On the Path to Becoming an American-Trained Radiologist
The radiologist is the key to a correct diagnosis. Radiology has a large number of examinations to achieve that objective — conventional radiology, ultrasound, CT, magnetic resonance, hybrid imaging, SPECT scanner, PET-CT, and PET-RM. But the art of radiology is in the accurate selection of these tests.
Since the inception of imaging as a medical tool, the benefits of diagnostic imaging have been immense and have revolutionized the practice of medicine: most especially in my chosen field of pediatric radiology.
It was a month after Roentgen’s discovery of x-rays and their basic properties, on February 3, 1896, when the first pediatric patient was radiographed. A 14-year-old boy who was thought to have broken his wrist two weeks earlier was radiographed (the exposure took 20 minutes). The image showed “the fracture in the ulna very distinctly,” which marked the first clinical radiographic examination in America and the birth of pediatric radiology. 1
The increased sophistication and clinical efficacy of imaging have resulted in dramatic growth in radiology over the past quarter century. Since children have been a major reason to encourage the best, pediatric radiology has led the growth. Pediatric imaging practitioners spend more care with diagnoses, as patients’ bodies are still developing and greater thought must be paid to radiation dosage, an important pediatric imaging issue. The radiologists’ techniques allow them to capture the best quality image while using the smallest radiation dose possible, which is the goal for the future of all radiology.
Radiologists are able to provide interpretation of an image, and diagnose, handle, and treat some pathologies. But today, radiology is all about the technology and informatics used to manage the information. After technologists complete the imaging, the outcome depends on the data flow between multiple information systems. Informatics in a modern radiology department is the DNA of service. Managing vital information to improve radiology information systems (RIS), voice dictation, and picture archiving and communication systems (PACS) make the work of radiology an example of efficiency.2
The path to create a radiologist is a convergence between the academic environment, which encourages residents to continue to learn actively, and constant continuing medical education after the fact. Diligence to learning and research will ultimately lead residents to become professionals in the role of consultant and educator.
The duties of a resident in radiology are basically the same over most of the world. In Europe and Latin America the essential training focusses on developing a big puzzle of information flow. In America, a young radiologist possesses the freedom to innovate and create a motivated team. During residency, young radiologists develop the applications of the basic theories. The sessions are designed to teach didactically; and PGYII residents know the importance of sharing knowledge on different topics. Discussions are always encouraged. The attendants allow the continuous study, research, and publication of acquired knowledge. The most precious characteristic is the way the residents are members of the professional team.
This different behavior of the American team during training is observed around the world. It showcases the performance of residents in the path of becoming specialists. It is displayed during exhibitions and national and international meetings. An American radiology resident is an example of how America is constantly encouraging innovation and brilliance on the journey to success.
Another quality of being an American radiology resident is having the ability to encourage practice-based learning and improvement. Residents are taught to evaluate patient care practices. The key to designing new advances and protocols in medicine is allowing reductions in radiation dosages, while encouraging other specialties, such as nuclear medicine and radiation oncology, to follow the same path. An American radiology resident is as important and influential as a radiologist who has completed training.
Finally, history can be communicated in words or showed in images.1 We young radiologists are writing the chapters of radiology history. The recipe for a successful radiologist is to work diligently every day with the collaboration of multiple departments and discover the best ways to improve and achieve the common goals of a successful health system. Collaborating with colleagues and learning to achieve common objectives is the most productive way to build and at the same time create strong professional relationships that allow improvement of the quality of health services.
By Veronica Del Prete, MD