Fostering medical student interest in radiology and nuclear medicine

In today's rapidly evolving medical landscape, the fields of radiology and nuclear medicine occupy a distinct and indispensable position. These disciplines serve as vanguards of modern healthcare, providing essential tools for disease diagnosis, treatment planning, and cutting-edge research. However, like any medical specialty, the sustained development of these fields relies on cultivating and nurturing the interest of medical students. Ensuring a steady supply of skilled professionals in radiology and nuclear medicine is paramount to meeting the burgeoning demand in these domains. We would like to delve into the profound significance of radiology and nuclear medicine and into the challenges encountered in attracting medical students and present a comprehensive array of strategies designed to effectively ignite their interest.

Radiology and nuclear medicine have carved out pivotal roles in the realm of modern medicine. Radiology, encompassing modalities such as X-rays, CT scans, MRI, and ultrasound, offers noninvasive imaging techniques that facilitate precise and accurate disease diagnosis. In parallel, nuclear medicine harnesses radioactive tracers to visualize physiological processes, greatly aiding in diagnosing complex ailments like cancer, heart disease, and neurological disorders. These specialties not only excel in diagnosis but also substantially contribute to treatment guidance. Radiological interventions, including image-guided biopsies and minimally invasive procedures, have revolutionized patient care. Similarly, nuclear medicine showcases its therapeutic potential, as seen in treatments like radioactive iodine therapy for thyroid disorders [1].

Furthermore, radiology and nuclear medicine have become the cornerstone of medical research, propelling innovations in imaging technology and therapeutic modalities. Researchers utilize these disciplines to explore the intricacies of diseases and develop groundbreaking treatments such as the novel [177Lu] Lu-PSMA-617 radioligand therapy for metastatic castration resistant prostate cancer [2]. On a broader scale, the two disciplines play indispensable roles in global health initiatives. They assist in detecting and combating diseases in resource-constrained regions, with mobile X-ray units and portable nuclear medicine devices proving instrumental in disease surveillance and treatment.

However, despite their irrefutable importance, radiology and nuclear medicine face a series of challenges in attracting medical students. From a personal perspective, there are only about 3–5 in 150 students that say would consider a career in radiology or nuclear medicine. Often, radiology and nuclear medicine occupy the periphery of medical education, with limited exposure during the formative years of medical training. According to the “Your Training Counts” report by the Medical Council of Ireland in 2015, just 53% of first-year postgraduate residents felt adequately prepared by their prior medical education for their roles as residents. Additionally, 64% of these residents considered the lack of preparedness to be a significant or moderately sized issue [3]. Many students only encounter these fields during their clinical rotations done usually in departments other than radiology or nuclear medicine since in Italy these specialties are counted as service sector departments and do not count for the compulsory 300 h of internship (“tirocinio abilitante” in Italian), leaving them unaware of the full spectrum of possibilities. Widespread misconceptions about radiology, such as concerns about automation impacting job prospects (aggravated by the lack of awareness regarding artificial intelligence [AI]) or the perceived lack of patient interaction, can dissuade students from considering these specialties. Dispelling these myths is critical [4, 5]. Residencies in radiology and nuclear medicine tend to be highly competitive in certain countries like the USA, which can be intimidating for aspiring students [6]. The fierce competition may discourage some from pursuing these fields. The rapid advancement of technology within radiology and nuclear medicine can appear daunting to students. The perception of a steep learning curve can act as a deterrent. Thus, it is necessary to introduce a foundation of knowledge regarding AI into medical student curricula. The conversations regarding these themes need to move from the expert to the student, apart from the expert to the expert. Finally, in certain regions, shortages of radiologists and nuclear medicine physicians have led to heavy workloads and concerns about work–life balance, creating apprehension among potential candidates [7]. These regional disparities are further influenced by the income, the length of specialty training, and the number of training posts available in each country (Table 1).

