The destination is a station at which intensity modulated radiation therapy (IMRT) is at a state of development whereby it can be wisely but widely applied to all patients who need it, with quality assured and with due notice taken of all the potential impediments. The professionals developing IMRT certainly would like the train to be at the destination right. The railway officials are the doctors, physicists, radiographers, engineers, all those professionals whose skills combine to move the IMRT train safely. Like railway officials of old, they work together, the only sensible way to ensure the passage of the train. Consider IMRT as a train and the development of IMRT as like a long train journey. The train started in a cold siding a long way from its destination. The train got an extra locomotive in the late 1990s as companies began to market the needed equipment.