Nuclear Medicine Scientists: Findings and Recommendations

Nuclear Medicine Scientists Findings and Recommendations Based on a 2006 Survey February 2007

Prepared by Center for Health Workforce Studies School of Public Health, University at Albany 7 University Place, B334 Rensselaer, NY 12144 518-402-0250 (V)

Preface In the Spring of 2006 the Center for Health Workforce Studies at the School of Public Health, University at Albany (the Center), in collaboration with the Society of Nuclear Medicine (SNM), conducted a survey of nuclear medicine scientists to learn about their demographic characteristics, education, employment, career paths, and attitudes about their profession. This report summarizes the survey responses and presents a variety of insights about this unique set of professionals. This is the fourth of a series of eight reports planned for this major study of the nuclear medicine workforce. The initial report, prepared in 2005, was based solely on then existing data and information about the nuclear medicine workforce. The second focused on Nuclear Medicine Technologists. The third examined nuclear medicine technology education program directors. Subsequent reports will describe nuclear medicine technology students about to complete their training, physicians involved in nuclear medicine, nuclear medicine physician education program directors, and residents about to complete their training. A final report will also be prepared synthesizing the findings and conclusions from the several component reports and presenting a series of recommendations about both the field of nuclear medicine and the several nuclear medicine professions. The report was prepared by Margaret Langelier and Paul Wing of the Center staff, with assistance from Ajita De. The authors are indebted to the nuclear medicine scientists who took the time to complete the survey about their backgrounds and professional work. The survey design and execution was facilitated by Gaetano J. Forte, the Survey Manager for the Center. The authors acknowledge the contributions of Joanna Spahr, the project officer from SNM, to both the survey and the report. The contributions of an informal advisory committee are also gratefully acknowledged. Responsibility for the accuracy of the report rests solely with the authors. The Center was established in 1996 to collect, analyze, and present data about health care workers to inform provider, professional, government, and education organizations; policy makers; and the public. Today, the Center is a national leader in the field of health workforce studies. It supports and improves health workforce planning and access to quality health care through its collection, tracking, analysis, interpretation, and dissemination of information about health professionals at the national, state, and local levels. Additional information about the Center can be found on its website, http://chws.albany.edu. Questions about this report, the larger nuclear medicine workforce study, or the Center can be directed to Ms. Langelier or Dr. Wing at 518-402-0250.

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Table of Contents Executive Summary ........................................................................................................................ 1 The Survey of Nuclear Medicine Scientists................................................................................ 1 Findings from the 2006 Survey................................................................................................... 2 Key Concepts .......................................................................................................................... 2 Important Issues for Nuclear Medicine Science ..................................................................... 3 Key Findings........................................................................................................................... 3 Recommendations................................................................................................................... 9 Five Themes for the Future................................................................................................... 10 Introduction................................................................................................................................... 15 Classifications and Terminology .............................................................................................. 15 Nuclear Medicine Scientist Survey........................................................................................... 16 Survey Design....................................................................................................................... 16 Sample Design ...................................................................................................................... 17 The Survey Process............................................................................................................... 17 Survey Responses ................................................................................................................. 18 Limitations ............................................................................................................................ 18 Key Findings................................................................................................................................. 19 Demographics ........................................................................................................................... 20 Education and Training............................................................................................................. 23 Educational Attainment of Active Nuclear Medicine Scientists .......................................... 24 Future Education................................................................................................................... 26 Level of Additional Future Education .................................................................................. 27 Discipline of Future Education ............................................................................................. 31 Current Discipline in Nuclear Medicine Science and Educational Background .................. 33 Entry into Nuclear Medicine..................................................................................................... 35 First or Second Career Choice .............................................................................................. 35 Second Careers...................................................................................................................... 36 Introduction to Careers in Nuclear Medicine Science .......................................................... 39 Educational Level at Which Formal Nuclear Science Education Began.............................. 42 Current Work Environment ...................................................................................................... 44 Primary and Secondary Employment Settings ..................................................................... 44 Number of Years in Primary Employment Setting............................................................... 47 Organization of Nuclear Medicine Departments .................................................................. 47 Branches of Science of Nuclear Medicine Scientists ............................................................... 48 Nuclear Medicine Scientists in Clinical Nuclear Medicine Departments ............................ 50 Nuclear Medicine Scientists in R&D.................................................................................... 51 Other Nuclear Medicine Scientists in Employment Settings................................................ 52 Work in Clinical Nuclear Medicine Departments or R&D .................................................. 54 Employment Settings of Those Not Working in Clinical Nuclear Medicine or R&D ......... 56 Primary and Secondary Tasks and Roles in Nuclear Medicine Science .................................. 56 Basic Science Research......................................................................................................... 58 Applied Science Research..................................................................................................... 60 Technical Support ................................................................................................................. 61 Administrative Support......................................................................................................... 62 Salaries of Nuclear Medicine Scientists ................................................................................... 63

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Salary by Branch of Science ................................................................................................. 64 Salary of Scientists in One Employment Setting.................................................................. 64 Salaries of Scientists in Two or More Employment Settings ............................................... 66 Salary of Scientists by Years Certified in a Nuclear Medicine Specialty............................. 66 Work Hours of Full Time Nuclear Medicine Scientists ....................................................... 67 Attitudes About Salaries in Nuclear Medicine Science........................................................ 69 Mentors and Mentoring............................................................................................................. 70 Recruitment of New Scientists.................................................................................................. 72 Recruiting Preferences .......................................................................................................... 73 Attitudes About Current Supply of Qualified Nuclear Medicine Scientists............................. 77 Strategies to Improve Workforce Recruiting........................................................................ 80 Attitudes About Nuclear Medicine ........................................................................................... 82 Current Environmental Issues That Impact Nuclear Medicine Science ............................... 82 Opinions About the Future of Nuclear Medicine ................................................................. 83 Opinions About the Effect of Molecular Imaging Science on Nuclear Medicine Science .. 85 Opinions About the Professional Environment in the U.S. and Other Countries................. 86 Prototype for Nuclear Medicine Emulation.......................................................................... 86 Future Plans by Ease or Difficulty in Sustaining a Nuclear Medicine Science Career ............ 87 Key Factors for Future Careers in Nuclear Medicine Science. ................................................ 88 Certifications and Professional Associations............................................................................ 94 Years Since Initial Certification............................................................................................ 95 Years Certified by Branch of Science................................................................................... 96 Years Certified by Employment Setting ............................................................................... 97 Years Certified by Work Clinical Nuclear Medicine Department and R&D ....................... 98 Membership in Professional Associations ................................................................................ 99 Reasons for Belonging to a Professional Association ........................................................ 100 Future Plans of Active Nuclear Medicine Scientists .............................................................. 102 Future Plans by Branch of Science ..................................................................................... 103 Future Plans by Roles and Functions.................................................................................. 104 Future Plans by Expected Ease or Difficulty of Sustaining a Nuclear Medicine Career ... 105 Future Plans by Location .................................................................................................... 107 Future Plans by Primary Employment Setting.................................................................... 108 Future Plans by Gender....................................................................................................... 110 Future Plans by Place of Birth ............................................................................................ 111 Future Plans by Age............................................................................................................ 111 Future Plans by Salary ........................................................................................................ 113 Expected Ease or Difficulty in Sustaining a Nuclear Medicine Science Career .................... 114 Expected Ease or Difficulty by Career Sustainability Factors............................................ 117 Expected Ease or Difficulty by Salary Level...................................................................... 118 Expected Ease or Difficulty by Age Group ........................................................................ 119 Chemists.................................................................................................................................. 120 Pharmacists ............................................................................................................................. 124 Physicists................................................................................................................................. 128 Computer Scientists and Engineers ........................................................................................ 132 Appendix A. 2007 Nuclear Medicine Scientist Workforce Questionnaire................................ 136 Appendix B. Responses to Open-Ended Questions by Nuclear Medicine Scientists................ 145

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List of Tables Table 1. Geographic Distribution of Active Nuclear Medicine Scientists by USDHHS Region, 2006....................................................................................................................................... 20 Table 2. Gender Mix of Active Nuclear Medicine Scientists, 2006............................................. 20 Table 3. Racial Ethnic Composition of Active Nuclear Medicine Scientists, 2006, and U.S. Population, 2005 ................................................................................................................... 22 Table 4. Place of Birth of Active Nuclear Medicine Scientists by Age Group, 2006 .................. 22 Table 5. Place of Birth of Nuclear Medicine Scientists by Gender, 2006 .................................... 23 Table 6. Nuclear Medicine Specialties of Highest Degree of Nuclear Medicine Scientists by Place of Birth, 2006 .............................................................................................................. 24 Table 7. Highest Degree of Active Nuclear Medicine Scientists, 2006 ....................................... 25 Table 8. Disciplines in which Active Nuclear Medicine Scientists Earned Bachelor’s Degrees, 2006....................................................................................................................................... 25 Table 9. Number of Disciplines in Which Active Nuclear Medicine Scientists Earned Their Highest Degree, 2006............................................................................................................ 26 Table 10. Percentages of Active Nuclear Medicine Scientists Who Expect to Pursue More Education by Highest Current Degree Held ......................................................................... 26 Table 11. Nuclear Medicine Scientists Expecting to Pursue Further Education in the Next Five Years by Age and Gender, 2006 ........................................................................................... 27 Table 12: Levels of Additional Education Desired by Active Nuclear Medicine Scientists, by Current Highest Degree, 2006 .............................................................................................. 28 Table 13. Levels of Additional Education Desired by Active Nuclear Medicine Scientists, by Current Highest Degree, 2006 .............................................................................................. 29 Table 14. Levels of Additional Education Desired by Current Branch of Nuclear Medicine Science, 2006 ........................................................................................................................ 30 Table 15. Levels of Additional Education Desired by Active Nuclear Medicine Scientists by Current Branch of Nuclear Medicine Science, 2006 ............................................................ 30 Table 16. Discipline in which Active Nuclear Medicine Scientists Expect To Seek Additional Education in the Future, 2006............................................................................................... 31 Table 17. Disciplines of Expected Additional Education by Current Branch of Nuclear Medicine Science, 2006 ........................................................................................................................ 32 Table 18. Disciplines in which Active Nuclear Medicine Scientists Earned Bachelor’s Degrees, by Branch of Science of Current Work, 2006....................................................................... 33 Table 19. Disciplines in which Active Nuclear Medicine Scientists Earned Bachelor’s Degrees, by Branch of Science of Current Work................................................................................. 34 Table 20. Active Nuclear Medicine Scientists Whose First Career Choice Was Nuclear Medicine Science by Age Group, 2006 ................................................................................................ 35 Table 21. Percentage of Active Scientists For Whom Nuclear Medicine Science Was a First Career Choice........................................................................................................................ 36 Table 22. Prior Careers of Nuclear Medicine Scientists............................................................... 37 Table 23. Reasons For Initial Interest in Nuclear Medicine Science by Age Group, 2006.......... 39 Table 24. Education Level at First Knowledge of Nuclear Medicine Science Career Opportunities, 2006............................................................................................................... 40 Table 25. Educational Level at Which Nuclear Medicine Scientist Became Aware of Careers in Nuclear Medicine Science by Academic Area of Most Advanced Degree, 2006 ................ 41

