Nuclear Medicine – 2025 review results

Current priority areas

• 10 Year Health Plan for England: fit for the future
• Science in healthcare: Delivering the NHS Long Term Plan – The Chief Scientific Officer’s strategy

Stakeholder feedback

Feedback collecting through the Curriculum Library survey collected between January 2024 and November 2025. All stakeholder feedback is presented verbatim.

Programme

• Not sure whether this is the right place to leave this feedback, but I think this Radioactive Materials module is excellent and should be included in the Nuclear medicine specialism. This topic is integral to Nuc Med and should most definitely be covered by someone qualifying to work as a scientist in Nuc Med.
• I think its a real shame that all radiopharmacy aspects have been removed from the curriculum. Its such an important foundation to understanding clinical nuclear medicine.
• I feel that radiation risk assessments should be a fundamental competency for Nuclear Medicine trainees. All clinical scientists working with ionising radiation need to have a good professional understanding of IRR17, and risk assessments are the absolute backbone of that legislation. Leaving it solely to the radiation protection specialism propagates the frustrating convention that radiation protection are responsible for managing risk assessments across all specialisms – this should not be the case.
• It would be really helpful for Nuclear Medicine trainees to have Learning outcomes associated with writing IRR risk assessments, and also some associated with radiopharmacy.  Previously there were too many, now there are none.
• The nuclear medicine (NM) STP radiation protection training is very weak compared with the Radiation Safety and Diagnostic Radiology (RSDR) specialism, particularly covering radioactive waste and transport, two areas in which nuclear medicine physicists are fully involved (and key parts of my role as Consultant Nuclear Medicine physicist).

For waste the RSDR has ‘Critically appraise a healthcare facilities best svailable techniques statement and make recommendations’ and ‘Carry out an assessment of the environmental impact from releases of radioactive material from the hospital into the environment’ and ‘Participate in annual reporting requirements for radioactive discharges into the environment as required by permit’, while the NM has ‘Record, store and dispose of radioactive waste’. This latter is down as an ETA but we have found it difficult to do as it is a technologist or radiographer role, and the radiology department has not been happy to have an outside trainee doing this work, rather than observing or advising.

Transport RSDR has ‘Assist in the preparation of packing a radioactive source for transport and completion of accompanying documentation’, which is more involved with the regulatory approach; NM has Consign or receive a package of radioactive material and confirm adherence with transport regulations as an ETA, again a technologist or radiographer role.

I think the way the curriculum is written in general reflects the role of NM clinical scientists in large city hospitals, where they might expect regulatory support to be separately provided, but carry out many technical roles which elsewhere are done by radiographers or technologists. In most parts of the country, and in particular uniformly across my region the South West of England, nuclear medicine clinical scientists are the Radioactive Waste Advisers and Radiation Protection Advisers for Nuclear Medicine, as well as working heavily in areas such as transport regulations, as well as emergency planning (CBRN, NAIR) which is completely ignored here, as is radiopharmacy apart from a brief mention in the RSDR rotation.

As a simple change I suggest replacing S-NM-S2 8 with S-DR-S1 2, and S-NM-S2 10 by S-DR-S1 5. However I think a full review of the radiation protection content of the nuclear medicine syllabus is in order, and it would be possible to slim down for example Multidisciplinary Practice in Nuclear Medicine, and bring in quite a lot which is currently in RSDR – I would completely replace this with the Radioactive Materials Module.

As an aside, nuclear medicine physicists are spending a considerable amount of time helping with the training of diagnostic radiology STPs who will not use this training. I feel the Radioactive materials aspects of RSDR could be reduced, but that should come from DR physics side.

Comments from the 2023 syllabus; I believe 2025 is largely unchanged as the  S-DR-S1 2 still mis-spells available!

• The portfolio of specialists does not include bone health which is potentially a huge gap. This would ideally be a morre Clinical training programme with similarities with the audiology programme or the cardiac physiology. With the rising focus on healthy aging, one such programme would have incredible benefits at population level.
• The speciality doesn’t touch upon the importance of radiopharmacy anymore. I believe that having some basic knowledge on the workings of a radiopharmacy is essential for a Nuclear Medicine physicist and therefore feel that this should be incorporated into the curriculum in some capacity.
• I would like to plug reintroducing a little bit of radiopharmacy back into the specialism for Nuc Med. I think it is fundamental to a Nuc Med clinical scientist to have a basic understanding of how the radiopharmacy works so they can understand issues with supply / demand.
• In my opinion the nuclear medicine specialty should have a bit more CT content such that trainees are more confident in interpreting CT exposure factors and more knowledgeable about how CT is used in nuclear medicine. CT is often used in nuclear medicine and PET in slightly unusual ways (AC only, SPECT-guided CT etc.) which is not always known or appreciated by DR specialists, and so there is the potential for these studies to be poorly optimised if the nuclear medicine specialists are under-trained in CT.
• I think the in general the contents of the training activities were good and well thought out to reflect actual practice in a nuclear medicine department. They are a definite improvement on the previous competencies which were very rigid (hearing from other trainees). A few improvements that could be considered:
  • In the specialty module 1 a number of the activities required carrying out ‘commissioning’ tests, this is often not possible if a department does not commission new equipment in your 2 years there. This could be made more broad e.g QC tests or commissioning tests could be described but not required to be carried out.
  • The CBD and OCE forms could be improved; often there were sections which were very much not relevant to the situation being assessed.
  • It might be good to provide examples of some good write ups on the school website as I’m aware there are vastly different requirements from different assessors as to length/ depth of content.
• Future versions of the curriculum would benefit from the inclusion of some radiopharmacy and scientific computing – not a full module on each, but a small number of competencies on each to cover the core principles would be hugely beneficial.
• Our main point is that, given the significant advances and increased prevalence, we (the IPEM AI Group) recommend AI is included as a mandatory part of medical physics / clin engineering STP training (and HSST). It already is a small part of CSC training.

