Over the last decade the role of the Nuclear Medicine Technologist (also referred to as Clinical Technologists or Healthcare Science Practitioners in Nuclear Medicine) has become more and more complex. This has primarily been due to the increased demand for more complex nuclear medicine procedures, such as single photon emission computed tomography (SPECT) and positron emission tomography (PET).

As the equipment in nuclear medicine has become more sophisticated, so do the skills of the Nuclear Medicine Technologist. For example, in SPECT-CT and PET-CT, nuclear medicine scanners are combined with a computerised tomography x-ray system. This requires the operator to have the necessary skills to operate two separate imaging systems and a sound knowledge of cross sectional anatomy.

Working with these new technologies demands a continued commitment to education and research, with developments continually in medical imaging software/hardware and in new radiopharmaceuticals.

The precise roles of the Nuclear Medicine Technologist vary in different departments but can include:
• Preparation and/or administration of the radioactive tracers (radiopharmaceuticals).
• Obtaining the images using a gamma camera, SPECT-CT or PET-CT scanner.
• Gaining the patient’s trust, explaining the procedure, answering the patient’s questions and obtaining additional information from the patient relevant to the procedure.
• Monitoring and reassuring the patient during the procedures – this may involve specialised skills when working with children.
• Processing the acquired images using sophisticated, but generally easy to use, computer software.
• Presenting the processed images and any additional information obtained from the patient to either a Nuclear Medicine Physician or Radiologist.
• Research

How do I get into the profession?
About 50% of Nuclear Medicine Technologists are trained first as Radiographers and then specialise in nuclear medicine. The remainder are directly trained as Clinical Technologists.

Currently, there are undergraduate degree courses for healthcare science practitioners specialising in nuclear medicine in a couple of UK universities which are accredited by the National School of Healthcare Science as part of the Healthcare Science Practitioner Training Programme (PTP). PTP is an undergraduate training scheme that includes work-based and academic learning. You can apply for healthcare science degrees as part of the PTP via the Universities and Colleges Admissions Service (UCAS).

A degree apprenticeship route has recently been rolled-out for “in-house” training of Nuclear Medicine Technologists while they also study for a bachelor degree (the course fees entirely funded by the employer via the apprenticeship levy), so apprentices finish their studies with no tuition fee debt and can then become registered Technologists. Some Technologists enter the profession by first working as an Assistant Practitioner and seeking enrolment on the PTP scheme from the employing hospital Trust.

Completion of training leads to being on the Register of Clinical Technologists (RCT) which is run by Institute of Physics and Engineering in Medicine (IPEM), or on the Academy for Healthcare Science (AHS) Practitioner Register.

For Radiographers wishing to specialise in nuclear medicine, practical experience is often obtained by rotation into the nuclear medicine department with an option to take a postgraduate qualification, an additional minimum of two years. There are a couple of postgraduate courses nationally (at postgraduate certificate, postgraduate diploma and masters levels).

What skills are required?
Nuclear Medicine Technologists are able to bring together knowledge and skills from the academic fields of physics, chemistry and biology. These are combined with the practical skills required to work with both precision equipment and people who are often frightened and anxious.

Manual dexterity is a pre-requisite as Technologists are required to handle radioactive substances. Even at entry level it is routine for Technologists to perform their own radiopharmaceutical injections and to perform imaging procedures. With more experience, Technologists may perform advanced computer processing, along with imaging the patient and checking the technical quality of their imaging output.

So-called “soft skills” of understanding people, putting them at their ease and being able to work with patients under sometimes stressful situations are also core skills. Patients have their own individual worries and physical problems. Dealing with these in a professional but caring way that will maximise the value of the procedure and minimise the effect on the patient is probably the most important and most difficult skill a Nuclear Medicine Technologist must master. This makes for a very interesting and varied workload, which brings new challenges every day.

It is a career that provides an important and worthwhile service and yet still demands a high level of scientific skill and technology. It also means being part of a multidisciplinary team sharing knowledge with others, including doctors and medical physicists.


How does a Technologist’s career proceed?
Qualified Technologists should expect to progress through Agenda for Change (AfC) posts, usually from a Band 5 (considered entry level) to Band 6 and then to Band 7 as a senior Technologist. At all levels it is important to maintain continuing professional development (CPD) in order to demonstrate up-to-date skills and knowledge, and to stay on either of the registers.

In some departments senior Technologists have extended their roles, which involve performing duties that were formally in the medical or clinical scientist domain. For example:

• Running cardiac stress sessions for myocardial perfusion scanning
• Managing the quality control programme of imaging equipment
• Issuing technical reports and clinical reports for imaging procedures
• Administering beta and alpha-emitting radionuclide therapy
• Intradermal and subcutaneous injections for lymph node localisation for breast, head and neck, melanoma and gynaecological cancers

Nuclear Medicine Technologists may become Advanced Practitioners and even Consultant Practitioners by undertaking some of these areas of advanced practice. Many Technologists with significant years of experience go on to manage entire departments with many high-level responsibilities as Chief Technologists (or Superintendent Radiographers) and Service Managers. Band 8 Technologists are usually Advanced Practitioners with specific areas of expertise e.g. leading a radionuclide therapy or nuclear cardiology service, or managing a department. Some Nuclear Medicine Technologists go onto train as Clinical Scientists (medical physicists) although this is a separate profession should not be viewed as an automatic career pathway.

The British Nuclear Medicine Society is actively trying to enhance the role of the Nuclear Medicine Technologist within the UK. The BNMS Radiographers, Technologist & Nurses (RTN) Group offers further career guidance. For details of this training in your area contact the Chair of the Group listed below.

Chris Mayes, Chair of the Radiographers, Technologists & Nurses Group
Royal Liverpool University Hospital
For further information visit https://www.bnms.org.uk/ or Email: office@bnms.org.uk