CORRESPONDENCE DIAGNOSTIC R A D I O L O G I S T S AND N U C L E A R M E D I C I N E SIR - As Dr McCready (1990) rightly states, the philosophy of having a comprehensive imaging department which provides conventional radiography, ultrasound, C T and radioisotope imaging is functionally attractive and should be encouraged when departments of imaging are planned. It certainly makes good clinical sense integrating the different modalities within imaging departments and undoubtedly makes the provision of these services m u c h more efficient and convenient. This is in fact what is happening in the USA and in Australia. Dr McCready details what is required to provide a service in nuclear medicine techniques and preferably more than one specialist is desirable if the services are to be available on a full-time basis in such a comprehensive imaging department 7 days per week. One must consider what qualifications, training and experience are desirable, nay essential, for such a specialist if the practice of nuclear medicine imaging is to be provided at the highest standards. The F R C R certainly provides a sound introduction to nuclear medicine imaging and there is some, albeit limited, assessment of this knowledge in Parts I and II of the examinations. The F R C R is inadequate in itself for a consultant radiologist to become involved in the running of a radioisotope imaging service. Where a radiologist has a commitment to nuclear medicine - and in the majority of cases in imaging departments this will not be a full-time c o m m i t m e n t - i t would seem unnecessary and contraindicated to expect a radiologist with the F R C R to have to undergo another 2 years' training in nuclear medicine, including 1 year in an approved nuclear medicine department. Why should this be necessary when it does not apply to any of the other imaging modalities? Since the early 1970s diagnostic radiologists in all age groups have shown their adaptability, application and flexibility in rapidly becoming skilled in the use of the newer modalities. On the other hand, when one considers the syllabus of the M R C P it is understandable that a further 2 years' training in nuclear medicine is necessary and it would appear highly desirable that an appreciable part of this training not be spent in isolation in a nuclear medicine department where no other medical imaging is practised. Diagnostic radiologists by virtue of their training and experience across the whole spectrum of imaging modalities are at a distinct advantage in the practice of nuclear medicine imaging. There is no doubt that further training under supervision is essential for diagnostic radiologists and specialist physicians who wish to practise nuclear medicine on a part-time basis in departments of medical

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imaging. W h a t is required, at least for diagnostic radiologists, is a much shorter period, say between 6 and 12 months, in an accredited department of nuclear medicine. Supervision of this training is mandatory as well as attendance at a course of lectures on the relevant physics, radiation protection for both staffand patients, radiopharmacy and the nuclear medicine techniques relevant to medical imaging. The course should be pitched at a diploma level with assessment by examinations. Examinations really are the only way competence can be assessed and this applies to both diagnostic radiologists and specialist physicians who are desirous of practising radioisotope imaging. On the other hand it should not be forgotten that there is a very important place for centres of excellence in nuclear medicine techniques across the whole spectrum of medicine. Such centres would of necessity be at the forefront of research and the development of new techniques and the assessment of radioisotope imaging in relation to the other imaging modalities. Workers in these institutions which ideally should not be isolated from X-ray departments are more likely to be involved in nuclear medicine full time and to be involved in programmes for higher degrees such as a MSc or PhD. The practice of nuclear medicine in a u t o n o m o u s departments in isolation from diagnostic X-ray departments, which nowadays have so m u c h to offer, is one of the major reasons holding back the use of nuclear medicine imaging techniques. There is also in m y mind a real need for a realistic practical approach to the provision of training programmes for diagnostic radiologists and specialist physicians who are desirous of providing nuclear medicine imaging services at a high standard. There would also appear to be a need for a diploma course for qualified diagnostic radiologists and specialist physicians in this area of medical imaging which one hopes would help to rectify the present unsatisfactory state of affairs. F. S C H U B E R T

Department of Radiology The Wesley Hospital Auchenflower Brisbane A ustralia 4066

Reference

McCready, VR (1990). Diagnostic radiologists and nuclear medicine. Clinical Radiology, 42, 225.

Diagnostic radiologists and nuclear medicine.

CORRESPONDENCE DIAGNOSTIC R A D I O L O G I S T S AND N U C L E A R M E D I C I N E SIR - As Dr McCready (1990) rightly states, the philosophy of havi...
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