Getting ACR-ready: the physics a survey actually checks.

Accreditation and reaccreditation come around whether or not your physics program is ready for them. On the physics side, the surveyor isn't looking for surprises — they're looking for a specific, knowable set of records and practices. Here's what actually gets examined, and where programs most often fall short.

What the physics review covers

• Machine QA records. A complete, current TG-142 program — daily, monthly, and annual QA, with the documentation to prove it happened on schedule.
• Calibration and output. Beam calibration per accepted protocol, with traceable records.
• Patient-specific QA. A defined process for IMRT/VMAT/SBRT/SRS QA and plan review — and evidence it's followed.
• Chart-check process. Initial, weekly, and final chart QA, documented against the written directive.
• Personnel qualifications. A clearly identified Qualified Medical Physicist of record with verifiable board certification and, where required, state licensure.
• Policies and procedures. Written procedures for the physics program — not just the practice of it, but the documentation of it.

Where programs fall short

Rarely because the physics is bad — usually because the documentation is incomplete. The recurring gaps: missing or late monthly/annual QA records, an unclear or lapsed QMP of record, written procedures that don't exist or don't match practice, and — most commonly — holes that opened during a staffing transition, when nobody owned the paperwork for a stretch.

The point of preparation

A survey is far easier when a physicist who has taken programs through it walks the documentation first — reconciles the QA records, confirms the QMP-of-record and credentials, closes the procedural gaps, and finds the holes before the surveyor does. The goal isn't to perform for the survey; it's to run a program that's continuously ready, so the survey is uneventful.