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Cheng BL, Duminie SP, Mitei M, Pickhardt PJ, Kanne JP, Parker RK, Hartung MP. CT without borders: Comparison of diagnoses for abdominal pain from a teaching hospital in rural Kenya and a US academic medical center. Abdom Radiol (NY) 2023; 48:2196-2205. [PMID: 36941388 PMCID: PMC10027257 DOI: 10.1007/s00261-023-03869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Radiology global health opportunities are expanding as more hospitals in low- and middle-income countries utilize CT. This creates opportunities for global health program building, education, service, and research. This study determines the diagnostic yield and variety of abdominopelvic CT diagnoses for abdominal pain in a US academic medical center (UW) compared to a rural Kenyan teaching hospital (Tenwek). METHODS A retrospective, cross-sectional sequential sample of 750 adults from both hospitals who underwent abdominopelvic CT for abdominal pain from February 2019 through July 2020 was obtained. Exclusion criteria were trauma, cancer staging, and recent hospitalization or surgery. Patient age, sex, comparison studies, use of contrast, known cancer diagnosis, and CT diagnoses were compared. Negative exam rate, acute abdomen diagnosis, and new cancer diagnosis were recorded. Statistical analysis was performed using R. RESULTS 750 UW patients met inclusion criteria (mean age 53.3 ± 20 years; 442 women) and 750 Tenwek patients met inclusion criteria (mean age 52.5 ± 18 years; 394 women). 72% of UW patients had comparison imaging compared to 6% of Tenwek patients. 11% (83/750) of UW patients had a known cancer diagnosis compared to 1% (10/750) of Tenwek patients. 39% of UW patients had a negative exam compared to 23% of Tenwek patients (p < 0.001). 58% of UW patients had an acute abdomen diagnosis compared to 38% of Tenwek patients (p < 0.001). 10 of the 15 top acute abdomen diagnoses were shared, but in different order of frequency. Diagnoses unique to UW were diverticulitis, constipation, stercoral colitis, and epiploic appendagitis. Diagnoses unique to Tenwek were tuberculosis and hydatidosis. 3% of UW patients received a new cancer diagnosis (7/19 metastatic), compared to 40% of Tenwek patients (153/303 metastatic) (p < 0.001). CONCLUSION For adults undergoing CT for abdominal pain, there are differences in the prevalence of abdominal pain diagnoses, new cancer diagnosis, and negative exam rate between the rural Kenyan teaching hospital and the US academic medical center.
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Affiliation(s)
- Bryan L Cheng
- University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Sean P Duminie
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Mercy Mitei
- Department of Surgery, Tenwek Hospital, Bomet, Kenya
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, E3/311 CSC, Madison, WI, 53792-3252, USA
| | - Jeffrey P Kanne
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, E3/311 CSC, Madison, WI, 53792-3252, USA
| | | | - Michael P Hartung
- Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Ave, E3/311 CSC, Madison, WI, 53792-3252, USA.
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England RW, Lugossy AM, Mollura DJ. Increasing Opportunities for Trainees to Engage in Global Health Radiology: Radiology In Training. Radiology 2021; 300:E320-E322. [PMID: 34128726 DOI: 10.1148/radiol.2021210371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ryan W England
- From the Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287 (R.W.E.); and RAD-AID International, Chevy Chase, Md (R.W.E., A.M.L., D.J.M.)
| | - Anne-Marie Lugossy
- From the Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287 (R.W.E.); and RAD-AID International, Chevy Chase, Md (R.W.E., A.M.L., D.J.M.)
| | - Daniel J Mollura
- From the Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287 (R.W.E.); and RAD-AID International, Chevy Chase, Md (R.W.E., A.M.L., D.J.M.)
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Sosna J, Pyatigorskaya N, Krestin G, Denton E, Stanislav K, Morozov S, Kumamaru KK, Jankharia B, Mildenberger P, Forster B, Schouman-Clayes E, Bradey A, Akata D, Brkljacic B, Grassi R, Plako A, Papanagiotou H, Maksimović R, Lexa F. International survey on residency programs in radiology: similarities and differences among 17 countries. Clin Imaging 2021; 79:230-234. [PMID: 34119915 DOI: 10.1016/j.clinimag.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE With the initiative of the ACR International Economics Committee, a multinational survey was conducted to evaluate radiology residency programs around the world. METHODS A 31-question survey was developed. It included: economic issues, program size and length, resident's activities during daytime and call, academic aspects including syllabus and examinations. Data was tabulated using the forementioned thematic framework and was qualitatively analyzed. RESULTS Responses were received from all 17 countries that were invited to participate (France, Netherlands, Israel, UK, Russia, USA, Japan, India, Germany, Canada, Turkey, Croatia, Serbia, Italy, Ireland, Hungary, and Greece). Residency length varied between 2 and 5 years. The certificate of residency completion is provided by a local hospital [4/17 (23%)], University [6/17 (36%)], National Board [6/17 (36%)], and Ministry of Health [1/17 (6%)]. There was variability among the number of residency programs and residents per program ranging from 15 to 300 programs per nation with a 1-700 residents in each one respectively. Salaries varied significantly and ranged from 8000 to 75,000 USD equivalent. Exams are an integral part of training in all surveyed countries. Length of call varied between 5 and 26 h and the number of monthly calls ranged from 3 to 6. The future of radiology was judged as growing in [12/17 (70%)] countries and stagnant in [5/17 (30%)] countries. DISCUSSION Radiology residency programs worldwide have many similarities. The differences are in the structure of the residency programs. Stagnation and uncertainties need to be addressed to ensure the continued development of the next generation of radiologists. SUMMARY STATEMENT There are many similarities in the academic aims and approach to education and training of radiology residency programs worldwide. The differences are in the structure of the residency programs and payments to individual residents.
