National Forum on Changing
Entry-to-Practice Requirements
Professional Panel
Canadian Association of Medical Radiation
Technologists (CAMRT)
Claire Hatch
Roberta McCammond
Richard Lauzon
Debbie Bolger-Ingimundson
Ottawa April 2003
Addressing three questions today:
• Plans to change entry requirements?
• Rationale for the change?
• Challenges and issues identified by CAMRT
in achieving its plans?
CAMRT Mission Statement
The CAMRT fosters excellence in patient
care by providing medical radiation
technologists with standards of practice
and opportunities for continuing
professional development, by advancing
the profession, and by establishing
effective partnerships with related health
professionals.
CAMRT National / Provincial
Federation Structure
Federation
Association
Association
Association
Individual Members
Individual Members
Individual Members
CAMRT History
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1942
1943
1945
1955
1964
1966
1968
1974
1987
1996
2001
Canadian Society of Radiological Technicians established
Ad hoc Committee on university education
New curriculum created and certification exams set
Separate certification exam for radiation therapy
First Fellowship examinations held
First nuclear medicine certification examination
Adoption of Alberta AC program nationwide
Ad hoc Committee re: Radiologist Assistant program
BS (Health Studies) collaboration with WMU
Magnetic Resonance discipline established
AIT Labour Mobility Mutual Recognition Agreement
Budget Invested in
Education Programs, 2002
• Education (total):
$742, 759
CAMRT Budget 2002
$2,190,770
Administration
Member
Services
16%
23%
• Certification:
$290,000
19%
Finance
9%
33%
• Continuing education:
$275,000
Education
Communications
Plans to change entry requirements?
• Degree motion and provincial implementation
• Degree chronology
• Program status to date
1995 MOTION - 53rd AGM CAMRT
Degree as Entry-to-Practice Requirement
That CAMRT support the proposal for a degree as
the entry-level requirement for medical radiation
technologists as of the year 2005.
In response to questions, President Brodie stated: “…since education falls
within provincial jurisdictions, implementation of a degree program would
be the responsibility of each province.”
CAMRT Degree Chronology
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1943+
1994
1995
1997
1998
1998
2001
2001
2002
CSRT/CAMRT Degree activity
Strategic objective re: feasibility study for degree
Degree motion passed / Provincial implementation
Report: Degree Initiatives – A blueprint for action
Report: Degree Education – Facts and Fiction
First sitting of CAMRT competency-based exams
Degree Addendum – additional degree models
Rationale for deadline extensions accepted by BoD
Validations completed of competency profiles
Degree Initiative Status to Date
Nuclear Medicine
• 5 programs nationwide
– 3 have degree operational (ON, NS, NB)
• 2 offer a diploma exit option (NS, NB)
• 1 has no diploma exit option (ON)
– 1 fully developed, approaching the government
approval process (BC)
– 1 diploma program in place (QC)
Degree Initiative Status to Date
Radiation Therapy
• 11 programs nationwide
– 4 fully developed degree programs, awaiting provincial
government support (AB, SK, MB, NB)
– 3 programs favor degree, will be working towards
implementation (QC)
– 1 approved degree, moving to implementation (BC)
– 1 fully integrated degree, no diploma exit option (ON)
• Serves three provinces (ON, NF, NS)
Degree Initiative Status to Date
Radiological Technology
• 21 programs
– 7 have degree operational with diploma exit option
(ON, NB, NS, PE, NF)
– 5 under active development (BC, SK, MB, ON)
– 4 programs favor degree, working towards (QC)
– 2 investigating degree-completion model (AB, ON)
– 1 moving to full degree implementation (ON)
– 1 fully integrated program – no diploma exit (ON)
Degree Initiative Status to Date
Magnetic Resonance
• Currently a post-certification, second discipline
• 4 programs nationally (BC, AB, MB, ON)
– 2 offer distance ed option (BC, ON)
– 1 is a full time program (MB)
– 1 currently inactive and undergoing redesign (AB)
• Once MR education programs are developed as postsecondary programs, it is expected they will be degree
level programs.
Rationale for the change?
