In 1964, a report published by McCormack noted that the amount and complexity of nuclear medicine procedures was increasing and he suggested the 3 months of nuclear medicine training that diagnostic radiology residents were receiving at that time was probably not adequate ( ). The minimum requirement of time in nuclear medicine training was subsequently increased to 6 months, where it has remained until recently. In March 2004, the American Board of Radiology decreased the nuclear medicine minimum training requirement to 4 months. This was primarily in response to the reduction in hourly training requirements of the Nuclear Regulatory Commission (NRC) for licensure ( ). The growth of new nuclear medicine modalities such as positron emission tomography (PET)/computed tomography (CT), single-photon-emission computed tomography/CT, and molecular imaging would suggest that more time is needed for nuclear medicine training. Given the recent reduction in time for training, it is important to identify aspects of resident training in nuclear medicine that can be improved on. This study was undertaken under the sponsorship of the Society of Nuclear Medicine (SNM) Committee on Education, the SNM Young Professionals Committee, and the SNM Program Directors Association, which are working to develop new educational tools for resident training in nuclear medicine. Our goals were to assess radiology residents’ perceptions regarding various aspects of their nuclear medicine training and to assess residents’ preferred formats for new nuclear medicine educational materials.
Materials and methods
A Web-based survey consisting of 24 multiple choice, matrix, or one-word open-ended questions was created to assess radiology residents’ perceptions of various aspects of their current training and to assess residents’ preferred formats for nuclear medicine educational materials ( Table 1 ). The survey was distributed to 305 chief radiology residents by the SNM Young Professionals Committee and the SNM Program Directors Association in conjunction with the Association of University Radiologists and the Association of Program Directors in Radiology. The survey was placed on the Web at http://www.surveymonkey.com and distributed via e-mail. The chief residents were encouraged to ask other residents in their respective programs to also participate in the survey. Responses were accepted between August 2005 and November 2005. Residents were asked to rate the quality and quantity of their clinical, didactic, and nuclear medicine physics training. Residents were also asked if they had enough training/experience to perform various nuclear medicine tasks including: performing therapies and interpreting PET/CT, nuclear cardiology, and general nuclear medicine studies. Last, they were asked about their preferred formats for educational materials including: didactic lectures in CD-ROM format, a Web-based case lecture series or modules, and nuclear medicine board review courses. Data were analyzed on a percentage basis for all respondents and for some questions for the subset of fourth-year radiology residents.
Table 1
Survey Questions
1. What year are you in your radiology training program? a. 1 b. 2 c. 3 d. 4 2. How much nuclear medicine training have you already received? a. 4–6 months b. 2–4 months c. 0–2 months d. none 3. How have you received the above training (give as % of all nuclear medicine training)? a. Clinical rotations b. Didactic lectures c. Self-study d. On-call experience e. Other (please indicate type) 4. How would you rate your nuclear medicine training on a scale of 1 to 5 for each of the following (5 being the best)? a. Amount of clinical training (adequate months) b. Quality of clinical training (clinical experience) c. Quality of didactic training (clinical lectures) d. Quantity of nuclear medicine physics/instrumentation e. Quality of nuclear medicine physics/instrumentation 5. Have you had enough training/experience to do nuclear medicine therapies (radioimmunotherapy, thyroid, bone pain, etc.)? a. Yes b. No 6. Have you had enough training/experience to read PET and PET/CT? a. Yes b. No 7. Have you had enough training/experience to read nuclear cardiology? a. Yes b. No 8. Have you had enough training/experience to read general nuclear medicine? a. Yes b. No 9. The proposed new requirement of 4 months in nuclear medicine training (to now include therapy) as compared with 6 months is: a. More than enough b. Adequate c. Inadequate 10. I am considering a nuclear medicine fellowship. a. Yes b. No 11. I plan to read nuclear medicine in my practice. a. Yes b. No 12. I plan to read PET/CT in my practice. a. Yes b. No 13. In my institution, the nuclear myocardial perfusion stress tests are read by: a. Nuclear medicine b. Cardiology c. Both 14. In my institution, PET and PET/CT reading is done by: a. Radiology b. Nuclear medicine c. Either, but individually d. Radiology and nuclear medicine together 15. Would you be interested in nuclear medicine review materials or a nuclear medicine–focused board review if available? a. Yes b. No 16. What topics would you like the review materials to cover? (Please give each topic a rank from 1 “most needed” to 5 “least needed”) a. General nuclear medicine (bone, pulmonary, GI, GU …) b. Nuclear medicine physics c. Cardiovascular nuclear medicine d. Molecular Imaging/PET e. Unsealed source therapy f. Radiopharmaceuticals g. Pediatric nuclear medicine h. Other (please specify) 17. For the topics listed in question 16, please list the letters in order of importance to cover in review materials (first most important, last least). 