Dr. O'Mara is Professor of Radiology and Chief of the
Division of Nuclear Medicine at the University of Rochester
Medical Center in Rochester, NY. He is also a member of the
editorial advisory board of this journal.
I
t is always difficult to balance manpower needs in medicine between
over and under supply. Efforts by various groups, ranging from
those in the private sector up to the Federal Government, have not
been particularly successful at mandating medical staffing
requirements. The balance between primary care and specialist needs
remains as fragile as it was a decade ago, even excluding the
special considerations of balancing coverage in localities with
overserved and underserved populations in the United States.
In radiology, in general, we have done a fairly decent job of
fulfilling such staffing needs over the years. This likely is the
result of allowing the basic principles of free enterprise to
determine the attraction of young men and women from medical school
to our field. However, in my small area of expertise, nuclear
medicine, we are facing an upcoming dire shortage. The field is
"graying" rapidly. It is estimated that within 5 years, more than
half of the current full-time practitioners of nuclear medicine
will cease practicing due to retirement or attrition. The numbers
of candidates sitting for either special certification in nuclear
medicine or the American Board of Nuclear Medicine certification is
not sufficient. I must admit to adding to this problem myself.
Those of us established in the field of nuclear medicine are in no
way keeping pace to resupply this field with interested and
concerned individuals. What is needed is a concerted effort from
the various societies that deal with the full-time practice of
nuclear medicine or nuclear radiology to establish programs at the
medical school teaching level to attract students interested in
specialty medicine into this area. We certainly must make efforts
to keep the field open to all practitioners of medicine, whether
they come into it via radiology or through other branches. In
addition, we must ensure that enough training slots are maintained
or established so as to be able to accommodate these individuals,
even in this age of reducing residency positions. This will require
great effort and cooperation among the radiology and nuclear
medicine groups responsible for such residency positions and
training.
Can this problem be solved? I certainly hope so. I have been
around long enough to live through 4 or 5 "deaths" of nuclear
medicine, and it is as strong now as it has ever been. As we move
into truly functional molecular imaging, nuclear medicine offers
more diagnostic and curative potential than ever before. It would
be a shame to let it backslide now, as its strengths and abilities
are just coming to light, because we cannot supply or train enough
interested full-time practitioners.