Medical Physics Education, Clinical Training, and Workforce Disparities In Low- and Middle-Income Countries: A Cross-Sectional Survey
Abstract
Purpose
Medical physics is essential to the safe and effective use of ionizing radiation in radiotherapy, diagnostic imaging, and nuclear medicine, with clinically qualified medical physicists (QMPs) playing a critical role in quality assurance, accurate dosimetry, and patient safety. This study aims to evaluate disparities in medical physics education, clinical training pathways, workforce density, and continuing professional development (CPD) across low- and middle-income countries (LMICs), and to assess their implications for the delivery of safe radiation medicine.
Methods
A cross-sectional online survey was conducted from March to August 2025 under the Global Alliance for Medical Physics Education and Research (GAMPER), targeting key respondents from 23 LMICs across Asia, Africa, Europe, South America, and Oceania. Data on academic programs, accreditation, residency training, certification, radiation protection education, CPD opportunities, medical physicist (MP) workforce, and external beam radiotherapy (EBRT) facilities was collected at country-level using the structured questionnaire. Microsoft Excel and IBM SPSS Statistics software were used to perform descriptive statistics, cross-tabulations, and correlation analyses (Pearson and Spearman).
Results
Respondents reported accredited academic and residency programs existed in only 4/23 countries (17.4%); accredited clinical training in 6/23 (26.1%). Eight countries had no formal programs. MP density ranged from 0.05–7.92 per million population, with major IAEA benchmark shortfalls (e.g., 604–862 in Nigeria; 390–522 in Ethiopia). EBRT infrastructure imbalances showed moderate correlation with MP density (Pearson r = 0.63, p = 0.0013), indicating equipment growth outpacing workforce. CPD relied on informal courses or external aid, reflecting dependency. These findings align with prior global surveys, confirming persistent inequities that compromise treatment accuracy
Conclusion
Profound gaps in education, training, certification, and workforce persist in surveyed LMICs, exacerbating cancer care disparities. Urgent interventions—expanded residencies, regulatory frameworks, competency-based CPD, and international partnerships—are needed for a robust CQMP workforce ensuring safe, equitable radiation medicine.