Patient Relations
Bilal Jalal, a radiation oncology physics consultant at JHAH, works with fellow volunteers at US-based nonprofit Rayos Cancer Center to design and run free online training courses for radiation physicists in low and middle-income countries.
“I remember this one training session distinctly where several people got really upset and started crying after we showed them they’d done something wrong,” Bilal Jalal says. “Their patient had suffered serious side effects after undergoing radiotherapy, but they couldn’t figure out why.”
Mr. Jalal, a radiation oncology physics consultant at Johns Hopkins Aramco Healthcare (JHAH), was hosting an online training session for radiation physicists in developing countries. A group of participants had shown him their treatment plan for a brain tumor patient.
“With any tumor, you want to maximize the dose of radiation received by the tumor while minimizing spillage; that is, the dose to the surrounding tissue,” Mr. Jalal explains. “This was a brain tumor case, so there needed to be heightened sensitivity around spillage given that optic nerves and other sensitive organs were close by. Dosing these organs unintentionally can cause huge complications.
“Unfortunately, we showed the team that they had dosing spillage. Their dose was correct, but they hadn’t properly considered the direction of the beam.”
Mr. Jalal says this is exactly what the training programs are designed to catch and correct. “After we provided the necessary training, their work improved dramatically. The same clinicians went on to show us excellent dosing plans that helped to save patients’ lives.”
Mr. Jalal was hosting the course as part of his volunteer work for Rayos Contra Cancer, a US-based nonprofit that seeks to improve outcomes for cancer patients who undergo radiotherapy in low and middle-income countries. Rayos designs and operates free online training programs for clinicians who have access to functional radiotherapy equipment but limited education about its real-world use.
“We provide clinical training for the people who are in the field, from other people who have deep experience in the field,” Mr. Jalal says. “We’re training people all over the world. All our sessions are live and hands-on; they’re not just lectures. We have training exercises for things like dose planning, where we look at what the participants are doing on-screen to ensure they’re following the steps correctly. We also have evaluations and quizzes.”
He adds: “It’s about building confidence and competence in real time. We want participants to leave each session with practical skills they can immediately apply.”
Mr. Jalal has worked in the field of radiation oncology for more than 20 years. He is certified by the American Board of Radiology and the Institute of Physics and Engineering in Medicine, and serves as an examiner for the International Board of Medical Physics. He is co-chair of the virtual training committee at Rayos and a member of its teaching faculty.
One focus of Rayos is improving access to training and education about high-quality intensity-modulated radiation therapy (IMRT), which is also known as volumetric modulated arc therapy (VMAT). It is an advanced radiotherapy technique that minimizes collateral damage to non-cancerous tissues.
One of the Rayos courses, entitled “Mastering IMRT/VMAT for Medical Physicists,” is a free 15-week program composed of weekly, hour-long live online teaching sessions led by expert volunteers. The course, launched in 2022, aims to fill skills gaps for advanced radiotherapy techniques among clinicians in developing countries. Participants are instructed on matters such as treatment planning, dosing, quality assurance, simulation, motion management, and shielding.
The IMRT/VMAT course is the subject of two academic papers that were co-authored by Mr. Jalal and his colleagues at Rayos. One paper was published in the journal Radiotherapy and Oncology and the other, in the International Journal of Radiation Oncology - Biology - Physics.
The study examined the effectiveness of the course on improving confidence and knowledge among more than 500 medical physicists, dosimetrists, and medical physics residents, the majority of whom were based in Africa. It concluded that the course “significantly enhanced knowledge, confidence, and treatment planning skills among participants, demonstrating a scalable, low-cost intervention for improving IMRT/VMAT implementation” in developing countries.
The findings underscore the potential of virtual education to bridge global disparities in cancer care.
We do what we do because we see the positive impact of our work on the capabilities of the clinicians we teach,
This will translate into better outcomes for the patients in their care.
He adds: “Ultimately, it’s about saving lives through knowledge.”