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Flight Plan for Travel
To Lusaka, Zambia
With the support of the ACR Foundation Goldberg-Reeder international travel grant, I spent 4 weeks across January and February of 2018 (my final year of radiology residency) living in Zambia’s capital, Lusaka, and working at the University Teaching Hospital, an 1800-bed hospital that serves as the premier center of medical education for Zambia.
My trip coincided with the travel of a neuroradiology attending, Michael Potchen, and a junior resident, Harris Chengazi, from my hospital (the University of Rochester’s Strong Memorial Hospital) in Rochester, NY. Our shared primary goal in traveling to Lusaka was to initiate a newly-organized class of radiology trainees into a brand new multi-year radiology training program (analogous to a residency program) and to do everything we could to foster this program’s success.
Although my attending from the University of Rochester had already met some of the new trainees during prior trips to Zambia, it was exciting for us as US-based residents to get to know them for the first time. Despite their lack of prior formal radiology training, the trainees who were inducted into this inaugural class quickly showed us that they were observant, brilliant, and committed to the hard work that was needed to successfully complete their training.
Most days, my American co-resident and I would start the work day giving one or two hours of formal lectures, after which the Zambian trainees returned to the hospital’s radiology department to work until lunch. While they spent the remainder of the morning working with the hospital’s local in-house radiologists, we would focus our efforts on interpreting a large backlog of MRI and CT cases. This backlog was the unfortunate result of a shortage of Zambian radiologists, which this new training program is intended to ameliorate.
After lunch, we would reconvene to review any additional lecture topics and spend the afternoon contributing to workstation teaching in the hospital’s main reading room while the trainees continued reading studies. When the work day ended, we would walk back to our apartments a few blocks away and often keep reading cases after dinner or work on lectures tailored to our new colleagues’ needs.
During our stay, we met many wonderful physicians, both from radiology and from other departments. We were able to lead multidisciplinary tumor board meetings, give lectures to neurosurgery residents, implement a weekly case conference through Zambia’s National Telemedicine Centre, meet with administrators from local institutions who are invested in the success of the program, address radiology departmental meetings (including the non-physician staff in the radiology department), and spend time with CT and MRI technologists to help troubleshoot specific issues that were of concern to them. We were also able to form strong professional relationships and personal friendships with these wonderful people who are committed to serving the people of Zambia and who are doing a remarkable job with sometimes-limited resources.
My month in Lusaka also gave me invaluable experience interpreting studies for diseases and conditions that are rarely seen among our patient base in Rochester. The combination of infectious agents that I think of as exotic (such as schistosomiasis, malaria, tuberculosis and listeria), a very high prevalence of immunocompromised patients due to HIV infections, and the often too late initial presentation of many patients resulted in my exposure to numerous radiology cases for which I can hardly overstate the educational value. I was fortunate to have had access to doctors with experience interpreting these studies, who were willing to help me make sense of the sometimes-confusing constellations of findings I would encounter.
The month was absolutely exhausting for me and for my wife (she offered to stay in Rochester with my young daughter, despite working herself). Difficulties were not infrequent, including the untimely demise of my laptop shortly after my arrival, followed by the untimely demise of my external hard drive a few weeks later. Despite the inconveniences I experienced during this trip, my experience of working in Zambia has been the unqualified highlight of my radiology training career, and I hope it will be the beginning of many experiences that give me the opportunity to collaborate with radiologists from a diverse set of backgrounds.
By Andrew Olsen, MD