Nuclear Medicine.. Isn't the future bright?

[doc_radio]

Hey! I'm interested in doing a residency in Nuclear Medicine😍
In my opinion its cool because
1. less number of years 2+1 of Residency
2. less competitive as compared to radio
3. People like me who want to stay associated with Teaching institutions have a career here in this field.
4. Has brighter areas of research.
5. Job is less tiring.
6. People like me who aren't very keen to go for Private practice in future can have a good life in Nucs.
7. Nucs is getting in demand these days..

Hey! If I'm wrong Please correct me. Its an important decision for me!!
Is there any loop hole in my conclusion?
Is nucs a good idea If private practice isn't on my mind???

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[Ruban]

 

[doc_radio]

thats silly!
being a senior member how can u post such a silly message, anyways may god bless you with some brains!👎

 

[doc_radio]

hey nobody helped me!
But I found answers to my questions so I'll enlighten other ppl about whatevr i got to know!!!
1. less number of years 2+1 of Residency

Not really true as of 2007. it will become 3+1 program UNLESS you are board certfied by any other field such as IM FP PEDS etc. In that case, it will mean you need to do only 2 more years of training.

2. less competitive as compared to radio

Yes
3. People like me who want to stay associated with Teaching institutions have a career here in this field.

thats true, it has a lot of scope if you want to be in academics

4. Has brighter areas of research.

Certainly there are more opportunities to publish.
5. Job is less tiring.

Absolutely.

6. People like me who aren't very keen to go for Private practice in future can have a good life in Nucs.

Yes, there are more jobs in Academics

I'll post more as I get to know more about it!!👍

 

[scully]

Thanks Doc-Radio, I am interested too, so I appreciate the info!

 

[hans19]

I would have some reservations about pursuing a Nuclear medicine residency in this day and age. For one thing, yes PET is proving a superior tool for oncologic imaging, but now PET fusion imaging is coming to the forefront. You will be at a severe disadvantage when PET-MR comes into being as MRI is significantly more challenging than CT to read. As it is, I don't see how one can get enough CT experience in nuclear medicine to confortably read the CT part of the PET-CT studies.

Further more, PET is great but only for certain cancers, it is not useful in RCC or BACs. It is helpful in reading nuclear medicine studies if you can correlate them with their sister diagnostic imaging studies, and not just the written impression from the report.

Furthermore, there are increasing applications for MRI technology that can yield functional information. Molecular imaging are buzz words, but PET has been available for a while and is a type of molecular imaging. As far as immunolabeled molecular imaging goes, until the price of immunolabeling technology comes down, I don't see how it can become a viable (if not profitable, then at least break even) mainstream modality.

There are rumors that, in the future the government will require a minimum of 2 years of dedicated nuclear medicine experience training before one can be reimbursed for interpreting a PET study. This may breathe life into nuclear medicine residencies, as the majority are not filling, or simply closing down. Again if you pursue this route you need to be sure you can get good cross sectional training in CT or MR.

I still think that a career in pure nuclear medicine is only viable as a niche in academics. But I think you would be better served doing a radiology residency followed by a nuclear medicine fellowship. Radiology is competitive, but not as competitive as a few years ago.

What ever your decision, I wish you luck.

 

[doc_radio]

Thanks Hans!
For giving me the insight!!🙂

 

[f_w]

> 1. less number of years 2+1 of Residency

But also a lot narrower a scope.

> 2. less competitive as compared to radio

Not necessarily an advantage.

> 3. People like me who want to stay associated with Teaching
> institutions have a career here in this field.

The good academic jobs are very competitive to get in nucs. There are still more graduates than jobs, the good academic institutions can pick.

> 4. Has brighter areas of research.

Certainly. Lots of room for people with a firm grasp on physiologic processes and imagination.

> 5. Job is less tiring.

Than digging ditches, yes. If you do the same volume of nucs studies that a typical radiologist does in other modalities you will see little white mice by 5pm as well.

> 6. People like me who aren't very keen to go for Private
> practice in future can have a good life in Nucs.