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Table 26. Educational Levels at which Active Nuclear Medicine Scientists Learned About Nuclear Medicine by Age Groups ........................................................................................ 42 Table 27. Academic Area of Most Advanced Degree by Academic Level at which the Scientist Began Nuclear Medicine Education in Earnest, 2006 .......................................................... 44 Table 28. Primary and Secondary Employment Settings of Active Nuclear Medicine Scientists, 2006....................................................................................................................................... 45 Table 29. Active Nuclear Medicine Scientists in Different Branches of Science, 2006 .............. 49 Table 30. Nuclear Medicine Scientists in Clinical Nuclear Medicine Departments and Nuclear Medicine Research and Development, 2006 ........................................................................ 55 Table 31. Branch of Science of Nuclear Medicine Scientists Working in Clinical Departments and in R&D ........................................................................................................................... 55 Table 32. Employment Settings Of Scientists Not in Clinical or R&D Activities, 2006 ............. 56 Table 33. Primary Roles of Active Nuclear Medicine Scientists in Primary Work Settings, 2006 ............................................................................................................................................... 58 Table 34. “Other” Services Provided by Nuclear Medicine Scientists in Primary and Secondary Roles in Basic Research........................................................................................................ 59 Table 35. Active Nuclear Medicine Scientists Reporting Selected Primary and Secondary Tasks and Roles in Basic Science Research, 2006.......................................................................... 60 Table 36. Active Nuclear Medicine Scientists Reporting Selected Primary and Secondary Tasks and Roles in Applied Research, 2006 ................................................................................... 61 Table 37. Active Nuclear Medicine Scientists Reporting Selected Primary and Secondary Tasks and Roles in Technical Support, 2006 .................................................................................. 61 Table 38. Active Nuclear Medicine Scientists Reporting Selected Primary and Secondary Tasks/Roles in Administrative Support, 2006 ...................................................................... 62 Table 39. Salary Distribution of Nuclear Medicine Scientists by Branch of Science, 2006 ........ 64 Table 40. Salary Distributions of Nuclear Medicine Scientists by Number of Years Certified in a Nuclear Medicine Science Specialty .................................................................................... 67 Table 41. Nuclear Medicine Scientists by Past History of Being Mentored and Current History of Mentoring, 2006.................................................................................................................... 70 Table 42. Distribution of Age Group of Active Nuclear Medicine Scientists Who Had a Mentor, 2006....................................................................................................................................... 71 Table 43. Nuclear Medicine Scientists Currently Serving as Mentors for Potential Nuclear Medicine Scientists by Age Group, 2006 ............................................................................. 71 Table 44. Active Nuclear Medicine Scientists Recruiting New Scientists to Nuclear Medicine Science by Branch of Science, 2006..................................................................................... 72 Table 45. Nuclear Medicine Scientists Recruiting New Scientists to Nuclear Medicine by Major Role in Primary Work Setting, 2006..................................................................................... 73 Table 46. Recruiting Preferences of Active Nuclear Medicine Scientists Currently or Recently Recruiting New Scientists by Primary Employment Setting, 2006...................................... 74 Table 47. Percent of Active Nuclear Medicine Scientists Recruiting New Scientists by Branch of Science, 2006 ........................................................................................................................ 74 Table 48. Primary Source of Nuclear Medicine Scientist Funding by Nuclear Medicine Scientist Preference for Postdoctoral Fellows or Experienced Nuclear Medicine Scientists, 2006... 75 Table 49. Recruiting Preferences of Active Nuclear Medicine Scientists Currently or Recently Recruiting New Scientists by Branch of Science, 2006 ....................................................... 77

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Table 50. Ratings of Availability of New Nuclear Medicine Scientists by Active Nuclear Medicine Scientists Either Currently or Recently Recruiting New Scientists by Primary Employment Setting, 2006.................................................................................................... 78 Table 51. Assessment of the Supply of New Scientists by Active Nuclear Medicine Scientists Either Currently or Recently Recruiting New Scientists by Branch of Science, 2006......... 79 Table 52. Assessment of Supply of New Scientists Reported by Active Nuclear Medicine Scientists Currently or Recently Recruiting New Scientists by Recruiting Preferences, 2006 ............................................................................................................................................... 79 Table 53. Strategies for Improving Workforce Recruitment by Branch of Science, 2006........... 81 Table 54. Current Issues Impacting Nuclear Medicine Scientists by Branch of Science, 2006... 83 Table 55. Attitudes of Nuclear Medicine Scientists about the Future of Nuclear Medicine, 2006 ............................................................................................................................................... 84 Table 56. Attitudes of Current Nuclear Medicine Scientists about the Future of Nuclear Medicine, 2006 ..................................................................................................................... 85 Table 57. Opinions of the Effect of Molecular Imaging Science on the Work of Nuclear Medicine Scientists, 2006 ..................................................................................................... 85 Table 58. Comparison of Professional Environment for Nuclear Medicine Scientists in the U.S. and Other Countries .............................................................................................................. 86 Table 59. Future Plans of Active Nuclear Medicine Scientists by Views on the Ease of Sustaining a Nuclear Medicine Science Career at Present, 2006 ......................................... 88 Table 60. Key Factors to Sustaining Future Careers in Nuclear Medicine Science by Branch of Science, 2006 ........................................................................................................................ 89 Table 61. Key Factors to Sustenance of Future Careers by Primary Endeavor of Nuclear Medicine Scientist, 2006....................................................................................................... 90 Table 62. Mean Attitude Scores of Active Nuclear Medicine Scientists by Branch of Science, 2006....................................................................................................................................... 92 Table 63. Current Certifications of Active Nuclear Medicine Scientists, 2006 ........................... 94 Table 64. Current Certifications of Active Nuclear Medicine Scientists by Branch of Science, 2006....................................................................................................................................... 95 Table 65. Specialty of Nuclear Medicine Scientists by Years Certified, 2006............................. 97 Table 66. Primary Employment Setting of Nuclear Medicine Scientists by Years Certified in a Nuclear Medicine Specialty, 2006........................................................................................ 98 Table 67. Years Certified in a Nuclear Medicine Science Specialty by Work in a Clinical Department or R&D, 2006.................................................................................................... 99 Table 68. Professional Association Memberships of Nuclear Medicine Scientists, 2006............ 99 Table 69. Reasons for Belonging to A Professional Association, 2006 ..................................... 100 Table 70. Professional Associations to which Active Nuclear Medicine Scientists Belong by Branch of Science, 2006 ..................................................................................................... 101 Table 71. Ways That Professional Identity of Active Nuclear Medicine Scientists Is Encouraged by Branch of Science, 2006 ................................................................................................ 102 Table 72. Future Plans of Active Nuclear Medicine Scientists by Branch of Science, 2006..... 103 Table 73. Future Plans of Active Nuclear Medicine Scientists by Branch of Science, 2006..... 104 Table 74. Future Plans of Active Nuclear Medicine Scientists by Primary Roles in Primary Work Setting, 2006 ....................................................................................................................... 105 Table 75. Future Plans of Active Nuclear Medicine Scientists by Expected Future Ease or Difficulty of Sustaining a Nuclear Medicine Science Career, 2006 .................................. 106

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Table 76. Future Plans of Active Nuclear Medicine Scientists by Expected Ease or Difficulty of Sustaining a Nuclear Medicine Science Career, 2006. ....................................................... 107 Table 77. Future Plans of Active Nuclear Medicine Scientists by Regions, 2006 ..................... 108 Table 78. Future Plans of Active Nuclear Medicine Scientists by Primary Employment Setting, 2006..................................................................................................................................... 109 Table 79. Future Plans of Active Nuclear Medicine Scientists by Primary Employment Setting, 2006..................................................................................................................................... 110 Table 80. Future Plans of Active Nuclear Medicine Scientists by Gender, 2006 ...................... 110 Table 81. Future Plans of Active Nuclear Medicine Scientists by Place of Birth, 2006 ............ 111 Table 82. Future Plans of Active Nuclear Medicine Scientists by Age Group, 2006 ................ 112 Table 83. Future Plans of Active Nuclear Medicine Scientists by Age Group, 2006 ................ 113 Table 84. Future Plans of Active Nuclear Medicine Scientists by Salary Group, 2006............. 114 Table 85. Mean Scores of Current and Future Ease of Sustaining a Nuclear Medicine Science Career by Professional Branch of Science, 2006................................................................ 116 Table 86. Mean Scores of Current and Future Ease of Sustaining Nuclear Medicine Science Careers by Major Role in Primary Work Setting, 2006...................................................... 117 Table 87. Key Factors in Sustaining Nuclear Medicine Careers in the Future by Level of Anticipated Difficulty, 2006 ............................................................................................... 117 Table 88. Future Ease of Sustaining a Nuclear Medicine Science Career by Salary, 2006 ....... 118 Table 89. Anticipated Level of Difficulty in Sustaining a Nuclear Medicine Science Career by Salary Category, 2006......................................................................................................... 119 Table 90. Anticipated Level of Ease or Difficulty in Sustaining a Future Career in Nuclear Medicine Science by Age Group, 2006 .............................................................................. 119 Table 91. Subspecialty of Nuclear Medicine Scientists Who Identified Themselves as Chemists, 2006..................................................................................................................................... 120 Table 92. Percent of Time Spent by Chemists in Nuclear Medicine Science by Different Work Activities, 2006 ................................................................................................................... 121 Table 93. Primary and Secondary Areas of Research of Nuclear Medicine Scientists in Chemistry, 2006.................................................................................................................. 122 Table 94. Primary and Secondary Clinical Application Areas of Work in Chemistry in Nuclear Medicine Science, 2006 ...................................................................................................... 123 Table 95. Subspecialty of Nuclear Medicine Scientists Who Identified Themselves as Pharmacists, 2006 ............................................................................................................... 124 Table 96. Percent of Time Spent by Nuclear Medicine Scientists in Pharmacy by Different Work Activities, 2006 ................................................................................................................... 124 Table 97. Primary and Secondary Areas of Research of Scientists in Pharmacy, 2006............. 126 Table 98. Primary and Secondary Areas of Clinical Application of Nuclear Medicine Science Pharmacy, 2006................................................................................................................... 127 Table 99. Subspecialty of Nuclear Medicine Scientists Who Identified Themselves as Physicists, 2006..................................................................................................................................... 128 Table 100. Percent of Time Spent by Nuclear Medicine Scientists in Physics by Different Work Activity, 2006 ..................................................................................................................... 129 Table 101. Primary and Secondary Areas of Interest of Scientists in Physics, 2006 ................. 130 Table 102. Primary and Secondary Areas of Interest of Active Nuclear Medicine Scientists in Computer Science and Engineering, 2006.......................................................................... 133

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Table 103. Time Spent by Nuclear Medicine Scientists in Computer Science and Engineering by Type of Work, 2006............................................................................................................ 134 Table 104. Primary and Secondary Clinical Areas Impacted by Computer Scientists and Engineers in Nuclear Medicine Science, 2006 ................................................................... 135