To effectively harness the interest of medical students in radiology and nuclear medicine, a multifaceted approach is essential. Initiating exposure to radiology and nuclear medicine concepts within the preclinical curriculum is foundational. Lectures, case-based learning, and hands-on workshops can provide students with an early understanding of the relevance and possibilities in these fields. Similarly, establishing mentorship programs connecting medical students with experienced radiologists and nuclear medicine specialists is invaluable. A study conducted at Newcastle University (UK) clearly demonstrates that medical students have a strong preference for interactive case-based discussions as their primary mode of learning, as opposed to other methods such as traditional topic presentations or exam-style questioning [10]. This preference is supported by findings from other authors as well. Zou et al. discovered that a significant majority of students favored teaching through interactive dialogs, particularly in small group settings where students actively participate in answering questions [11]. Furthermore, in 1993, the American College of Radiology (ACR) introduced the ACR Appropriateness Criteria. This resource has been regularly updated and serves as a valuable online tool for both physicians and medical students. It aids in the identification of appropriate imaging requirements by providing evidence-based, peer-reviewed guidelines that encompass diagnostic imaging selection, radiotherapy protocols, and image-guided interventional procedures [12]. Indeed, joining radiological societies such as the ACR or Royal College of Radiologists have proved invaluable as they offer a vast exposure to radiology-related content, symposia, courses, etc. Additionally, personalized guidance can debunk misconceptions, provide career advice, and foster a sense of belonging within these specialties.

In addition, offering comprehensive and engaging clinical rotations in radiology and nuclear medicine during the clinical years is pivotal. Encouraging active participation enables students to witness firsthand the real-world impact of these specialties. Promoting research opportunities within radiology and nuclear medicine deepens students' understanding and appreciation. Medical students could interact with radiology research published in several journals through letters to the editors, commentaries, etc., and this should be encouraged by experts in the field by giving them the necessary guidance or supervision [13]. Engaging in research projects opens doors to academic careers and underscores the importance of these fields.

Moreover, developing interactive learning tools, such as virtual radiology labs and online platforms simulating real-world scenarios, can enhance students' confidence in interpreting imaging studies and make learning more engaging. Also, establishing a diverse and inclusive environment within radiology and nuclear medicine departments is essential. A diverse workforce serves as an inspiration to students from underrepresented backgrounds. Providing accurate information about job market conditions, including demand and opportunities for subspecialization, helps allay concerns and showcase the potential for fulfilling careers in these fields. Offering ongoing educational opportunities to medical students and residents ensures they stay abreast of the latest advancements in imaging technology and clinical practice.

Advocating for the significance of radiology and nuclear medicine in healthcare and society is imperative. Raising awareness about their contributions to patient care and research can generate greater interest among students and change how the specialty is viewed in the eyes of the general public. Collaborating closely with medical schools to align curricula with the evolving needs of healthcare is vital. Dialog and adaptation of educational approaches are necessary to cater to the interests and aspirations of students.

In conclusion, radiology and nuclear medicine represent essential pillars of modern healthcare. Nurturing the interest of medical students in these fields is critical for the continued advancement of diagnostic excellence. Addressing challenges, providing early exposure, fostering mentorship, promoting research and diversity, dispelling misconceptions, and advocating for these fields all contribute to ensuring a continuous influx of passionate and skilled professionals. Together, we can empower the next generation of radiologists and nuclear medicine specialists who will push the boundaries of medical imaging and enhance patient care worldwide.

Arosh S. Perera Molligoda Arachchige analyzed the data and prepared the first draft of the manuscript, participated in the conception, and design of the study; Francesca Romana Centini constructively revised the manuscript; Arosh S. Perera Molligoda Arachchige and Francesca Romana Centini participated in data collection and organization; Niccolò Stomeo participated in and supervised the study throughout, and they share corresponding authorship. All authors commented on previous versions of the manuscript and approved the final version.

The authors declare no conflict of interest.

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