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Sarangi PK, Narayan RK, Panda BB, Rao MK, Panda S, Mittal C. Subspecialization, Senior Residency, or Private Practice: The Dilemma of Final-Year Radiology Postgraduate Residents in India. Indian J Radiol Imaging 2023; 33:295-301. [PMID: 37362370 PMCID: PMC10289856 DOI: 10.1055/s-0043-1761255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Background Radiology is among India's top five speciality choices pursued by meritorious medical graduates. With the advent of the subspecialization degree courses, fellowships, the requirement of senior residency as faculty eligibility criteria, and the lucrative option of private practice, the final-year postgraduates are given opportunities to choose from but with little guidance on what and how to choose. This study aims to analyze the views of the final-year radiology postgraduate residents in India regarding their understanding of how to proceed in their professional life with options available. Materials and Methods A cross-sectional, questionnaire-based study was conducted online via Google forms distributed via email and social media platforms. The questionnaire was prepared after going through previous literature, video blogs, and media available on the Internet and was further validated for content. Results About half (48%) of them wished to pursue higher studies in the form of Doctorate of Medicine (DM) degree courses or fellowships. Almost three-quarters of the participants preferred short-term subspecialization via fellowships over 3-year DM courses (28%). Regarding clinical practice, 61.9% preferred to take up senior residency, while slightly over one-third (35.7%) expressed their will to move on to private practice. Conclusion A relative conundrum was observed in the decision to take up senior residency or private practice or to go for DM but had to pursue a fellowship due to limited choice in topics and seats available in the country for subspecialization.
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Affiliation(s)
- Pradosh Kumar Sarangi
- Department of Radiology, Dr. B.C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, West Bengal, India
| | - Ravi Kant Narayan
- Department of Anatomy, Dr. B.C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, West Bengal, India
| | - Braja Behari Panda
- Department of Radiodiagnosis, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
| | - M.V. Kameswar Rao
- Department of Radiodiagnosis, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur, Odisha, India
| | - Swaha Panda
- Department of Otorhinolaryngology, Institute of Medical Sciences and Sum Hospital, Siksha “O” Anusandhan University, Bhubaneswar, Odisha, India
| | - Chaitanya Mittal
- Department of Forensic Medicine and Toxicology, Dr. B.C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, West Bengal, India
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Hetenyi S, Goelz L, Boehmcker A, Schorlemmer C. Quality Assurance of a Cross-Border and Sub-Specialized Teleradiology Service. Healthcare (Basel) 2022; 10:1001. [PMID: 35742052 PMCID: PMC9223114 DOI: 10.3390/healthcare10061001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The current literature discusses aspects of quality assurance (QA) and sub-specialization. However, the challenges of these topics in a teleradiology network have been less explored. In a project report, we aimed to review the development and enforcement of sub-specialized radiology at Telemedicine Clinic (TMC), one of the largest teleradiology providers in Europe, and to describe each step of its QA. EVALUATION The company-specific background was provided by the co-authors-current and former staff members of TMC. Detailed descriptions of the structures of sub-specialization and QA at TMC are provided. Exemplary quantitative evaluation of caseloads and disagreement rates of secondary reviews are illustrated. Description of Sub-specialization and Quality Assurance at TMC: Sub-specialization at TMC is divided into musculoskeletal radiology, neuroradiology, head and neck, a body, and an emergency section operating at local daytime in Europe and Australia. Quality assurance is based on a strict selection process of radiologists, specific reporting guidelines, feedback through the secondary reading of 100% of all radiology reports for new starters, and a minimum of 5% of radiology reports on a continuous basis for all other radiologists, knowledge sharing activities and ongoing training. The level of sub-specialization of each radiologist is monitored continuously on an individual basis in detail. After prospective secondary readings, the mean disagreement rate at TMC indicating at least possibly clinically relevant findings was 4% in 2021. CONCLUSION With continuing and current developments in radiology in mind, the essential features of sub-specialization and innovative QA are relevant for further expansion of teleradiology services and for most radiology departments worldwide to respond to the increasing demand for value-based radiology.
