Having worked as a radiologist at the recent Commonwealth Games, I would like to tell you my thoughts – both good and bad – on volunteering for such an event.
A fantastic learning opportunity
If you are interested in sports imaging, this is one of the few opportunities you may have of examining athletes of all disciplines very early after their injury. This can sometimes make things more challenging. You will not see a muscle tear using ultrasound within the first few hours, as fresh blood has a similar echogenicity to muscle, but it will be clearly seen on immediate MRI. The day after the injury, the MRI becomes very hard to interpret as everything in the limb becomes oedematous. At this stage, ultrasound becomes the more useful diagnostic tool if you do not want to over-grade the injury.
This is an opportunity to see unusual injuries and to be able to use any technique you want to without the restrictions of normal practice in the NHS, when injuries are most often several weeks to months old when imaged. As a young consultant, you will see injury patterns that you may only have read about in books. Even the older radiologists among us had not knowingly seen a subclavius muscle tear before.
In a Games polyclinic, you work alongside other consultants and specialists so you can review each other’s images and discuss the image findings, improving the quality of reporting. Camaraderie is quickly established, and you make new friends from different disciplines. You also have the opportunity to discuss cases first-hand with the clinical team. This can help with the overall management of the patient and is a superb teaching and learning environment. Decisions must be made whether the athlete is fit to compete, needs to modify their activity or must stop competing immediately.
As a registrar in radiology, it is an invaluable experience, as you see lots of injuries in a short space of time and build connections with other radiologists and clinical professionals that will be useful in later life.
What are the downsides?
While this was a great experience, as with many volunteering opportunities, there will invariably be downsides. I feel it’s important to make people aware of these.
The organisation of the polyclinic could have been improved. For example, equipment was only installed the day before it was opened and therefore took several days to establish processes that could be used to obtain images, write reports and have a way of communicating reports. The MRI installations were a long way from the reporting hub so there was a lot of wasted time walking between areas. The day-to-day organisers in the polyclinics worked very hard but were sometimes let down at the last minute by supplies being unavailable.
Logging patients on to the systems before scanning was only possible in the main reporting area, meaning radiologists undertook multiple administrative tasks before completing the report. We then copied this to a second computer, as the picture archiving and communication system (PACS) and patient records did not talk to one another.
If you are hoping to collect interesting images for your collection, teaching or publication, unfortunately this is frowned upon! I would argue that this does not make the most of information gained from these events. The fact that you cannot see a muscle tear with ultrasound, however big, within the first few hours of injury, was first noticed at the Commonwealth Games in 2002. Anonymised images should be able to be used to teach the next generation of radiologists.
The radiologists working will have done so at substantial financial penalty. Most will have taken annual leave to be part of the event. Others will have lost money in private practice earnings. All will have had to pay for travel and accommodation, as none of this was reimbursed. Due to these penalties, fewer professionals will have offered their help and therefore, the shifts became more onerous for those that did volunteer.
There were small carrots along the way, such as a free lunch. However, in the Commonwealth Games 2002 we were allowed to visit one venue for an afternoon to soak up the real reason for working for the Games. This did not occur at either the Olympics or the latest Commonwealth Games. It would be a lovely gesture if this were to be reintroduced. It would likely encourage more clinicians to sign up as volunteers, too.
Closing thoughts
So young radiologists – is it worth volunteering for such an event? For the experience, absolutely yes. You will learn first-hand things you would never otherwise see outside of a textbook, and you will make wonderful connections. However, for the cost to yourself financially – no! Volunteering involves sacrificing both your time and, sometimes, your money and young radiologists especially should bear this in mind.
Some will gain solace from the pride of being part of the Games. Perhaps the kudos from patient admiration will go some way to recompense.
Perhaps all professionals should be paid for these events. This of course might change the motivation and camaraderie, so perhaps free tickets to attend some events would go a little way to show a higher level of appreciation for such a skilled workforce.
Professor Gina Allen
Consultant Musculoskeletal Radiologist and Director, St Luke’s Radiology, Oxford