Houdini’s Illusions: Some Acts Are Not What They Seem to Be

Abstract

Houdini's Illusions: Some Acts Are Not What They Seem to Be TO THE EDITOR: In The Netherlands, the residency training programs for nuclear medicine and radiology were merged in 2015. This integrated residency training program was born from the vision that clinicians should not have to deal with multiple imaging specialists who are modality-based and partially knowledgeable but rather with a single imaging specialist who is knowledgeable with respect to all imaging modalities utilized to answer a clinical question. This change not only facilitated and improved the interpretation of hybrid imaging but also paved the way toward deeper understanding of disease processes, better therapies, and increased costeffectiveness. The nuclear radiologist (nuclear medicine and molecular radiology) is our next-level nuclear medicine physician.The paper of Velleman et al.(1) provides a snapshot, taken mid-2020, based on a sample of less than one third of Dutch residents, with only 9 respondents from the nuclear medicine subspecialty program. Because of these small numbers, the results have to be interpreted with care. Velleman et al. correctly state that only 14 new residents had chosen the nuclear medicine differentiation in April 2020, down from over 50 in 2015. This information prompted an editorial (2) pointing out that "Because of this more than 70% decrease within just 5 y, the question is not 'if' but 'when' nuclear medicine as a strong and innovative discipline will disappear in The Netherlands." These numbers, together with the alarming editorial, underscore the need for further analysis and critical appraisal of the situation.Within the new 5-y Dutch curriculum, residents choose their subspecialty (e.g., nuclear radiology) after completion of 2.5 y of general training in imaging. At that time, their choice is registered. This fact alone reduces the number of registered residents in nuclear medicine by a factor of 2, as half the residents involved in the new curriculum have simply not recorded their choice yet.