Russia: Scanners plentiful but radiologists too scant

However, investments in equipment and advanced training are attracting medical students, John Brosky reports

Christian Lauer, Belgium-based radiologist and artist, is fascinated by the...
Christian Lauer, Belgium-based radiologist and artist, is fascinated by the idea of using radiology images to fuse art and medicine. The work of art on our front cover links Russia – one of this year’s guest countries and home of this year’s ECR President – with the European Congress of Radiology.
Christian Lauer, Belgium-based radiologist and artist, is fascinated by the...
Christian Lauer, Belgium-based radiologist and artist, is fascinated by the idea of using radiology images to fuse art and medicine. The work of art on our front cover links Russia – one of this year’s guest countries and home of this year’s ECR President – with the European Congress of Radiology.

‘Going back 20 years we had problems with access to high-end technologies for radiology. CT, MRI and PET scanners were quite rare,’ sighed Valentin Sinitsyn MD. Then, he laughed. ‘Now suddenly we have the opposite problem with more and more new technologies and a shortage of radiologists qualified to operate all this equipment.’

Over the past decade, he explained, the Russian Ministry of Health has invested heavily in the acquisition of high-end radiology platforms, significantly including information systems to process, store and share images. ‘In absolute numbers, we can claim to have between 14,000 or 15,000 radiologists, but most have been trained in basic examinations for X-ray or else specialised in just CT or MRI. There simply wasn’t a need for more advanced training,’ he said.

As a result, the Russian Society of Radiology has endorsed the European Training Curriculum for Radiology developed by the European Society of Radiology (ESR) as a basis for a national training programme.

Chief of Radiology at the Federal Centre of Medicine and Rehabilitation, Dr Sinitsyn is also a member of the ESR Executive Council and, over the past year, served as the Chairman of the Congress Committee responsible for the scientific and educational programme. He has given special attention to organising a special session, ‘ESR meets Russia,’ that will feature some of his country’s most prominent radiologists, two cultural interludes and a panel discussion on the theme, Future developments in Russian radiology: which path to take?

‘I would not want to predict what the panellists will decide, but my own greatest hope is that we will encourage and support this great interest that young people are showing in radiology,’ said Dr Sinitsyn, who is also a professor and the Head of the Radiology Course at Moscow State University. ‘Radiology has become very attractive for Russian medical students. They find it exciting with all the high technology, computerised processes, information technologies, 3-D imaging and functional imaging. It is a field that is developing very fast, which also appeals to them.’

‘Most of these students speak a high level of English, which is essential as so much data and information is available for them everywhere in English-language journals and, of course, on the internet. To the point where increasingly we can offer radiology courses for Russian students in English,’ Prof. Sinitsyn explained.

Among the students and residents he teaches he said he is impressed by their drive and enthusiasm to be successful, well-trained and knowledgeable professionals. Attending international congresses has convinced them they also need to demonstrate an expertise by presenting results from their work.

‘I am very pleased that we have seen an increase this year of more than 60% in papers and posters submitted to the European congress from Russia. My country is now among the leading contributors of scientific work this year and I believe it is a general trend and that we can expect it will be sustained with future congresses.’

There remain significant challenges for Russia with its uneven expansion of capabilities in radiology, he added. ‘While we have seen an acceleration in the development of digital networks and PACS, many hospitals have boldly gone ahead purchasing these expensive systems without building the required infrastructure or assuring they have a sufficient number of workstations. Often they cannot see further than acquiring stand-alone systems. On the other hand, we have quite successful programmes at hospitals that are fully equipped and fully-digital with regional radiology networks and teleradiology. It becomes a question of cultural change, of finding the appropriate approach for creating these services.

‘Service for the new equipment is another, quite complicated issue,’ he added. ‘Sooner or later something will stop a scanner operation, of course, but repair or replacement takes a lot more time than radiologists may be used to in western countries. One one hand, we have very complex regulations and custom requirements in Russia. The required registration of tenders can be quite long. Even where a hospital has the funding there are very lengthy delays.

‘On the other hand, we continue to have challenges for maintaining operations with the manufacturers themselves. These are very big, international companies, but I regularly find myself telling them they need to improve service and support. They have a shortage of technicians, of spare parts, even for minor parts, and this takes time.’

These obstacles can be disturbing, frustrating the smooth operation of a radiology group by leaving a scanner standing idle for months, ‘a waste of resources, especially human resources,’ he pointed out.

Nevertheless, Prof. Sinitsyn believes that Russian radiology is now moving in a positive direction and that current challenges will be resolved with continued progress and improvements.

06.03.2014

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