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Environmental forecast
The changing workplace
Emerging independent roles for MRTs
Benefits to:
– Patients
– Technologists
– Management
Environmental Forecast
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Changing demographics and pattern of disease
Revolutionary advances in MRT technologies
Substantial decline among medical specialists
Increased Canadian capacity for telemedicine
Changing practice patterns of radiologists
Increasing use of high tech diagnostic procedures
Increased time for sophisticated MRT protocols
Less time and $ for professional development
The Changing Workplace
20 Years Ago
• Film/Screen Technology
• No post-processing capabilities
• CT brand new, MR and PET in infancy, Fusion
Imaging still theoretical
• Cross sectional anatomy not taught, little formal
emphasis on pathology, patient care,
communication, ethics, legislation, etc.
The Changing Workplace
Today
• Film/Screen PLUS Digital Imaging Modalities, hugely
expanded scope of post-processing capabilities
• Advent of spiral and multi-slice CT, MR, MRA, PET,
SPECT, 3D imaging, BMD and screening mammography,
integrated computerized planning in radiation therapy and
CT Sim/MR Sim and Fusion Imaging
• Emphasis on interpersonal communication skills, patient
education and participation with health care team
• Widespread use of radio-pharmaceuticals in NM
The Changing Workplace
All modalities
• Significantly expanded equipment capability
– new and more interventionalist approaches to disease detection
– greater numbers and types of examinations performed
• Greater emphasis on computer application and usage
– demands a solid understanding of computer principles for
optimization of the functions and applications
– requires an entirely new knowledge/skill set
• Patient demographic shift
– an older, population means increased demand for diagnostic and
treatment procedures
• Scarce health care $ means working smarter with less
– Expanded roles, more delegated physician functions
The Changing Workplace
All modalities
• Injection of contrast media
– increased responsibility for patient care and
monitoring
• Patient and staff education
• Increased awareness of multicultural diversity and
the need for effective communication and problem
solving
• Quality Assurance/ Quality Control now integral
to all departments
Emerging Independent Roles
for MRTs
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Upper and lower gastro-intestinal imaging
Bone mineral densitometry
Mammography screening
Patient education: cancers, osteoporosis, etc.
Screening clinic management
Telemedicine / teleradiology, PACS admin.
Research and evaluation studies
Degree-entry as a Benefit
to Patients
• More comprehensive skill set
• Improved basis to solve problems, appraise
solutions, make decisions
• Enhanced sensitivity to socio-cultural
determinants of care
• Better verbal and written reporting skills
• More efficient service delivery
Degree-entry as a Benefit
to Technologists
• Maximizes application of education and
experience to benefit patients
• Enhanced roles promotes > job satisfaction
• Greater job flexibility, natl. / intl. mobility
• More competitive for managerial positions
• Offers broader career ladder: specialization,
education, management, research
Degree-entry as a Benefit
to Management
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Access to broader range of competencies
Pool of MRT research talent available
Improved supervisor skill sets
More “autonomous” technologists
Reduced cost for selected MRT procedures
Better decision-making skills reduces risk
of liability
Degree Status in Other Countries
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United Kingdom* / Rep. of Ireland 1989
Australia* / New Zealand
1995
Hong Kong
1992
Netherlands
1990s
United States of America*
1980s
Israel
1993
Norway
1990s
Denmark
late 1990s
* Post-graduate training avail.
Challenges and issues in achieving
CAMRT degree plans?
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Lack of / soft government support
Personnel shortages
Dual exit / two-tiered system
Agreement on Internal Trade / MRA
Extension delays implementation
Community college / university concerns
Perceived subsequent wage impact
CAMRT Actions to
Address the Challenges
• Created two committees to assist provinces and to
facilitate the implementation of degree programs
• In response to AB, CAMRT expanded the number
of models eligible for degree status
• At BC, AB and ON request, CAMRT extended the
date for examination access (reasonable progress)
• Willingness by provincial associations and
CAMRT to dialogue on any degree
implementation issue
Degree-entry as Change
There is nothing more difficult to carry out
nor more doubtful of success, nor more
dangerous to handle than to initiate a new
order of things. For the reformer has
enemies in all who profit by the old order
and only lukewarm defenders in all those
who would profit by the new order.
Machiavelli, c. 1520