How to appoint the right architect for a LINAC facility

The AERB eLORA process for a LINAC facility is a distinct skill. Each stage has specific documentation requirements, AERB query patterns, and compliance logic that only direct experience reveals. A general hospital architect — even an excellent one — who has not completed this process will be navigating it for the first time on your project. The cost is measured in months, not fees.

Ar. Rahul Saxena at Studio Athenos, Jaipur, designed the radiotherapy facility at Jeevan Raksha Complete Cancer Care, Bikaner — a 300-bed NABH oncology hospital with two LINAC bunkers, PET-CT and a gamma camera, a project that demanded everything this building type demands. What that project revealed about what goes wrong, and why, is the basis for this guide.

An architect who describes their physicist as someone who ‘reviews drawings after design’ has told you everything you need to know about how the project will go.

The physicist is not a reviewer

The medical physicist is a co-designer of the bunker — not a consultant brought in to verify completed drawings. Shielding calculations determine wall thicknesses. Wall thicknesses determine room dimensions. Room dimensions determine the structural system. The structural system determines the cost. This sequence cannot be reversed.

At Jeevan Raksha, the physicist was part of the team before a single drawing was produced. The shielding design drove the architectural layout. This is the correct sequence — and any architect who does not work this way will produce either a facility that fails AERB review or one that requires expensive structural revision before submission.

What happens when AERB raises queries

AERB routinely raises design queries during the Licence to Construct review. Each query requires a formal written response with revised drawings where applicable. An architect unfamiliar with AERB’s query patterns will treat each one as a new problem — adding weeks per cycle. An experienced architect anticipates the queries before submission and prepares documentation that reduces the number of cycles. The difference between one query cycle and three is four to six months of construction delay before a column has been cast.

The other failure mode is construction deviation. When the Licence to Install inspection finds that the as-built structure does not match the approved drawings, the project stops. Remediation is expensive and slow. This is the reason well-funded LINAC projects in Rajasthan have run significantly over schedule.

What to ask before you appoint

Ask the architect to name a completed LINAC facility and provide a contactable person at that hospital — not a project name, a contact. Ask who their medical physicist is and whether the physicist can attend your first meeting. Ask how they handle AERB design queries and what their standard response process is. Ask what has gone wrong on their LINAC projects and how it was resolved. Ask what the realistic timeline is from first meeting to Licence to Operate.

An architect with genuine experience will answer each of these without hesitation. The answers will be specific — stage names, query patterns, concrete specifications, coordination failures encountered and resolved. Vague answers about experience with healthcare regulation are not the same as having navigated the eLORA process.

What the right appointment actually buys you

When the architect, physicist, structural engineer, and vendor are coordinated from the first meeting — when the submission is complete, the construction is supervised, and the deviations are zero — a LINAC project in India can move from decision to first patient in under 30 months. That is the outcome of a team that understood the process before they began it.

The patients who will use this facility are cancer patients. They are travelling, often from significant distances, for treatment that determines their prognosis. The timeline of your project is not an administrative matter. It is a clinical one.

“We built our cancer care facility in Bikaner — LINAC bunker, PET scan, gamma camera — with Ar. Rahul of Studio Athenos. The difficult parts, the shielding and AERB requirements, were sorted at the drawing stage itself, so nothing held us up at commissioning. He understands how a cancer hospital runs, not just how to build one.”