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List of Figures Figure 1. Estimated Number of Nuclear Medicine Scientists per Million Population in the United States, 2006 ........................................................................................................................... 19 Figure 2. Age Distribution of Active Nuclear Medicine Scientists by Gender, 2006 .................. 21 Figure 3. Percentage of Active Nuclear Medicine Scientists Who Were Women by Age Group, 2006....................................................................................................................................... 21 Figure 4. Number of Years Nuclear Medicine Scientists Spent in Previous Career, 2006 .......... 36 Figure 5. Academic Level at which Formal Education in Nuclear Medicine Science Began, 2006 ............................................................................................................................................... 43 Figure 6. Primary Employment Setting of Active Nuclear Medicine Scientists, 2006 ................ 46 Figure 7. Number of Years of Employment With Current Primary Employer, 2006 .................. 47 Figure 8. Departments in which Nuclear Medicine Scientists Work, 2006.................................. 48 Figure 9. Percentages of Active Nuclear Medicine Scientists in Different Branches of Science, 2006....................................................................................................................................... 49 Figure 10. Percent of Scientists Working in Clinical Nuclear Medicine Services and Services Provided by Scientists in Clinical Settings, 2006 ................................................................. 50 Figure 11. Areas of Interest of Nuclear Medicine Scientists in R&D, 2006 ................................ 51 Figure 12. Employment Settings for Nuclear Medicine Scientists Working in R&D, 2006........ 52 Figure 13. Interests of Other Nuclear Medicine Scientists Working at the Primary Work Settings with the Respondent Nuclear Medicine Scientist, 2006 ....................................................... 53 Figure 14. Specialty Areas of Active Nuclear Medicine Scientists Who Work With Other Nuclear Medicine Scientists at Their Primary Workplace, 2006 ......................................... 54 Figure 15. Percentages of Active Nuclear Medicine Scientists with Different Primary Tasks and Roles, 2006 ........................................................................................................................... 57 Figure 16. Distribution of Total Annual Salaries of Active Nuclear Medicine Scientists from All Nuclear Medicine Positions, 2006 ........................................................................................ 63 Figure 17. Distribution of Annual Salaries of Nuclear Medicine Scientists Reporting One Nuclear Medicine Employment Setting ($000), 2006 .......................................................... 65 Figure 18. Distribution of Annual Salaries of Nuclear Medicine Scientists Reporting Two or More Nuclear Medicine Employment Settings ($000), 2006............................................... 66 Figure 19. Work Hours of Full Time Active Nuclear Medicine Scientists by Number of Employers, 2006 ................................................................................................................... 68 Figure 20. Salary Range Comparison of Full Time Active Nuclear Medicine Scientists by Number of Jobs Held, 2006 .................................................................................................. 69 Figure 21. Attitudes of Nuclear Medicine Scientists About Salaries, 2006 ................................. 70 Figure 22. Nuclear Medicine Scientists Recruiting New Scientists to Nuclear Medicine by Primary Employment Setting, 2006...................................................................................... 72 Figure 23. Nuclear Medicine Scientists’ Recruiting Preferences by Source of Nuclear Medicine Science Research Funds, 2006.............................................................................................. 76 Figure 24. Strategies to Improve Nuclear Medicine Science Workforce Recruitment Identified by Active Nuclear Medicine Scientists, 2006............................................................................ 80 Figure 25. Cities Identified as the Best Prototype for Nuclear Science Emulation by at Least Five Survey Respondents.............................................................................................................. 87 Figure 26. Extent of Agreement Across the United States with Statement “Nuclear Medicine Will Continue to Grow in Importance in Health Care,” 2006 .............................................. 93

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Figure 27. Active Nuclear Medicine Sciences by Number Of Years Since Initial Certification in a Nuclear Medicine Specialty, 2006. .................................................................................... 96 Figure 28. Most Important Ways that Nuclear Medicine Scientists Maintain Professional Currency, 2006.................................................................................................................... 101 Figure 29. Rating of the Current Ease or Difficulty of Sustaining a Career in Nuclear Medicine in the United States, 2006 ....................................................................................................... 115 Figure 30. Primary Research Area within Chemistry Specialty, 2006 ....................................... 121 Figure 31. Primary Areas of Clinical Application of Chemists’ Work in Nuclear Medicine Science, 2006 ...................................................................................................................... 123 Figure 32. Primary Research Activities within Pharmacy Specialty in Nuclear Medicine Science, 2006..................................................................................................................................... 125 Figure 33. Primary Clinical Areas within Pharmacy Specialty, 2006 ........................................ 127 Figure 34. Percentage Distribution of Primary Interest Area within Physics Specialty, 2006... 130 Figure 35. Primary Clinical Areas within Physics Specialty, 2006............................................ 131 Figure 36. Primary Specialties of Computer Scientists and Engineers Working in Nuclear Medicine Science, 2006 ...................................................................................................... 132 Figure 37. Percentage Distribution of Clinical Area of Primary Work Application, 2006 ........ 134

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Executive Summary Nuclear medicine science is a critical foundation for the entire field of nuclear medicine. The fact that the nuclear medicine field is evolving rapidly makes the seminal contributions of nuclear medicine scientists even more important, since they are among the key determinants of the direction and pace of future change. Thus, nuclear medicine scientists are vital change agents in this important field of creative endeavor. These professionals play major roles in generating the scientific and technological breakthroughs that lead to the new cameras and diagnostic and therapeutic procedures currently transforming the entire field of medical imaging. Despite the important roles of nuclear medicine scientists, these professionals are not well understood. In fact, little is known about who they are, what they do, their roles in employing organizations, what tasks they perform, and where they work. Their diverse scientific interests, which include specialties in a number of disciplines including chemistry, physics, pharmacy, and computer science/engineering, adds additional confusion. Nuclear medicine scientists are scattered across all kinds of health care settings, including academic medical centers, technology development firms, research organizations, and clinical provider offices so there is no particular concentration of scientific endeavor in one locale. This report helps to describe and understand the characteristics of nuclear medicine scientists and their contributions to the field of nuclear medicine, medical imaging, and medicine more generally. The information and insights provided in the report are designed to inform planners, policy makers, and educators interested in ensuring that nuclear medicine science flourishes in the future. The Survey of Nuclear Medicine Scientists This report is based on the responses of the nuclear medicine scientists to a survey conducted in the Spring 2006. The survey, which was conducted by the Center for Health Workforce Studies at the University at Albany under a contract with the Society of Nuclear Medicine, is the first ever conducted of this group of professionals. A questionnaire containing over 60 questions was administered to more than 4,000 nuclear medicine scientists, using mailing lists from eight different professional organizations. This report is based on the 1,243 responses to the questionnaire, especially the 898 respondents who indicated they were active in nuclear medicine science. After reducing the denominator for those who indicated they were not involved in nuclear medicine and bad addresses, this represented a response rate of 38.2%. Most of the findings presented below were based on the responses of the 898 individuals who indicated they were working in nuclear medicine science. A copy of the survey instrument is provided in Appendix A. The report provides a compendium of tabulations of the survey responses, including the several themes covered in the survey questionnaire: personal demographics, education and training, entry into nuclear medicine, current work environment, salaries, recruitment of new scientists, attitudes about nuclear medicine, future plans, and certification and professional associations. It also summarizes responses to an open-ended narrative section and sections that compiled more detail about the four key branches of nuclear medicine science.

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Findings from the 2006 Survey This section presents a series of specific findings based on the responses to the 2006 Nuclear Medicine Scientist Survey. The selection highlights responses that appeared to have important implications for the future of nuclear medicine science. Additional findings, including tabulations of responses and interpretive text can be found in the body of the report. Additional details, including the narrative comments provided by the survey respondents, can be found in Appendix B. Key Concepts In addition to the myriad of details about the characteristics, employment, career paths, and attitudes of nuclear medicine scientists, a number of seminal concepts and themes were identified that seemed central to understanding the roles nuclear medicine scientists have in the field of nuclear medicine and health care more generally. The clinical practice of nuclear medicine was highly dependent on nuclear medicine science for new tools and techniques. Nuclear medicine scientists had central roles in developing these new tools and techniques, although many years of effort were often required to translate scientific breakthroughs into clinical practice. There was no formal career pathway that lead scientists into nuclear medicine. Most nuclear medicine scientists first considered nuclear medicine as a possible career in graduate school. Although this non-system seemed to have worked satisfactorily in the past, more structured pathways to the profession would benefit the field—and society—in the future. Many nuclear medicine scientists focused their research efforts on narrow, technical subjects that by themselves often yielded fragments of knowledge of little value in clinical practice. There was a continuing need for better communication and coordination to take scientific breakthroughs from the laboratory into clinical practice. Responses indicated that nuclear medicine science is both a global and a collegial enterprise with much cooperation and sharing. Many nuclear medicine science ventures were collaborations among scientists in the U.S., Europe, Japan, and elsewhere. In fact, 28.2% of the respondents to this survey were born in other countries. Funding support for nuclear medicine science, which came primarily from the federal government, was both limited and fragile. The recent decision to cut funds for basic nuclear medicine science research from the Department of Energy budget was a case in point. This cut could have a major negative impact on nuclear medicine practice in coming years. Business played an important role in nuclear medicine science and practice. The nuclear medicine cameras developed by major corporations were essential to the delivery of the diagnostic and therapeutic benefits of nuclear medicine to patients. Rules about ownership, use, and taxation of these cameras had a major impact on the use of these tools. Responses indicated that nuclear medicine—and nuclear medicine science more generally— suffers from serious misconceptions about the risks of radiation exposure. Despite the fact that radiation exposure from nuclear medicine procedures was a tiny fraction of that from regular x-rays, federal regulations treated radiopharmaceuticals on a par with more dangerous radioactive substances.

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Like many cutting-edge fields of science, nuclear medicine science was very entrepreneurial. Nuclear medicine scientists improvised their research programs and agendas based on a host of relationships and ventures. Funding came from multiple sources. Staffing was arranged by chance and happenstance. Progress was often affected by outside factors. Important Issues for Nuclear Medicine Science There are a number of important issues currently facing nuclear medicine science, including: •

Maintaining a critical mass of nuclear medicine scientists to maintain a steady flow of scientific advances and breakthroughs to the nuclear medicine field;

•

Understanding, maintaining, and developing the mechanisms by which new nuclear medicine scientists are attracted and recruited into the field of nuclear medicine;

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Promoting adequate funding for nuclear medicine research to sustain the flow of knowledge and information about nuclear medicine to appropriate stakeholders;

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Maintaining adequate levels of reimbursement for clinical nuclear medicine studies to help support appropriate clinical and scientific research;

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Creating and sustaining centers of excellence in nuclear medicine research, education, and practice where scientific exploration can flourish;

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Supporting the initial and continuing education and training of new nuclear medicine scientists so there are competent replacements for those who leave the field; and

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Publicizing the relative safety of current nuclear medicine procedures in terms of radiation exposure with the hope that government regulations can be relaxed in the future.

Key Findings With as few as 1,500 practitioners, nuclear medicine scientists are a very small segment of the health workforce in the U.S.—and a tiny component of the entire workforce. Their small numbers belie their importance to both the health care system and the larger economy. They play important roles in developing and implementing the advanced technologies that have led to exciting new paradigms of medical diagnosis and treatment over the past several decades. The contributions of these scientists have not gone unnoticed. By many measures, this cadre of highly educated and creative professionals has been well rewarded for their efforts. Salaries are generally commensurate with education levels. Professional roles and responsibilities are varied and interesting. Demand for scientists appears to exceed supply. Opportunities for fulfilling scientific work abound. These conclusions were based on the survey responses summarized in this report. The survey responses also highlighted concerns about nuclear medicine science that deserve attention by policy makers and other stakeholders. Highlights from the survey responses are summarized below to give readers some perspectives on nuclear medicine science as of 2006.

Geographic Dispersion

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•

Compared to the overall population, nuclear medicine scientists were overrepresented in the New England, Northeast, Mid Atlantic, Mid West, and Southwest regions; and underrepresented in the Southeast, Mountain, Pacific, and Northwest regions.

Demographics •

Nuclear medicine scientists who responded to the survey were 83% male and 17% female, compared to 49% and 51%, respectively, in the general population.

•

More than one-quarter of active nuclear medicine scientists (28%) were born outside the U.S. This pattern was similar to that for physicians (32% of active nuclear medicine physicians were international medical graduates).

Education •

A majority of survey respondents held professional degrees at the doctoral level or held combined doctoral/professional degrees as doctors of medicine/osteopathy and doctors of philosophy. More than 59% of active nuclear medicine scientists held doctoral degrees such as PharmD, PhD, MD, DO, JD, DVM, and SciD. About 25% held master’s degrees, and 14% held bachelor’s degrees.

•

More than one in four (27%) of active nuclear medicine scientists earned their bachelor’s degree in physics, followed by 22% in pharmacy, and 19% in chemistry. Four percent indicated they had dual majors.

