Successful business requires a variety of management skills, but one essential factor is to project the business forward and evaluate future trends and technological advances both for the product range and methods, and delivery of services. Radiology is no different, and its success has been partly due to the far-sightedness of our predecessors to embrace and develop many new and increasingly sophisticated imaging modalities.
Delivering these new imaging modalities as a service to the patient, however, often requires a comprehensive change management process, of which education is a major component. This educational programme involves two major parts. The first is training of the current workforce in the new techniques, facilitated by proper preparation. This will form part of the ongoing continuous professional development process through courses, workshops and secondments.
The second part is the training programme for new entrants to the field. It is important to work from a well-organised curriculum and teaching programme, structured into group and individual lectures and tutorials and computer-based teaching balanced with supervised practical experience. It is vital that trainees are provided with an excellent grounding in the fundamental skills and knowledge of the specialty before embarking on more sophisticated and specialised fields.
The curriculum is of major importance. Most European countries have these in place, many based around the detailed curriculum produced by the European Society of Radiology (ESR) and the radiological section of the Union of European Medical Specialists (UEMS). However, this curriculum must be an active document designed for the radiologists of tomorrow.
Trainees undertake a five-year training programme and are expected to be at the forefront of the specialty when they become fully registered specialists. They must therefore have the knowledge and skills with which to enter the workplace already able to understand and perform the latest procedures and hopefully eager to develop those in the earlier stages of gestation. A key feature of this change is the increased use of molecular imaging to evaluate function and changes at molecular level. This requires greater emphasis on physiology and cell biology in the early years of the curriculum and more focused training in the latter years.
This training must also recognise changes that are occurring in the delivery of imaging to the patient and be geared up to adapt. The European working time directive had a dramatic effect on training in many countries by altering the work to training balance and the availability of trainees to develop their skills. The development of teleradiology has also had a detrimental effect on some training programmes and the availability of material to trainees in some clinical conditions.
However, these factors have paralleled the development of sophisticated computer training and assessment models, which have enabled a change in the delivery of training programmes. It is clear that computer-based teaching will play a major part in future educational structures. The delivery of new techniques and services requires resources and changes in work patterns and roles. It is important that radiological personnel are at the forefront of this process and to do so they require training in management concepts and techniques. As with all education, this should be an ongoing process of career development but should also be included in the specialist training period.
This issue of the journal provides an example of all these processes through a complete revamp of the education system in Sweden where functional and pathological imaging are being amalgamated. This will profoundly affect training and service delivery and require workforce adjustments and altered management structures illustrating the interdependency of these elements and the importance of always looking forward, planning accordingly and managing change.
Prof. Iain McCall