India's Growing Nuclear Medicine Infrastructure and Emergence of Radiotheranostics in Cancer Care: Associated Challenges and the Opportunities to Collaborate

摘要

Background A historical pledge to use “atoms for peace” was taken after the landmark and maiden speech of 34th US president Dwight David Eisenhower in 1st UN assembly meet in 1953. This strategic UN meet was chaired by Mrs. Vijaya Laxmi Pandit. Later, an eminent Indian and a nuclear physicist Sir Dr. Homi J Bhabha was made the president of the 1st UN Congress on “atoms for peace” that was held in Vienna, Austria in 1955. These two landmark UN initiatives spearheaded by the Indian stalwarts, disseminated the drive of using the atoms for peace globally. The radiation cell laboratory was set up in Delhi (DRDO) in 1953 that is immediately after the 1st UN assembly passed the resolution to harness the peaceful uses of radiation. Under the mentorship of Dr. Brigadier SK Mazumdar, this radiation cell laboratory was upgraded to a full-fledged Institute – the Institute of Nuclear Medicine and Allied Sciences (INMAS) under DRDO, the ministry of defence, Government of India in 1961. He was the first Indian physician having put the use of radioiodine in to clinical practice for the treatment of thyrotoxicosis and thyroid cancer. Brigadier Mazumdar named as the Father of Nuclear Medicine in India, introduced in INMAS in 1968 – the world’s first formal nuclear medicine training course (DRM) for medical graduates. Subsequently, an another prominent institute, namely, Radiation Medicine Centre (RMC) was built-up in Mumbai under BARC, Department of Atomic Energy (DAE) in 1963. RMC started its first formal training in nuclear medicine in 1973 both for medical (DRM) and nonmedical (DMRIT) graduates. These two giant nuclear medicine institutes (INMAS and RMC) played a leading mentorship role in producing great leaders, and with this, the specialty of nuclear medicine expanded gradually throughout the country. Expansion of Nuclear Medicine: Workforce Generation and Infrastructure Built-up Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS, Lucknow), the All India Institute of Medical Sciences (AIIMS), New Delhi, the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, and JIPMER, Pondicherry introduced 3-year residency (MD) program in nuclear medicine. Many private sector institutes/hospitals also introduced 3-year residency (DNB) in nuclear medicine. Subsequently, MD nuclear medicine was also introduced in RMC, TMH Mumbai and in many new AIIMS institutes across the country. Similarly, many institutes in the country have also introduced M. Sc and B. Sc Nuclear Medicine technological courses. The country (in about 25 public and private sector institutes) on an average produces about fifty medical (MD/DNB) postgraduates (PGs) and 150 technological (MSc./BSc.) graduates. Many premiere institutes of the country are also running highly competitive PhD programs. AIIMS, New Delhi is the only medical institute in the country imparting superspecialization (DM) in radionuclide therapy which is the first formal course of its kind not only in India but also in the world. Few premiere institutes of the country are also offering PET fellowships of 1-year duration. The Government of India has opened and is planning to open at least one (even 2) AIIMS/state with the current number of 22 AIIMS in various states across the country. Each of these AIIMS institutes has provision for starting nuclear medicine facility including MD program. Over the past 10 years as an exercise of revamping and escalating the health services by the Indian Government, the total number of PGs seats per year has been increased to 65,335 in the country which is double than (31,185) that was available in 2014. The anticipated and proportionate increase in the number of PG seats in nuclear medicine can be achieved if the prominent central and state medical colleges in the country also introduce the requisite technological infrastructure and MD nuclear medicine residency programs. At present, the country is producing only about fifty nuclear medicine PG