The department of nuclear medicine is an unfamiliar field, even within the medical community. The only time the department made headlines was at the end or beginning of every year when medical colleges announced the application status of would-be specialists, like “Nuclear medicine hits rock bottom, again.”

It’s often used as a comparative word to show how serious application rates are for other “shunned departments.” Outsiders worry about the future of this “perennial tailender.”

However, the future envisioned by the nuclear medicine department is bright.

That’s because it is more closely related to technological development than other departments. It is safe to say that it was accompanied by the history of introducing digital technology in hospitals. Specialists, who attended private academies to learn about the UNIX operation system even more unfamiliar than the just-popularized personal computer (PC), installed an internet network in the medical office for themselves, and used to play network games, have become the authorities of nuclear medicine 30 years later and are training juniors.

With the advent of "theranostics," they are also creating "dream cures" with global companies.

One such specialist is Professor Kang Keon-wook of the Department of Nuclear Medicine at Seoul National University Hospital (SNUH), also chairman of the Korean Society of Nuclear Medicine. Professor Kang, an aspiring engineer who was dismayed with the “departure from technology forever” after entering the medical school at the recommendation of others, is now at the forefront of technological development by stepping into the department.

Nuclear medicine is associated with basic sciences, such as chemistry, physics, and biology, through the medium of molecules. It is also closely connected to engineering and data departments in examination and inspection, such as positron emission tomography (PET). And that explains why Professor Kang says, "Technology development is the development of nuclear medicine."

It also shows why Kang remains confident of the future of the nuclear medicine department, which takes the “last place in application rate.”

“Nuclear medicine is a study that shares technological trends. Beyond simply following, it is in a position to fuse and lead various technologies,” Professor Kang said. “It awaits challenges from those not afraid to graft various studies to it and create new years, looking not the present but 10 or 20 years ahead.”

Korea Biomedical Review met with Professor  Kang who leads the society and listened to his visions about nuclear medicine and its role.

Professor Kang graduated from Seoul National University College of Medicine in 1991 and accumulated his career as a nuclear medicine specialist at the Seoul National University Hospital and the National Cancer Center. He took office as the Korean Society of Nuclear Medicine chair in November last year. Kang also chairs the Asian Regional Cooperative Council for Nuclear Medicine (ARCCNM).

Question: The Korean Society of Nuclear Medicine celebrated its 60th anniversary in 2021. Despite the long history, many still say they are unfamiliar. Now that you head the society, why did you choose the nuclear medicine department as your future career?

Answer: It was even more unfamiliar when I was a medical student. My seniors asked me why I opted to enter such a department. Thirty years ago, personal computers began to be distributed to colleges. There was nothing that could be called digital technology. I wanted to enter an engineering college but landed in a medical school. So, I thought I should at least go to a department that could shine along with technology development. It may sound funny, but I also thought I could receive good treatment when the department was unpopular with fewer people.

Q: Looking back 30 years from then, was your judgment proper?

A: It hit the mark. Nuclear medicine specialists are physicians, but they explore both basic and intermediary research and participate in developing new medicines and medical devices. They naturally are engaged in technology patents and easily jump into a business using such experiences. Nuclear medicine is an interesting area, indeed. You can become a doctor, an engineer, and an entrepreneur. If opportunities come, you can also work at international organizations, including the International Atomic Energy Agency. IAEA aims at the peaceful use of nuclear power, and the core part of this area is nuclear medicine. I also received an offer from it.

Q: It was an excellent opportunity to live in Vienna. Why didn’t you move?

A: I receive higher salaries at SNUH. Let me talk about income for a while. Nuclear medicine specialists get paid salaries and make considerable extra money by working as outside directors at businesses or doing service programs. There is also a free atmosphere where others do not meddle in your work if only you handle it neatly. When I was a medical resident, the internet came in first. We drew network lines, installed good servers, and played games. I think such an atmosphere has been maintained well until now. We can also keep a work-and-life balance as much as we want. Frankly, no other department can provide such balance than nuclear medicine. “Lifetime work-life balance” is possible here.

Q: Is it a well-founded confidence?

A: Yes. Bluntly, there is little work related to inpatient treatment, so the burden on duty is less. Most of the hospitalized patients in the nuclear medicine department stay one night and two days at the hospital, and many are in stable condition. I see an average of 12 patients a week. Therefore, professors take turns on duty at SNUH.

Q: It may be because of PET, but some people ask what difference there is between nuclear medicine and radiology departments.

A: Basic concepts are different. If the radiology department interprets the images taken, the nuclear medicine department targets and tracks molecules. If the target is amyloid, it can diagnose dementia. If the target is a dopamine transporter, we diagnose Parkinson's disease. It also diagnoses and treats cancer according to various biomarkers. New biomarkers are also emerging in the anti-aging sector. Human aging will be a quantifiable and measurable concept. That leads to the development of new drugs. Novartis, a multinational pharmaceutical company, has already released a targeted treatment for prostate cancer. If the target is clear, side effects and pain decrease, and the effectiveness of treatment increases. Demand for nuclear medicine will explode in anti-aging, early diagnosis, and preventive treatment.

Q: What is the advantage of the nuclear medicine department differentiated from other departments?

A: As said earlier, since nuclear medicine interacts with basic science and clinical medicine, creating a network centered on nuclear medicine is easy. In addition, nuclear medicine doctors have used all the technologies in clinical fields. They knew about unmet medical needs, niche markets, and technological competition. For entrepreneurs and investors, too, we are reliable partners for investors. This is the beauty of being a nuclear scientist. I am a platform and hub, and a network is formed around me.

Q: Building a network between research and technology, healthcare and industry, should be done at the national level, not at the individual level. However, experts say Korea falls short of it. What do you think?

A: Korea is not a country that does not invest and make efforts. The Korea Health Industry Development Institute (KHIDI) injects hundreds of billions of won into research alone annually. Why can’t we do like the U.S. or Israel, then? The key lies not in technology but in people. The government must create an environment where physicians., scientists, engineers, businesspeople, and investors can exchange with one another and make partnerships whenever needed. So, there is a joke that the government should pay dining and wining fees, not research money. It is also not entirely a joke. Investors can pay research money. With that money, we should apply for patent technology, commercialize it, and apply it to clinical practice. We can obtain practical results even if we don’t produce a research paper. We should make a change of consciousness in that direction.

Q: You might have some regrets about weak interests in nuclear medicine despite its role and potential and low application rate. Right?

A: Nuclear medicine’s future is crystal clear. Global businesses express hope to collaborate with Korea’s nuclear medicine. I can see progress, and it is within our reach. There are no reasons to feel regretful or depressed with the currently low application rate if we envision the sector 10 or 20 years ahead. However, such a time can come somewhat earlier or later, depending on when medical students recognize it. The future potential of nuclear medicine will become a reality only when juniors enter the department. In teaching students, I stress that they see 20 years ahead as I did. I don’t mean all medical students should apply for nuclear medicine. I only hope that the nuclear medicine department will not be pushed back in the future career options of students who find it fits their aptitude.

Q: Lastly, a word for future nuclear medical scientists and nuclear medicine specialists.

A: When I entered medical school, I regretted it a lot because I thought I would never become an engineer. But look at me now. I became myself whom I wanted and hoped for so much. There are still a lot of stories to be said about the department of nuclear medicine. For those who love science and like research and development, those who want to challenge the endless world of business, and those who want to realize themselves through this, nuclear medicine will offer a way to render help.