Towards a More Inclusive Future: A Comprehensive Assessment of Gender Diversity in Nuclear Medicine Education, Training and Workforce.

The field of nuclear medicine has undergone remarkable advances, particularly with the introduction of new devices, radionuclides for imaging and therapy, new clinical applications, and emergence of medical evidence. As this dynamic field continues its rapid expansion, there is an urgent need to increase the number of well-trained professionals globally. Consequently, advocating for nuclear medicine as a thriving field of study and work for women becomes paramount in ensuring the establishment of a robust workforce capable of meeting the growing demands. True gender equality will only be achieved when there is equal representation across the spectrum of the nuclear medicine professions, including nuclear medicine technologists, radiopharmacists, radiochemist, medical physicists, nuclear medicine physicians, administrators, academics, and leaders. Currently, the workforce exhibits an imbalance, with females predominating among nuclear medicine technologists, while the number of female physicians, and those in leadership positions remains comparatively lower. There are various factors which contribute to the existing inequities. Societal expectations often impose traditional gender roles that somehow discourage women from pursuing a career in the science, technology, and mathematics (STEM) fields, including nuclear medicine. Additionally, prevailing unequal work conditions and gender biases within the workplace can create barriers that hinder women's professional growth and development. Ways of addressing inequalities includes ensuring female participation at all levels of education and training and promoting the field at undergraduate level in medical school. Mentorship programs have demonstrated great success in guiding and supporting women at various stages of their careers. Therefore, there is a need for their expansion and enhancement. Furthermore, female role models play a pivotal role in shattering gender stereotypes and inspiring other women to pursue careers in nuclear medicine and its related fields. By addressing the existing imbalances and fostering an environment that actively encourages and supports women, we can harness the full potential of all professionals, thus ensuring the ongoing progress and advancement of nuclear medicine.

Radiotherapy resources in Latin America and the Caribbean: a review of current and projected needs based on International Atomic Energy Agency data.

The inequitable access to radiotherapy globally is a complex undertaking that will require sustained work identifying gaps and mobilising efforts to resolve. The purpose of this review is to identify gaps and needs in radiotherapy in Latin America and the Caribbean. Data from 41 countries in Latin America and the Caribbean on teletherapy megavoltage units and brachytherapy resources were extracted from the International Atomic Energy Agency (IAEA) Directory of Radiotherapy Centers. These data were then matched to open-source data from GLOBOCAN and World Bank Data which included data on population size, gross national income per capita, cancer incidence, and mortality. These data were matched to current and projected cancer incidence and mortality (as estimated by the Global Cancer Observatory in 2020) to calculate current and projected gaps in external beam radiotherapy facilities. For brachytherapy, the analysis was focused on cervical cancer and included high dose rate and low dose rate machines. As of Oct 22, 2022, external beam radiotherapy was available in 32 (78%) of 41 countries, representing 742 radiotherapy centres and 1122 megavoltage units. Average coverage was 63%. LINACs accounted for 85% (955 of 1122) of megavoltage units and Cobalt-60 capacity decreased to 12% compared with in 2018. Median megavoltage units per 1000 cancer cases were 0·8 (IQR 0·54-1·03). Most countries clustered in the same range of gross national income per capita for teletherapy units per 1000 cases at a median of US$9380. The current deficit in megavoltage units is estimated at 668 units and is projected to be 2455 units by 2030. 28 (68%) of 41 countries had 279 installed brachytherapy services, both high dose rate and low dose rate, which could treat 108 420 patients with cervical cancer per year and meet the current needs, albeit with inequitable distribution of resources. Overall, this review indicated a 15% improvement in the current external beam radiotherapy capacity in Latin America and the Caribbean compared with 2018. However, there is still a current shortage of at least 668 extra units. By 2030, the need for megavoltage units will be double the current capacity. There is inequitable distribution of brachytherapy resources across the region primarily in the Caribbean. Adoption of hypofractionation can help overcome machine shortage; however, it will present technical challenges that need to be taken into account. Rays of Hope, is a novel IAEA initiative that is designed to mobilise global efforts to address radiotherapy gaps while ensuring the highest return on investment.