Top 12 Medical Physicist Skills to Put on Your Resume
A compelling resume for a medical physicist must showcase a unique blend of technical prowess and soft skills, reflecting the candidate's ability to navigate the complex intersection of physics and medicine. Highlighting the top skills in your resume can significantly enhance your visibility to potential employers, demonstrating your readiness to tackle the challenges of this critical and evolving field.
Medical Physicist Skills
- Dosimetry
- Radiation Therapy
- MRI Technology
- CT Simulation
- Brachytherapy
- PACS Expertise
- Linear Accelerator
- Monte Carlo Simulations
- Quality Assurance
- Treatment Planning
- Radiobiology
- Eclipse (Varian)
1. Dosimetry
Dosimetry, in the context of a Medical Physicist, involves the measurement, calculation, and assessment of the absorbed dose delivered by ionizing radiation, especially in the treatment of cancer through radiation therapy. It ensures the optimal dose is administered to the target area while minimizing exposure to surrounding healthy tissues.
Why It's Important
Dosimetry is crucial for a Medical Physicist because it ensures the precise measurement and delivery of radiation doses to treat cancer effectively while minimizing exposure to surrounding healthy tissues, thereby optimizing treatment outcomes and patient safety.
How to Improve Dosimetry Skills
Improving dosimetry, a critical aspect of radiation therapy, involves enhancing the accuracy and precision of dose delivery to the target area while minimizing exposure to surrounding healthy tissues. For a Medical Physist, focusing on the following strategies can be beneficial:
Advanced Imaging Techniques: Utilize MRI-guided radiotherapy and 4D CT scans for better tumor localization and motion management.
Treatment Planning Systems (TPS) Optimization: Regularly update and validate treatment planning systems for improved dose calculation accuracy.
Monte Carlo Simulations: Incorporate Monte Carlo methods in dose calculations for complex treatments to achieve higher precision.
Quality Assurance (QA) Protocols: Implement comprehensive QA protocols for equipment and procedures, ensuring consistent and accurate dosimetry.
Adaptive Radiotherapy (ART): Use adaptive radiotherapy to adjust treatment plans in response to changes in tumor size, shape, or position.
Professional Development: Stay updated with the latest research and technologies through continuous education and training. Engaging with professional organizations such as the American Association of Physicists in Medicine (AAPM) can provide valuable resources and guidelines.
By focusing on these areas, medical physicists can significantly contribute to the enhancement of dosimetry in radiation therapy, ultimately improving patient outcomes.
How to Display Dosimetry Skills on Your Resume
2. Radiation Therapy
Radiation therapy is a medical treatment that uses high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells. For a medical physicist, it involves the application of physics principles to ensure the safe and effective delivery of radiation, optimizing treatment plans and ensuring the accurate dosimetry for targeted therapy while minimizing exposure to surrounding healthy tissue.
Why It's Important
Radiation therapy is crucial as it allows Medical Physicists to precisely target and destroy cancer cells while minimizing damage to surrounding healthy tissue, thereby improving patient outcomes and quality of life.
How to Improve Radiation Therapy Skills
Improving radiation therapy involves enhancing precision, safety, and effectiveness. A medical physicist can focus on the following key areas:
Adopt Advanced Imaging Techniques: Utilize advanced imaging technologies like MRI-guided radiation therapy (MR-linac systems) to improve tumor targeting and minimize damage to surrounding healthy tissue.
Personalize Treatment Plans: Leverage software and algorithms for adaptive radiation therapy that adjusts treatment plans in real-time based on changes in tumor size, shape, and patient anatomy.
Incorporate AI and Machine Learning: Utilize AI and machine learning to analyze data and predict optimal treatment plans and outcomes, enhancing decision-making processes.
Optimize Dose Delivery: Employ techniques like Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for precise dose distribution, reducing exposure to healthy tissues.
Enhance Quality Assurance (QA): Implement comprehensive QA protocols and regular equipment checks to ensure the accuracy and safety of radiation delivery.
Continued Education and Training: Stay updated with the latest research, techniques, and professional development opportunities to continuously improve skills and knowledge.
By focusing on these areas, medical physicists can significantly contribute to the advancement of radiation therapy, leading to better patient outcomes.
