Building Malawi's MRI Future: A Four-Year Curriculum to Train the Country's Next Radiologists
Remote readouts and case-based learning accelerate MRI expertise as access grows
As MRI capacity expands in Malawi, a southeastern African nation, radiology educators are working to ensure the workforce can use the technology safely and effectively.
A new four-year MRI training curriculum, developed through an educational partnership between Radiology-Aid (RAD-AID) Malawi and Malawi’s newly formed radiology residency program, was created to help residents gain MRI experience ahead of planned scanner installations.
RAD-AID is a nonprofit organization dedicated to improving medical imaging and radiology services in underserved regions worldwide.
“When I began developing the curriculum, there was already a plan in place to install three to five MRI scanners in Malawi, with one already actively being installed,” said Katrina McGinty, MD, a radiologist with Mecklenburg Radiology Associates in Charlotte, NC.
Dr. McGinty received a 2024-2025 RSNA R&E Foundation Education Project Award while on faculty at the University of North Carolina (UNC) at Chapel Hill and has continued her work with RAD-AID in her current role.
“The residents in Malawi had limited MRI experience, and the goal was to allow them to have hands-on experience protocoling, reading and troubleshooting MRI prior to MRI installation so that they would be prepared as this equipment was beginning to be deployed in country,” Dr. McGinty said.
MRI access across Malawi had been limited and image quality inconsistent. “Although RAD-AID had been mobilizing technologist-focused training, the newly appointed diagnostic radiology residents in Malawi had limited opportunities to learn MRI acquisition and interpretation,” she said.
A Progressive, Case-Based Curriculum Built for Practice
The curriculum is built around real MRI cases that residents work through from start to finish. They review sequences, draft reports and receive structured feedback.
“The objective was a progressive curriculum, starting with faculty driven cases and progressing to resident driven cases that they uploaded for consultation,” Dr. McGinty said.
Dr. McGinty developed the curriculum with collaborators that included radiologists from UNC and a group of radiology colleagues in Amsterdam.
To match the realities of residency schedules, modules were timed to coincide with the Malawian residents’ clinical rotations. “I coordinated with residency directors, Dr. Karen Chetcuti and later, Dr. Ankit Bansal, to align the modules with the planned resident curriculum,” Dr. McGinty said. “We recruited subspecialty faculty to teach in their areas of expertise. This included both academic and private practice radiologists, from domestic and international institutions in a true global team effort.”
The curriculum is organized into approximately 10-week subspecialty blocks, with each week focused on a theme or pathologic subgroup. In an abdominal MRI block, for example, Dr. McGinty noted that early sessions emphasize normal anatomy, sequence recognition, artifacts and common quality pitfalls before moving into benign and malignant hepatic lesions.
“Residents interpret complete, multi-sequence cases and draft reports that are submitted for review, scoring and feedback,” she explained. “Each module also includes pre- and post-tests, paired with learner evaluations, to measure knowledge gains and refine the approach.”
Early results suggest the model is meeting a real need. “Resident feedback was also very positive, especially when sessions were led by instructors with whom trainees had already built relationships,” Dr. McGinty said. “Over time, the teaching team also observed marked improvement in report accuracy during remote consultations.”
As a consultant, Dr. McGinty said understanding constraints on imaging in the country was essential. “IV contrast is often not available and sedation in the MRI scanner is challenging, limiting imaging on pediatric or claustrophobic patients,” she said.
Follow-up options are limited. “I have had to adapt my own practice and recommendations—and sometime be quite creative—to remain relevant and helpful when providing consultation,” she said.
As the program scaled and resident schedules diversified, the team shifted from a more rigid module cadence to more regular remote readouts. Readouts now run regularly along subspecialty lines, led by remote faculty.
From Imported Cases to Local Ownership
A defining feature of the curriculum is its glide path toward local ownership. Residents are recording case logs and building case libraries in their PACS accounts, laying the groundwork for a repository that reflects the pathology they see every day.
As the project evolves, Dr. McGinty is also planning in-country work to support quality monitoring and improvement for newly installed scanners, including strengthening MRI quality assurance and quality improvement processes at Queen Elizabeth Central Hospital.
With Malawi’s first class of radiology residents graduating, the partnership is also looking beyond residency. “We have discussed having ongoing consultation sessions, even as the residents leave training, to provide mentorship and support for challenging issues with MRI, including cases, protocoling and quality, among others,” Dr. McGinty said.
Karen Chetcuti, MD, FRCR, and Katrina McGinty, MD.
Grant Support That Enabled Connection and Capacity
Dr. McGinty said the RSNA R&E Foundation grant was helpful in allowing small but invaluable infrastructure purchases to assist with teleconferencing, as well as in-person travel to facilitate ongoing relationships.
“Although so much can be accomplished virtually, having these periodic face-to-face interactions is essential for relationship building and bidirectional longitudinal growth,” she said. “This structure of synchronous reviews of cases, supplemented by independent asynchronous study review and periodic in-person visits is a model that I have found to be very successful.”
Emphasizing the need for strong longitudinal relationships in global radiology, Dr. McGinty said it’s also important for radiologists to be adaptable. “Changing from our initial more rigid structure to a more fluid review and readout was necessary, and there continues to be strong bidirectional learning.”
That flexibility has been central to the Malawi partnership, which evolved from a more structured module sequence to regular subspecialty readouts as training needs and schedules changed.
Looking ahead, Dr. McGinty sees Malawi’s expanding MRI and radiologist capacity as a turning point. Three residents are graduating, and Dr. McGinty said the pipeline of new residents is strong.
“Graduating the first-ever Malawian radiology class is a landmark I thought I would never see when I started my global health work,” she said. “To see well-trained, enthusiastic residents, trained in-country, start to build our profession and train future generations is something I’m proud to have been part of.”
For More Information
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