Radiology education programs pursue standardization

Although locations as geographically distinct as the Czech Republic and Hong Kong have accredited radiology training programs, most nations, especially those in the developing world, have no clear standards for evaluating radiology education.

But national and international organizations are working hard not only to improve educational standards but to bring them into harmony with one another. The Ministry of Health in Russia recently accepted recommendations from chairs of university radiology programs to reorganize the country's radiology education system. The independent, not-for-profit International Certification and Education Accreditation Foundation (ICEAF) is gearing up to start accrediting training programs in ultrasound. And countries throughout Western and Eastern Europe are adopting the 1997 "yellow book" training and education guidelines from the European Association of Radiology (EAR).

RUSSIAN REVOLUTION IN RADIOLOGY

The system of professional training in radiology has not changed significantly in Russia since Soviet times, said Dr. Valentin Sinitsyn, chair of radiology at the Moscow Medical Academy. Postgraduate education focuses primarily on traditional x-ray technology and offers two programs in primary training: a two-year, 2456-hour program and a short, 706-hour course. The latter may soon be dropped because it does not do justice to the complexities of modern diagnostic imaging. Subspecialty courses totaling no less than 500 hours in duration also are provided in CT, MRI, angiography, pediatric radiology, and other segments of radiology.

Russia has program-specific standards for postgraduate education and professional specialization; it does not have a unified standard for radiology education across the country. Chairs of radiology departments decide on the content and format of university educational programs (lectures, seminars, self-education tasks, and hands-on training), and local examining boards conduct reviews at the end of the training courses.

In mid-April representatives from university radiology programs met at the Moscow Medical Academy to discuss problems in radiology training and to push for change in the Russian system of education in radiology. Participants at the meeting called for an additional three to four years of training after completion of an obligatory two-year primary educational program. They also urged that standards of radiology education in Russia be revised so they are more in keeping with those of the EAR and American College of Radiology. They emphasized the need for radical restructuring of continuing medical education, teach-the-teachers efforts in many parts the country, and modernization of educational materials.

According to Sinitsyn, the Ministry of Health has accepted these recommendations, and a committee of top radiology chairs has begun developing universal and compulsory content for postgraduate training.

INTERNATIONAL ULTRASOUND CERTIFICATION

The ICEAF, founded by ultrasound luminaries Dr. Barry B. Goldberg, Dr. Peter N.T. Wells, and Dr. Christopher R. B. Merritt, seeks to create effective means for determining the level of knowledge of physicians who perform ultrasound. It also aims to assure that training programs in ultrasound meet recognized educational standards.

The ICEAF does not intend to provide or sponsor training programs. Its purpose is to accredit formal training venues and educational materials, including books, CD-ROMs, journals, and Internet sources, and to certify physicians who have at least three years' experience in ultrasound or have completed a radiology or fellowship program with a strong ultrasound element or an ICEAF-accredited ultrasound training program.

In the first test of its certification program, the ICEAF worked with the Chinese Ultrasound Society and the examination branch of the Chinese government in August 2002 to test 3117 professionals, 399 of whom passed. The ICEAF conducted its first computerized test in Brazil in 2002.

EAST MEETS WEST

In the Czech Republic, radiology is fully recognized as a medical specialty with accredited training programs and certification for both radiologists and radiographers. Postgraduate training in radiology, which is provided by two specialized nonacademic institutions and the radiology departments of seven academic institutions, was nevertheless harmonized according to the EAR recommendations in 1999.

The Czech Radiological Society has adopted European standards for basic certification in general radiology. These require five years of training after a 12-month general internship and a qualification examination, and three advanced certificates in interventional radiology, neuroradiology, and pediatric radiology, which require three more years of training and certification.

A number of other countries in Eastern Europe as well as some in the West, including Hungary, Poland, Italy, and France, are following suit by switching to the five-year training system recommended in the EAR guidelines.