The purpose of our training program is to produce fully equipped leaders in the field rather than merely competent, journeyman-level practitioner.
The residency training program in Nuclear Medicine at Johns Hopkins has been approved by the Residency Review Committee of the AMA and Liaison Committee on Graduate Medical Education. The program, in broad outline, consists of training in the academic, clinical and research aspects of Nuclear Medicine in approximately equal proportions.
Incoming residents attend a course in Nuclear Medical Sciences during the months of July, August, and September. Residents are free of other responsibilities during lecture hours to permit the presentation of a course that is both intensive and rigorous. The course is intended to prepare the resident for his impending clinical responsibilities by explaining the relevant principles of Nuclear Physics and Instrumentation, Radiochemistry and Radiopharmacology and the rationale and technical details of current diagnostic procedures.
Further training is provided during daily clinical conferences as well as special conferences on clinical PET or clinical PET, thyroid imaging, breast imaging, journal club and follow-up conferences. In addition, the full range of graduate and undergraduate courses offered by the University are available to satisfy the particular needs of individual residents.
In order that they may appreciate the present state of the art of Nuclear Medicine, trainees are assigned to the diagnostic Radioisotope Laboratory for a maximum of 20 percent of their time at the beginning of their training period.
For the first several months, junior residents in the clinic work in tandem with a senior resident or staff member under progressively diminishing supervision. As soon as he is able, a junior resident assumes full responsibility for the daily clinical activities.
Clinical studies are performed on both in-patients and out-patients of the Johns Hopkins Hospital. The trainee assigned to the clinical section evaluates each patient referred for a nuclear medicine procedure. After assessing the clinical problem to be answered (by hospital chart review, personal history and physical examination), the trainee evaluates each study and determines the potential role of radioisotopic procedures on the diagnostic process. Additional studies are ordered in an attempt to answer the diagnostic query as completely as possible before discharging the patient from the Nuclear Medicine Division. The trainee then presents the results, the clinical correlation, and his final interpretation to our clinical conference attended by other trainees, faculty consultants and technical assistants. Presentation of problem cases in the various specialty and sub-specialty clinics, i.e., Hematology, Endocrine, Pulmonary, Neurosurgery, Urology, etc., and participation in the formal training of visiting scientists and nuclear medical technologists are important parts of the program. In addition, residents-in-training are assigned to the in vitro procedures laboratory for a period of four weeks and to the radioisotope therapy section for sufficient time to participate in treating a minimum of ten patients.
The trainee remains assigned to the Diagnostic Nuclear Medicine Clinic only for such time as it remains a learning experience. The time required for a trainee to accumulate sufficient clinical experience is, of course, variable. Trainees are encouraged to move into areas of either fundamental or clinical research as soon as feasible.
Most of our trainees have an initial inclination towards research since they are interested in careers in academic medicine. During their orientation period and formal course work, trainees are continuously exposed to the type of research that is being conducted by senior faculty, other trainees, graduate students and other members of the Hopkins environment, through their attendance at research seminars, lectures and conferences. Trainees are encouraged to pursue any relevant line of research that excites their interest, it being our experience that interest in research is highest when it is self-generated. The choices open to a trainee are extremely broad. He or she may:
Initiate and pursue an entirely independent project of his/her own choosing provided only that it is scientifically sound and technically feasible;
Engage in a cooperative research project with other departments or divisions of the University.
Choose to ally him/herself with any of a number of ongoing research projects. Here, too, the choice is broad since all of the faculty are engaged in research and the range of projects is wide. A trainee is expected to make a fundamental contribution to such a project, and, while he/she may properly work on the development of new procedures or techniques, the execution of a new technique is turned over to a technician as soon as it becomes routine.
The trainee's research is guided by frequent consultation with members of the faculty, especially, although not exclusively, with his faculty advisor(s). Although a specific staff member is primarily responsible for a given trainee, several may be called upon for assistance during the course of a single project. In addition, the trainee is required to present seminars at regular intervals, at which time his/her progress is reviewed by the entire faculty.
Our experience indicates that many graduates from our training program have assumed positions as heads of divisions of nuclear medicine. The purpose of our training program is to produce fully equipped leaders in the field rather than merely competent, journeyman-level practitioners. In the two year training program, we are able to offer a large number of formal courses and extensive opportunity for clinical experience and research, to the end that the graduate is provided with sufficient knowledge and experience to take charge of a division of nuclear medicine and to plan and execute worthwhile original research.
We believe that our training program satisfies the above aims.
Richard L. Wahl, M.D., FACR
Director, Division of Nuclear Medicine Department
Current Resident Program