American Brachytherapy Society consensus guidelines for medical physics residency training endorsed by the American Association of Physicists in Medicine, Part I: High-dose-rate remote afterloader brachytherapy

PURPOSE: To provide recommendations on training guidelines for therapeutic medical physics residents, including standards for satisfaction of the Nuclear Regulatory Commission (NRC) Authorized Medical Physicist (AMP) high-dose-rate (HDR) brachytherapy training and experience requirements. METHODS AND MATERIALS: Following the Nominal Group Technique, an expert panel of 15 American Board of Radiology-certified medical physicists from 14 institutions, including academic centers and freestanding clinics, developed consensus recommendations that align with NRC form 313A (AMP). RESULTS: Training and experience requirements were defined at two levels. Level I addresses NRC training requirements and focuses on foundational HDR brachytherapy competencies. Trainees should understand quality assurance (QA) equipment needs, perform or describe all QA procedures, and demonstrate knowledge of shielding principles, regulatory dose limits, and emergency procedures. Clinical training should include at least 10 3D planned cases, 6 involving 2 or more channels. Level II addresses NRC work experience requirements. Trainees must meet all Level I standards and be capable of performing Level I clinical duties, providing QA and clinical guidance for new applicators or techniques, as well as emergency training for staff. Level II experience requires a minimum of 15 3D planned cases, including at least seven interstitial procedures (hybrid applicators allowed) and no more than five single-channel cases. CONCLUSIONS: Proper training and experience are essential for HDR brachytherapy. The two levels defined in this work offer a clear, structured pathway for trainees to achieve AMP status and ensure readiness for independent practice.