How to Display Radiation Therapy Skills on Your Resume
3. MRI Technology
MRI (Magnetic Resonance Imaging) technology is a non-invasive imaging technique that utilizes strong magnetic fields and radio waves to generate detailed images of the internal structures and organs of the body. It exploits the magnetic properties of atomic nuclei (primarily hydrogen) to produce high-resolution images, aiding in diagnosis and treatment planning without the use of ionizing radiation.
Why It's Important
MRI technology is crucial because it provides high-resolution, non-invasive imaging of soft tissues, facilitating accurate diagnosis, treatment planning, and research without exposing patients to ionizing radiation, aligning with a Medical Physicist's goal of ensuring the safety and effectiveness of radiological procedures.
How to Improve MRI Technology Skills
Improving MRI technology, especially from a Medical Physicist's perspective, involves enhancing image quality, reducing scan time, and increasing patient comfort. Here are concise strategies:
High-Field Magnets: Using ultra-high-field MRI systems (7 Tesla and above) improves the signal-to-noise ratio (SNR), offering better image resolution and detail.
Advanced Coil Technology: Implementing novel coil designs, like phased array coils, enhances SNR and accelerates image acquisition.
Parallel Imaging Techniques: Techniques like SENSE (Sensitivity Encoding) and GRAPPA (Generalized Autocalibrating Partially Parallel Acquisitions) reduce scan time by acquiring less data and reconstructing images without compromising quality.
Compressed Sensing: Compressed sensing leverages sparsity to reconstruct images from fewer samples, significantly speeding up the imaging process without losing image quality.
Machine Learning and AI: Integrating AI and machine learning in MRI can automate tasks, improve image reconstruction, enhance diagnosis accuracy, and optimize scanning protocols.
Quantitative Imaging: Developing quantitative MRI techniques, like qMRI, provides absolute physiological information (e.g., tissue composition) for better diagnosis and treatment monitoring.
Silent MRI: Research into reducing MRI noise, such as Silent Scan technology, enhances patient comfort and compliance, especially in vulnerable populations (e.g., children).
Improving MRI technology involves a multidisciplinary approach, leveraging advancements in physics, engineering, and computer science to push the boundaries of what's possible in medical imaging.
How to Display MRI Technology Skills on Your Resume
4. CT Simulation
CT Simulation is a process used in radiation therapy planning where a CT (Computed Tomography) scan is performed to precisely map the treatment area in three dimensions. This allows medical physicists and radiation oncologists to accurately target the tumor while minimizing exposure to surrounding healthy tissues.
Why It's Important
CT Simulation is crucial for precise treatment planning in radiation therapy, enabling accurate tumor localization, and healthy tissue sparing by providing detailed anatomical information necessary for optimizing dose distribution.
How to Improve CT Simulation Skills
Improving CT simulation in the context of medical physics involves enhancing image quality, accuracy, and patient safety. Here are concise strategies:
Optimize Protocols: Customize scanning protocols based on patient size and clinical indication to minimize dose while maintaining diagnostic quality. AAPM Report 204 provides guidelines for protocol optimization and management.
Implement Advanced Imaging Techniques: Utilize iterative reconstruction techniques to improve image quality and allow for dose reduction. Radiological Society of North America (RSNA) explains the benefits and applications of these techniques.
Quality Assurance Programs: Establish and maintain a comprehensive CT quality assurance (QA) program, ensuring equipment is performing optimally. The American College of Radiology (ACR) offers resources for QA program development.
Education and Training: Continuously educate and train staff on the latest CT simulation techniques and radiation safety principles. The International Atomic Energy Agency (IAEA) provides educational resources for enhancing safety and technique.
Utilize 4D CT and Motion Management: For areas prone to motion, 4D CT can account for motion artifacts, improving accuracy for treatment planning. The Journal of Applied Clinical Medical Physics discusses the implementation and advantages of 4D CT.
By focusing on these areas, medical physicists can significantly improve the effectiveness and safety of CT simulation in clinical practice.
How to Display CT Simulation Skills on Your Resume
5. Brachytherapy
Brachytherapy is a form of radiotherapy where a radiation source is placed inside or next to the area requiring treatment, allowing for the delivery of high doses of radiation to small, localized areas. For a Medical Physicist, it involves precise planning and calculation to optimize dose distribution, minimize exposure to surrounding healthy tissues, and ensure patient and staff safety.