We understand some AI lectures are being given ad-hoc already by the medical physics HEI providers (Newcastle, KCL, Liverpool). It would be useful to bring these people together to discuss unifying the academic AI training component. Ideally to include the other nations too (Msc in Aberdeen for Scottish trainees).

There is already an outline syllabus in the IAEA AI in Medical Physics document  (section 5.1.1), where the IAEA have stated what topics they would expect an AI module to cover for medical physics – which also includes several example practical sessions that could be useful to integrate into the STP competencies.

Local centres may find it challenging to deliver any AI based competencies. There are a few potential solutions to this e.g. IPEM could provide some training activity examples or masterclasses (e.g. at STEF)? If there was fairly unified AI requirements across clin eng / med phys / CSC there could be some appetite from e.g. Surrey Uni to run a dedicated course like they did for computing competencies.

S-NM-R1 Introduction to Nuclear Medicine

Training activities

• 1
  • Task- A somewhat straightforward activity but practically they’re getting involved in all the meetings anyway and I find the reflections seem forced and not particularly helpful to the trainee.

It’s hardly a big time sink so if this is intended to ensure departments are involving trainees and not just leaving them in a corner then I wouldn’t get rid of it, but equally in an 8 week rotation I want to allocate their time most effectively. I’d rather they focus on getting involved/helping with projects/shadowing/experiencing/doing, reflecting on something they’ve done themselves is surely the best earning experience, reflecting on something they’ve seen first hand is a good second, reflecting on a meeting which more often than not covers updates to things they’re unfamiliar with seems like it could use improvement.

I think I would like to re-evaluate what this competency is fundamentally aiming to get them to experience/reflect on, and see if there’s a better way to do it than write about a meeting they were in. But that’s just my thought, and if this also forces departments to include trainees more than it is probably worth keeping in!

• • Type- Seems good to me!
  • Considerations- It seems most of the reflections fall into a “this highlights this aspect of the job” or “this highlights the need for this team members speciality/collaboration” which are technically reflections but seem a bit surface level. Equally as meetings are often progress updates/task allocation/overviews and changes to existing systems, reflecting on details is quite a task when they’re just getting familiar with a very varied modality is probably too much of an ask.

Essentially I think that the reflections and takeaways here are very similar to the role of a clinical scientist Training acitivity. If the aim is to highlight other staff groups, this is usually covered in the diagnostic scanning or reporting activities.

• 4
  • Task- There is not a requirement to have both training activity 9 and 4. For most of the diagnostic investigations that are completed the reporting of the images is a key element of the process and would be commented on as part of the patient pathway. They could not overlap if it is specifically referring to a quantitive test. If this is the aim of the training activity this should be made clear.
  • Type- it is the right type of training activity
• 8
  • Task- Most of the image processing that occurs is done automatically and can’t be observed. The theory behind it can still be commented on
  • Considerations- It is common for smaller departments to not do any gated images so many won’t be able to comment on this section. Particularly if they are rotating in from a separate specialism

Direct Observation of Practical Skills (DOPS)

• “Perform gamma camera probe quality control”- this honestly makes it sound like there’s a piece of equipment called a ‘gamma camera probe’. Could this be reworded to be clear that its a gamma camera or gamma probe?

Observed Communication Events (OCE)

• “Introduce yourself and explain your role to a patient.”- As a rotational trainee you are unlikely to be taking an active role in these discussions with a patient and your role will be to observe. To explain that you are just their to observe as you are a trainee doesn’t prove any knowledge. To explain the purpose of physics to then not contribute to the rest of the appointment might be a little odd for a patient. Seeing as this is avoidable I believe it will best to replace this with another OCE

Another element of a module

• We’ve swung too far the other way from ‘doing’ to ‘observing/reflecting’.