18. In what format would the review materials be most valuable? a. Didactic lectures (Board review courses, regional cities around the country) b. Didactic lectures (Board review courses at a meeting such as AUR or RSNA) c. Didactic lectures (CD-ROM presentations, sent to each program director) d. Web-based, case-based lectures or modules e. Other (please specify) 19. I would attend a board review course for nuclear medicine if held at a city near me. a. Yes b. No 20. I would attend a board review course for nuclear medicine if held at one or two sites (East or West coast) nationally. a. Yes b. No 21. I would attend a board review course for nuclear medicine if held in conjunction with a national meeting (RSNA, AUR). a. Yes b. No 22. I would listen to a CD- or Web-based didactic review lecture. a. Yes b. No c. Depends on topic (please specify) 23. I would work through a CD- or Web-based, case-based review module. a. Yes b. No c. Depends on topic (please specify) 24. I: a. Do not care about learning nuclear medicine b. Care only enough to pass the boards c. Find nuclear medicine very interesting and want to learn more d. Other (please specify)
Results
A total of 151 responses was received. The absolute response rate was not calculated because chief residents were encouraged to forward the survey to other residents in their respective programs and it was not possible to determine the total number of possible respondents. Respondents may have included both chief residents and non–chief residents. Sixteen of the respondents were first-year residents, 19 were second years, 49 were third years, and 67 were fourth years. At the time of the survey, 5% had no training in nuclear medicine, 23% had 0–2 months, 47% had 2–4 months, and 25% had 4–6 months ( Table 2 ). Eighty-six percent of residents ( n = 143) said that they received between 50% and 100% of their training via their clinical rotations. Didactic lectures and self-study accounted for the second largest component of training. Call accounted for the smallest component of training, with 100% of residents stating that call comprised only 0% to 24% of their training. Only 8% of residents were considering a fellowship in nuclear medicine ( n = 149). Seventy-two percent of respondents planned to read nuclear medicine in their future practices ( n = 150), and 81% planned to read PET/CT ( n = 150).
Table 2
Previous Radiology and Nuclear Medicine Training
n (%) Year of training First year 16 (11%) Second year 19 (13%) Third year 49 (32%) Fourth year 67 (44%)
n (%) Months of nuclear medicine training None 7 (5%) 0–2 35 (23%) 2–4 71 (47%) 4–6 38 (25%)
Residents were asked to rate the amount or quality of their clinical, didactic, and nuclear medicine physics training on a scale of 1 to 5 (5 being the best quality training or adequate months of training). Seventy-seven percent gave their clinical training and 61% gave their amount of clinical training a score of 4 or 5 ( n = 139 and 140, respectively). Fifty-four percent gave the quality of their didactic training one of the two highest scores ( n = 145). Thirty-nine percent of residents rated the amount of nuclear medicine physics training with one of the two highest scores, and 36% rated the quality of nuclear medicine physics training with either a 4 or 5 ( n = 137 and 138, respectively). Of fourth-year radiology residents, 33% felt they had enough experience to perform nuclear medicine therapies ( n = 67), 74% felt they had enough training to read PET/CT ( n = 66), 66% felt they had enough training to read nuclear cardiology studies ( n = 64), and 91% felt prepared to interpret general nuclear medicine studies ( n = 67) ( Table 3 ). Residents were asked to comment on the change in the new minimum requirement in nuclear medicine training from 6 months to 4 months. Eighty-one percent of residents thought that 4 months as opposed to 6 months was adequate or more than enough nuclear medicine training ( n = 149).
Table 3
Fourth-Year Residents Perceptions of Preparedness
n (%) I feel prepared to: Perform nuclear medicine therapies 22/67 (33%) Interpret PET and PET/CT studies 49/66 (74%) Interpret general nuclear medicine studies 61/67 (91%) Interpret nuclear cardiology studies 42/64 (66%)
PET: positron emission tomography; CT: computed tomography.
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Discussion
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References
1. McCormack K.R.: Training in nuclear medicine for radiology residents. Radiology 1964; 83: pp. 22-25.
2. The American Board of Radiology: 2006. Available at: http://www.theabr.org/DR_Pri_NUCTraining.htm . Accessed October 15
3. Harolds J., Graham M., Maurer A., et. al.: Recent changes in nuclear medicine/radiology training and certification requirements. Acad Radiol 2006; 13: pp. 1405-1409.
4. The US Nuclear Regulatory Commission: 2006. Available at: http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0290.html . Accessed November 22