Why It's Important
Brachytherapy is important for a Medical Physicist because it allows for the precise delivery of high-dose radiation directly to the tumor site, minimizing exposure to surrounding healthy tissues, and enabling better control of the radiation dose distribution for improved treatment outcomes and reduced side effects.
How to Improve Brachytherapy Skills
Improving brachytherapy involves advancements in technology, technique, and patient-specific planning. Here's a concise guide:
Advanced Imaging Technologies: Utilize MRI, PET, and CT imaging to enhance tumor visualization and normal tissue delineation for precise dose delivery. American Association of Physicists in Medicine (AAPM).
Treatment Planning Systems (TPS): Leverage the latest software for 3D and 4D treatment planning to optimize dose distribution. International Commission on Radiation Units and Measurements (ICRU).
Real-Time Dosimetry: Implement real-time in vivo dosimetry for immediate feedback and dose adjustment during treatment. International Atomic Energy Agency (IAEA).
Adaptive Brachytherapy: Use adaptive brachytherapy techniques to modify treatment in response to anatomical changes, improving dose accuracy. European Society for Radiotherapy & Oncology (ESTRO).
Interdisciplinary Collaboration: Foster collaboration between medical physicists, radiation oncologists, and dosimetrists for innovative solutions and personalized care. American Society for Radiation Oncology (ASTRO).
Quality Assurance (QA): Implement rigorous QA protocols for equipment and procedures to ensure consistent and accurate treatments. AAPM Task Group Reports.
Education and Training: Continuously update skills and knowledge through workshops, seminars, and certification courses to stay abreast of the latest technology and techniques. Medical Physics Education Programs.
By focusing on these areas, medical physicists can significantly contribute to the advancement of brachytherapy, enhancing safety, efficacy, and patient outcomes.
How to Display Brachytherapy Skills on Your Resume
6. PACS Expertise
PACS (Picture Archiving and Communication System) expertise for a Medical Physicist involves the technical and operational knowledge of managing digital imaging systems in healthcare. This includes ensuring the efficient acquisition, storage, retrieval, and distribution of medical images, maintaining image quality, ensuring system security, and compliance with medical standards and regulations.
Why It's Important
PACS (Picture Archiving and Communication System) expertise is crucial for a Medical Physicist because it ensures efficient, accurate, and secure access to imaging data. This expertise enables the optimization of diagnostic imaging processes, facilitates quality control, and supports compliance with health information standards, ultimately enhancing patient care and safety in a medical setting.
How to Improve PACS Expertise Skills
Improving your PACS (Picture Archiving and Communication System) expertise as a Medical Physicist involves a combination of theoretical knowledge and practical experience. Here’s a concise guide:
Educational Courses: Enroll in specialized PACS courses offered by accredited institutions. Radiological Society of North America (RSNA) and American Association of Physicists in Medicine (AAPM) frequently offer relevant courses and webinars.
Certifications: Consider obtaining PACS-related certifications like Certified Imaging Informatics Professional (CIIP) to validate your expertise.
Practical Experience: Gain hands-on experience by working closely with your institution’s IT department on PACS management, troubleshooting, and optimization.
Networking: Join professional groups on platforms like LinkedIn to connect with other professionals and exchange knowledge.
Stay Updated: Regularly read journals like Journal of Digital Imaging and attend workshops or conferences focused on medical imaging informatics to stay abreast of the latest developments.
Vendor Training: Participate in training sessions offered by PACS vendors. This can provide deep insights into specific systems.
By following these steps and continually practicing and engaging with the PACS community, you’ll enhance your expertise and contribute more effectively to your medical physics role.
How to Display PACS Expertise Skills on Your Resume
7. Linear Accelerator
A Linear Accelerator (Linac) is a device used in radiation therapy to treat cancer. It generates high-energy x-rays or electrons, precisely targeted to conform to the shape of a tumor, minimizing damage to surrounding healthy tissue. It operates by accelerating electrons in a straight line using microwave technology, before colliding them with a heavy metal target to produce the therapeutic x-rays.
Why It's Important
Linear accelerators (linacs) are crucial in medical physics because they generate high-energy X-rays or electrons for precise and targeted radiation therapy, effectively treating cancer by destroying tumor cells while minimizing damage to surrounding healthy tissue.
