The Radiopharma Workforce Gap: Who’s Actually Running These Trials?
Radiopharmaceutical trials are expanding quickly. More programs are entering the clinic, and expectations around imaging, dosimetry, and treatment delivery are increasing.
But these trials do not run on infrastructure alone. They depend on people with highly specific expertise. And that workforce is limited.
As development accelerates, the gap between available talent and operational demand is becoming a defining challenge for clinical execution.
These Trials Require a Different Skill Set
Radiopharmaceutical trials are often grouped under oncology. On paper, that makes sense. In practice, they operate very differently.
These studies require coordination across nuclear medicine, radiology, medical physics, radiopharmacy, radiation safety, oncology, and clinical research operations. Each function plays a distinct role. Together, they create a workflow that is more complex than a traditional oncology trial.
Recent literature highlights rapid growth in radiopharmaceutical development while also identifying workforce training as a key constraint [1].
Administering a radiopharmaceutical is not the same as delivering a standard drug. It requires handling radioactive material, managing exposure, coordinating imaging timepoints, and often integrating dosimetry into the protocol.
That level of coordination depends on people who understand both the science and how to execute it in a clinical setting.
The Talent Pool Has Not Kept Pace
The challenge is not just specialization. It is scale.
Radiopharmaceutical development is growing faster than the workforce needed to support it. Nuclear medicine physicians, technologists, radiochemists, nuclear pharmacists, medical physicists, and radiation safety professionals are all essential. Many of these roles already operate within a limited labor pool.
This is especially visible for nuclear medicine technologists. Published data show rising demand while supply remains constrained due to training limitations and workforce attrition [2].
Industry reporting reflects the same trend, pointing to talent shortages as a constraint on the expansion of radiopharmaceutical therapies [3].
The result is predictable. Sites become selective about which studies they can support. Activation timelines extend. Trial throughput is limited by staffing, not just equipment.
Experience Is Concentrated in a Small Number of Sites
Radiopharmaceutical trials tend to cluster in experienced centers.
These sites often have established nuclear medicine programs, trained staff across disciplines, and existing workflows for handling and administering radiopharmaceuticals.
That concentration creates efficiency. It also creates bottlenecks.
Sponsors often compete for the same institutions, investigators, and operational teams. Expanding beyond these centers is possible, but it requires training, workflow development, and realistic startup planning.
Implementation studies of radioligand therapy programs highlight that expanding access requires coordinated infrastructure, staffing, and operational planning across teams [4].
Without that investment, site expansion remains limited.
Not Every Role Is Interchangeable
Workforce constraints are also shaped by regulation.
In the United States, the use of radioactive materials requires specific authorized roles. These include authorized users, nuclear pharmacists, medical physicists, and radiation safety officers. These roles are tied to defined training, experience, and licensing requirements [5].
Regulatory frameworks also define how radiation safety programs must be structured and maintained [6].
These requirements are essential for safety. They also limit how quickly teams can scale.
Not every clinical research staff member can step into these roles. Training and credentialing take time.
Operational Complexity Increases the Burden
Radiopharmaceutical trials require tight coordination across teams.
A single patient visit may involve dose preparation, time sensitive administration, imaging at defined intervals, radiation safety monitoring, and data collection.
Each step must align.
When experienced personnel are limited, the burden on site teams increases. Staff must understand not only their role, but how their work connects to the full protocol.
This is where execution risk becomes visible. A site may have the right equipment and approvals, but still lack the staffing depth to run a complex trial consistently.
Theragnostic Insight - Radiopharmaceutical development is scaling faster than the workforce required to execute it. Capacity is not just about sites. It is about people.
What This Means for Sponsors
For sponsors, workforce constraints should be part of early planning.
Site selection is not only about infrastructure or prior experience. It is also about staff availability, cross functional expertise, and the ability to support complex workflows over time.
Key questions include:
- How many radiopharmaceutical trials is this team currently supporting
- What experience does the staff have with similar protocols
- Which roles are required by license or institutional policy
- Where are the staffing pressure points
- What support or training will be needed
Ignoring these factors can lead to delays that are difficult to recover later.
What This Means for You
Radiopharmaceutical trials depend on a level of coordination that traditional development models often underestimate.
The right site is not just one with the right equipment. It is one with the right team.
At Theragnostic Insights, we help development teams evaluate site readiness beyond infrastructure. That includes assessing workforce capacity, identifying execution risks, and aligning trial strategy with real clinical operations.
Because in radiopharmaceutical development, progress is not limited by science or capital alone.
It is limited by the people who make execution possible.
Stay tuned for more in this mini-series: Clinical Capacity Crisis: The Hidden Bottleneck in Radiopharma Development.
In the coming weeks, we’ll continue exploring the clinical capacity crisis holding back radiopharmaceutical innovation, from regional access gaps to operational gridlock and infrastructure blind spots. Don’t miss the next post as we map out the road to a truly trial-capable ecosystem.
- The Trial Site Gap: Why Radiopharmaceutical Innovation Is Hitting a Wall
- Geography Is Destiny: The Clinical Access Gaps in Radiopharmaceutical Research
- Operational Gridlock: Where Radiopharmaceutical Trials Break Down on Site
- Beyond the Badge: Rethinking What “Trial-Ready” Really Means in Radiopharma
- Infrastructure as Investment Strategy: Clinical Site Access and Radiopharma ROI
- Built for What’s Next: Redefining Clinical Site Design for Theragnostic Trials
- Speed as Strategy: How Site Scarcity Is Slowing Radiopharmaceutical Pipelines
- One Roof, Many Bottlenecks: Why Fragmented Site Models Undermine RLT Trials
- The Dosimetry Dilemma: Why Many Sites Aren’t Ready for Radioligand Trials
- Licensing & Radiation Safety: The Regulatory Maze Behind Radiopharmaceutical Trials
- The Hidden Role of Radiation Safety in Clinical Trial Activation
- The Radiopharma Workforce Gap: Who’s Actually Running These Trials?
References:
[1] Scott et al., 2024. Trends in nuclear medicine and the radiopharmaceutical sciences in oncology: workforce challenges and training in the age of theranostics. The Lancet Oncology.
[2] Nguyen, Guenther, and Davis, 2023. Future Challenges and Occupational Prospects of Nuclear Medicine Technologists. Journal of Nuclear Medicine.
[3] STAT, 2024. New cancer treatment may be hamstrung by “talent shortage”. STAT.
[4] Mittra et al., 2024. Establishing a robust radioligand therapy program: A practical approach for North American centers. Cancer Medicine.
[5] U.S. Nuclear Regulatory Commission, 2025. Authorized Individuals. U.S. Nuclear Regulatory Commission.
[6] Electronic Code of Federal Regulations, 2025. 10 CFR Part 35 Subpart B: General Administrative Requirements. eCFR.
https://www.sciencedirect.com/science/article/abs/pii/S1470204524000378?
https://jnm.snmjournals.org/content/64/supplement_1/TS19?
https://pmc.ncbi.nlm.nih.gov/articles/PMC10905220/?
https://www.nrc.gov/materials/miau/med-use-toolkit/auth-individuals?
https://www.ecfr.gov/current/title-10/chapter-I/part-35/subpart-B/?
