Exposure to radiology during medical school

Radiology is a multi-faceted, expansive speciality. It includes numerous imaging modalities, has both diagnostic and therapeutic capabilities, and it is at the frontier of many technological advances. Despite the position radiology holds in modern medicine, it remains an undervalued subject in medical school. During clinical training, students rotate through a variety of medical and surgical specialities, and gain experience with both hospital and community healthcare; however, they rarely get dedicated time in the radiology department. Irish and UK medical schools that do incorporate a radiology rotation into their rota, often limit the training to a cursory 1 week placement. During this short time, students scarcely have the opportunity to get acquainted with the workings of the department, let alone gain meaningful experience with plain film radiography, computerised tomography, ultrasound, magnetic resonance imaging, nuclear medicine, and interventional radiology. The accurate interpretation of radiographs is a skill that cannot be easily learnt from textbooks. For example, there is no succinct written definition to differentiate interstitial lung disease, from pulmonary oedema, or from an underexposed chest radiograph. To the untrained eye, these presentations can be easily confused. Structured clinical radiology experience would be an ideal way to ensure a thorough education in imaging. For those students who are keen to improve their understanding of imaging, organising an elective is often the only option to gain clinical experience. Ireland’s Medical Council [1] and the UK’s Royal College of Radiologists [2] recognise the importance of imaging experience as a part of undergraduate education. Diagnostic imaging plays a crucial role in the diagnosis and staging of many diseases, and interventional radiology plays an equally prominent diagnostic and therapeutic role. Experience with radiology will give junior doctors the confidence to report common findings on plain radiographs, and give them an understanding of the pertinent information that ought to be included on radiology request forms. It will also allow junior doctors to partake in multidisciplinary team meetings more effectively. The lack of clinical imaging experience is especially problematic for students with an interest in pursuing a career in radiology. Trainees in Ireland and the UK are eligible for radiology training posts immediately after completion of 2 years of clinical work. While those applying for medical or surgical specialities will have worked in general medical or surgical wards during their postgraduate training, the same is not true for radiology. Many of those applying to radiology will have little clinical experience with radiology. Of the 754 applicants to radiology training in Great Britain, 210 were successful in obtaining a position in 2012–2013. Twelve of these radiology trainees left the programme [Personal communication with Anna Campbell, Education Executive Officer, Royal College of Radiologists (5th of August, 2013)] within their first year. For such a sought after training programme, this drop-out rate (6 %) represents a significant minority. Were radiology placements given a more prominent role in medical training, these applicants would A. Nanapragasam Department of Radiology, Ashford and St. Peter’s Hospitals NHS Foundation Trust, Chertsey, UK