Learning never stops in globalized world of healthcare

Lifelong learning in an era of globalized healthcare science and practice is essential, according to Sunday's opening session of RSNA 2008, which also stressed the need for standardization in training and certification.

RSNA president Dr. Theresa McLoud noted that the concept of lifelong learning, named by the United Nations Educational, Scientific and Cultural Organization (UNESCO) as one of the key issues for the 21st century, also was adopted as one of four components of maintenance of certification by the American Board of Radiology.

To achieve worldwide standards of practice, McLoud cited the four elements necessary to accomplish this goal: consistent selection process, standardized curriculum, research training, and certification and maintenance of certification.

Referring to subspecialty training, she noted that 70% to 80% of U.S. radiology residents take fellowships as part of their educational process.

"All curricula should be adaptable to include cutting-edge technology such as molecular imaging," McLoud said. "In addition to all of the subspecialty areas, training should have a strong grounding in core areas, such as anatomy, pathology, and radiation protection."

To thrive in the new global environment, she stressed the need to focus particular attention on subspecialty training, noting that five to six years would be reasonable. A resident's clinical year should include subspecialty training, and McLoud suggested a revised training timeline of three years of core training, followed by two years of subspecialty education.

The ABR recently adopted a revised examination schedule that includes a core exam after three years, followed by a final certification test 15 months after diagnostic residency is completed. The image-rich, computer-based certification exam will include five modules, including three selected by the individual based on training or planned practice emphasis.

"[The changes] reflect the inevitable fact that very few radiologists in the U.S. are truly generalists and that subspecialization has become a reality," she said.

McLoud didn't think research could be forced but added that a scholarly project should be required as part of curriculum development.

"The key element is allowing trainees the time they need for research. That means building flexibility into the curriculum," she said.

Regarding global certification qualification standards, McLoud cited several components that should be considered, including national boards to oversee standardized examinations, a core exam that includes general and subspecialization knowledge, and a focused subspecialized exam.

A global standardized model also should be established for maintenance of certification, she said. This global approach to training and certification maintenance could be accomplished through a cooperative effort with international radiology societies.

"We need to resist the temptation to commoditize radiology education," McLoud said.

To succeed in the new global radiological marketplace, she stressed the need to rethink radiology's education and training programs.

"Our global interconnectedness brings with it the possibility of improved delivery of services, higher quality, and expanded access to radiology," McLoud said.