A newly developed set of residency training pathways, crafted by an American College of Radiology (ACR)/Society of Nuclear Medicine (SNM) task force, integrates the complementary disciplines of diagnostic radiology (DR), nuclear radiology (NR), nuclear medicine (NM) and molecular imaging (MI), which are described in an article published in the April issue of the Journal of the American College of Radiology.

“Given the considerable spectrum of established and emerging imaging modalities, including multiple hybrid technologies, it is clear that patient care will be best served by a versatile imaging physician who has training and expertise in selecting, applying, interpreting, and correlating these various multimodality diagnostic tools in clinical practice,” wrote M. Elizabeth Oates, MD, of the University of Kentucky in Lexington, and a DR participant of ACR/SNM Task Force II.

Task Force I issued recommendations for training programs and board certification in January 2011. The follow-up, ACR/SNM Task Force II, was charged with developing realistic models for combined DR, NR, NM and MI training programs. Oates wrote that the proposed pathways of the future created by Task Force II were created by following six guiding principles:

1. Adopt a forward-thinking rationale with visionary planning.
2. Anticipate future public needs and create opportunities to meet them through medical training practice paradigms.
3. Develop a unified, cohesive approach with a common infrastructure to support the pathways and participating programs.
4. Use, as much as possible, existing training programs to achieve pathways with acceptable [Accreditation Council for Graduate Medical Education] structure and realistic implementation timeframes.
5. Integrate MI into current and future training pathways.
6. Position NR, NM and MI to flourish when goals, resources and expertise are aligned.

Common foundations of the current four-year pathways and the proposed five-year pathways include recurring of resident through the National Resident Matching Program and planning for continuing DR clinical experience during the last year of training. Both have flexible rotations determined by local institutions and oversight designated by faculty members under authority of the DR core program director.

The proposed five-year pathways can be structured as a 3-2 model, with the first three years under the core DR residency program director and the final two years und a subspecialty program director. ACGME oversight would be handled by a single residency review committee for simplicity and consistency. The pathway would be operated under the department radiology, with program directors reporting to the chair of radiology.

“The DR participants in [Task Force II] offer these pathways of the future as a mechanism to ensure that the traditional and emerging clinical, educational, and research domains of NR, NM and MI will not only be sustained but will indeed flourish within the context of foundational training in DR,” wrote Oates.