Preparing for Practice, Part 1: Clinical Partner Perspectives on Entry-Level Competency in Radiopharmaceutical Therapy-A Program Improvement Initiative.

The rapid expansion of radiopharmaceutical therapy and theranostics has introduced new expectations for nuclear medicine technologists and created ongoing challenges for educational programs preparing students for this evolving field. Variability in clinical exposure and institutional resources has made it difficult to define what constitutes appropriate entry-level competency versus skills that should be developed through structured clinical onboarding. GateWay Community College's nuclear medicine technology program undertook a program improvement initiative to better align curriculum with regional clinical expectations. Outreach was conducted to clinical preceptors, affiliate education supervisors, nuclear medicine managers, and a physician assistant with nuclear medicine technologist experience, representing affiliated sites that include community hospitals, large academic medical centers, a comprehensive cancer center, and institutions with active 90Y-radioembolization and interventional radiology-integrated therapy programs. Convergent themes across respondents revealed a consistent distinction between foundational competencies expected at graduation and procedural skills appropriately developed after entry into practice. Several themes emerged that extend beyond the scope of traditional nuclear medicine curricula: the structural barriers limiting student access to theranostics, specific skill gaps most commonly observed in students and new graduates, the NMT's emerging role as an interdisciplinary radiation safety educator, and the growing importance of postinfusion imaging and dosimetry as future technologist competencies. Vendor-provided training was identified as insufficient to develop the broader clinical reasoning required for safe, independent practice. Part 2 of this series describes the simulation-based curriculum framework developed in response to these findings.