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Among scientists indicating plans to seek additional degrees, almost half (46%) indicated their chosen discipline was “other.” The most frequently cited “other” discipline was the MBA.

•

Of the 35% of nuclear medicine scientists expecting to pursue further education in the next five years who held doctoral/professional degrees (PhD, MD, DO, and combined degrees), the most frequently selected level was “other.” This included business administration, health care administration, hospital administration, molecular and medical pharmacology, and molecular physiology.

Entering Nuclear Medicine Science Careers •

A much higher percentage (63%) of scientists younger than age 40 had selected nuclear medicine as a first career than had scientists age 60 and older (28%). This suggested that expanding opportunities in nuclear medicine science increased knowledge of the nuclear medicine science disciplines among younger professionals making first time career choices.

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More than one-quarter (36%) of current nuclear medicine scientists initially learned about the field of nuclear medicine science from a professor, followed by a work experience (27%).

•

More than one-third of current nuclear medicine scientists (36%) first learned about nuclear medicine science during their undergraduate education. An additional 22% of current nuclear medicine scientists learned about nuclear medicine opportunities at the master’s level. About one-third of current nuclear medicine scientists (33%) learned about opportunities in nuclear medicine in their doctoral program or medical school (19%), or during postdoctoral training (14.1%).

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Among respondents younger than age 30, 60% first learned of opportunities in nuclear medicine science in their undergraduate years. Among those in the 50 to 59 year age group, only 35% first learned of nuclear medicine science opportunities at the undergraduate level.

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Nearly 500 survey respondents identified 279 different careers that preceded their work in nuclear medicine. These careers ranged from aeronautical engineering and archeology to veterinary medicine and x-ray crystallography. This breadth of experience suggested that the current field of nuclear medicine science represents synthesis of a very broad range of scientific and non-scientific interests and experiences.

Current Work Setting •

Among active nuclear medicine scientists, medical centers were the most common primary work setting. More than one in four (28%) worked primarily in academic medical centers and 23% worked in hospitals/medical centers. Another 18% of nuclear medicine scientists worked primarily in radiopharmacies.

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Nearly half (48%) of active nuclear medicine scientists reported having a secondary employment setting. The three secondary work settings reported most were hospitals/medical centers (9%), academic institutions (6%), and academic medical centers (6%).

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More than one-third of nuclear medicine scientists (34%) had worked for their current primary employer for five years or less, and another 18% had worked for their current primary employer between six and ten years.

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Forty-five percent of active nuclear medicine scientists worked in either a nuclear medicine center in a radiology department, a radiology department, or a nuclear medicine department. This suggests strong ties to clinical care for a large fraction of nuclear medicine scientists.

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Only 9% of active nuclear medicine scientists worked in an academic research department and 7% worked in a corporate research and development department. An additional 1% of nuclear medicine scientists worked in corporate sales and marketing.

Branch of Science •

The branches of science with which respondents identified most closely included physics (33%), pharmacy (20%), chemistry (14%), computer science and engineering (3%), some combination of these four (16%), and “other” (15%). This pattern illustrated the interdisciplinary nature of nuclear medicine science research and clinical nuclear medicine services.

Clinical Service •

Nuclear medicine scientists were not involved solely in basic science work in laboratory settings. A high percentage (70%) of respondents worked in a department that provided clinical nuclear medicine services. The most frequently cited functions of scientists in clinical departments were radiation safety monitoring (42% of respondents) and professional/patient education (41%).

Research and Development (R&D) •

Nearly half (46%) of nuclear medicine scientists responding to the survey indicated that they worked in R&D.

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•

Among those scientists that worked in R& D, a majority (63%) worked in radiopharmaceutical development. About half of respondents (48%) working in R&D worked in “in vivo research,” whereas 23% worked in “in vitro research.”

•

The percentage of active nuclear medicine scientists working in technology development (45%) was more than twice the percentage working in radionuclide development (20%) and cellular/molecular biology research (20%).

•

Most scientists in R&D reported working in academic medical centers (43%) or college/universities (25%). Private corporations employed 22% of survey respondents engaged in R&D. “Other” settings cited by nuclear medicine scientists working in R&D included national laboratories and research institutes.

Roles and Tasks •

The umbrella of nuclear medicine science covers a myriad of research activities and scientific roles. The roles of nuclear medicine scientists included: basic science research only (20%), applied research only (3%), technical support only (15%), administrative support only (5%), two or three roles (30%), all four roles (12%), and “other” (15%).

•

Of scientists reporting basic science research as their primary role, 37% worked in radiopharmaceutical development and 35% worked in “other” areas.

•

Of scientists reporting their primary role as applied research, roughly equal percentages indicated research in image processing (18.6%), new applications (18.1%), and “other” (18.l%).

•

Of scientists reporting their primary role as technical support, 36% reported working in radiopharmaceutical preparation and 31% in radiation safety.

•

Of scientists reporting administrative support as their primary role, 35% were involved in regulatory oversight and 30% educated other clinicians and professionals.

Salaries •

The mean annual salary of active nuclear medicine scientists in 2006 was $123,800, and the median was $108,000. Additional details about salaries are provided in the body of the report.

•

Although nearly half (49%) of survey respondents indicated that nuclear medicine salaries were competitive in the marketplace, 28% indicated that salaries in academic environments were not competitive with corporate salaries.

Mentors and Mentoring •

Although nearly three in five (60%) active nuclear medicine scientists had a mentor in nuclear medicine in the past, only about one-third of nuclear medicine scientists (35%) indicated that they now mentor a potential nuclear medicine scientist.

•

A majority (81%) of scientists who were not personally mentored were not currently mentoring prospective scientists. However, among those scientists who were mentored in the past, less than half (45%) were currently mentoring any prospective scientists.

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•

The fact that more than half of the scientists in all age groups had a nuclear science mentor suggested that mentoring is important for recruiting new scientists.

Recruitment of New Scientists •

About one in three (36%) of nuclear medicine scientists participated in recruitment of new scientists into nuclear medicine. Respondents working in chemistry (50%) or in multiple branches (46%) of nuclear medicine science were most likely to be involved in recruitment of new professionals.

•

Overall, 86% of active nuclear medicine scientists from all branches of science indicated that there were few qualified candidates for available jobs. Only 4% of scientists indicated that there were no qualified candidates available to fill open positions.

•

Nuclear medicine scientists working in academic institutions (71%), research organizations (67%), and academic medical centers (61%) were more likely to recruit new postdoctoral students. Scientists working in academic institutions (50%) were the most likely to recruit new PhD students. Scientists working in consulting companies (88%) and in pharmaceutical companies (71%) preferred to recruit experienced professionals.

•

Scientists responding to the survey suggested multiple strategies to improve recruitment of new professionals into nuclear medicine science including improved salaries (47%), more support for graduates in related fields (36%), more nuclear medicine fellowships (34%), endowed training grants (33%), and a national public relations campaign for nuclear medicine (28%).

Attitudes About Nuclear Medicine •

Scientists were asked to indicate current issues that affect nuclear medicine scientists. Respondents were consistent across all branches of science in selecting “government regulation” (61%) as a current issue that impacts nuclear medicine scientists.

•

“Reimbursement and financial issues” was also consistently chosen by 60% of scientists as a current issue. This was selected more often by pharmacists (68%) than any other category of scientist.

•

Among all response options, “restriction on imports of nuclear material” was the least selected (except “other”) with only 9% of respondents marking this response.

•

Respondents expressed overall agreement with the statement that nuclear medicine will continue to grow in importance in health care (with an average score of +1.02 on –2 to +2 scale). This opinion was supported by general disagreement with the statement that nuclear medicine will become less important in the future (-0.88).

•

There was also agreement with the statement that the costs of nuclear medicine studies will increase in the future (+0.74).

•

Respondents agreed that nuclear medicine science will become more integrated in the future (+0.75). They also agreed that regional centers of nuclear medicine science R&D should be established in the future (+0.70), although there was less agreement that such centers would actually be established (+0.16).

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•

Three in five (59%) scientists agreed or strongly agreed that shortages of nuclear medicine scientists will limit future research.

•

Overall, the majority of nuclear medicine scientists responding to the survey perceived that molecular imaging science would have a positive effect on the work of nuclear medicine scientists. More than half (55%) of respondents believed that molecular imaging science will enhance employment opportunities for nuclear medicine scientists.

•

Only about one-fifth (21.2%) of respondents indicated that nuclear medicine research in the U.S. is more restricted than in other countries.

•

Two in five scientists (44.8%) expressed the opinion that scientists in the U.S. encounter more regulatory barriers to progress than scientists in other countries.

Sustaining Nuclear Medicine Science Careers •

In all branches of science except chemistry, almost two-thirds of active nuclear medicine scientists indicated that continued reimbursement for nuclear medicine procedures by Medicare and other insurance carriers was needed to sustain careers in nuclear medicine. Many of these scientists worked in hospitals and other clinical settings.

•

Over one-third (38%) of responding nuclear medicine scientists felt that continued financial support for nuclear medicine research was key to sustaining a career in nuclear medicine. Almost three-quarters of chemists (70%) indicated this was a key factor for career sustainability in the future, which was consistent with the high percentage of chemists found in “basic research only” roles.

•

Only 14% of respondents indicated that relaxation of federal regulations was a key factor for sustaining future careers in nuclear medicine.

Future Career Plans •

Regional differences were observed in the future career plans of nuclear medicine scientists. Greater proportions of scientists in the Midwest (12%) and the Northwest (11%) expected to seek jobs outside nuclear medicine science over the next five years than in other regions of the country.

•

Although 21% of nuclear medicine scientists in the Mid-Atlantic Region and 18% of scientists in the Northeast expected to seek other jobs in nuclear medicine science in the next five years, the profession seemed relatively stable in those regions with only 7% of scientists in the Mid-Atlantic and only 3% of scientists in the Northeast expecting to seek a job outside nuclear medicine science.

Certifications and Professional Associations •

Nuclear medicine scientists held a variety of different certifications, depending on their branch of science. These included certifications by the American Board of Health Physics (ABHP), the American Board of Science in Nuclear Medicine (ABSNM), the American Board of Medical Physics (ABMP), the American Board of Radiology (ABR), the Board of Pharmaceutical Specialties (BPS), and the Board Certified in Nuclear Pharmacy (BCNP). Nuclear medicine scientists were also certified by a variety of other credentialing organizations including the American Board of Nuclear Medicine (ABNM) and the Nuclear

8

Medicine Technology Certification Board (NMTCB). (See Appendix B for the complete list of other responses for question I.1.) Professional Association Memberships •

Scientists indicated with similar percentages of responses a variety of reasons for membership in professional groups including annual meeting opportunities (64%), publications (63%), education opportunities (59%), and peer interaction (58%).

•

The professional associations of which respondents reported they were members included: the Society of Nuclear Medicine (56%), the American Association of Physicists in Medicine (35%), the Health Physics Society (16%), the American Pharmacists Association (13%), the American Chemical Society (12%), the Academy of Molecular Imaging (11%), and the IEEE (11%).

Maintaining Professional Currency •

The two most cited ways of maintaining professional currency were attendance at professional meetings (40%) and reading professional journals (39%).