How to Improve Linear Accelerator Skills
Improving a Linear Accelerator (Linac) in the context of medical physics involves enhancements in safety, precision, and treatment efficiency. Here are concise strategies:
Upgrade Software and Hardware: Regular updates to control systems and imaging technology enhance precision and treatment delivery. Varian and Elekta often release updates and upgrades for their systems.
Implement Advanced Imaging Techniques: Utilizing Cone Beam CT (CBCT) or MRI-guided therapy improves tumor localization and reduces margins. ViewRay’s MRIdian offers real-time MRI-guidance.
Adopt Adaptive Radiotherapy: Adjusting treatment plans based on daily changes in patient anatomy can significantly improve outcomes. This involves software capable of rapid re-planning. RaySearch Laboratories provides advanced adaptive therapy solutions.
Enhance Quality Assurance (QA) Protocols: Implementing rigorous and automated QA processes ensures consistent performance. Sun Nuclear offers comprehensive QA tools for Linacs.
Invest in Staff Training: Ongoing education for technicians and physicists on the latest techniques and technologies ensures optimal use of the Linac capabilities. Professional bodies like AAPM offer resources and training.
Optimize Beam Shaping and Modulation: Utilizing multileaf collimators (MLCs) with finer leaf widths and advanced modulation techniques like VMAT or IMRT improves dose conformity.
Each of these strategies contributes to the safety, efficacy, and efficiency of Linac-based treatments, directly impacting patient care quality in the field of medical physics.
How to Display Linear Accelerator Skills on Your Resume
8. Monte Carlo Simulations
Monte Carlo simulations are a computational technique that uses random sampling to model and analyze complex systems. In the context of medical physics, they are used to simulate the interactions of particles (such as photons, electrons, protons) with human tissues, allowing for precise calculation of dose distributions in radiation therapy planning and radiological imaging, thereby improving treatment accuracy and patient safety.
Why It's Important
Monte Carlo simulations are crucial in medical physics because they provide highly accurate predictions of radiation dose distributions within complex geometries, such as the human body. This enables precise treatment planning and optimization in radiotherapy, ensuring effective cancer treatment while minimizing exposure to healthy tissues.
How to Improve Monte Carlo Simulations Skills
Improving Monte Carlo simulations, especially in the context of medical physics, involves enhancing accuracy, reducing computational time, and ensuring the reliability of simulation outcomes. Here are concise strategies:
Variance Reduction Techniques: Implement variance reduction techniques like importance sampling or Russian roulette to decrease the number of simulations needed for statistical precision. Variance Reduction Techniques provide a deep dive into methods suitable for medical physics applications.
Parallel Computing: Utilize parallel computing frameworks to distribute the workload across multiple processors or nodes, significantly cutting down computation time. The use of GPUs in Monte Carlo Simulations has shown promising results in accelerating computations.
Algorithm Optimization: Optimize algorithms for the specific hardware being used. This involves code profiling and refactoring to eliminate bottlenecks. Optimized Monte Carlo Algorithms discusses optimizations for medical physics applications.
Use of Pre-calculated Databases: For components of the simulation that are repetitive or can be standardized, using pre-calculated databases can save significant computational time. Pre-calculated Dose Databases in radiotherapy planning exemplify this approach.
Adaptive Mesh Refinement: Implement adaptive mesh refinement to focus computational resources on regions of interest, improving accuracy without a proportional increase in computation time. Adaptive Techniques in Monte Carlo outlines strategies relevant to medical physics.
Code Verification and Validation: Ensure the reliability of simulations through rigorous verification and validation against experimental data or standardized benchmarks. Code Verification Strategies provide a framework for assessing the accuracy of Monte Carlo simulations in a medical context.
Incorporating these strategies can lead to more efficient and accurate Monte Carlo simulations, facilitating their use in complex medical physics applications such as radiation therapy planning, dose calculation, and imaging.
How to Display Monte Carlo Simulations Skills on Your Resume
9. Quality Assurance
Quality Assurance (QA) in the context of a Medical Physicist involves systematic procedures and activities aimed at ensuring that all medical equipment and procedures meet predefined standards of safety and effectiveness, thereby ensuring the best possible patient care.
