HealthManagement, Volume 9 - Issue 1, 2009

The Changing Face of European Radiological Education:The Perspective of the Radiology Trainees Forum

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Dr. Christiane Nyhsen

Consultant Radiologist

Department of Radiology

Sunderland Royal Hospital

Sunderland, UK

[email protected]

Tell Us About Your Roles in the Sunderland Royal Hospital (SRH), and the Radiology Trainees Forum (RTF).

I was appointed as consultant radiologist at the SRH in October 2007. My main interests are cross-sectional imaging and ultrasound. I am also honorary clinical senior lecturer of the Newcastle University with weekly radiology teaching commitments for 3rd and 5th year medical students. In addition I am a member of the Royal College of Radiologists (RCR) European subcommittee.


From 2003 – 2007, I was the UK national representative in the Radiology Trainees Forum (RTF). I was elected RTF vice-chair in 2005 and I have been chairing the RTF since 2007. In this role I, and other executive members, coordinate the activities of the RTF such as sample surveys, short RTF exchanges and activities during the ECR, in particular the RTF Highlighted Lectures. I also attend other ESR committee meetings as junior representative.

Please Tell Us About the Origins and Achievements of the RTF.

The RTF was established during the 1991 edition of the European Congress of Radiology in Vienna, Austria to improve training, career development and research for junior radiologists. We also aimed to develop exchange programmes and promote the creation of national junior radiologists' organisations.


Over the years we increased the number of active national representatives in the RTF to 36 countries. There are regular communications with national delegates who participate in data collection for RTF sample surveys and voice their concerns and suggestions for future activities. I also ask for the views of national representatives and take discussion points forward to represent junior views in the main ESR committees.

European Radiological Education is Inherently Fragmented – can This be Remedied?

Every European country has a different hospital system, including training of junior doctors. Radiology training also varies. The ESR Training Curriculum offers excellent guidance working towards homogeneity and many training schemes across Europe are already adapting their programmes. This process will take many more years and since legally this is guidance rather than law, changes cannot be implemented 100%.


However, exchange programmes such as ERASMUS, are key to harmonising education in Europe. I took part in an ERASMUS exchange as a 4th year medical student and enjoyed studying with French students in Dijon. It showed me at an early stage how beneficial exchanges are to broaden one’s horizon.


ESOR’s (European School of Radiology) visiting fellowships are a great success and I have spoken to a few trainees personally who were very impressed. Other ESOR courses are also well attended and easily affordable as they are heavily sponsored. On a smaller scale, the RTF organises short exchanges on a personal level and if anybody is interested, please do not hesitate to contact us!

What Deficiencies in the Education System Impact European Radiological Residents?

General working pressures are increasing and managers are pushing for ever-greater efficiency and cost-savings to cope with the rising demand on radiology departments, often without an increase in staffing or funding. As a consequence, stress levels worsen and there is less time for direct supervision for trainees. Training of junior radiologists is not always seen as a priority, in particular when they are inexperienced and not able to contribute significantly to work output. This is worrying as no book or internet-based training course can replace the daily teaching offered by an experienced radiologist.

Are Residents Keen to Learn More About Management Topics? Are Facilities and Courses Widely Available to Them?

RTF data from a sample survey amongst national representatives from 2005/6 shows that 23% replied that management course were obligatory, and 30% stated that no management courses were available to them. I think that many trainees probably have little access to “hands-on” management tasks and see it as a rather dry topic. Raising interest amongst trainees is important, as management vitally needs competent clinical input to be successful in balancing the books as well as offering the best service for patients.


Dr Strickland, Chairman of Management in Radiology (MIR), and a supporter of management training amongst trainees, aims to provide a platform for this to allow more trainees to get involved in management and to improve their CV.

What is the Impact of the Rapid Advances in Technology on Residents' Educational Programmes?

There are considerable training resources freely available on the internet and most trainees I know use them on a daily basis, with equal access for trainees whether in a well-equipped university hospital or a small district general hospital.


On the other hand, teleradiology will change the way we work significantly in the future. This technology can be used very effectively to get a second opinion from a specialist centre (such as for example neuroradiology), which will improve training. Teleradiology can however also be used for outsourcing and may as a consequence limit the type and number of examinations which can be reported by trainees under supervision of an experienced radiologist in their base hospital. Offering training in outsourcing centres could prevent training from suffering, but this may not be cost-effective for a private company.

Many State That There is Considerable Difficulty in Attracting Women to Radiology What do You Think Women Find off-Putting About Radiology?

I personally always liked radiology very much and found the variety of the job (patients from all specialties and age groups as well as the different modalities) fascinating. The interaction with clinicians and the opportunities to make the final diagnosis are also appealing.


In the UK, there are a lot of female radiology trainees and I personally think it is a job, which allows flexible working times better than many other jobs (such as medicine or surgery). With advances in technology, reporting of images from home may also become easier, contributing further to flexibility, which is an important fact for women who are planning to start a family. I am personally very happy with my career choice and can only recommend radiology to other women!

Please Tell Us About Your Favourite Memory From Your Own time as a Radiology Resident.

One very happy memory was travelling down to London for the admittance ceremony as “Fellow of the Royal College of Radiologists”. We had a very good time and celebrated the fact that there were no more exams after years of studying. This was a good feeling!

What is Your Key Advice for Radiology Residents, to Make Them More Attractive to Potential Employers?

Showing initiative and doing something over and above the required standard in radiology training should attract the attention of potential employers. Good audits and research projects are also likely to impress, in particular published works of research, as everybody will know how much effort this takes. On a smaller scale, case submissions, for example to EuroRAD or national case collections will be recognised and look good on a CV.

Interviewee: Dr. Christiane Nyhsen Consultant Radiologist Department of Radiology Sunderland Royal Hospital Sunderland, UK [email protected]

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