The rapid pace at which knowledge is expanding and technological innovations are emerging presents both challenges and opportunities in imaging sciences. As workload and training demands increase, the ways in which we practice and train future practitioners must evolve to meet the new demands. For those involved in medical education, a reconsideration of the way the business of imaging is conducted is needed. Revolutionary changes are on the medical imaging horizon, and responses must address the a new realitya (TM) on a global scale. This includes planning for outreach programs that may be extended to developing countries with emerging economies.