| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Editorial |
1 From the Departments of Radiology and Orthopedic Surgery, University of Missouri Hospitals and Clinics, Columbia. Received August 18, 2000; accepted September 21. Address correspondence to the author, 908 Martin Dr, Columbia, MO 65203 (e-mail: copejray@hotmail.com).
Index terms: Editorials • Education • Radiological Society of North America
In the early 1980s, the Radiological Society of North America (RSNA) began looking at ways of assisting in radiologic education in evolving countries. It was soon realized that education of the radiology resident in his or her own country was preferable to both continuing medical education there and to a postgraduate experience in North America. A program of visiting professors was considered to be the best educational method, and this was officially commenced at the annual meeting of the RSNA in 1986, with support by the RSNA Board and funding by the trustees of the Research and Education Foundation (then the Research and Education Fund) (1).
A committee, initially called the Committee on Radiology Education in Evolving Countries and later termed the Committee on International Relations and Education, was established to oversee the selection process and to determine the host institutions and the visiting professors. Dr Peter Cockshott was very active in all these preliminary discussions and was the first chairman of this committee.
The Visiting Professor Program
The Visiting Professor Program was originally envisaged such that the individual professors would spend 3–6 months in the host country, where they would deliver didactic lectures and conduct group sessions at the view box (1).
Initially, countries in Africa, Asia, and Central and South America were selected for visits, but countries in Eastern Europe such as the Baltic republics and parts of the former Soviet Union such as Ukraine, were soon added. Currently, some 23 countries have been served, with several having had multiple visits. Host institutions are given $1,500 worth of educational aids. Individual visiting professors frequently leave behind books, other teaching materials, and teaching radiographs and other images. The professors’ travel expenses are paid, and they receive a living allowance to cover the cost of a short-term lease accommodation.
Adaptability and enthusiasm were, from the beginning, thought to be essential for these teachers, and the role was considered to be particularly suitable for those on sabbatical leave (1). Retired radiologists have, of course, also participated. Of late, however, sabbatical leave has become more difficult to obtain, largely due to the advent of managed care. Hence, the program is currently being reevaluated, and changes involving shorter visits are expected in the near future.
Each individual visit to a specific site is unique, and other visits have been reported (2–5). However, it is thought that a brief description of a recent visit to Ecuador would be of interest and illustrate some of the problems and experiences that were encountered.
My Visit to Quito
In December 1999, having made the appropriate application, I was asked if I would accept an assignment in Quito, Ecuador, as a visiting professor. Although I did not speak Spanish, Dr Hugo Guerra, the Director of Postgraduate Radiology of the Central University of Ecuador in Quito, assured me that interpreters would be available and that my linguistic deficiency would not cause any problems. Nevertheless, I began an immediate study of the Spanish language by means of books, tapes, and a private tutor. I arrived in Quito in the middle of April 2000.
Quito lies in the northern Andes mountains at an altitude of 9,500 feet (2,896 m). It has a population in excess of 1.5 million. Although virtually on the equator, Quito’s altitude gives it a pleasant temperature for most of the year, which has been referred to as "perpetual Spring."
The medical school of the Central University has a 6-year course and graduates nearly 300 physicians annually. These physicians then undergo a 1-year internship, after which they spend a further year in a rural setting. Two smaller private medical schools in Quito have recently opened, but the Central University has the only radiology residency program.
There were 17 radiology resident physicians attending my lectures. Two were from Colombia, two were members of the Ecuadorian Army, and two were sponsored by the health ministry; these residents had their residency training fees paid for them. The other residents were required to pay $700 annually for training. The residents’ salary was about $280 per month in 1997. Owing to economic reasons, this remuneration had been reduced to just $80 per month by 2000.
The residents worked at two principal state hospitals in Quito, the Social Security and the Military, both of which had facilities for ultrasonography, computed tomography, and magnetic resonance imaging. However, no nuclear medicine imaging is available at the public hospitals, and these studies must be performed at private institutions and paid for by the patient. The residents also rotate through a children’s and an oncologic hospital. Residents assume "on call" duties, but otherwise appear to finish work at 3:00 PM each day. All of the current residents were in their 2nd year of training because of funding restrictions in the past to hire residents.
The residency training is broadly similar to that in the United States, and the program appears to be well structured with good teaching. Frequent visits from an RSNA visiting professor, however, seem to be an almost integral part of the program, with four such visits in the past 6 years.
My teaching was centered on an early-morning lecture, which usually lasted for 90 minutes. Unfortunately, there was no U.S.-style reading room in the hospital used for the lectures, so it was difficult to teach alongside the residents at work. However, several case-review sessions were held, mainly using teaching radiographs and other images that I had brought with me for this purpose. In addition, clinicians would bring problem cases along after the lecture, as would some radiology residents. Case-review sessions were also held from time to time at other hospitals.
Attendance at lectures was very satisfactory, and the residents were assiduous in their interest, note taking, and follow-up reading. Overall, I was most pleased with resident performance on multiple-choice examinations I administered.
My time in Quito passed all too quickly. I enjoyed the opportunity to see the very varied beauty of the country, learn about the many cultures, and meet the friendly helpful people. Most of all, however, I found great satisfaction in my interactions with the residents whom I taught and in their gratitude, which they freely expressed to me. I left with considerable regrets but with a real sense of accomplishment.
ACKNOWLEDGMENTS
I thank Dr Margarita Brito and Dr Hugo Guerra, both of Quito, Ecuador.
REFERENCES
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| RADIOLOGY | RADIOGRAPHICS | RSNA JOURNALS ONLINE |
