TRAINING IN NUCLEAR MEDICINE - Basic Components - B. K. DAS Director and Chief of Nuclear Medicine UTKAL INSTITUTE OF MEDICAL SCIENCES BHUBANESWAR

POTENTIAL SCOPE OF NUCLEAR PHYSICIAN TRAINING May make use of complementary methods as far as these relate to N.M.Procedures such as : Ultrasound Fine-needle biopsy Non-reactive lab. procedures Spirometry Bone densitomerty ECG during pharmacological stress

SCOPE OF NUCLEAR TRAINING ( Cont..) Cooperate in the assessment, prevention of radiation accidents with contamination or incorporation of radionuclides Engage in multi-disciplinary research activities

DIFFERENT LEVELS OF TRAINING Super specialty training ( Nuclear Cardiology, Nuclear Oncology etc. ) Postgraduate Training ( M.D., Masters program, Board Certification etc. ) B.Sc / M.Sc. in Nuclear Medicine Technology Diploma in Nuclear Medicine Technology Training of other specialists in N.M.

BASIC TRAINING FOR Nuclear physician

CHALLENGES To understand the medical problem of the patient and decide the appropriate investigation To discuss with other specialists with equal level of knowledge and confidence To run a facility which is multidisciplinary in nature and has diversified activities (promoting NM, patient care, teaching and training etc. )

TRAINING REQUIREMENTS Availability of trained teachers practicing Nuclear Medicine Doctors motivated to follow a career as Nuclear Physician ( The student ) * A recognized curriculum Mechanism for supervision of training Appropriate equipments & infrastructure

TRAINING REQUIREMENTS ( Cont… ) Prior General Professional Training ( MBBS or equivalent ) Entry through : Entrance Exam On the basis of merit Candidates aptitude

TRAINING IN N. M. ( Cont…) Additional Training : * Education in the audit of clinical nuclear medicine and in the administration and financing of a nuclear medicine service * Legal expertise in healthcare problems due to unsealed radio nuclides

REQUIREMENTS ( Cont… ) Availability of Equipments : * One Dual headed variable angle Gamma Camera with WB facility & Cardiac analysis package, ECG 12 lead with monitor, automatic BP monitor, Infusion pump, Trade Mill One Single head Gamma Camera with soft wares for analysis of dynamic studies Desirable : One Double Head variable angle Gamma Camera with built in CT with display software analysis package.

CURRICULUM FOR POSTGRADUATE TRAINING Year 1 : Basic principles of Medical Physics, Radio pharmacy, Clinical Nuc.Med. Year 2 : Clinical Nuc. Med. + Radioharmacy with practice, Computer applications, Basic software programs, Posting in Radiology Year 3 : Clin. Nuc. Med. + Legal aspects, Postings in Neurosciences, Endocinology, Cardiology, Cardiac sciences, Radiation oncology,Nephrourology

FIRST YEAR OF TRAINING Nuclear Physics : What is radiation Units of Radiation Radiobiology and Radiation Risks Radiation Safety Radiochemistry & tracer technology Use of Nuclear Medicine for the study of normal physiology

SECOND YEAR OF TRAINING Conduction and supervision of Nuclear Medicine Procedures in : Nuclear Cardiology, Endocrinology, Oncology, Neurology, Haematology, Nephro-Urology, Genital system, Respiratory system, Digestive system, Skeletal system, Infection imaging in vitro studies

THIRD YEAR OF TRAINING Training in Communication Training in Teaching Training in Management Training in Ethics and Legal Aspects Cost-effective Analysis

CLINICAL TRAINING The responsibility of indication, performance and interpretation for a sufficient number of various in vivo diagnostic procedures must be taken A total of 3000 documented procedures must be reached during the training period. Maintenance of a Log Book is mandatory

CLINICAL TRAINING ( Cont…) Minimum number of procedures : Central nervous System : 100 ( 80 % SPECT or PET ) Skeletal System : 700 ( should include multi phase studies ) Cardio vascular system : 500 ( 50 % SPECT or PET ) Pulmonary system : 300 ( 50 % combined with V / Q ) G. I. System : 150 ( Including HBS ) Nephro - urology : 400 (should include calculation of GFR) Endocrine system : 400 ( Including Neuralcrest Tumors ) Hemapoetic & Lymphatic : 100 ( Include Sentnel LN detection ) Tumor Imaging : 300 ( 80 % SPECT & PET ) Inflammation Imaging : 50 ( Ga, Leuko and Ciprofloxacin ) Other studies

TRAINING IN N.M. ( CONT…) Training in in vitro procedures : Should cover analysis with radio- immunological methods, quality control and interpretation. A minimum of 3 months posting in RIA Lab is recommended.

TRAINING IN R.N. THERAPY Training should include indication, administration, dosimerty, radiation protection and follow up of therapeutic activities of radio nuclides. Documentation ( Log Book ) of taking part in sufficient number of various therapeutic procedures. Recommended numbers : Thyroid cases : Benign diseases : 60 Malignant diseases : 10 Other therapies : 30

TRAINING IN N. M. ( Cont…) Additional Training : * Education in the audit of clinical nuclear medicine and in the administration and financing of a nuclear medicine service * Legal expertise in healthcare problems due to unsealed radio nuclides

TRAINING OF OTHER SPECIALISTS IN NUCLEAR MEDICINE Should include theoretical and practical / clinical training. A minimum of 30 hours of formal description of general principles of nuclear medicine procedures is required. Active participation in clinical presentations, seminars and combined meetings is necessary.

NOW REFRESH !

Look in to the mirror : I am the most beautiful !! NOW ENJOY THE ENENING !!!