I am glad you have no illusions about the prospects of 'nucs-only' people in private practice.

> 7. Nucs is getting in demand these days..

Yes and no. PET-CT has been growing like crazy over the last 3-5 years, however the recent deficit reduction act will put quite a damper on that growth.
The dirty secret is that most of this growth is in private practice, most of these studies are not interpreted by nucs physicians but rather by nuclear radiologists, general radiologists and often cardiologists. So looking at the utilization numbers and translating them into equal growth in job opportunities is a fallacy.

 

[f_w]

I don't see how one can get enough CT experience in nuclear medicine to confortably read the CT part of the PET-CT studies.

The good thing about the PET-CT setup these days is that most of these patients had regular diagnostic CTs before the PET-CT. So the person interpreting the PET-CT often has a diagnostic CT to correlate the findings.

Molecular imaging are buzz words,

Everytime someone babbles to me about 'molecular imaging being the future of nuclear medicine', I try to get an answer what 'molecular imaging' actual means (if I give a patients 350yCi of I123 and scan their thyroid, is that 'molecular imaging' as well ?)

As far as immunolabeled molecular imaging goes, until the price of immunolabeling technology comes down,

So far not exactly a raging success. 'Neotect' got pulled from the market because PET-CT (and a biopsy needle or surgeons video thoracoscope) can do the job at hand so much better.

I don't see how it can become a viable (if not profitable, then at least break even) mainstream modality.

It can become a viable modality once it has a 'killer-App', preferably something in a common and treatable disease, e.g. heart disease (doesn't help to find a tracer for tsutsugamushi fever, you need to detect a disease that fat people get in order to pay for R&D)

There are rumors that, in the future the government will require a minimum of 2 years of dedicated nuclear medicine experience training before one can be reimbursed for interpreting a PET study.

I don't see that happening. Hard to make that case, and there is so much money being made with PET at this time that I see strong interests who will lobby this away (mostly cards).
Only 2 years ago, the NRC reduced the minimum requirements for a materials license from 1000 to 700 hours. Don't see that they would go up specifically for PET.

But I think you would be better served doing a radiology residency followed by a nuclear medicine fellowship.

Amen to that.

Radiology is competitive, but not as competitive as a few years ago.

If you have the brains and credentials to make yourself a research career in nuclear medicine, you should be able to get into a radiology residency.

 

[fedupme]

hey f_w thanks!!!!😛 😀 😳 🙂 😉 😎

 

[ir1234]

A career in nuclear medicine😉

Nuclear medicine is the branch of imaging that uses radio-isotopes to study the physiology and metabolism of the body (rather than the anatomy shown by x rays, computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI)). Nuclear medicine today is the exciting development of the early 20th century pioneering work of, among others, Rutherford, the Curies, and Lawrence, who built the first cyclotron in 1933. With all the new isotopes and radiopharmaceuticals we now have available, there is huge scope for advances in the field. If you are the sort of person who would enjoy the challenge of working in a rapidly developing multicraft specialty, then you may well be a candidate for a national training number (NTN) in nuclear medicine. It also helps to be computer literate. There have been many recent advances in nuclear medicine, but without doubt the most exciting is the development of positron emission tomography (PET) imaging, and in particular PET/CT. This has revolutionised oncological imaging, and ideally no major cancer centre should be without PET.

Today, nuclear medicine encompasses a wide range of investigations and treatments.

Nuclear medicine, being essentially physiological, correlates well with all other forms of imaging, which are mainly anatomical. We can show the activity of disease rather than the anatomical appearance. For example, in Crohn's disease the barium enema will show what the bowel looks like, but the labelled white cell scan will show the extent of activity. It's a vital tool for the clinician. There is therefore a huge interaction with the rest of imaging, the clinicians and the oncologists. Box 1 shows a typical week in nuclear medicine.