Why It's Important
Quality Assurance (QA) is crucial for a Medical Physicist to ensure the safety, accuracy, and effectiveness of radiation treatments and diagnostic procedures, thereby protecting patients, staff, and ensuring regulatory compliance.
How to Improve Quality Assurance Skills
Improving Quality Assurance (QA) in the context of a Medical Physicist involves adopting a comprehensive, systematic approach to ensure the safety and efficacy of radiation therapy and diagnostic imaging. Here’s a concise guide:
Establish Robust QA Programs: Develop and implement rigorous QA programs tailored to the specific needs of radiation therapy and diagnostic imaging. The American Association of Physicists in Medicine (AAPM) provides guidelines and resources for creating effective QA protocols.
Regular Equipment Calibration and Maintenance: Ensure that all equipment is calibrated and maintained according to the manufacturer's recommendations and international standards. The International Atomic Energy Agency (IAEA) offers standards and guidance on equipment QA.
Continuous Education and Training: Invest in ongoing education and training for staff to keep abreast of the latest QA methodologies and technologies. The AAPM Education & Training page provides resources and opportunities for professional development.
Implement Incident Learning Systems: Utilize incident learning systems to capture, analyze, and learn from QA failures or near misses. The Radiation Oncology Incident Learning System (RO-ILS) is one such example tailored for radiation oncology.
Peer Review and Auditing: Conduct regular peer reviews and audits of QA processes to ensure compliance with established standards and identify areas for improvement. The Quality Assurance Review Center (QARC) provides auditing services and resources for clinical trials in radiation oncology.
Leverage Technology for QA: Adopt advanced technologies like automated QA tools and software to enhance the efficiency and accuracy of QA processes. Research current and emerging technologies that can support QA efforts.
By integrating these strategies, Medical Physicists can significantly enhance the quality assurance framework within their practice, ensuring the highest standards of patient care and safety.
How to Display Quality Assurance Skills on Your Resume
10. Treatment Planning
Treatment planning, in the context of a Medical Physicist, refers to the process of designing a radiation therapy regimen tailored to a patient's specific medical condition, with the aim of maximizing the radiation dose to the target area (tumor) while minimizing exposure to surrounding healthy tissues. This involves detailed calculations and the use of sophisticated software to simulate and optimize the treatment parameters.
Why It's Important
Treatment planning is critical for a Medical Physicist because it ensures the precise and effective delivery of radiation therapy to target cancerous tissues while minimizing exposure and damage to surrounding healthy tissues, thereby optimizing patient safety and treatment outcomes.
How to Improve Treatment Planning Skills
To enhance treatment planning as a Medical Physicist, focus on the following steps:
Stay Updated with Technology: Regularly update your knowledge on advancements in treatment planning systems (TPS) and imaging technologies to utilize the latest features and achieve more accurate planning. Radiological Society of North America (RSNA) is a good resource for latest updates.
Optimize Protocols: Continuously review and optimize planning protocols to improve accuracy and efficiency. Tailoring protocols to specific treatment types can significantly impact outcomes. American Association of Physicists in Medicine (AAPM) offers guidelines and studies on protocol optimization.
Interdisciplinary Collaboration: Work closely with radiation oncologists, dosimetrists, and other healthcare professionals to ensure that each treatment plan is optimized for the individual patient’s needs. This promotes a comprehensive approach to treatment planning.
Quality Assurance (QA) Programs: Implement robust QA programs for both the TPS and planning process to ensure accuracy and safety in patient treatment. Regular QA checks help identify and rectify potential issues early. International Atomic Energy Agency (IAEA) provides resources on QA standards and practices.
Education and Training: Engage in continuous education and training to improve your skills and knowledge in treatment planning. Attending workshops, seminars, and online courses can keep you informed on the latest techniques and software improvements. Medical Physics Web offers a range of educational resources.
Patient-specific Quality Control: Implement patient-specific quality control measures, such as independent dose calculation checks and plan peer review, to ensure the accuracy and safety of each treatment plan.
Leverage Artificial Intelligence (AI): Explore the use of AI and machine learning in treatment planning to enhance efficiency and precision. AI can assist in automating aspects of the planning process, leading to reduced planning times and potentially more optimized treatment plans. PubMed can be searched for the latest research on AI in treatment planning.
