Training programs move toward harmonization

Europe is debating the acceptance of a common legal framework, a single constitution, for all European nations. This is a challenge, as was the free circulation treaty and the introduction of the euro as a common currency. Through alternating moments of shake-up and tranquillity, Europe is advancing in stages toward unification.

A wave of harmonization is suffusing entire national and international structures and organizations of our sometimes ankylosed continent. Will we radiologists also be capable of constructing a common framework for such basics as training, professional career paths, and continuous education and accreditation?

The European Association of Radiology executive committee has charged the education committee, together with the Professional Organisation Committee-Union of Medical Specialists, to prepare a basic program for residents in training, common for all European centers.

Gathering information has been a fundamental step, accomplished by surveys, to learn firsthand the situation of different training programs across Europe. A visiting program of teaching centers has allowed assessment in situ of the specific development of each training syllabus in a broad group of European hospitals.

Together with representatives of several nations, the education board has developed a draft of the proposed training program, which was presented during the European Congress of Radiology session, Harmonization of training programs: myth or reality? The session was part of the Challenges for European radiology presentation coordinated by Prof. P.A. Grenier, chair of the European Association of Radiology education board. It addressed several questions: What type of radiologists will have to be trained? What are society's needs?

The profile of the specialist has long been "clinical radiologists actively involved in the diagnostic and therapeutic process of the patients." Although the data are still not clear, about 65% to 70% of European radiologists define themselves as general radiologists, perhaps specializing in two or three areas of knowledge. About 30% to 35% are sub- or superspecialized radiologists in one or two areas such as neuroradiology.

The training program should accommodate both possibilities, which are in no way opposed but are essential for harmonious development of the specialty, well-balanced operation of departments, and the ability to answer the needs of society. The general radiologists attend to important and difficult duties by solving the diagnostic or therapeutic guidance problems of patients and by teaching students and residents. The superspecialists have the responsibility of being the best in their field. They must be knowledgeable about patients' specific problems; capable of innovation and research in new, diagnostic, and therapeutic applications; and able to expand the confines of the specialty.

Few disciplines in current medicine are as innovative as interventional radiology, for example. Ongoing research in the development of new image-guided percutaneous tools, the basis of interventional radiology, will continue to open new therapeutic horizons.

We European radiologists have an interesting challenge ahead of us. We must discover how to harmonize the training peculiarities of each country and the characteristics of superspecialization. We should be aware of the challenges the new administrative structures pose and be ready not only to adapt but to move ahead in this always-changing scenario of high-quality medicine.

Prof. Bilbao is director of radiology at the Clinical University of Navarra, Spain.