"The Amazon was huge, awesome, powerful and absolutely fascinating," said Erik K. Paulson, M.D., vice-chair of clinical services and chief of the Abdominal Imaging Division in the Department of Radiology at Duke University Medical Center in Durham, N.C. "We realized that despite the cultural and language differences, the Brazilian radiologists have the same thirst for knowledge and zeal for life that we have." Dr. Paulson was one of three doctors who traveled to Brazil as part of RSNA's International Visiting Professor (IVP) Program, which annually sends teams of North American professors to lecture at national radiology society meetings and meet with radiology residency training programs at selected host institutions in developing nations. The trip was hosted by the Brazilian College of Radiology and Diagnostic Imaging. The Amazon excursion was the last stop on the two-week trip devoted to educating Brazilian radiologists and assessing the state of healthcare in a country facing challenges much different than the U.S. "Infectious diseases such as TB and the waterborne infection schistosomiasis are common in Brazil," Dr. Paulson said. "There's a different spectrum of diseases than we're accustomed to seeing in the U.S."
The trip began at the Brazilian Congress of Radiology National Meeting in Rio de Janeiro, where each team member gave several lectures. Translators were provided for the Brazilian audience. "The highlight of our time in Rio was a tour of the city, which included all of its famous sites and was delightful," Dr. Paulson said. Next, the team traveled to Clinica da Imagem de Goiania in central Brazil, where the physicians presented lectures and case conferences to a group of residents and attending radiologists from the area. Along with the chance to meet colleagues from other institutions, the experience offered a wonderful opportunity to present MR cases to radiology staff at the clinic, which are not widely available, according to team member Donna Blankenbaker, M.D., an associate professor of musculoskeletal imaging in the Department of Radiology at the University of Wisconsin in Madison. "The best part was getting to know the residents and spending time on a personal level and discussing radiology training," Dr. Blankenbaker said.
The team's tour of government and public hospitals in Goiania revealed a huge discrepancy in the quality of care for the insured versus the non-insured. Staffed primarily by radiology residents, the public hospital was significantly underfunded compared to the private facility, according to team members. "The private clinics generally have imaging equipment very similar to that in the U.S., while government hospitals have considerably fewer resources," according to team member Robert Hurst, M.D., director of interventional neuroradiology at the Hospital of the University of Pennsylvania in Philadelphia. For example, there is no public health system for managing chronic disease in Brazil, he said. In terms of radiology, Brazil's public hospitals offer general radiology and limited access to CT scanners but not MR imaging, which is done in private hospitals, Dr. Blankenbaker said. "The technology offered in private imaging hospitals is great—similar to what we have in the U.S.," Dr. Blankenbaker said. "They are right up to date." The last stop was Belem, at the mouth of the Amazon River, where the team visited a private imaging clinic, Clinica Lobo, where team members conducted two days of talks for trainees and practicing radiologists and visited Belam's government hospital, assessing the facility's resources. "We were able to fly over the area around Belem in a small plane piloted by a local radiologist to get an idea of the geography and some of the challenges involved with providing medical care to areas outside of cities that make up the majority of the country but are quite isolated," Dr. Hurst said.
Despite the exotic locale, team members agree the highlight of the trip was interacting with radiology residents and attending physicians in Goiania and Belem. "The Brazilians were hungry for our teaching material and were interested in all aspects of American radiology and culture," Dr. Paulson said. "Likewise, we were very interested in Brazilian practice patterns, expectations and culture. The trip was extremely successful as a cultural and educational exchange." The programs and lectures were "very well received at each location we visited," according to Dr. Hurst, adding, "I would be happy to return to Brazil or other countries with similar programs." "I would definitely go back if I ever had the opportunity," Dr. Blankenbaker concurred. In addition to Brazil, 2010 IVP teams traveled to Mexico, the Philippines and Thailand. In 2011, IVP teams will travel to Lithuania, Malaysia, Myanmar and Mexico. Other recent trips have included Estonia, China, Nigeria and Vietnam.
For more information on the RSNA International Visiting Professor Program, go to RSNA.org/international/CIRE/ivpp.cfm.
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