EUROPE
Special Section: Building a better radiologist

Russian health authorities are planning to implement major changes to the country's radiology training program, which has not yet been restructured in the wake of the collapse of the Soviet bloc.

Among other changes, the Russian government will impose a mandatory two years of training in general radiology, effective at the start of 2003.

At present, the training offered at about 50 centers around the country consists of five months, or 700 hours, spent primarily on basic x-ray studies. Graduates subsequently receive on-the-job training under the supervision of senior radiologists for an unspecified period of time. They then may obtain subspecialty training through three-to-six-month courses in a full range of modalities and subspecialties at about 19 training centers.

Virtually every kind of diagnostic imaging training is available at high-volume centers of excellence in Russia's major cities, but formal organization has been lacking, said Professor Valentin Sinitsyn, chair of radiology at the Moscow Medical Academy in Moscow.

As an alternative to the five-month program, the country offers a more thorough two-year fellowship program in radiology, but only an estimated 25% of practicing radiologists have completed it. The plan is to make the two-year training program mandatory. Longer term, the country is moving toward a four-year training program based on the EAR general radiology guidelines, Sinitsyn said. It may be possible to meet this goal by 2005.

"We cannot immediately move to a four-year training program-that would demand a lot of resources," he said.

Many other specialties in Russia already have two-year training programs, but radiology has fallen behind because it has been a lower priority for the country's government officials.

"Some officials have thought of radiology as an auxiliary specialty that is not as important as cardiology or surgery," Sinitsyn said.

But since 2001, the government has been investing heavily in replacing old imaging equipment with new, more complex systems that require a greater degree of training for radiologists. Consequently, it has recognized the need for changes to the education system.

In addition to the basic structure of resident training, other changes to the educational system are under way. The government has asked two leading centers for medical postgraduate education to submit proposals for a new program of radiology continuing medical education by the end of this year. Currently, CME content is limited and requirements are minimal: 72 hours every five years. It is possible a new program may be adopted next year.

"It should be increased at least fourfold. That would be the minimum, but more would be better," Sinitsyn said.