Starring: ‘Technical physicians’
“In the rapidly evolving world of technology-driven innovations in radiotherapy, technical physicians are an ideal bridge between clinicians, medical physicists and RTTs.” – Professor Dr Remi Nout, head of the department of radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Medical technology has become an integral part of modern healthcare, and treatment methods are becoming increasingly advanced and technology-driven. These innovations require medical professionals who also possess deep technical knowledge—professionals capable of ensuring that technologies are applied safely, effectively, and meaningfully in patient care. Therefore, a new type of healthcare professional is emerging and becoming increasingly recognised in the Netherlands: the technical physician [1]. These special professionals are trained in both medicine and technology, equipping them with the knowledge and skills to bridge the gap between these dynamic fields and contribute meaningfully to patient-centred innovation.
Bachelor and Master of Technical Medicine
Technical physicians are educated across disciplines through a six-year bachelor’s and master’s programme in Technical Medicine, which combines scientific, medical, engineering, and informatics knowledge [2]. The programme concludes with two years of clinical internships, which are intended to provide experience in patient care and to integrate technical knowledge into real patient settings. Graduated technical physicians can register in the Dutch register of Professions in Individual Health Care, which gives them a protected professional title and allows them to perform specific clinical tasks independently. The programme was launched in 2003 and is currently offered at two Dutch technical universities in collaboration with university medical centres. By June 2025, more than 1000 technical physicians had graduated. The added value of technical physicians is increasingly acknowledged internationally, with several technical physicians now employed in healthcare institutions abroad.
Technical physicians in radiotherapy
Technical physicians work in a wide range of healthcare fields, including medical imaging, physiological measurements and simulations, ionising radiation, and radiopharmacy [3]. Several of these professionals are active in the field of radiotherapy. According to a survey conducted in June 2025, there are currently 29 technical physicians working in radiotherapy in ten different institutes in the Netherlands (Figure 1). Of these, 20 are mainly involved in research, including three assistant professors; seven are directly employed as technical physicians, while one works as an innovation physicist and another as a medical software engineer (Figure 2). Ten of the 29 technical physicians working in radiotherapy are directly involved in patient care. Their main areas of interest include online adaptive radiotherapy, hyperthermia, treatment planning, and proton therapy.
Technical physicians in clinical practice
A clear example of the added value of technical physicians in radiotherapy is their role in online adaptive radiotherapy. Their combined medical and technical expertise enables them to assume responsibilities traditionally held by both radiation oncologists and medical physicists, such as supervising radiation therapists (RTTs) during online adaptive treatment sessions. Moreover, they play a key role in RTT training, RTT-only education, implementation of new treatment sites, quality assurance, and research. They also serve as the primary point of contact for RTTs when questions arise during online adaptive treatments. Currently, four technical physicians are active in this field and have become indispensable members of their teams.
Technical physicians also play a key role in proton therapy, in which they are trained to develop complex treatment plans for this advanced modality. Their expertise, combined with academic problem-solving skills, enables them to drive the implementation of new indications and innovative techniques. In addition, their integrated knowledge of treatment planning, medicine, engineering, and informatics allows them to support the automation of planning workflows, both through the integration of artificial intelligence and scripting of manual steps. These efforts help to reduce workload pressures in a healthcare system that is increasingly under strain.
More practical examples of technical physicians working in the field of radiotherapy can be found on principles-of-tm.nl in the section Clusters > Imaging > Radiotherapy [4].
Conclusion
Technical physicians are healthcare professionals who combine medical and technical expertise to optimise workflows and to develop or implement innovations in the field of radiotherapy. As innovations in medicine and technology continue to evolve, their role is becoming increasingly integrated and valued within the Dutch healthcare system and is gaining recognition internationally.
Figure 1: Number of technical physicians working in radiotherapy per institute in the Netherlands.
Figure 2: Roles of technical physicians in radiotherapy in the Netherlands
Eva Negenman
Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
Department of Medical Physics and Informatics, Holland PTC, Delft, The Netherlands
e.negenman@erasmusmc.nl
Judith Sluijter
Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
j.sluijter@erasmusmc.nl
References
- Groenier, M., Spijkerboer, K., Venix, L., Bannink, L., Yperlaan, S., Eyck, Q., van Manen, J. G., & Miedema, H. A. T. (2023). Evaluation of the impact of technical physicians on improving individual patient care with technology. BMC Medical Education, 23(1), 181. https://doi.org/10.1186/s12909-023-04137-z
- Groenier, M., Pieters, J.M. & Miedema, H.A.T. Technical Medicine: Designing Medical Technological Solutions for Improved Health Care. Med.Sci.Educ. 27, 621–631 (2017). https://doi.org/10.1007/s40670-017-0443-z
- Slart, R.H.J.A., de Geus-Oei, LF. A new colleague in nuclear medicine, the clinical technologist: quo vadis?. Eur J Nucl Med Mol Imaging 49, 3012–3015 (2022). https://doi.org/10.1007/s00259-022-05789-7
Tamsma, J., et al. Principles of Technical Medicine. Retrieved June 25, 2025, from https://principles-of-tm.nl/