Recommendations Before recommendations based on the findings are presented, it may be useful to share some of the narrative comments and suggestions provided by a few of the survey respondents. These provide more visceral perspectives on the current condition of nuclear medicine science, perspectives that should be factored into any set of change strategies. The perspectives of other respondents can be found in Appendix B, starting on page 189. I think nuclear medicine is going to have a bigger role in therapy rather than diagnostics soon enough and we all need to prepare for this. SNM needs to promote NM and support appropriate regulations rather than diluting them. Baby boomer retirements will lead to manpower shortages. It is too expensive to do well-designed [NM] studies. NIH reviewers understand neither this nor the methodology required to analyze data—PET/SPECT researchers at small centers suffer without funding. Cost reduction is a primary concern. A regional referral system should be created to avoid duplication of resources and technical personnel. I would like to have more SNM involvement, but nothing is geared in any way toward pharmacists, i.e., CE credits, articles, etc. If reimbursement continues to decrease, it will be difficult to maintain quality NM departments. I'm really concerned about how the U.S. government keeps cutting reimbursement for imaging studies. I believe this is a huge detriment to all imaging. It is important to educate patients and provide documentation for them to carry concerning radiopharmaceuticals. This may reduce delays if stopped by radiation monitors. In my field of nuclear pharmacy, burnout is the biggest concern. Quality of life issues are a concern as well, with on call and very early morning hours the norm.

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Nuclear Medicine in the U.S. is totally overwhelmed by Radiology for a number of reasons. Nuclear Medicine is quickly being replaced by alternative imaging technologies such as multislice CT and MRI and not enough new innovative techniques for NM are being discovered. NM must develop a program to educate/market to other medical professionals, third party payers, and patients on the cost/benefits of NM procedures and its complimentary aspects to other medical practices. NM needs to maintain its identity in biomarker development and applications and not become absorbed into radiology. NM is undergoing resurrection, driven by CMS reimbursement, PET, and new awareness of scientific merits of molecular-based imaging. But NM professionals [are being] out-muscled by radiologists and oncologists. Unless reimbursement system is changed (which is not likely), politics will determine the tempo of NM practice. NM has the best potential for future development in basic molecular bioscience, and less [potential] in clinical research where non-radioactive procedures are increasingly preferred. Force specialties to work together and use best modalities for diagnosis and therapy. Nuclear medicine will naturally rise to a position of respectability; otherwise non-nuclear medicine specialists will take over nuclear medicine imaging. I believe NM is more science-based than other imaging. Revisit the National Biomedical Tracer Facility (NBTF) plan. It could provide a supply for interesting radionuclides and provide training for radio chemists, hot cell operations, nuclear pharmacists and physicists. Poor reimbursement and a shortage of nuclear medicine physicians impact research, especially clinical trials of new radiopharmaceuticals. The MDs are being pushed to spend all their time on clinical scan reading (not research). NM [research] is poorly funded and poorly integrated with community nuclear medicine. Little inclusion of community hospitals in research opportunities. No incentive for community hospital based research. High likelihood of further erosion due to turf wars.

The recommendations that follow were based on the impression that nuclear medicine science and its related education programs are fragmented and disorganized. Major transformations of nuclear medicine—including all nuclear medicine professions—seem certain over the next five to ten years. There is a significant risk that nuclear medicine scientists will not reach their full potential, either individually or collectively, for moving the field of nuclear medicine forward. This risk could be minimized if efforts were mounted to organize the education programs that produce new nuclear medicine scientists and focus the efforts of nuclear medicine scientists and their professional organizations on public advocacy for greater research funding. If nothing is done, however, there is a significant risk that nuclear medicine could fragment and be scattered into other medical specialties. Five Themes for the Future The recommendations presented below are organized into five broad categories, each dealing with a different aspect of the scientific environment. Several of the categories are relevant to the segments of the nuclear medicine workforce in addition to nuclear medicine science, especially

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physicians and technologists. Some of the tasks should be easily accomplished. Others will require concerted effort by teams of stakeholders from many fields and many organizations. Attract strong candidates into nuclear medicine science. As with any enterprise, nuclear medicine science will flourish to the extent that it recruits and retains intelligent, creative candidates to design and conduct the research studies that will lead the field into the future. This can be accomplished through a variety of mechanisms, including: a) Earlier exposure to nuclear medicine for potential candidates. All of those interested in science, engineering, or medicine should hear about nuclear medicine early in their college careers. SNM or some other organization should prepare and distribute flyers, press releases, public interest ads, and other mechanisms to inform students in high schools and colleges about career opportunities in nuclear medicine. b) Career development network. Publicize SNM’s Internet-based job posting system. This will facilitate the process of notifying interested scientists and students about career opportunities in nuclear medicine science and connecting interested candidates with job opportunities. c) Encourage mentoring. This report has documented the importance of mentoring to the development of nuclear medicine scientists, especially those involved in advanced research. Perhaps the career network described above could be extended to encourage and guide research scientists and managers to get involved in mentoring as a way of improving the flow of new talent into nuclear medicine science. d) Better nuclear medicine science job opportunities. This is a challenging task that will entail reaching out to the organizations that hire nuclear medicine scientists and other professionals involved in the practice of nuclear medicine. It will also require communication with the organizations and agencies that provide funding for nuclear medicine research and reimbursement for clinical practice. Increase funding for nuclear medicine science and research. Funding was cited by many survey respondents as a critical issue for nuclear medicine science. Several avenues are available for improving funding for this important activity. a) Government funding of basic research. The federal government has always been a primary source of support for nuclear medicine science. On the clinical side, this often occurs under the auspices of National Institutes of Health (NIH). On the basic science side, limited funding was available through the Department of Energy. It is important to ensure that both of these funding streams are maintained. b) Broad-based funding for applied research. Corporate and foundation funding for nuclear medicine research should be encouraged and expanded, not only in private labs, but also in the labs of academic institutions. It is essential that a steady stream of scientific breakthroughs and technical advances be available to move the practice of nuclear medicine forward to its full potential. c) Adequate reimbursement to support clinical research. As Medicare and other thirdparty payers seek ways to reduce the cost of health care, it is essential they do not cut funding so much that nuclear medicine research is eliminated. Such research is critical for confirming the efficacy of new diagnostic tools and techniques and new therapeutic

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protocols. It is also important not to abdicate responsibility for PET/CT and other fusion imaging procedures to radiologists as these new technologies become more common. d) Adequate funding for nuclear medicine by the National Institutes of Health. Ensuring that an appropriate share of NIH funding is devoted to research related to nuclear medicine will be a continuing concern. SNM should continue to work to ensure that nuclear medicine has as high a priority for NIH funding as possible. Educate the public about the value, safety, and future potential of nuclear medicine procedures. Many of the regulatory restrictions and limitations that nuclear medicine is subject to appear to be based on misconceptions of the public, elected officials, and government bureaucrats about the safety of the radioactive materials used in nuclear medicine practice and research. This set of initiatives will help to correct these misconceptions. a) Legislative and agency briefings. It is extremely important to correct misconceptions about the safety of nuclear medicine procedures in legislative arenas and especially in agencies responsible for regulating nuclear medicine protocols and substances. Done effectively, this will lower some of the barriers to the introduction of new radiopharmaceuticals and nuclear medicine procedures and protocols. b) Public education programs. Though perhaps less important than legislative briefings, public education about nuclear medicine science needs additional attention. This will help to promote legislative agendas, stimulate public interest in nuclear medicine, and help to find new recruits for careers in nuclear medicine science. c) Communication networks. An important goal of this initiative is to promote continuing communication between the nuclear medicine community and its constituents and supporters. A variety of communication mechanisms are envisioned including the Internet, newsletters, press releases, and periodic reports. d) White papers. As new nuclear medicine tools and techniques are introduced into practice, and as new scientific breakthroughs take place in research organizations across the country, it is important that information be shared with those in the communication networks. A variety of different vehicles are envisioned including policy white papers, briefing memos, and simple notices. Reorganize nuclear medicine research and education around Centers of Excellence in Nuclear Medicine. Given the small size of the nuclear medicine enterprise in the U.S., it is not possible to have viable research efforts in more than a small number of facilities. The vision presented in this report is for a series of seven or eight regional centers of excellence in nuclear medicine geographically dispersed around the U.S. Ideally, these centers would be located in academic research institutions or consortia that already have a significant presence in nuclear medicine, as shown in Figure 25 on page 88 of this report. Each of these centers would support a critical mass of clinicians, investigators, mentors, educators, scientists, administrators, and equipment to serve the clinical and scientific needs of its region. In addition, each center would have responsibility for coordinating nuclear medicine research and clinical services in its home region. The result would be a much more cost-effective approach to both the conduct of research and the provision of clinical services. Each center would coordinate several aspects of nuclear medicine science:

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a) Professional education. This would include clinical education for physicians, technologists, and technicians, and scientific education for researchers, investigators, and technical support staff. b) Scientific research. Each center would have a full range of capabilities for clinical research, basic science research, theoretical research, and applied research. Depending on the interests and capabilities of their investigators and funding, the centers may be encouraged to specialize in one or more sub-fields of nuclear medicine. c) Infrastructure development. Each regional center would have appropriate infrastructure to support a wide range of clinical, basic science, and educational activities. This would include such major equipment as cyclotrons and supercomputers, as well as the latest in imaging equipment. This infrastructure would support not only research, but also education and clinical service. d) Communication networks. An important element of this design is the latest in communication capabilities to permit both internal and external networking. The opportunity to cross-fertilize the efforts of all the centers and to connect with researchers elsewhere would multiply the impact of the basic capability that each brings to the field. The centers could also play an important role in public education and legislative briefings. e) Strong ties with vendors and corporations. A special effort should be made to attract vendors into the networks of partners of these centers. By encouraging earlier sharing of ideas, it would be possible to accelerate the introduction of new pharmaceuticals and cameras into practice. f) Special interest groups. Patients, consumers, ethicists, foundations, regulators, and other interested parties should be encouraged to join as partners in the center. These additional perspectives would strengthen the centers’ teams, help maximize the impact of the centers, and ensure the centers serve the public interest. Enhance SNM as a key advocate for nuclear medicine science. SNM can play important roles in implementing this vision of the future for nuclear medicine and molecular imaging. The different stakeholders have much to gain or lose depending on the strategies and priorities chosen to move nuclear medicine science forward. Several strategies are possible including: a) Comprehensive strategies for educating nuclear medicine scientists, physicians, and techs. Although breadth in participating scientific disciplines in nuclear medicine science is essential to support and advance nuclear medicine, this diversity in disciplines confounds the creation and maintenance of professional identity as a nuclear medicine scientist. Annual professional meetings, educational opportunities, interaction with peers and peerreviewed journals were cited by the majority of survey respondents as reasons for membership in professional associations. These activities should be encouraged and enhanced. b) Comprehensive continuing nuclear medicine education. The current professional enrichment activities of SNM are an important aspect of this initiative. Although most survey respondents indicated they belong to professional associations relevant to their particular scientific discipline (e.g., physics, pharmacy), SNM provides an important interdisciplinary forum for exchange of professional ideas and information. This should be continued and expanded.

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c) Policy leadership for nuclear medicine science. Survey respondents expressed concern about the lack of current research funding, the difficulty in obtaining source materials for research, the current approval process for radiopharmaceuticals, and the lack of visibility of nuclear medicine scientists vis-à-vis other medical and health professionals. Advocacy is needed: to address issues related to public policy, regulatory guidelines, funding issues, and infrastructure development for nuclear medicine science; to build articulated curricula for clinical and scientific programs to prepare and maintain a competent and competitive scientific workforce; and to increase public understanding of the benefits and safety of nuclear medicine, the usefulness of radioactive materials, and the value of nuclear medicine research. d) Cooperative nuclear medicine venture leadership. It seems unlikely that any single organization will dominate the nuclear medicine landscape. There are simply too many threads and themes for one organization to control. This creates an important opportunity for SNM to continue to serve as the conductor of the “nuclear medicine orchestra.” This should be possible to the extent that SNM can help the various constituents to achieve their respective objectives, while shepherding the entire field of nuclear medicine into the future. e) Public relations campaigns for nuclear medicine. Strategies and ideas without dissemination are like one hand clapping -- they don’t make much noise or have much impact. SNM should assume the critical role of promoter of nuclear medicine science—and nuclear medicine practice, more generally—to the public. This would enhance SNM’s image with the public, and more importantly, with its professional constituents -- the physicians, scientists, technical staff, facilities, and vendors that comprise the nuclear medicine industry. f) Legislative lobbying for nuclear medicine. Advocacy at the federal level is critical for preservation of the science of nuclear medicine. The small size of the profession creates challenges for building reputation and recognition. Nevertheless, it is essential that government policy makers and bureaucrats be informed of the changes that should take place to enable nuclear medicine to reach its full potential.

