training in nuclear medicine - basic components - b. k. das director and chief of nuclear medicine...
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TRAINING IN NUCLEAR MEDICINE
- Basic Components -
B. K. DASDirector and Chief of Nuclear Medicine
UTKAL INSTITUTE OF MEDICAL SCIENCES
BHUBANESWAR
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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
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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
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DIFFERENT LEVELS OF TRAINING
• Super specialty training ( Nuclear Cardiology, Nuclear Oncology etc. )
• Postgraduate Training ( M.D. , Master‘s program, Board Certification etc. )
• B.Sc / M.Sc. in Nuclear Medicine Technology
• Diploma in Nuclear Medicine Technology• Training of other specialists in N.M.
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BASIC TRAINING FOR
Nuclear physician
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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. )
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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
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TRAINING REQUIREMENTS ( Cont… )
• Prior General Professional Training
( MBBS or equivalent )
• Entry through :
Entrance Exam
On the basis of merit
Candidate’s aptitude
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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
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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.
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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
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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
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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
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THIRD YEAR OF TRAINING
• Training in Communication• Training in Teaching• Training in Management• Training in Ethics and Legal
Aspects• Cost-effective Analysis
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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
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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
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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.
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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
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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
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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.
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NOW REFRESH !
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Look in to the mirror : I am the most beautiful !!
NOW ENJOY THE ENENING !!!