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Affiliation(s)
- Szabolcs Hetenyi
- European Telemedicine Clinic SL, Torre Mapfre, C/Marina 16-18, 08005 Barcelona, Spain; (S.H.); (A.B.); (C.S.)
| | - Leonie Goelz
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Alexander Boehmcker
- European Telemedicine Clinic SL, Torre Mapfre, C/Marina 16-18, 08005 Barcelona, Spain; (S.H.); (A.B.); (C.S.)
- AIDOC Medical, Aminadav St. 3, Tel Aviv-Yafo 6706703, Israel
| | - Carlos Schorlemmer
- European Telemedicine Clinic SL, Torre Mapfre, C/Marina 16-18, 08005 Barcelona, Spain; (S.H.); (A.B.); (C.S.)
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Iyawe EP, Idowu BM, Omoleye OJ. Radiology subspecialisation in Africa: A review of the current status. SA J Radiol 2021; 25:2168. [PMID: 34522434 PMCID: PMC8424752 DOI: 10.4102/sajr.v25i1.2168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/04/2021] [Indexed: 12/05/2022] Open
Abstract
Background Radiology subspecialisation is well-established in much of Europe, North America, and Australasia. It is a natural evolution of the radiology speciality catalysed by multiple factors. Objectives The aim of this article is to analyse and provide an overview of the current status of radiology subspecialisation in African countries. Methods We reviewed English-language articles, reports, and other documents on radiology specialisation and subspecialisation in Africa. Results There are 54 sovereign countries in Africa (discounting disputed territories). Eighteen African countries with well-established radiology residency training were assessed for the availability of formal subspecialisation training locally. Eight (Egypt, Ethiopia, Kenya, Morocco, Nigeria, South Africa, Tanzania, and Tunisia) out of the 18 countries have local subspecialist training programmes. Data and/or information on subspecialisation were unavailable for three (Algeria, Libya, and Senegal) of the 18 countries. Paediatric Radiology (Ethiopia, Nigeria, South Africa, Tunisia) and Interventional Radiology (Egypt, Kenya, South Africa, Tanzania) were the most frequently available subspecialist training programmes. Except Tanzania, all the countries with subspecialisation training programmes have ≥ 100 radiologists in their workforce. Conclusion There is limited availability of subspecialist radiology training programmes in African countries. Alternative models of subspecialist radiology training are suggested to address this deficit.
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Affiliation(s)
- Efosa P Iyawe
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Bukunmi M Idowu
- Department of Radiology, Union Diagnostics and Clinical Services PLC, Yaba, Lagos State, Nigeria
| | - Olasubomi J Omoleye
- Department of General Medicine, LouisMed Hospital and Fertility Centre, Lekki Phase 1, Lagos State, Nigeria
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RADIAL: leveraging a learning management system to support radiology education. Pediatr Radiol 2021; 51:1518-1525. [PMID: 33666732 DOI: 10.1007/s00247-020-04950-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/20/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
Increasing volume and complexity of cases in academic radiology and the drive toward pediatric sub-specialization have threatened knowledge assimilation for radiologists. There is a clear need for a system that retrieves vetted information from the excess available on the internet. Partnered with an interdisciplinary team from the Graduate School of Education, the authors created the first comprehensive learning management system (LMS) for radiology, implemented in the reading room to augment image interpretation and point-of-care education. The LMS supports quantitative analysis using a robust analytics platform to evaluate user statistics, facilitating improved quality of patient care by revolutionizing the way radiologists assimilate knowledge. This integration promises to enhance workflow and point-of-care teaching and to support the highest quality of care.
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Thaker S, Botchu R, Gupta H. Insights into obtaining FRCR and beyond: Obstacles, opportunities and post-relocation dilemma - An Indian perspective. Indian J Radiol Imaging 2020; 30:70-76. [PMID: 32476753 PMCID: PMC7240893 DOI: 10.4103/ijri.ijri_438_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/05/2019] [Accepted: 02/11/2020] [Indexed: 11/20/2022] Open
Abstract
Indian radiology trainees and radiologists are interested to have FRCR (Fellow of the Royal College of Radiologists) qualification for various reasons including academic career progression, subspecialty interest and other socioeconomic factors. The path for acquiring FRCR qualification is adventurous yet onerous and exhausting. Perseverance, meticulous planning and clarity in the vision are essential prerequisites for an Indian graduate aiming to complete FRCR qualification, and one may require to invest an average of 1.5–2 years even if there is no reattempt in this tripartite examination. Indian doctors including radiologists are considered amongst the finest across global medical fraternities. However, the Indian medical education is skewed and variably distributed over the subcontinent due to organisational inability to provide single radiology curriculum-based education to all radiology training programmes. Parallel educational boards and a variety of institutions such as government, trust-funded and private organisations provide radiology training to further complicate the grand picture of radiology education in India. Conversely, UK radiology education is uniform nationally and rigorously enforced by deaneries based upon state-provided guidelines. UK training opportunities are essentially academically rewarding experience but they require herculean efforts to gain access to one. One should constantly focus on building a resume at par with that of a UK trainee by obtaining experience required to fulfil checklist for such opportunities. Alongwith addressing local (UK) competition thoughtfully, hard work, diligence, and high standards of work ethics are absolute musts to build a great resume, to obtain training opportunity and, in turn, to satisfy the ultimate goal of carrier advancement.
