The previous issue of our journal featured a commentary about clinical radiology by
Prof. Kapilamoorthy, who is a senior and mentor to several of us in the Indian Radiology
fraternity.[1] He identifies several major challenges affecting the growth of radiology in the
“Indian” context, including the nonuniform training standards, our inertia to play
an active role in patient management, and, turf wars with other specialists. This
commentary gets us thinking about the current curriculum for resident education and
its adequacy to suit contemporary practice in the real-world scenario. While radiology
has come a long way from being just a service-provider to becoming a full-fledged
clinical specialty, the change in resident education curriculum has been disproportionately
minimal.
The whole focus of clinical medicine has shifted toward patient- and disease-centric
approaches (inflammatory bowel disease, hepatocellular carcinoma, mesenteric ischemia,
epilepsy, etc.), rather than just being organ-specific (liver, bowel, pancreas, colorectal,
pituitary, and so on), and at this juncture, the role of a clinical radiologist cannot
be emphasized much more. A good clinical radiologist offers much more information
other than the diagnosis (including several qualitative and semiquantitative metrics
which decide the suitability of a chosen treatment, and help in prognosticating the
patient) and is a vital member of the multidisciplinary team. This requires keeping
updated to the domain advances by regular appraisal of literature and constant communication
within the multidisciplinary team. Interventional radiology (IR) has undergone exponential
progress and transformed the way several diseases are being treated. All radiology
residents need to be aware of IR treatment options for different diseases and need
to be exposed to how IR procedures are performed. The mindset of residents who are
opting for radiology, needs to be tuned in line with this thought process, at an early
stage.
Training and education regarding radiation protection and magnetic resonance safety
needs should be offered and tested during assessment, so that a safe radiological
practice could be ensured. Several patient-related soft skills such as communication
and bioethics should be taught during the course of residency, so that the main concepts
of interaction with patients (first as a physician, then as a clinical radiologist)
are imbibed and could be adopted life-long. Prof. Kapilamoorthy has rightly recognized
one of our major strengths which is innovation and creativity in developing new techniques
and procedures.[1] Knowledge on patent filing by collaborating with local industry should be a part
of training at the start of career. Regular journal clubs should be a part of the
teaching program to inculcate a research and innovation mindset, not only confined
to clinical research, but also transdisciplinary research along with biomedical engineers.
Several premier scientific institutes (like Indian Institute of Science, Indian Institutes
of Technology [IIT] Delhi, IIT Jodhpur) have identified the need for such transdisciplinary
research and the potential within India. Radiology residents should be made aware
of such options to pursue a research career and potential advantages of taking combined
MD-PhD/DM-PhD courses which are currently being offered by institutes like Sree Chitra
Tirunal Institute for Medical Sciences and Technology (SCTIMST) and All India Institute
of Medical Sciences (AIIMS) Jodhpur.
It is up to us senior radiologists and radiology teachers, to guide our young fraternity
to the right paths. Will we initiate this step of “yahi samay hai sahi samay hai” so that it is “Amrit Kaal” for our junior fraternity?
