Getting the interest of students in the specialty: Promoting NM in the undergraduate curriculum and...

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

Lectures during theoretical blocksCardiovascularRespiratoryEndocrine (thyroid and other)Genito-urinaryNeurologyOrthopedicsInfection and inflammation

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

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

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

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.

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

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

Getting the interest of students in the specialty: Promoting NM in the undergraduate curriculum and...

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