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Introduction Nuclear medicine scientists are a critical component of the workforce related to nuclear medicine. Even though many nuclear medicine scientists work “behind the scenes,” their contributions to the practice of nuclear medicine should not be underestimated. They have played—and are continuing to play—significant roles in the design and development of new nuclear medicine tools and techniques that are positioning nuclear medicine procedures as the gold standard in medical diagnosis and treatment for a growing number of diseases and illnesses. Despite the important roles they play in designing and developing nuclear medicine tools, technologies, and techniques, nuclear medicine scientists have remained a tiny fraction of the nuclear medicine workforce, with perhaps as few as 1,500 practitioners in the U.S. This small number is further divided into several branches of nuclear medicine scientific inquiry including physics, chemistry, pharmacy, computer science, and engineering. Smaller states may have only one or two active nuclear medicine scientists in their entire workforce, and some branches of nuclear medicine science may not be represented in some states. This report is the first to document the characteristics, employment, and opinions of nuclear medicine scientists. It has been prepared as part of a larger study of the nuclear medicine workforce being conducted by the Center for Health Workforce Studies, under a contract with the Society of Nuclear Medicine. The hope is that the report will inform several audiences about the important contributions made by nuclear medicine scientists to the nuclear medicine field, including nuclear medicine scientists, other nuclear medicine stakeholders, and interested planners and policy maker. Classifications and Terminology The enterprise of nuclear medicine science is both complex and fragmented. One of several challenges of this study was to identify characteristics of nuclear medicine scientists that can be used in different combinations to generate classifications useful for understanding their roles, responsibilities, and tasks. Among the most important of the characteristics identified by the project staff and their advisors were: •

Branch of Science. Nuclear medicine scientists are found in a number of different branches of science. The four primary branches used in this study were physics, chemistry, pharmacy, and computer science/engineering. Several tabulations presented in this report used two other branches either none of these four (or “not specified”), or more than one of these four (or “multiple branches”).

•

Areas of Research. Areas of research varied by scientific specialty and subspecialty in each of the branches of science. These categories or areas of interest in research are often unique to the different branches of science but may not be exclusive to a single branch. It is also possible that the list of categories may change over time as scientists and others learn more about the mechanisms, methods, and outcomes of nuclear medicine.

•

Clinical Emphasis. One of the characteristics of nuclear medicine science that separates it from many other scientific endeavors is its ultimate relationship to clinical medicine. This is another characteristic that may change over time as the knowledge, theory, and practice of nuclear medicine evolves and transforms.

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•

Work Setting. Nuclear medicine scientists are found in a variety of settings including academic laboratories, clinical settings, and corporate offices. Typically, these settings represent employers whose goals define the employment objectives, work patterns, and other characteristics of the work of the nuclear medicine scientists employed in them.

•

Roles and Tasks. Nuclear medicine scientists perform a variety of tasks, depending on their clinical or research orientation. The four major categories of Basic Science Research, Applied Research, Technical Support, and Administrative Support were selected to encompass nuclear medicine science activity in the workplace. This study helps to understand the many configurations of nuclear medicine science roles and tasks in those areas of endeavor.

•

Professional Memberships. The variation in interests and orientation among nuclear medicine scientists is reflected in the myriad professional organizations to which these professionals belong. While this characteristic may not be as important as some for clarifying professional work patterns, it is relevant to understanding the scientific disciplines with which nuclear medicine scientists associate and communicate.

By considering these characteristics of nuclear medicine scientists in different combinations and sequences, this report helps to develop at least a partial understanding of nuclear medicine scientists and their contributions to the larger field of nuclear medicine. The report also creates a frame of reference for planners and policy makers as they consider how to channel resources to different aspects of nuclear medicine science. Nuclear Medicine Scientist Survey This report is based on the responses to a survey of nuclear medicine scientists conducted in 2006 that asked 64 questions about several aspects of scientists’ professional work, including demographics, education and training, entry into nuclear medicine, current work environment, salaries, recruitment of new scientists, attitudes about nuclear medicine, future plans, and certifications and professional associations. Many of the questions had multiple categories that increased the total number of possible responses to well over 300. Survey Design The survey questionnaire was designed with the guidance of a small panel of nuclear medicine scientists who assisted project staff in determining the broad categories of questions to be included in the questionnaire, in designing individual questions and response categories, and in determining to whom the survey should be sent. A copy of the questionnaire is provided in Appendix A. Although there are advantages to conducting surveys of this type online, e-mail addresses were not available for all identified scientists so the survey was offered only on paper through a postal mail process with three mailings. A decision was made to provide an incentive for nuclear medicine scientists who responded to the survey by offering drawings for awards of $500 (first mailing response), $250 (first or second mailing response), and $250 (first, second, or third mailing response) at the conclusion of each of the three survey mailings. Each survey was sent with a letter from the Society of Nuclear Medicine explaining the purpose of the survey and a letter of explanation of survey process from the Center for Health Workforce Studies. A packet was mailed to all identified scientists beginning in March of 2006. In the

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following month (April 2006) a second mailing went to scientists who had not yet responded to the first request. Likewise in May 2006 a third and final mailing was sent to all scientists who were nonresponsive at that time. Sample Design The difficulty in identifying and locating nuclear medicine scientists was a fundamental issue for sample design. A decision was made to cast a broad net among professional societies and credentialing organizations to identify scientists across the U.S. involved in either basic or applied research or clinical applications of nuclear medicine science. With the cooperation of the American Board of Science in Nuclear Medicine (ABSNM), the Society of Nuclear Medicine (SNM), the Board of Pharmaceutical Specialties (BPS), the American Society of Nuclear Cardiology (ASNC), the American Association of Physicists in Medicine (AAPM), the Academy of Molecular Imaging (AMI), and the Society of Radiopharmaceutical Sciences (SRS), which each supplied a list of possible nuclear medicine scientists as determined by professional credentials, an unduplicated list of 4,309 possible scientists was compiled. All identified scientists were mailed a survey with a request for participation. It was assumed the list of scientists likely included nonnuclear medicine scientists. However, it was not possible to ascertain specialty distinctions among the list of credentialed scientists. Ultimately, this expectation was confirmed by communication from scientists in receipt of the survey instrument. Responses, including declination of survey participation, were received from 1,648 scientists. A number of scientists refused participation because of primary involvement in radiation oncology or other specialty activity. It was strongly suspected that among the 2661 scientists from whom no response was received, a number were not also engaged in nuclear medicine science as a primary activity. After filtering responses for scientists who indicated they were working in nuclear medicine, the response database was further restricted to 898 scientists in physics, chemistry, pharmacy/radiopharmacy, and computer science and engineering with a nuclear medicine specialty. In summary, 4,309 credentialed professionals were solicited for participation. Responses were received from 1,648 scientists including declination of participation. Of those who responded, 1,243 individuals completed the survey questionnaire. Among those, the responses of 898 scientists who indicated primary involvement in nuclear medicine at some level were selected for analysis. Most of the tabulations in this report reflect this filtered group of active nuclear medicine scientists. In some cases, the 1,243 individual responses were included. The narrative comments, which were transcribed and appended to this report, include all comments from all responding survey participants to understand and clarify the broader environmental context for nuclear medicine science and scientists. The Survey Process The survey process included the following steps: •

Develop a consolidated mailing list, eliminating duplicate names from the final file;

•

Create mailing labels and a corresponding database to track respondents and nonrespondents;

•

Conduct three mailings, dropping those who responded to a current mailing from subsequent mailing lists;

•

Scan the survey responses into an SPSS data file for processing and analysis;

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•

Create several new variables based on the responses, e.g., age from year of birth;

•

After closing the survey process, strip personal identifiers from the file; and

•

Analyze the data set and prepare an interpretive report.

Survey Responses Including a broader scientific group in the survey sample design was an important strategy to reach the scientists in the specialized discipline of nuclear medicine. Nuclear medicine scientists were difficult to locate and identify as a small cohort among scientists. The survey process yielded 1,243 usable responses from the 4,309 individuals on the final consolidated mailing list. The large denominator that likely included scientists not engaged in nuclear medicine science lowered the final response rate. After reducing the denominator to exclude those who indicated they were not nuclear medicine scientists and those with bad addresses, the final response rate for the survey was estimated at 38.2%. This was lower than expected for a survey of this complexity and design, but the sample for the survey included scientists who were unlikely to respond because of lack of knowledge of nuclear medicine science. Limitations The key limitation of the survey was the difficulty in identifying nuclear medicine scientists. The survey was also limited in its capacity to describe the myriad professional activities among nuclear medicine scientists. Despite its length and detail, it is apparent from scientists’ responses, especially the narrative and “other” responses to many of the questions, that the breadth and depth of nuclear medicine science could not be captured by a single workforce survey.

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Key Findings Before summarizing the responses to the questions in the different sections of the survey questionnaire, it is interesting to consider the geographic distribution of the individual scientists and other professionals to whom the instrument was distributed. Except where noted, the tabulations and percentages presented below were for respondents to the 2006 survey who indicated they were active in nuclear medicine science. Figure 1 shows the ratio of nuclear medicine scientists per million population across the 50 states. It shows clearly that there was a wide range of penetration of nuclear medicine scientists across the U.S., with as few as two nuclear medicine scientists per million population in Alaska and as many as 36 per million in the District of Columbia. The ratio of the highest to lowest scientist to population ratios was 18, which was relatively high for health-related professions. It indicates a very uneven geographic penetration of these professionals, and suggests an equally uneven penetration of nuclear medicine science facilities and services. This may disadvantage some parts of the country in terms of access to new nuclear medicine technologies. Figure 1. Estimated Number of Nuclear Medicine Scientists per Million Population in the United States, 2006

WA MT

ME

ND MN

OR

VT

ID WI

SD

NY

MI

WY

RI

PA

IA

NE

NH MA CT

NJ

NV

OH UT

IL

MD

IN

DE

WV

CO CA

VA

KS

MO

KY NC

TN OK

AZ

AR

NM

SC

NMS / M Pop MS TX

AL

GA

30 to 35 15 to 30

LA

HI

FL

10 to 15 5 to 10

AK

U.S. Average = 12.0

2 to 5

Note: Excludes Those Listing Radiation Oncology as Field of Work.