By focusing on these areas, Medical Physicists can significantly improve the treatment planning process, enhancing both the quality and safety of patient care.
How to Display Treatment Planning Skills on Your Resume
11. Radiobiology
Radiobiology is the study of the action of ionizing radiation on living organisms, particularly the understanding of the effects at the cellular and molecular levels. For a Medical Physicist, it involves applying this knowledge to optimize radiation therapy treatments for cancer, ensuring maximum damage to cancer cells while minimizing harm to surrounding healthy tissue.
Why It's Important
Radiobiology is crucial for a Medical Physicist because it provides the foundational understanding of how ionizing radiation interacts with biological tissues, enabling the optimization of cancer treatment plans to maximize tumor control while minimizing damage to healthy tissues.
How to Improve Radiobiology Skills
Improving radiobiology knowledge as a Medical Physicist involves a multifaceted approach focusing on continuous education, practical application, and research. Here’s a concise guide:
Continuous Education: Engage in ongoing learning through accredited courses and webinars. The American Association of Physicists in Medicine (AAPM) offers resources and courses tailored for medical physicists.
Certifications and Workshops: Attain certifications or attend workshops from recognized bodies like the International Atomic Energy Agency (IAEA) which focuses on applying radiation medicine safely and effectively.
Hands-On Practice: Apply theoretical knowledge in clinical settings under the supervision of experienced professionals. Practical application is crucial for understanding the complexities of radiobiological effects.
Research and Innovation: Stay abreast of the latest research by reading peer-reviewed articles in journals like Radiotherapy and Oncology or International Journal of Radiation Oncology, Biology, Physics. Engage in research projects to contribute to the field’s growth.
Networking and Collaborations: Join professional networks like LinkedIn groups specific to Medical Physics or the Radiation Research Society to exchange knowledge, experience, and collaborate on projects.
Utilize Simulation Software: Engage with radiobiology simulation software and tools to better understand dose-response relationships and radiation interactions with tissue at the cellular level. Companies like Varian provide sophisticated software for treatment planning and radiobiological evaluation.
Attend Conferences: Participate in international conferences such as those organized by the European Society for Radiotherapy & Oncology (ESTRO) to gain insights into the latest research findings, technological advancements, and clinical applications.
By integrating these approaches, Medical Physicists can enhance their expertise in radiobiology, contributing to improved patient care and safety in radiation therapy.
How to Display Radiobiology Skills on Your Resume
12. Eclipse (Varian)
Eclipse (by Varian) is a sophisticated radiation therapy treatment planning system used by medical physicists and clinicians to design and optimize cancer treatment plans. It integrates imaging, dose calculation, and plan evaluation tools to tailor radiotherapy treatments to individual patient anatomy and tumor characteristics, ensuring precise and effective delivery of radiation.
Why It's Important
Eclipse (Varian) is important for a Medical Physicist because it is a sophisticated treatment planning system that enables precise and accurate planning of radiation therapy, ensuring optimal dose distribution while minimizing exposure to healthy tissues, critical for patient safety and treatment effectiveness.
How to Improve Eclipse (Varian) Skills
Improving Eclipse (Varian) for Medical Physicists involves enhancing accuracy, efficiency, and user experience. Here's a concise guide:
Stay Updated: Regularly update Eclipse to the latest version to access new features and improvements. Varian provides updates and support.
Custom Scripts: Utilize or develop custom scripts for repetitive tasks to save time and reduce errors. Explore the AAPM TG-275 report for guidelines on safe and effective script use.
Training and Certification: Engage in continuous training and certification programs offered by Varian and other educational platforms to enhance proficiency.
Optimize Hardware: Ensure that your computing hardware meets or exceeds Varian's recommendations for optimal performance. Regularly check the Varian support page for hardware specifications.
Network with Peers: Join forums and user groups, such as AAPM or Medical Physics, to exchange tips, scripts, and experiences with other professionals.
Leverage AI and Automation: Explore Varian's AI-driven tools and automation features for planning efficiency and accuracy improvements. Keep an eye on Varian's latest innovations.
Feedback Loop: Actively provide feedback to Varian for features or improvements you'd like to see, fostering a product that better suits clinical needs.
By staying informed, leveraging technology, and engaging with the community, Medical Physicists can significantly enhance their use and efficiency of Eclipse in clinical practice.