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Affiliation(s)
- Jacob Sosna
- Department of Radiology, Hadassah Medical Center, Hebrew University Faculty of Medicine, Jerusalem, Israel.
| | - Nadya Pyatigorskaya
- Department of Radiology Pitié-Salpêtrière, Sorbonne Universités, UPMC Univ Paris 6, Paris, France; Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Gabriel Krestin
- Department of Radiology Pitié-Salpêtrière, Sorbonne Universités, UPMC Univ Paris 6, Paris, France
| | - Erika Denton
- Department of Radiology, Norfolk & Norwich University Hospital, UK
| | - Kim Stanislav
- Radiology Research and Practical Centre, Moscow, Russia
| | | | | | | | - Peter Mildenberger
- Department of Radiology, Universitätsmedizin Mainz Klinik und Poliklinik Radiologie, Mainz, Germany
| | - Bruce Forster
- Department of Radiology, University of British Columbia, Faculty of Medicine, Vancouver, Canada
| | | | - Adrian Bradey
- Department of Radiology, Mercy University Hospital, Cork, Ireland
| | - Deniz Akata
- Department of Radiology, Hacettepe University, Ankara, Turkey
| | - Boris Brkljacic
- Department of Radiology, Dubrava Hospital, University of Zagreb, Croatia
| | - Roberto Grassi
- Department of Radiology, Università della Campania Luigi Vanvitelli, Naples, Italy
| | - Andras Plako
- Department of Radiology, University of Szeged, Hungary
| | | | | | - Frank Lexa
- The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology, Reston, VA, United States of America
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Yibrehu B, Kancherla R, Azzie G. Global Surgery Opportunities in Canadian General Surgery Residencies: A Cross-Sectional Study. JOURNAL OF SURGICAL EDUCATION 2020; 77:1186-1193. [PMID: 32536576 DOI: 10.1016/j.jsurg.2020.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/05/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In recent years, there has been an explosion of interest in global surgery (GS) among students, residents, and surgeons. However, little information regarding the landscape of GS in general surgery residencies exists. This study was therefore designed to explore the opportunities and the framework for global surgery in Canadian general surgery training programs. DESIGN The Program Director (PD) at each Canadian general surgery residency program was invited to complete an online survey. RESULTS All 17 PDs participated. Only 3 institutions have a formal curriculum in GS, while 9 have an Office of GS. Seven residencies mention GS on their department website. Ten of 17 residencies have had trainees participate in GS experiences in the last academic year. Funding or pre-experience training is available at less than half of all institutions. Only one residency ranked GS exposure as being "very important" to their program. Across all programs, the average ranking of GS experiences was 2.3 out of 5, which translates descriptively to being of "little importance". Despite this, 10 PDs identified GS as attractive to applicants, and 5 stated their plans to expand GS opportunities at their institution. CONCLUSIONS This is the first study to look at the GS landscape in general surgery residencies across Canada. These results may inform graduating medical students and residents about the current status of GS in Canadian residencies. This study may also assist other residencies in the development and tailoring of GS programs.
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Affiliation(s)
- Betel Yibrehu
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
| | | | - Georges Azzie
- Hospital for Sick Children, Toronto, Ontario, Canada
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Haver HL, Rosen MP, DeBenedectis CM. Global Radiology Training Prevalence Among Radiology Residency Programs. Curr Probl Diagn Radiol 2019; 50:141-146. [PMID: 31837834 DOI: 10.1067/j.cpradiol.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 11/05/2019] [Accepted: 11/12/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Global Radiology aims to enhance access to medical imaging services and education, worldwide. To date, few reports have evaluated Global Radiology Training (GRT) in radiology residency programs. Here, we examined how radiology residency programs perceive and incorporate GRT into their curriculum, and how this information is promoted online. METHODS Two methods were used to examine the current state of GRT. First, radiology residency program directors (identified via the Association of Program Directors in Radiology) were surveyed on topics including: Electives, institutional partnerships, resident and faculty involvement, inquiry by prospective residents, and barriers to implementation. Second, radiology residency program websites (n = 193) were examined for existing GRT on the programs' publicly available webpages. RESULTS There were 62 survey responses (response rate of 19%). Thirty-eight percent (24/62) of residency programs offered a Global Radiology elective to their residents within the past academic year and 27% (17/62) of programs have active affiliations with medical institutions outside of the United States. Eighty-four percent of program directors (52/62) received questions from residency applicants regarding opportunities to participate in Global Radiology. Furthermore, only 13% (26/193) of all radiology residency programs listed at least one GRT elective on their webpage. DISCUSSION GRT in radiology residency is more widely available than previously reported and has been underrepresented on residency program websites. In the present survey, the majority of radiology residency program directors reported that radiology is an important component of Global Health, one-third of whom have already incorporated the subject into their curriculum. However, most common barriers to GRT include, perceived lack of time in the curriculum and lack of faculty interest. The high prevalence of inquiry from residency program applicants about GRT suggests that it may be a notable factor for applicants during the ranking process. Programs build up GRT may choose to share related information seeking to may choose to emphasize work in Global Radiology on their program webpages.
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Affiliation(s)
- Hana L Haver
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA.
| | - Max P Rosen
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA
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