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Nuclear Medicines - Medical

Nuclear medicine is a branch or specialty of medicine and medical imaging that uses radionuclides and relies on the process of radioactive decay in the diagnosis and treatment of disease. In nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical compounds, to form radiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs or cellular receptors. This property of radiopharmaceuticals allows nuclear medicine the ability to image the extent of a disease-process in the body, based on the cellular function and physiology, rather than relying on physical changes in the tissue anatomy. In some diseases nuclear medicine studies can identify medical problems at an earlier stage than other diagnostic tests.

In nuclear medicine procedures, elemental radionuclides are combined with other elements to form chemical compounds, or else combined with existing pharmaceutical Compounds, to form radiopharmaceuticals. These radiopharmaceuticals, once administered to the patient, can localize to specific organs or cellular receptors. This property of radiopharmaceuticals allows nuclear medicine the ability to image the extent of a disease-process in the body, based on the cellular function and physiology, rather than relying on physical changes in the tissue anatomy. In some diseases nuclear medicine studies can identify medical problems at an earlier stage than other diagnostic tests.

Nuclear Medicine Careers:
Nuclear Medicine Technologist:

The nuclear medicine scientist works closely with the nuclear medicine physician. Some of the scientist's primary responsibilities are to:

  • Prepare and administer radioactive chemical compounds, known as radiopharmaceuticals
  • Perform patient imaging procedures using sophisticated radiation-detecting instrumentation
  • Accomplish computer processing and image enhancement
  • Analyze biologic specimens in the laboratory
  • Provide images, data analysis, and patient information to the physician for diagnostic interpretation.

During an imaging procedure, the scientist works directly with the patient. The scientist:

  • Gains the patient's confidence by obtaining pertinent history, describing the procedure and answering any questions
  • Monitors the patient's physical condition during the course of the procedure
  • Notes any specific patient's comments which might indicate the need for additional images or might be useful to the physician in interpreting the results of the procedure.

Nuclear medicine scientists work in a wide variety of clinical settings, such as

  • Community hospitals
  • University-affiliated teaching hospitals and medical centers
  • Outpatient imaging facilities
  • Public health institutions
  • Government and private research institutes.

The physician career in nuclear medicine:

Nuclear medicine physicians are primarily responsible for interpretation of diagnostic nuclear medicine scans and treatment of certain diseases, such as cancer, thyroid disease and palliative bone pain.

There are a variety of reasons why physicians have chosen to specialize in nuclear medicine. Some became nuclear medicine physicians because of their interest in nuclear physics and medical imaging. Others may have switched to nuclear medicine after training in other specialties, because of the regular work hours (on average about 8 to 10 hours a day). Others have chosen nuclear medicine because of research opportunities in molecular medicine or molecular imaging.

Nuclear medicine physicians frequently interact with other specialties in medicine and consult on a variety of clinical cases. A nuclear medicine report may save a patient from more invasive or high risk procedures, and/or lead to early disease diagnosis. Nuclear Medicine physicians can be called upon to consult on complex or equivocal clinical cases. Aside from consultations with other physicians, nuclear physicians may directly interact with patients through various nuclear medicine therapies (e.g.: I131 thyroid therapy, refractory lymphoma treatment, palliative bone pain therapy).

A disadvantage of a nuclear medicine career for a physician is that it suffers from low job turnover and a small job market, owing to the specialized nature of the field. Advantages of the field include job satisfaction and more regular hours than many fields of medicine, since very rarely are the procedures in this field performed on an emergency basis.

 

Obstetrics and gynecology are the two surgical–medical specialties dealing with the female reproductive organs in their pregnant and non-pregnant state, respectively, and as such are often combined to form a single medical specialty and postgraduate training programme. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients.

Subspecialties:

Examples of subspecialty training available to physicians in the US are:

  • Maternal-fetal medicine — an obstetrical subspecialty, sometimes referred to as perinatology, that focuses on the medical and surgical management of high-risk pregnancies and surgery on the fetus with the goal of reducing morbidity and mortality.
  • Reproductive endocrinology and infertility — a subspecialty that focuses on the biological causes and interventional treatment of infertility
  • Gynecological oncology — a gynecologic subspecialty focusing on the medical and surgical treatment of women with cancers of the reproductive organs
  • Urogynaecology and pelvic reconstructive surgery — a gynecologic subspecialty focusing on the diagnosis and surgical treatment of women with urinary incontinence and prolapse of the pelvic organs. Sometimes referred to by laypersons as "Female urology"
  • Advanced laparoscopic surgery
  • Family planning — a gynecologic subspecialty offering training in contraception and pregnancy termination (abortion)
  • Pediatric and Adolescent Gynecology
  • Menopausal and geriatric gynecology

Of these, only the first four are truly recognized sub-specialties by the Accredited Council of Graduate Medical Education (ACGME) and the American Board of Obstetrics and Gynecology (ABOG). The other subspecialties are recognized as informal concentrations of practice.