Technology provides Belarus with a bridge to high-level radiology

According to Dr. Serguey Khoruzhik, his country is often compared to a black hole.

"A lot of people don't even know about Belarus," said Khoruzhik, a diagnostic radiologist and radiation therapist at N.N. Alexandrov Research Institute of Oncology and Medical Radiology in Minsk. "When I go to international meetings and tell people I am from Belarus, I see the surprise in their eyes."

A small country of 10 million in the Commonwealth of Independent States (CIS), Belarus doesn't turn up often in discussions of radiological development, but the country's imagers are moving forward, most notably with the recent acquisition of the country's first multidetector CT scanner.

At age 29, Khoruzhik already has six years' experience as a full-time radiologist under his belt, and he has established the two most frequently used Russian language online radiological resources. "News of Beam Diagnostics Belarus" is a radiology news site, and "Basis of Radiological Images" offers access to Belarussian teaching files.

In a recent interview with Diagnostic Imaging, Khoruzhik shed some light on the difficulties, developments, and goals of Belarussian radiology.

"Our training system is completely different from what is common in the U.S. and is slowly changing in most of Western Europe. It is much shorter. I consider this the weak aspect of our educational system," he said.

Radiology residency in Belarus lasts just one year, although continuous medical education is a requirement. Khoruzhik views the obligatory one-month courses every three years for up to 12 years as the strong side of medical training in his country. Radiologists are free to choose subjects for these courses that are of particular interest to them.

The private sector in Belarussian healthcare began to develop three to five years ago. Most diagnostic equipment and services, excluding some ultrasound, are solely state property. Although patients are often willing to pay for exams, the healthcare system in Belarus is still soviet: The nation's constitution includes a provision for free healthcare.

"Probably this is the last such promise in the world," Khoruzhik said.

His 1000-bed hospital employs 18 radiologists and about 100 radiologic staff, including nurses, radiographers, and technical personnel. Ultrasound and CT are the most commonly used modalities in the country, which has 26 CT units and 19 MR scanners.

"The status here is not in accordance with Western European standards, but I do not consider it that bad," Khoruzhik said.

Other countries in the CIS may have more radiology machines, but they also have long waiting lists for imaging examinations. Some people die while waiting for radiation therapy.

"That is impossible in Belarus," Khoruzhik said. "Even with limited resources, we do our best to provide full service. Any patient requiring service will get it."

Requests for imaging have increased since Khoruzhik's hospital bought its new multidetector CT scanner last year. The institute previously performed 30 exams a day on conventional CT, but the average jumped to 50 with MDCT.

"We have found that the new scanner has unique possibilities that were not available before," Khoruzhik said. "That, along with highly qualified radiologists in Minsk, provides us with a high level of diagnoses and treatment."

With limited access to training and current radiology literature, Belarussian radiologist have learned to improvise.

"We have to study by ourselves," Khoruzhik said. "Luckily, information is not a problem nowadays because of the Internet."

Working with the most advanced CT scanner in the country, Khoruzhik hopes to achieve one of the goals he has set for himself and for the Republic of Belarus: to achieve the top level of clinical diagnostic imaging. His other goals include active participation in research and the formation of solid contacts between Belarus and the international radiological community.

Khoruzhik is cofounder of the European Forum for Radiologists, an international community of more than 400 radiologists who share ideas and respond to one another's questions through an Internet mailing list. He often consults with colleagues abroad on difficult diagnostic cases, participates in several international radiology conferences a year, and writes articles about Belarussian radiology for the international community.

"Last year, the Belarussian football (soccer) team beat the Netherlands in the World Cup," he said. "Now a few more people know about Belarus."

A new multidetector CT scanner, along with a World Cup victory, is sure to help put Belarus on the international map.

For a list of radiology teaching resources on the web, visit http://www2.dimag.com/globalfaceofradiology/resources/?id=3865.

Russian language radiology resources
nld.unibel.bynld.hut.runld.hut.ru/bri