International Services Opportunities?

[7summits]

Are there any international service opportunities for IR?

Plastics and ENT residents and attendings will travel to foreign countries to fix cleft palates and I’ve heard of other surgeons doing the same and removing goiters and masses, etc.

Anybody know of any opportunities to do something similar in IR? If not, any suggestions for how this might be possible? Obviously it’s a high tech field that requires specialized equipment…but IRs in general are creative and I’m interested to hear any ideas.

Thanks.

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[vent]

i have heard some programs of vein treatment (EVLT, RF, etc) in developing countries done by group of US professionals

 

[werewethere]

Are there any international service opportunities for IR?

Plastics and ENT residents and attendings will travel to foreign countries to fix cleft palates and I’ve heard of other surgeons doing the same and removing goiters and masses, etc.

Anybody know of any opportunities to do something similar in IR? If not, any suggestions for how this might be possible? Obviously it’s a high tech field that requires specialized equipment…but IRs in general are creative and I’m interested to hear any ideas.

Thanks.

First of all, there are numerous opportunities for foreign involvement in both interventional and diagnostic radiology. However, the opportunities are usually in a more organized setting that other traditional non-for-profit organizations provide. This is essentially due to technological requirements.

If you check out the ACR and SIR websites, there should be some information.

Regarding specific opportunities:

From the SIR last year in Tampa there were plenary sessions with speaks from the uniformed services regarding IR treatment of members of the military in Iraq and victims of the Tsunami in 2005. Additionally, one of the speakers spoke about the establishment of an IR section in a Kenyan city (not Nairobi or Mombasa, don't remember the actual name) and the challenges and effect of IR on the patients. For instance, the abilitly to use drainage catheters for patients who had large TB abscesses who would have not tolerated surgery.

There are setting in which combined IR/fluoro/US services may be used. For instance, a hospital in Tanzania at the base of Kilimanjaro offers opportunties for visiting radiologists to teach their residents and educate patients. Of course, there has been a strong DR effort in Haiti, particularly with ultrasound given the poor infrastructure. Don't know about IR in that setting.

If you are thinking of collaboration in training and research, IR is a strong field in many countries. CIRSE is the European version of SIR and has a vibrant meeting and many contributors. There are numerous areas of research interest that are strongly supported in Europe, such as vascular and hepatic ablative therapy research in Italy (not just RFA, but new ways of delivery sclerotherapeutics such as ethanol, NeuroIR in France, etc.

Of course, there is tremendous work being done in East Asia. For instance, screening programs for early detection and ablation of HCC in Japan and Korea, given their much lower rate of transplantation, treatment of gastric varices in cirrhotics using BRTO (see articles in Radiology about a year ago), and large scale pilot studies in China on a number of topics.

So, if you're looking for a way integrating a foreign component to a IR career, it's out there, you just need to look for it.

 

[davidjones]

So there was an article in the recent RSNA news which descibed a brazillian radiologist who basically stuck a mobile C-ARM onto a truck and went around and did UFEs in rural brazil. He did about 100 in a 6 month period (in a hospital setting with sterile environment etc.) and followed up these women who had >90% success rate and a tremendous increase in their quality of life.

I imagine that something like this could be accomplished almost anywhere and certainly in rural areas in north america. Now some of the things we treat may not be that prevalent in third world countries: PAD.

But certainly there is room to treat AVMs (particularly ones causing gross physical deformities), Fibroids, Venous disease; going to war zones with organizations like doctors without borders (or the military?) and doing embolizations for trauma also seems like a feasible idea. And certainly US guided things like abscess drains or even diagnostic US would find an application abroad.

It also doesn't have to be limited to IR, many overseas countries don't have a good radiology infrastructure and simply going there and training the local radiologists would be useful (to us and them, since they probably see things we've never even heard of).
And although breast cancer is not quite as prevalent in the third world (basing this on a statistic i read in 1999) setting up a breast screening program would also be quite beneficial to the local population and rewarding to us.

Gvataken do you know of anyone at SIR working on things like this?

 

[Gvataken]

Yes. Absolutely, this was a topic discussion of SIR meeting. There was an IR physician performing embolizations for the military . Dr. Agarwal from IU presented the great stuff he was doing with ultrasound etc in Kenya and this was very impressive. There is a growing need for IR training and IR procedures in developing nations.

The IR doc from Brazil presented his experience with mobile UFE at SIR a few years ago.

 

[DeadCactus]

First of all, there are numerous opportunities for foreign involvement in both interventional and diagnostic radiology. However, the opportunities are usually in a more organized setting that other traditional non-for-profit organizations provide. This is essentially due to technological requirements.

If you check out the ACR and SIR websites, there should be some information.

Regarding specific opportunities:

From the SIR last year in Tampa there were plenary sessions with speaks from the uniformed services regarding IR treatment of members of the military in Iraq and victims of the Tsunami in 2005. Additionally, one of the speakers spoke about the establishment of an IR section in a Kenyan city (not Nairobi or Mombasa, don't remember the actual name) and the challenges and effect of IR on the patients. For instance, the abilitly to use drainage catheters for patients who had large TB abscesses who would have not tolerated surgery.

There are setting in which combined IR/fluoro/US services may be used. For instance, a hospital in Tanzania at the base of Kilimanjaro offers opportunties for visiting radiologists to teach their residents and educate patients. Of course, there has been a strong DR effort in Haiti, particularly with ultrasound given the poor infrastructure. Don't know about IR in that setting.

If you are thinking of collaboration in training and research, IR is a strong field in many countries. CIRSE is the European version of SIR and has a vibrant meeting and many contributors. There are numerous areas of research interest that are strongly supported in Europe, such as vascular and hepatic ablative therapy research in Italy (not just RFA, but new ways of delivery sclerotherapeutics such as ethanol, NeuroIR in France, etc.

Of course, there is tremendous work being done in East Asia. For instance, screening programs for early detection and ablation of HCC in Japan and Korea, given their much lower rate of transplantation, treatment of gastric varices in cirrhotics using BRTO (see articles in Radiology about a year ago), and large scale pilot studies in China on a number of topics.

So, if you're looking for a way integrating a foreign component to a IR career, it's out there, you just need to look for it.

Any good journal articles or transcripts of talks on this subject? Particularly interested in reading about the role of IR in the military and emergency/trauma.

 

[Gvataken]

http://online.wsj.com/article/SB100...37930294.html?mod=WSJASIA_hpp_MIDDLEThirdNews



http://www.afcea.org/signal/articles/templates/Signal_Article_Template.asp?articleid=2652&zoneid=325

http://www.rsna.org/Publications/rsnanews/December-2010/afghanistan_feature.cfm


There were some inspiring stories at SIR and ISET meetings from some of the IR in military.