S-NM-S1 Quality Control of Nuclear Medicine Equipment

• no feedback received

S-NM-S2 Regulatory Frameworks and Radiation Protection

• no feedback received

S-NM-S3 Radionuclide Therapies

Training activities

• 2 – Task – This is not an activity that a qualified physicist would undertake in our trust, therefore it is unreasonable to expect the trainee to perform this.  It is not safe for the trainee to do so.   You could change this to observe rather than administer.
• 2 – Task –  I am unable to complete this TA to the extent wanted by the national school as it is beyond the scope of practice for clinical scientists at our Trust to administer therapies to patients. I feel it would be more beneficial to consider and demonstrate knowledge of the proper PPE, SOPs, checks and communication needed without having to administer anything to patient even if it is under supervision. There is too mcuh risk in the patient not receiving proper care.
• 2 – Type – This training activity is entrustable and is to ‘Prepare, perform checks and administer a radionuclide therapy under supervision’, which I am not allowed to do in my Trust, and it is not something the physicists in my Trust do. It is not fair that it is entrustable when it will be very difficult for me to be able to complete this and not a task that physicists do at every centre.

S-NM-S4 Imaging and Diagnostic Nuclear Medicine

Training activities

• 2
  • Task – I think this is a valuable training activity but does fit how optimisation projects are practically carried out. I have often got trainings help or lead with support on optimisation. This tends to be a SPECT project that covers 1/2/4 and sometimes 3. Then a separate optimisation project for PET with similar TAs included. But the way 2 reads as SPECT and PET means one project can be completed but can not be signed off. It would be better to separate these, so when they have done the SPECT or PET optimisation it can be signed off as one piece of work. Then
  • Type – I think this is a useful training activity it is just the grouping on one file that makes it frustrating for trainees that have just successfully finished a good piece of work for SPECT/PET. But then cant get it signed off as a whole second project is required for SPECT/PET

Another element of a module

• There should be a training activity which requires a trainee to spend some time in a radiopharmacy environment and get a better understanding of radiopharmaceutical manufacture.

S-NM-S5 Multidisciplinary Practice in Nuclear Medicine

• no feedback received

Changes made

Module level changes

Programme level changes

• no changes made
  

Periodic review

This specialty curriculum requires significant change beyond the scope of an annual review.

Response – no

Rationale

Please provide an overview of the rationale for why the proposed changes are needed or why changes were not needed, with reference to stakeholder feedback.

Response

M1 is a simple change to clarify which piece of equipment is referred to in the DOPS.

M2 is in response to feedback received from multiple centres that it is not the physicist that administers the radioactivity for therapies in their centre. This change should allow trainees at these centres to get the same learning out of the training activity and be familiar with the issues surrounding the administration of radioactivity for therapeutic purposes, while removing the requirement to physically be the one doing the administration.

There are several areas of feedback that I concur with and will work to improve in future years, but which will not be possible during this review cycle:

• Computing in general and AI in particular are areas which will become increasingly important in the future, and definitely merit inclusion, however due to the difference in adoption across different centres there is no obvious candidate for a training activity which it could reasonably be expected will be deliverable in most centres which will address this. I have engaged with the IPEM SIG regarding what it might be feasible to include, and if a viable training activity is proposed in the future I’ll look at including it. In the meantime, I note that the SIG are also working to get more AI content included by the HEIs, which will also help to address this issue.
• I concur with the feedback received from multiple centres that trainees need an understanding of what goes on in a radiopharamcy, but I have not yet arrived at a suitable training activity to cover this. An observational training activity could be included in the rotation, but then this would become mandatory for all medical physics specialisms, which would be a considerable additional burden on training resources for no additional benefit. For inclusion in a specialist module it needs to be linked to a workplace task, but there isn’t a radiopharmacy-specific task that a physicist would routinely do in most centres. I have begun speaking to colleagues at centres with radiopharmacys to identify a practicable option, and will look at including this in future.
• There are several aspects of radiation safety and diagnostic radiology physics that have been suggested that I agree that our trainees would benefit from the inclusion of, and there are lots of options that could be the best way of incorporating this. Rather than commit to what to include and what to remove to make room for it now, I will look at the options and consider incorporating this in a major change at the next review.
• I can see the sense in regrouping the tasks in S-NM-4 TA’s 1-4, but it was set out like this initially to ensure that trainees at centres whose access to PET is more limited than to SPECT were not disadvantaged, so I’ll keep thinking about how to implement this change without disadvantaging trainees at these centres.

Additionally, there are a number of pieces of feedback on aspects of the scheme which fall outside of the scope of a curriculum review which has not been acted upon for that reason.

I confirm I have reviewed the Reflective Practice Guidance for ETAs and DTAs and have made any changes necessary.

Specialty Lead Editor signature: Neil Davis
Date: no date provided

Change control - completed by the school

Programme structure

Completed by: Chris Fisher
Date: 7 January 2026

Health and Care Professions Council (HCPC) mapping

• No changes to learning outcomes, HCPC mapping to 13.06 undertake or arrange investigations as appropriate, reviewed and strengthened due to change to core module learning outcomes.

Completed by: Chris Fisher
Date: 7 January 2026