audit), and so these have been merged.

S-DR-S3 Diagnostic Radiology Physics

Training activities – TA3 and TA4 did not allow for the significance of QA within the role of a clinical scientist in diagnostic radiology. These two TA’s have been expanded to now cover 4 training activities. TA10 (dose audit) has been moved to module S-DR-S2, where it has been merged with TA8. TA13 and 14 had significant overlap and have been merged.

S-DR-S4 Practical Radiation Protection

Training activities – TA15 (laser and phototherapy occupational exposure) – we feel that it is important that trainees have an appreciation of these areas, but acknowledge that making output measurements is not always feasible. The wording has been changed so that this can now be completed as a desktop exercise if required.

OCE – wording has been generalised to allow the trainee to present on any topic (not just personal monitoring) to an RPC meeting.

I confirm I have reviewed the Reflective Practice Guidance for ETAs and DTAs and have made any changes necessary.

Specialty Lead Editor signature: Rosemary Eaton, Andrew Bridges
Date: 23 December 2025

Change control - completed by the school

Programme structure

Completed by: Chris Fisher
Date: 8 January 2026

Health and Care Professions Council (HCPC) mapping

• No change to learning outcomes.  Mapping to 13.06, undertake or arrange investigations as appropriate, strengthened as a result of changes to the core modules.

Completed by: Chris Fisher
Date: 8 January 2026