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Affiliation(s)
- Siddharth Thaker
- Department of Radiology, Kettering General Hospital, Kettering, Leicester, UK.,University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Imaging, Royal Orthopaedic Hospital, Birmingham, UK
| | - Harun Gupta
- Department of Musculoskeletal Imaging, Leeds Teaching Hospital, Leeds, UK
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Elangovan SM, Sebro R. Positron emission tomography/computed tomography imaging appearance of benign and classic “do not touch” osseous lesions. World J Radiol 2019; 11:81-93. [PMID: 31396371 PMCID: PMC6597458 DOI: 10.4329/wjr.v11.i6.81] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/11/2019] [Accepted: 06/21/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Classic “do not touch” and benign osseous lesions are sometimes detected on 18-F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) studies. These lesions are often referred for biopsy because the physician interpreting the PET/CT may not be familiar with the spectrum of 18F-FDG uptake patterns that these lesions display.
AIM To show that “do not touch” and benign osseous lesions can have increased 18F-FDG uptake above blood-pool on PET/CT; therefore, the CT appearance of these lesions should dictate management rather than the standardized uptake values (SUV).
METHODS This retrospective study evaluated 287 independent patients with 287 classic “do not touch” (benign cystic lesions, insufficiency fractures, bone islands, bone infarcts) or benign osseous lesions (hemangiomas, enchondromas, osteochondromas, fibrous dysplasia, Paget’s disease, osteomyelitis) who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) at a tertiary academic healthcare institution between 01/01/2006 and 12/1/2018. The maximum and mean SUV, and the ratio of the maximum SUV to mean blood pool were calculated. Pearson’s correlations between lesion size and maximum SUV were calculated.
RESULTS The ranges of the maximum SUV were as follows: For hemangiomas (0.95-2.99), bone infarcts (0.37-3.44), bone islands (0.26-3.29), enchondromas (0.46-2.69), fibrous dysplasia (0.78-18.63), osteochondromas (1.11-2.56), Paget’s disease of bone (0.93-5.65), insufficiency fractures (1.06-12.97) and for osteomyelitis (2.57-12.64). The range of the maximum SUV was lowest for osteochondromas (maximum SUV 2.56) and was highest for fibrous dysplasia (maximum SUV of 18.63). There was at least one lesion that demonstrated greater 18F-FDG avidity than the blood pool amongst each lesion type, with the highest maximum SUV ranging from 9.34 times blood pool mean (osteomyelitis) to 1.42 times blood pool mean (hemangiomas). There was no correlation between the maximum SUV and the lesion size except for enchondromas. Larger enchondromas had higher maximum SUV (r = 0.36, P = 0.02).
CONCLUSION The classic “do not touch” lesions and classic benign lesions can be 18F-FDG avid. The CT appearance of these lesions should dictate clinical management rather than the maximum SUV.
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Affiliation(s)
- Stacey M Elangovan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Ronnie Sebro
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Genetics, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA 19104, United States
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Reddy KN, Grewal HS. Comment on: Subspecialization in radiology – Is it time to hatch out of the cocoon? Indian J Radiol Imaging 2019; 29:106-107. [PMID: 31000954 PMCID: PMC6467044 DOI: 10.4103/ijri.ijri_511_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- K Nihaal Reddy
- Department of Medical Imaging, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Harpreet S Grewal
- Body Imaging, Department of Radiology, USF Health, Tampa, Florida, USA
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