Editorial Guest short communication: Is education of RTTs really unnecessary? Mary Coffey a,⇑ , Eduardo Rosenblatt b a Discipline of Radiation Therapy, Trinity College, Dublin 2, Ireland b Division of Human Health, International Atomic Energy Agency, Vienna, Austria article info Article history: Received 7 September 2018 Accepted 7 September 2018 Keywords: Education radiation therapist Safety abstract Radiation TherapisTs (RTTs) are an integral part of the radiation oncology team, however the provision of high quality education for these professionals can be met with difficulties. Over many years, the RTT com- mittee of the European Society for Radiotherapy and oncology (ESTRO), together with the International Atomic Energy Agency (IAEA) have endeavoured to improve the educational standards of RTTs. This arti- cle summarises the main difficulties experienced in this field as well as the steps that both the IAEA and ESTRO have taken to improve the education of RTTs and thereby improve the safe treatment of cancer patients internationally. Ó 2018 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy & Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). This question seems quite extraordinary given the complexity of radiation therapy preparation and delivery and the potential for significant harm to patients but is sadly the reality in many parts of Europe and indeed globally. Perhaps one of the reasons for this unusual situation is histori- cal, dating from the era when radiation therapy was delivered through large fields with very little possibility of a geometric miss. Radiation oncologists were responsible for the prescription and overall management and the medical physicists responsible for the maintenance of equipment and together largely responsible for the preparation of treatment. The assumption was that very lit- tle could therefore go wrong. In this context a hierarchical system evolved that would inadvertently support the inadequacy of RTT education programmes. As no specialist education was required RTTs were drawn from a wide range of backgrounds some of which were peripherally related to the discipline but others not. Professional societies evolved over time and included the role of RTT within their scope of practice but without identifying the specific requirements of the discipline. Education programmes followed suit with at most a minimal radiotherapy content included, delivered primarily as guest lectures with no formal faculty staff drawn from an RTT background. In this setting it was almost impossible for the profes- sion of RTT to evolve and grow. Access to modern radiation therapy is now recognised as an essential component of high-quality cancer treatment and central to optimal patient care. In the field of radiation therapy, the inter- national normative exists to ensure that the professionals respon- sible for intentionally exposing human individuals to high doses of ionising radiation for medical purposes will do so most efficiently and safely. For two decades the RTT Committee of the European Society for Radiotherapy and Oncology (ESTRO) and the International Atomic Energy Agency (IAEA) have worked tirelessly to address the situa- tion of RTT education despite many obstacles and impediments to progress. Professional hierarchy in many cases still supports on- the-job training to carry out specific tasks as an adequate model for RTT education. Professional societies often persist in seeing the practice of radiation therapy as something that other profes- sionals can easily carry out without any specific education, this despite having put major effort into developing the professional profile, education standard and career progression options for the majority profession that they represent. Education Institutes often consider specialist programmes for RTTs to be non-economically viable given the perceived small numbers required and are gener- ally ‘lukewarm’ in considering other options of programme devel- opment to accommodate small numbers. As there is no speciality of RTT in many of the institutes there is no background on which to build the necessary expertise or for RTTs to pursue higher qual- ifications in the area of radiation therapy. All of these issues con- tributed to the sense that the difficulties are insurmountable but, in reality, they are just challenges that need to be confronted and ‘debunked’. It is a new era both within radiation therapy and also the awareness of radiation therapy and its role globally. There is now much evidence to support the importance of appropriate https://doi.org/10.1016/j.tipsro.2018.09.001 2405-6324/Ó 2018 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy & Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). ⇑ Corresponding author: Applied Radiation Therapy Trinity, Discipline of Radia- tion Therapy, School of Medicine, Trinity College, Dublin 2, Ireland. E-mail address: mcoffey@tcd.ie (M. Coffey). Technical Innovations & Patient Support in Radiation Oncology 8 (2018) 1–2 Contents lists available at ScienceDirect Technical Innovations & Patient Support in Radiation Oncology journal homepage: www.elsevier.com/locate/tipsro