Radiology Education: Can we do better?

Radiology is one of the most sought after specialities in the Indian medical field and yet there is a significant gap between what the students are taught and what are the requirements from an industry which undergoes a constant transformation, with new technological advancements happening every now and then. The first panel of Express Healthcare’s Radiology and Imaging Conclave addressed this issue along with several other factors that need revaluation when it comes to Radiology Education in India. Moderated by Dr Akshay Baheti, Assistant Professor, Department of Radiology, Tata Memorial Centre, the panel comprised of celebrated academicians and professionals from the industry: Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia; Dr Malini Lawande, Consultant, Innovision Imaging and Nanavati Superspeciality Hospital; Dr Yatish Agarwal, Dean, University School of Medicine and Paramedics Health Sciences, Guru Gobind Singh Indraprastha University and Professor Radiodiagnosis, Safdarjung Hospital; Dr Zainab Vora, Senior Resident, AIIMS; and Dr Jinita Majithia, Senior Resident, Breach Candy Hospital.

The discussion, which witnessed enthusiastic participation not only from the panellists but from the audience members as well, chiefly discussed what the present curriculum for radiology education in India lacks and what steps can be taken to do justice to this speciality. One of the first points of contention that were pointed out is the outdated nature of the examinations. “The exams are still about darkroom radiology,” Dr Baheti as he manoeuvred the discussion towards the fact that the exam pattern in radiology still lies in the “dark ages”. He asked the residents on the panel about their exam experiences, and if they feel that the exam pattern has been designed in such a way that it encourages students to cram a certain part of their syllabus. “For the ‘historical darkroom’ exams, we mostly mug up books which have been passed down to us from our seniors- these are no longer available in book stores! Even for practical exams, we are compelled to focus on things which have no relevance in the current times,” said Dr Vora. On this, Dr Agarwal agreed and said that indeed there is a need for course-makers to re-evaluate how exams are conducted and what is asked in them. The panel reached at a consensus that even advance papers are not touching upon the latest technology, and rather deal with outdated topics like spectroscopy.

“Students will study the most for what is asked the most,” said Dr Baheti, “for example, in the American Board, the MCQs are formed in such a way that they include a patient’s clinical history, talk about the various symptoms that the patient has, and are practically very clinical intensive. Such questions encourage students to be proactive learners.” This shifted the debate to the topic of what question pattern is the most suitable for the MCQ generation- the good old essay based on long answers or MCQs or both? “What is the purpose that these long answer questions solve?

Personally, I feel that to write a good theory paper, you only need to know how to write a good answer, even if you do not have sufficient knowledge of what you are writing. On the other hand, MCQs when smartly put can really test a student’s knowledge of concepts and practical problems. Perhaps a combination of both the types of questions could work out the best for us,” said Dr Majithia. Speaking on the need for practical exams to be updated, an audience member said, “We are no longer like the radiology of the old days, we are more like pathology now. We cannot have an exam that is so short. We work on workstations; we examine on films. There is a strong relationship between the two. So if taking out the workstation would make me helpless, how can I ask the candidate to perform?” The need to incorporate the latest technological developments like AI and practical aspects like ethics, scientific research and writing, soft skills, etc in the educational format for radiology was also acknowledged.Another observation that was made was that radiology education and exams do not focus on treatment enough, rather, the stress is solely on imaging. Even as professionals, radiologists need to be involved in a patient’s treatment process as well and not just making reports on tests done. To combat this issue and the others, the panel concluded that the exams should be standardisation across universities and colleges. They discussed how this standardisation can be executed and which body will look after it. Presenting an alternative view, Dr Agarwal stated that it is the view of the board of governors at MCI that universities should now be given the responsibility of curriculum making. Next was discussed the relevance of having a working academic schedule, how it could better help the academic authorities in an institution to plan and execute lectures and how it would help lecturers to balance teaching with their usual work commitments. Also, recording these lectures and using multimedia tools like YouTube could help residents keep up with these lectures. Another way the potency of lectures can be increased is by including a lot of case studies. “In our institute, we residents cite case studies, discuss them and the consultants then review them, pointing out the mistakes that we make.

This results in a very wholesome learning experience as we learn from our mistakes and get great insights. Such sessions can then be followed by supplementary talks,” said Dr Majithia.

The panel then further discussed how radiology syllabi can be modified so that it boosts critical/logical thinking, curiosity, critical orientation, and the knack for knowledge implementation in the new generation of students. “Radiology students need to be encouraged to interact with professionals from other specialities. That will help them learn where and how their radiology investigation will help in a patient’s treatment,” pointed out Dr Lawande. The session ended with panellists discussing how radiology learning can be made more interesting for students, and how their learning experience can be maximised.

Key Highlights:

• The education system in Indian radiology is outdated. There is a need to incorporate recent advances and practical aspects of radiology education and examination system.
• Standardisation is the way forward. MCI being taken over by the Board of Education is a positive step in this direction.
• Radiologists need to be more clinically oriented.
• We have to move beyond the lecture system. We should have sessions during reporting so that students can have practical knowledge.
• Doing away with essays in bad, we are stopping new concepts from flowing in. Educators need to inculcate the joy for learning among students.
• Critical thinking and curiosity among students, clinical orientation and implementation by educators and students are extremely crucial for effective education in radiology.