getting the interest of students in the specialty: promoting nm in the undergraduate curriculum and...
TRANSCRIPT
Getting the interest of students in the
specialty:Promoting NM in the
undergraduate curriculum and clinical
rotationsAnnare Ellmann
Nuclear MedicineStellenbosch University and Tygerberg Hospital
Introduction
NM teaching and training
Traditionally postgraduate
Linked to / separate from Radiology
Why undergraduate teaching in NM
Students of today are clinical colleagues
of tomorrow
Create awareness of NM
Questions about cost
Most training institutions under stringent financial control
Cost must be weighed in terms of marginal and opportunity cost *
* Smith et al. Invest Radiol 1994; 29:856-858
Questions about cost
Most training institutions under stringent financial control
Cost must be weighed in terms of marginal and opportunity cost *
How will doctors be able to refer if they know nothing about the specialty?
= long term investment
* Smith et al. Invest Radiol 1994; 29:856-858
Undergraduate teaching: International perspectives
Information through questionnaires and university web pages (181 colleagues, 162 departments)
Report included 86 departments (77 from Europe)
Results: Average length of NM curriculum Independent course: 25.4 hrs Integrated into Radiology / Radiation Oncology:
15.5 hrs Integrated into clinical modules: 8.1 hrs
Lass et al. Eur J Nucl Med Mol Imaging 2003; 30:1018-1023
Undergraduate teaching: International perspectives
Variations in: Length of NM curriculum
0 – 62 hrs Form of NM teaching
Integrated into other modules Independent Optional
Lass et al. Eur J Nuc Med Mol Imaging 2003; 30:1018-1023
Problems of undergraduate curriculum
Overcrowded / overloaded
Serious problem with information overload
Ell (editorial). Eur J Nucl Med 1997;24:1081-1082
Problems of undergraduate curriculum
Overcrowded / overloaded
Serious problem with information overload
What is important to be included?
Ell (editorial). Eur J Nucl Med 1997;24:1081-1082
NM teaching in South Africa
Postgraduate specialist qualification MMed or FCNP Four year study period
MSc in Medical Sciences (Nuc Med) Two year study period Includes research component Also for scientists / radiopharmacists Not offered by all universities
Status of undergraduate NM teaching and training at Stellenbosch University
Lectures during theoretical blocks 8 hrs
Middle Clinical Rotations 8 hrs
Rotating through NM in elective block 2-4 wks
Status of undergraduate NM teaching and training at Stellenbosch University
Lectures during theoretical blocksCardiovascularRespiratoryEndocrine (thyroid and other)Genito-urinaryNeurologyOrthopedicsInfection and inflammation
Status of undergraduate NM teaching and training at Stellenbosch University
Middle Clinical RotationsSmall group rotations (±20 students)During 4th and first 6 months of 5th year of studyInclude internal med, surgery, pediatrics, family
medicine, pathology, etc.Length of rotations varyRadiation and Imaging: one week, ±5 studentsRadiology, Radiation Oncology: 2 days eachNuclear Medicine: 1 day
Status of undergraduate NM teaching and training at Stellenbosch University
Nuclear Medicine RotationAttend:
Thyroid scanning and clinic, including administration of RAI for hyperthyroidism
Stress study and reporting myocardial perfusion imaging
General NM, e.g. skeletal scintigraphy Case discussion session
Evaluation: Pre- and post-test
Status of undergraduate NM teaching and training at Stellenbosch University
Evaluation: Pre- and post-testPre-test questions covering
Radiation physics taught in first year Physiology and pathophysiology
relevant to NM Knowledge acquired in lectures during
theoretical rotationsPost-test
Testing knowledge acquired during day rotation in NM
Status of undergraduate NM teaching and training at Stellenbosch University
Radiation and Imaging consider to addCase studies to integrate role of different
modalities in evaluation of patientStudents need to “follow” patient to various
areas, discuss potential imaging option with relevant staff
Write report on the management of the patient E.g. patient presenting with PUO, student
should consider role of NM infection imaging, CT/MR, etc.
Status of undergraduate NM teaching and training at Stellenbosch University
Elective moduleOne month in either 4th or 5th yearStudent can choose activitySome have chosen NMProgramme worked out according to
student’s interestsEmphasis on pathophysiology Will include thyroid module
Student feedback
Generally positive
Odd negative remarks Too much packed into too short time Too much testing Need more time in Radiology – take from
NM
Status in remainder of South Africa
Large variation in what is offered on undergraduate level
Some institutions virtually nothing, others extensive exposure
Perceptions from private NM specialists
Greater awareness of what NM has to offer amongst US students
Less difficult to market services in drainage areas of US graduates
Referring physicians trained at US refer more readily to NM
Conclusions
Need to create awareness of NM services at undergraduate level
Should be discussed on international level
International guidelines will assist local NM departments to negotiate with authorities / curriculum developers to include NM in undergraduate curriculum
