IRMER duty holder roles — ORE Part 1 MCQ

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HardDental RadiologyIRMER duty holder rolesORE Part 1

In a dental practice audit, a dentist refers a patient for a periapical radiograph, another trained colleague justifies the exposure under written procedures, and a dental nurse takes the image under supervision. The practice is reviewing IR(ME)R duty-holder terminology. What is the correct assignment of roles?

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Correct answer: C — Referrer requests exposure, practitioner justifies it, and operator carries out practical aspects

Under UK IR(ME)R 2017, the three key duty-holder roles in dental radiography are precisely defined. The referrer initiates a radiographic request; the practitioner (usually a dentist, but may be a suitably trained dental hygienist or therapist) justifies the exposure by determining that its diagnostic benefit outweighs radiation risk; the operator (which includes dental nurses under supervision) carries out practical aspects: patient identification, positioning, button pressing, film processing, and quality control. In the scenario, the dentist acts as referrer, the colleague acts as practitioner, and the dental nurse acts as operator. Option C correctly names all three roles and their functions. Option D conflates roles incorrectly (referrer does not expose; practitioner does not file administrative notes; operator does not prescribe treatment). Option B wrongly suggests operators justify exposures and may be untrained—a breach of IR(ME)R. Option E mistakes the patient for the practitioner. Option A incorrectly links IR(ME)R terminology to medicines, not radiation safety. The question discriminates because it requires candidates to distinguish the three distinct IR(ME)R duty-holder roles and match them to their correct functions in a typical dental practice scenario.

Reference: SDCEP Practice Support Manual (2024): Formal Appointments and Entitlement of Personnel; UK Government (2024): Guidance to the Ionising Radiation (Medical Exposure) Regulations 2017; https://www.psm.sdcep.org.uk/topics/radiation-protection/formal-appointments-and-entitlement-of-personnel/requirements-within-the-practice/; https://www.gov.uk/government/publications/ionising-radiation-medical-exposure-regulations-2017-guidance/guidance-to-the-ionising-radiation-medical-exposure-regulations-2017