Center for Health Workforce Studies, 2006

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•

Table 1 shows that more nuclear medicine scientists were located in the Mid-Central region (16.5% of all nuclear medicine scientists) of the U.S. than in other regional areas. Only 2.2% of identified nuclear medicine scientists were located in the Northwest region of the U.S. Nuclear medicine scientists were overrepresented in the New England, Northeast, Mid Atlantic, Mid West, and Southwest regions; and underrepresented in the Southeast, Mountain, Pacific, and Northwest regions. Table 1. Geographic Distribution of Active Nuclear Medicine Scientists, by USDHHS Region, 2006

New England

Nuclear Medicine Scientists 8.4%

Northeast

12.3%

9.4%

Mid Atlantic

14.3%

9.7%

Southeast

12.8%

19.4%

Mid Central

16.5%

17.3%

Southwest

10.9%

4.5%

Mid West

9.1%

3.4%

Mountain

2.5%

12.0%

Pacific

10.9%

15.5%

Northwest

2.2%

4.0%

USDHHS Region

Total U.S. Population 4.8%

Source: 2006 Nuclear Medicine Scientist Survey, Question D.2

Demographics The demographic characteristics of nuclear medicine scientists provided insights about these professionals and created a context in which to understand other aspects of their work. In addition, knowing the age of respondents provided a basis for understanding how the professions may be changing as new people enter the field. •

Table 2 shows that nuclear medicine scientists were predominantly male. Survey respondents were 82.9% male and 17.1% female, compared to 48.9% and 51.1%, respectively, in the general U.S. population. Figure 2 contrasts the age distributions of active male and female nuclear medicine scientists in 2006. Figure 3 shows that younger cohorts of nuclear medicine scientists had larger proportions of women. Table 2. Gender Mix of Active Nuclear Medicine Scientists, 2006 Gender

Percentage

U.S. Pop, 2005

Male

82.9%

49.0%

Female

17.1%

51.0 %

Sources: 2006 Nuclear Medicine Scientist Survey, Question A.2, U.S. Census, American Community Survey, 2005

20

Figure 2. Age Distribution of Active Nuclear Medicine Scientists by Gender, 2006 50%

Male

Female

40%

38.8% 32.2%

30%

26.6% 23.8%

20%

23.8% 18.7%

17.2%

8.8%

10% 4.8%

3.4%

1.9%

0.0%

0% < 30

30 - 39

40 - 49 50 - 59 Age Group

60 - 69

70 +

Source: 2006 Nuclear Medicine Scientist Survey, Questions A.1 (processed) and A.2

Figure 3. Percentage of Active Nuclear Medicine Scientists Who Were Women, By Age Group, 2006 40% 35.0%

30%

22.6%

23.6%

20% 13.5% 9.1%

10%

0.0% 0% < 30

30 - 39

40 - 49

50 - 59

60 - 69

70 +

Age Group Source: 2006 Nuclear Medicine Scientist Survey, Questions A.1 (processed) and A.2

21

•

Table 3 shows that Asian/Pacific Islanders were overrepresented in nuclear medicine science (17.5% compared to 4.3% in the general U.S. population in 2005). This overrepresentation occurred in the nuclear medicine physician workforce, as well. According to the American Medical Association in 2005, 12.4% of all self-identified nuclear medicine physicians also identified as Asian. Blacks/African-Americans (0.7% in nuclear medicine science vs. 12.1% in 2005 U.S. Population) and Hispanics/Latinos (1.7% in nuclear medicine science vs. 14.5% in 2005 U.S. Population) were underrepresented. While non-Hispanic Whites were slightly over represented compared to the general population, American Indians/Alaska Natives (AI/ANs) were slightly underrepresented. Table 3. Racial Ethnic Composition of Active Nuclear Medicine Scientists, 2006, and U.S. Population, 2005 Percent of Active NM Scientists

Percent of U.S. Population, 2005

Asian/Pacific Islander

17.5%

4.3%

Black/African-American (NH)

0.7%

12.1%

American Indian/ Alaska Native

0.2%

0.8%

White (NH)

78.0%

74.7%

Hispanic/Latino

1.7%

14.5%

Racial/Ethnic Group

Sources: 2006 Nuclear Medicine Scientist Survey, Question A.4, U.S. Census, American Community Survey, 2005

•

Table 4 shows that more than one-quarter of active nuclear medicine scientists (28.2%) were born in a country other than the U.S. This pattern was similar to that for physicians (32% of active nuclear medicine physicians were international medical graduates), suggesting that perhaps professional positions with high levels of technical expertise are especially attractive avenues for immigration to the U.S.

•

Among those born outside the U.S., a large proportion indicated their birthplace as either China or India. A number of scientists working in the U.S. were also born in Canada and the United Kingdom. Survey respondents listed 22 different countries of origin. Table 4. Place of Birth of Active Nuclear Medicine Scientists by Age Group, 2006 Age Group < 30 30 - 39 40 - 49 50 - 59 60 - 69 70 + Total (830)*

% Born in U.S. 80.0% 59.4% 70.1% 75.9% 75.2% 100.0% 71.8%

Source: 2006 Nuclear Medicine Scientist Survey, Questions A.3 and A.4 * The number in the parenthesis is the N for this group.

22

•

Table 5 shows that the percentage of responding nuclear medicine scientists born outside the U.S. was only slightly lower (28%) for females than for males (30%). Table 5. Place of Birth of Nuclear Medicine Scientists by Gender, 2006 Place of Birth Gender U.S.

Other Nation

Total

Male

70%

30%

720

Female

72%

28%

149

Total

70%

30%

869

Education and Training Education and training are a critical aspect of any profession. They define the knowledge and skills and level of education required for entry into a profession. Survey recipients were asked to indicate the area of academic study in which their most advanced degree had been obtained. Scientists were permitted to pick more than one area of study. •

Table 6 shows that in certain nuclear medicine science specialties a high proportion of current scientists were born in other nations. More than two-thirds (69.2%) of scientists working in nuclear medicine science instrumentation were born outside the U.S.

•

More than half (55.2%) of active nuclear medicine chemists were born in a nation other than the U.S., as were half (50%) of currently active computer scientists working in nuclear medicine.

•

Among nuclear medicine scientists with an advanced degree in medicine, 41% were born outside the U.S. As mentioned previously, this was corroborated by data on nuclear medicine physicians.

•

Among scientists working in pharmacy/radiopharmacy, only 13% were born in a nation other than the U.S. One factor affecting this profession differently than other scientific specialties within nuclear medicine may be the requirement for state licensure of pharmacists, which may have impeded transfer of education and professional qualifications to the U.S.

•

A small proportion of health physicists (14.8%) were born outside the U.S.

23

Table 6. Nuclear Medicine Specialties of Highest Degree of Nuclear Medicine Scientists, by Place of Birth, 2006 Nuclear Medicine Specialty

Place of Birth USA

Other Nation

Total

Health Physics

85.2%

14.8%

54

Medical Physics

65.0%

35.0%

180

Chemistry

44.8%

55.2%

134

Pharmacy/Radiopharmacy

87.0%

13.0%

207

Computer Science

50.0%

50.0%

14

Medicine

59.0%

41.0%

71

Radiologic Physics

72.1%

27.9%

61

Nuclear Physics

66.2%

33.8%

68

Molecular Biology

62.5%

37.5%

8

Nuclear Engineering

65.4%

34.6%

26

Instrumentation

30.8%

69.2%

13

Other

75.5%

24.5%

143

69.0%

31.0%

979

Total

Note: Specialties for which nuclear medicine scientists from other nations are at least half of total are shaded green. N is greater than 898 due to the option of multiple responses. Source: 2006 Nuclear Medicine Scientist Survey, Questions A.3 and B.3

Educational Attainment of Active Nuclear Medicine Scientists Nuclear medicine scientists are highly educated professionals. A majority of survey respondents held professional degrees at the doctoral level or held combined doctoral/professional degrees as doctors of medicine/osteopathy and doctors of philosophy (Table 7). •

More than 59% of survey respondents held doctoral/professional degrees such as Doctor of Pharmacy (PharmD), Doctor of Philosophy (PhD) in a variety of disciplines, Doctor of Medicine (MD), Doctor of Osteopathy (DO), Doctor of Jurisprudence (JD), Doctor of Veterinary Medicine (DVM), and Doctor of Science (ScD).

•

Among the 2.3% of current nuclear medicine scientists who indicated “other” as the highest degree, some held Doctor of Science (SciD), Doctor of Veterinary Medicine (DVM), Law degrees (LLB and JD), and Doctorates in Education (EdD).

24

Table 7. Highest Degree of Active Nuclear Medicine Scientists, 2006 Highest Degree

Percentage

Bachelor's

13.9 %

Master's

24.6%

PharmD

7.2%

PhD

44.0%

MD/DO

3.6%

MD/PhD

4.2%

Other

2.3%

Total (898)

100%

Source: 2006 Nuclear Medicine Scientist Survey, Question B.1

To better understand pathways to nuclear medicine science, respondents to the survey were asked to describe their major area of concentration at the bachelor’s level and area(s) of concentration for their most advanced degree. •

Table 8 shows that 27.1% of active nuclear medicine scientists earned their bachelor’s degree in Physics, followed by 22.4% in Pharmacy and 18.6% in Chemistry. A small percentage of respondents (4%) indicated they had dual majors. Table 8. Disciplines in which Active Nuclear Medicine Scientists Earned Bachelor’s Degrees, 2006 Bach Degree Discipline Physics Pharmacy Chemistry Engineering Biology Biology + Chemistry Physics + Other Computer Science Other Total

Percent 27.1% 22.4% 18.6% 9.7% 8.7% 1.7% 1.3% 1.0% 9.4% 100%

Source: 2006 Nuclear Medicine Scientist Survey, Question B.2

•

Table 9 shows that most nuclear medicine scientists had a single major field of graduate study. However, almost 10% of scientists active in nuclear medicine earned their highest degree in multiple fields of study. Although the percentage of respondents who studied in multiple fields was small, the largest percentage of those scientists (7.1%) earned their highest degree in two major fields of study.

25

Table 9. Number of Disciplines in Which Active Nuclear Medicine Scientists Earned Their Highest Degree, 2006 # of Fields for Highest Degree

Percent

0

2.4%

1

88.0%

2

7.1%

3

1.5%

4

0.7%

5

0.3%

6

0.1%

Total

100%

Source: 2006 Nuclear Medicine Scientist Survey, Question B.3

Future Education •

Table 10 shows that a majority of active nuclear medicine scientists (88.5%) did not expect to pursue further academic education in the next five years.

•

Among the 11.7% of scientists who expected to pursue further education in the near future, 22.4% indicated a bachelor’s degree as their highest current level of education.

•

Among scientists expecting to pursue further education in the coming five years, more than a third already hold a terminal degree including PharmD, PhD, or combined professional degrees. Table 10. Percentages of Active Nuclear Medicine Scientists Who Expect to Pursue More Education by Highest Current Degree Held Highest Current Degree (N)

Expect to Pursue More Education

Bachelor's (125)

22.4%

Master's (221)

16.3%

PharmD (65)

21.5

PhD (395)

4.3%

MD/DO (32)

12.5%

MD/PhD (38)

5.3%

Total N (101)

11.5%

Source: 2006 Nuclear Medicine Scientist Survey, Questions B.1 and B.5

26

•

Table 11 shows, as might be expected, half of nuclear medicine scientists (50%) who expected to pursue further education in the next five years were younger than age 30.

•

Among current nuclear medicine scientists, female scientists reported an intention to pursue further education in the next five years more frequently than male scientists (15.0% vs. 11.4%).

•

Similar percentages of U.S. born nuclear medicine scientists expected to pursue further education (11.6%) as those who were born in other nations (12.7%).

Table 11. Nuclear Medicine Scientists Expecting to Pursue Further Education in the Next Five Years by Age and Gender, 2006 Expect to Pursue More Education

Age Group

Male

Female

Total

< 30

46.2%

57.1%

50.0%

30 - 39

24.2%

22.9%

23.9%

40 - 49

14.1%

12.3%

13.6%

50 - 59

5.8%

8.6%

6.2%

60 - 69

2.3%

0.0%

2.1%

70 +

8.3%

N/A

8.3%

Total All Ages

11.4%

15.0%

12.0%

Source: 2006 Nuclear Medicine Scientist Survey Questions A.1 and B.5

Level of Additional Future Education Many nuclear medicine scientists sought additional education after they begin their professional careers. Some of this education involved earning a more advanced degree; some was less structured. •

Table 12 shows that the PhD was cited as the degree objective of 38% of active nuclear medicine scientists who expected to pursue further academic education in the next five years. An additional 28% expected to seek a master’s degree, 11% a PharmD degree, 4% an MD/DO degree, and 19% “other.”

