Ultrasonography is more and more discovered as an indispensable tool in clinical medicine. This holds true for both routine and for emergency/intensive care diagnostics. Looking by means of ultrasonography into abdomen, thorax, soft tissues, and heart is basically easy, and the technical equipment is comparatively low in price and safe in application. The true needlehole in a more widespread use of the beneficial potential of ultrasonography for our patients is in many a case the lack of expertise and systematical education.
The following report is based on a personal experience of some fifteen years performing courses, seminars, and congress lectures in clinical ultrasonography in the Near and Middle East, and in some parts of francophone (west-) Africa. In some 35-40 journeys, the teaching and training periods ranged between one day and one week (the latter on a periodical basis since eight years in Rabat/Morocco on behalf of the World Gastroenterology Organization WGO at the Postgraduate Training Center at the Ibn Sina University Hospital, in cooperation with Profs. Naima Amrani and Mustapha Benazzouz, gastroenterologists). Other training and teaching sites were in Syria (Dr.Fayez Sandouk), in Egypt (Dr.Nabil Elnahas ), and in Jordan, Iran, Sudan, Cameroun, Senegal, and others.
The most striking feature of these teaching events was the learning effects for the teacher himself: both in the medical and ultrasound related field, and concerning the local health care systems and additional multicultural experiences. This was, however, not the main reason to perform these activities. The rationale was and is to give and to share as much as possible expertise in clinical ultrasonography with other and preferably younger colleagues, in order to spread the fine art of ultrasonography as intensively as possible and on a high quality level. The background of an extended three decades teaching experience in the network of the EFSUMB and the German speaking national societies of ultrasonography ÖGUM, SGUMB, and DEGUM* was really and of course helpful, especially in transferring the courses certification rules and regulations.
The teaching events and training courses were usually and as far as possible embedded in the local hospital environments with hands on training. This was especially appreciated by all participants and trainees (Fig. [1]), and by the patients as well. As far as possible, the idea of a complete examination of e.g. all abdominal organs was underlined, and a systematic approach to the patient including the individual history and an initial physical examination were a continuous demand. These hands on exercises - in routine and even in emergency/ambulance settings - were without exception most attractive for all participants.
Ultrasound Courses in the Near and Middle East
In addition and as a rule, half of the total teaching times was dedicated to lectures on specific topics - be it organ related normal or pathological findings, or more generalized topics as e.g. focusing on the dynamic features in realtime ultrasound, an adequate examination technique, or variants of acute abdominal pain diagnosed with ultrasonography. Video movies quickly turned out to be an optimal teaching instrument in addition to static pictures. Hands on training turned always out to be the real challenge for the teachers and course supervisors in explaining again and again details of anatomy and pathology - as a rule meeting hard working and learning young colleagues with an intensive interest in learning more about the possibilities and limits of clinical ultrasonography.
A considerable number of colleagues from all countries mentioned made their way to Germany to our hospital or to friends in the sono field elsewhere to continue with an individualized training, always in combination with endoscopy and endoscopic ultrasonography (EUS). And meeting the trained colleagues again in congresses of e.g. hepatology or in the setting of the UEGW (United European Gastroenterology Week) - this is always a true pleasure.
Clinical ultrasonography is an important topic and message - and its further spread on a qualified basis is worth while any personal and more organized effort. The foundation of an officially acknowledged umbrella organization is considered - with the precursor of the email address below, which might friendly be used for further comments and discussion.
Lucas Greiner, MD
eMail: lucas@prof-greiner.de
eMail: ultrasonography@flyingfaculty.de
