Dr Andrew Lowe and Dr Helen O’Brien were the winners of the 2019-2021 International Travelling Fellowship. Their project was to deliver MRI educational courses in Myanmar and Vietnam.
Our International Travelling Fellowship journey started back in 2019, as we assembled a team of radiologists from the UK to travel to Myanmar to deliver MRI courses. This visit represented the first collaboration between The Royal College of Radiologists (RCR) and the Myanmar Radiology Society. Myanmar has essentially been a ‘closed country’ since coming under military rule from 1962 to 2010, and in the process has become one of the least developed nations in the world. Shortly after our visit in 2019, the country underwent a further military coup.
Due to this political situation, we were unable to return to Myanmar for the second part of our project, and instead travelled to Vietnam in February 2023 to complete the Fellowship. This visit also represented the first collaboration between the RCR and the Radiology Society in Ho Chi Minh City.
Being a radiologist in Myanmar requires an enormous amount of courage, determination and stamina. Radiologists work in tough conditions, frequently in single-handed practises serving hospitals with 500 or more beds. As a result, they can find themselves in a continuous on-call situation for radiological emergencies, often travelling to their hospitals in the evening and at the weekends. Imaging opportunities are limited with clinicians relying extensively on plain films, fluoroscopy and ultrasound to make the diagnosis. Currently, there are only 40 CT scanners and 19 MRI scanners in the whole of Myanmar, including some very old and basic pieces of equipment. It means experience of MRI in the country is currently very limited. Some radiologists have no experience at all and even the most experienced radiologists in the larger centres have had limited exposure to MRI technology.
Our project in Myanmar was intended to introduce the principles of MRI and explain how the images are obtained. We aimed to run through safety considerations and patient selection, as well as what information can be derived from the images. In addition, there were many small group workshops covering the musculoskeletal system, the brain, and abdominal organ imaging, with a view to both encouraging the delegates to ask questions and tackle cases for themselves in a nurturing environment. The delegates were receptive, eager to learn and full of enthusiasm and drive to embrace this new technology.
In Vietnam, the medical setup was far more advanced. Radiologists here work long hours, for up to six days a week – reporting up to 80 CT/MRIs per day. Reports are normally turned around within 90 minutes of image acquisition, and they have onerous on-call commitments. Demands on the radiologists are considerable.
Over 3,000 ultrasound examinations are performed every day at the University Medical Centre, where our MRI course was based. Many were same-day examinations for outpatients seen in clinic. Using 20 rooms and with lists starting at 7am, consultant radiologists scan between 150-180 patients per room each day, dictating directly to a secretary who types up the report immediately – resulting in a very impressive and timely service for patients. Due to the high volume of patients that Vietnamese radiologists serve and the lack of resources available, their research and continuous training activities are modest.
A rewarding and humbling experience
We have met some incredible people, and we have had shared experiences and a shared passion for radiology. It has been a rewarding and humbling experience and has left us with impressions that will last a lifetime. Experiencing radiology practice in another country has enabled us to reflect on how lucky we are in the UK to have had such rigorous and high-quality training and to be working in an environment where we enjoy tremendous professional freedoms, autonomy and working conditions.
It’s allowed us to develop a greater appreciation of our ability to incorporate areas such as research, audit, mentoring, teaching, training and governance activity into our everyday jobs. We are also lucky to have a world-renowned national Royal College to oversee training, maintain standards and provide guidance across the whole spectrum of our working practice.
Hopefully, this will represent the first of many collaborations between the UK and Vietnam in the field of radiology and we can continue to learn from each other. We also continue to hope that the political situation in Myanmar will improve enough for us to return once again in the future.
Applications for the 2023-25 International Travelling Fellowship are now open. Applications will close at midday on 2 March 2023.
MRI course, February 2023 – The first collaboration between the RCR and the Ho Chi Minh City University Medical Centre, Medical School and Society of Radiology.