•

A high percentage of scientists with a bachelor’s degree as their highest current degree expected to pursue further education in the next five years at the master’s degree (36%) level. At the same time, an additional 36% of those whose highest degree was currently a bachelor’s degree hoped to pursue a PharmD degree.

•

Among those who currently hold a master’s degree as their highest degree, 71% of those expecting to pursue further academic education in the next five years expected to do so at the doctoral level.

•

Among nuclear medicine scientists with current highest degree a PharmD, 50% of those expecting to pursue further academic education expected to do so at the Master’s level.

27

•

Among those nuclear medicine scientists with doctoral/professional degrees (PhD, MD, DO and combined degrees) who expected to pursue further education in the next five years, the most frequently selected level was “other,” which included business administration, health care administration, and hospital administration, molecular and medical pharmacology, and molecular physiology.

Table 12: Levels of Additional Education Desired by Active Nuclear Medicine Scientists, by Current Highest Degree, 2006 Highest Current Degree

Levels of Additional Education to Pursue Master’s

MD/DO

PhD

PharmD

Other

Bachelor’s (28)

36%

--

21%

36%

7%

Master’s (35)

14%

--

71%

3%

11%

Pharm D (12)

50%

8%

25%

--

17%

PhD (15)

33%

13%

13%

--

40%

MD/DO (4)

25%

--

25%

--

50%

MD-PhD (2)

--

--

--

--

100%

PharmD + Other (1)

--

100%

--

--

--

Total (97)

28%

4%

38%

11%

19%

Source: 2006 Nuclear Medicine Scientist Survey, Questions B. 1 and B. 5a.

•

Table 13 shows that among all nuclear medicine scientists expecting to pursue a master’s degree, 37% were scientists with a bachelor’s degree as their highest academic credential.

•

Among current PhDs expecting to pursue further education in the coming five years, 50% expected to pursue medical or osteopathic education.

•

Scientists indicated an interest in the disciplines of business and health administration in the “other” responses they supplied suggesting value for this type of education among scientists working in clinical settings.

28

Table 13. Levels of Additional Education Desired by Active Nuclear Medicine Scientists, by Current Highest Degree, 2006 Highest Degree of Active NMS

Level of Additional Education Master's

MD/DO

PhD

PharmD

Other

Total

Bachelor's

37%

--

16%

91%

11%

29%

Master's

19%

--

68%

9%

22%

36%

PharmD

22%

25%

8%

--

11%

12%

PhD

19%

50%

5%

--

33%

15%

MD/DO

4%

--

3%

--

11%

4%

MD-PhD

--

--

--

--

11%

2%

PharmD + Other

--

25%

--

--

--

1%

27

4

37

11

18

97

Total N

Source: 2006 Nuclear Medicine Scientist Survey, Questions B.1 and B.5a

•

Table 14 shows that among nuclear medicine scientists currently working in physics, computer science/engineering, or in multiple branches of nuclear medicine science most of those expecting to pursue further education were interested in the doctoral level. This was not surprising considering the high level of current education of many nuclear medicine scientists and that advanced degrees are in demand.

•

Among nuclear medicine scientists currently working in chemistry who wanted to pursue further education, 50% expected to pursue a master’s degree.

•

Equal percentages of pharmacists (37%) expected to pursue further education at the master’s and at the doctoral level.

29

Table 14. Levels of Additional Education Desired, by Current Branch of Nuclear Medicine Science, 2006 Level of Additional Education to Pursue Branch of Science Master's

MD/DO

PhD

PharmD

Other

Total N

Chemistry

50%

13%

25%

--

13%

8

Pharmacy

37%

4%

11%

37%

11%

27

Physics

9%

--

59%

--

32%

22

Computer Science/Engineering

25%

--

75%

--

--

4

Multiple Branches

33%

6%

44%

--

17%

18

Not Specified

18%

5%

50%

5%

23%

22

Total

27%

4%

40%

11%

19%

101

Source: Nuclear Medicine Scientist Survey, Questions B.5a, K.1, L.1, M.1, and N.1

•

Table 15 shows that among all scientists expecting to pursue further education, 27% worked in nuclear medicine pharmacy/radiopharmacy and 22% worked in physics.

Table 15. Levels of Additional Education Desired by Active Nuclear Medicine Scientists, by Current Branch of Nuclear Medicine Science, 2006 Level of Additional Education to Pursue Branch of Science Master's

MD/DO

PhD

PharmD

Other

Total N

Chemist

15%

25%

5%

--

5%

8%

Pharmacy

37%

25%

8%

91%

16%

27%

Physics

7%

--

33%

--

37%

22%

Computer Science/Engineering

4%

--

8%

--

--

4%

Multiple Branches

22%

25%

20%

--

16%

18%

Not Specified

15%

25%

28%

9%

26%

22%

27

4

40

11

19

101

Total N

Source: 2006 Nuclear Medicine Scientist Survey, Questions B.5a, K.1, L.1, M.1, and N.1

30

Discipline of Future Education The survey respondents provided insights about the discipline of additional education they expected to seek (Table 16). This information would be of special interest to educational planners. •

Among scientists stating plans to seek additional degrees, almost half (45.8%) indicated the chosen discipline as “other,” with the most frequently cited area of study being a Master’s of Business Administration (MBA).

•

Of the scientific fields listed on the questionnaire, the largest percentage of nuclear medicine scientists indicated an interest in medical physics (17.7%) or pharmacy/radiopharmacy (15.6%) as a field for additional study. Table 16. Discipline in which Active Nuclear Medicine Scientists Expect to Seek Additional Education in the Future, 2006 Discipline of Additional Education

Percent

Medical Physics

17.7%

Pharmacy/Radiopharmacy

15.6%

Radiochemistry

5.2%

Health Physics

4.2%

Molecular Biology

4.2%

Medicine

4.2%

Nuclear Engineering

1.0%

Radiologic Physics

1.0%

Nuclear Physics

1.0%

Other

45.8% Total

100%

Source: 2006 Nuclear Medicine Scientist Survey, Questions B.5 and B.5b

A high percentage of those planning to pursue further education in the coming five years expected to do so in a discipline other than their current discipline. With the exception of pharmacy (50% of those currently in pharmacy and planning to pursue further education expected to study pharmacy/radiopharmacy in the future), most other scientists from other branches of nuclear medicine science expected to study “other” subjects (Table 17). The “other” categories listed by survey respondents can be found in Appendix B.

31

Table 17. Disciplines of Expected Additional Education by Current Branch of Nuclear Medicine Science, 2006

Pharmacy/ Radiopharmacy

Medicine

Radiologic Physics

Nuclear Physics

--

25%

--

13%

--

--

Pharmacy

4%

4%

4%

50%

4%

--

4%

Physics

5%

48%

--

--

--

--

--

25%

--

--

--

--

6%

24%

6%

6%

6%

--

11%

5%

5%

3%

19%

5%

16%

Computer Science / Engineering

Multiple Branches

Not Specified

Total

Other

Radiochemistry

--

Nuclear Engineering

Medical Physics

Chemistry

Current Branch of Science of Active Nuclear Medicine Scientists

Molecular Biology

Health Physics

Disciplines of Expected Additional Education

13%

--

50%

8

--

31%

26

5%

--

43%

21

--

--

--

75%

4

6%

--

--

6%

41%

17

5%

--

--

11%

--

63%

19

4%

1%

1%

4%

1%

45%

95

Source: 2006 Nuclear Medicine Scientist Survey, Questions B.3 and B.5b.

32

Total N

Current Discipline in Nuclear Medicine Science and Educational Background •

Table 18 shows that when the major subject in which active nuclear medicine scientists received their bachelor’s degrees was linked with the branch of science in nuclear medicine in which the scientist was currently working, the major subject and current discipline generally coincided.

•

Among those working in multiple branches of nuclear medicine science, almost one-third (30.4%) were educated in physics during undergraduate studies and another 23.2% were educated in pharmacy. Among all nuclear medicine scientists responding to the survey, more than one-quarter (27%) indicated physics as their major area of study in undergraduate education. Table 18. Disciplines in which Active Nuclear Medicine Scientists Earned Bachelor’s Degrees, by Branch of Science of Current Work, 2006

Physics

Engineering

Pharmacy

Chemistry

Computer Science

Biology

Biology & Chemistry

Physics & Other

Biology & Physics

Engineering & Physics

Physics & Chemistry

Other

Bachelor’s Degree Disciplines

Chemistry

1.7%

2.5%

0.8%

84.7%

--

3.4%

3.4%

--

--

--

--

3.4%

118

Pharmacy

--

--

87%

3.4%

--

5.6%

0.6%

--

--

--

--

3.4%

177

Current Branch of Science of Active Nuclear Medicine Scientists

N

Physics

60.4% 11.6%

--

2.7%

1%

7.8%

1.4%

1.4%

1.4%

--

0.3%

11.9%

293

Computer Science / Engineering

8.3%

--

--

4.2%

16.7%

--

--

--

--

--

16.7%

24

Multiple Branches

30.4% 13.8% 23.2% 15.2%

1.4%

2.9%

3.6%

1.4%

--

0.7%

--

7.2%

138

Not Specified

10.9% 12.5%

7.8%

2.3%

21.9%

--

3.1%

1.6%

--

--

18.0%

128

27.0%

22.4% 18.6%

1%

8.3%

1.6%

1.1%

0.7%

0.1%

0.1%

9.3%

878

Total

54.2%

9.7%

21.9%

Note: Percents are row percents. Source: 2006 Nuclear Medicine Scientist Survey, Questions B.2, K.1, L.1, M.1, and N.1

33

Table 19 shows that scientists with bachelor’s education in a variety of disciplines were working in physics in their nuclear medicine careers. As presumed, 75% of nuclear medicine scientists educated at the undergraduate level in physics were working in physics. However, 40% of respondents with engineering majors and 33% of computer science majors at the bachelor’s degree level also reported they worked in physics. Those with multiple areas of concentration at the bachelor’s level also reported they were working in physics. Table 19. Disciplines in which Active Nuclear Medicine Scientists Earned Bachelor’s Degrees, by Branch of Science of Current Work

Engineering

Pharmacy

Chemistry

Computer Science

Biology

Biology & Chemistry

Physics & Other

Biology & Physics

Engineering & Physics

Physics & Chemistry

Other

Academic Discipline of Bachelor’s Degree

Physics

•

Chemistry

1%

4%

1%

61%

--

5%

29%

--

--

--

--

5%

13%

Pharmacy

--

--

78%

4%

--

14%

7%

--

--

--

--

7%

20%

Physics

75%

40%

--

5%

33%

32%

29%

40%

67%

--

100%

43%

33%

Computer Science / Engineering

1%

15%

--

--

11%

5%

--

--

--

--

--

5%

3%

Multiple Branches

18%

22%

16%

13%

22%

5%

36%

20%

--

100%

--

12%

16%

Not Specified

6%

19%

5%

17%

33%

38%

--

40%

33%

--

--

28%

15%

237

85

197

163

9

73

14

10

6

1

1

82

878

Current Branch of Science

Total N

Note: Percents are column percents. Source: 2006 Nuclear Medicine Scientist Survey, Questions B.2, K.1, L.1, M.1, and N.1

34

Total

Entry into Nuclear Medicine Pathways to nuclear medicine science varied. It was important to understand historical pathways to the discipline to aid in the recruitment of new professionals to nuclear medicine science. Understanding effective recruitment strategies is an important tool for both current nuclear medicine professionals and policymakers. Several questions related to this subject were included in the 2006 survey. First or Second Career Choice •

The younger the nuclear medicine scientist the more likely nuclear medicine science was the first career choice. The high percentage of those in the youngest age cohort (