Box 1: A typical week in nuclear medicine
Reporting all types of scans
Carrying out cardiac stress studies
Pretreatment clinics for thyrotoxic patients and for other treatments
Administration of treatment--for example, radio-iodine
Taking part in multidisciplinary teams
Teaching
Research and development
Other hospital committee work
Possibility of continuing radiology or general medicine work

Nuclear medicine treatment

You can also become involved in the therapeutic aspects of nuclear medicine, both curative as in the treatment of thyrotoxi-cosis with 131I, neuroendocrine tumours with yttrium and 131I, and palliative as in the administration of strontium or samarium to alleviate pain from bone metastases. In many centres, treatment of thyrotoxicosis with radio-iodine is the preferred option, and has excellent results. Nuclear medicine treatment offers the possibility to target neuroendocrine tumours, such as carcinoid, selectively and research is continuing to label specific monoclonal antibodies to various tumours both for diagnosis and treatment.

Nuclear medicine scans can be either static or dynamic, thus showing differing aspects of the body's function (box 2).

There is no doubt that the future lies with PET scanning. PET uses 18F labelled fluoro-deoxyglucose, a glucose analogue, to map the metabolic function of cells. This, when combined with modern CT, gives a most powerful weapon in the staging of malignancy.

PET is also useful in cardiac imaging to define hibernating myocardium, and in neurological imaging, particularly of dementia.

Box 2: Scans reflecting differing aspects of the body's function
Static

Bone
Thyroid
Lung scan
DMSA renal
PET
Dynamic

MAG3 renal
Cardiac

Job appeal and satisfaction

For all the reasons I have given, nuclear medicine can be a very satisfying career (box 3)

The satisfaction often comes from clarifying a diagnosis which is not clear clinically, such as pulmonary embolism. Your images alter the patient's treatment for the better. Nothing beats letters of thanks from patients you have helped or cured.


Box 3: Appeal of nuclear medicine
Intellectually very satisfying as part of a multicraft team
Intensive work
Good correlation with radiology and general medicine
Research involvement in all studies requiring an ARSAC licence
Friendly colleagues within nuclear medicine world
Job sharing possible
Good balance between work and life

The future

This is bright and good for nuclear medicine specialists. Without doubt, the future is CT/PET, as cancer and oncology enjoy a high priority. Nuclear medicine can and does have a vital role in both diagnosis and therapy, and you can be part of it.

Plan to visit your local nuclear medicine department, talk to the staff there, and see if you have what it takes.

 

[doc_radio]

cool post

 

[fedupme]

what's the average salary of a nuclear medicine physician, in private & academic setting, respectively. Anybody?
2006 AMGA PHYSICIAN COMPENSATION SURVEY say its $300k/annum... is that realistic?😕

 

[f_w]

what's the average salary of a nuclear medicine physician, in private & academic setting, respectively. Anybody?
2006 AMGA PHYSICIAN COMPENSATION SURVEY say its $300k/annum... is that realistic?😕

That number in all likelihood includes mostly 'nuclear radiologists', physicians who have completed a radiology residency and a nuclear medicine fellowship.

That said, I am sure there are nuclear medicine docs who make this and more. From the experience of the people I know who where looking for jobs fresh out of nucs residency, the job market is pretty dismal. Most of them went on to do DR residencies for that reason.

 

[Astrocyte]

Lots of good stuff here. I hope everyone ultimately gets to do what they enjoy, regardless of the path they take.

I will probably do a NM residency after neurology. I think it will give me a great tool to attack a clinical or basic problem - whatever that might be.

 

[ir1234]

GOOD LUCK TO YOU ASTROCYTE!!!!!
All said & done one should do what appeals to him/her the most! I'm convinced Nuc's will be good for me, to many others it might not be, IT's SUBJECTIVE!!!😎

 

[f_w]

All said & done one should do what appeals to him/her the most! I'm convinced Nuc's will be good for me, to many others it might not be, IT's SUBJECTIVE!!!😎

Well, objectively I know a couple of people who had great difficulty finding nuclear medicine attending positions. It is great to be excited about a field, but it is certainly not a bad idea to look at the cold hard facts.
That said, adding it on top of a neuro residency similar to a fellowship sounds like a good idea. If you specialize in the neuro applications and make a career out of it, it can certainly be very fulfilling.