Journal of Postgraduate Medicine Education

Medicine is an ever changing discipline.

One field that continues to change the face of clinical practice, and throw up new challenges is that of radiology.

The body no longer hides it’s secrets beneath skin that requires a surgeon’s skills to open up and explore, but can be encouraged to give them up through the various modalities of imaging that have been developed over the past few decades.

I remember the importance of imaging from my days as a house officer – being instructed to go and ‘lie in the scanner until they agree to do the CT’
Although perhaps I should reflect on my centrality to the team if I could be dispensed for long periods of time essentially obstructing other people’s work…

The role of radiologist has changed over time too – from gatekeeper to service provider in the eyes of one US-based specialist. The close working relationship I have with my radiology colleagues, and my adventures into the world of imaging with my portable ultrasound remind me on a regular basis the pivotal role imaging plays in the work I do.

But, the advances of radiology throw up new challenges…

Incidental findings are both the blessing and the curse of anyone involved in the requesting, interpretation and communication of scan findings. The report which lands in one’s inbox with just the reassuring answer one was looking for, only to have another three or four lines highlighting a completely unforseen abnormality is the start of a challenging clinical problem. The issue tends to be outwith the usual scope of the clinical practice of the requester, and therefore usually requires the invovlement of another team to assist or advise on the next steps to further investigate, to a satisfactory conclusion for patient and clinician.

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