Elective Extravaganza: Radiology in Cape Town

Finally I’ve found another victim amazing participant for Elective Extravaganza. Today I talk to Mari Gildenhuys, a fifth year medical student at Stellenbosch University. She did her fourth year elective in Radiology and had a fabulous time. Radiology has always been daunting to me, as you might have noticed in some of my previous posts. Here’s her take!

Before your elective, what was your experience with Radiology in Medical School?

We have a one-week Radiology rotation in our curriculum, but I haven’t rotated through it yet. So basically I had no experience, just semi-formal training in a busy trauma unit with regards to the “lines” of the cervical x-ray and some x-rays shown to us in class.

Why did you decide to do Radiology for your elective?

Mari (right) – Image provided

I am pretty happy with the current scope of our curriculum. In all areas I felt that training and exposure would be sufficient, except for Radiology. I wanted to use my elective to gain a skill that would help me in the future. I also considered Neurology as I found the whole subject daunting, but decided that I will never again have a chance to spend a month with a professional Radiologist to develop my skills in reading plain film, MRI, Ultrasound and so on.

Was it difficult to organise a site and supervisor for this elective? Do you have any advice in this regard for students planning to do radiology as an elective?

Not at all. The elective liaison at campus told me about my external supervisor as previous students also did their elective with her, and she was so helpful and friendly. Luckily the medical school agreed that I could do my elective at our home-base hospital, as they normally want you to “spread your wings” and use another hospital.

I contacted the radiologist, she agreed to be my external supervisor and I then had to send an email to the Radiology department formally requesting to be an elective student. They had a meeting and my application was accepted.

My advice? Always be professional when communicating verbally and via email. When you go to meet a possible supervisor, dress neatly. I had to check up on the format of a formal email but was glad I did!

Which skills and knowledge did you gain through this elective? Was the elective enjoyable, and which aspects of it were the most enjoyable?

It was one of the best months of medical school for me.

I rotated a week in plain film, which helped me spot the variants of common pathology (TB, Lung Cancer, Pneumothorax) as well as the variants of normal. I studied all matter of plain films, from chest to toe! This was by far the best skill to gain and practise, as I will use the knowledge in future.

I also rotated a week in Ultrasound, and – wow!- it helped a LOT. Before, U/S was just black and white shadows on a screen. Now I can identify which organ system we are looking at. I realised you just need the practice and it becomes clear.

My other two week were split into interventional theater (very interesting!!), Mammography, MRI and CT interpretation.

My best moment: on the second-last day the professor quizzed me in the meeting on an x-ray.

PROF: What do you see on this x-ray?

ME: The sail sign.

PROF: Yes! And what is the sail sign?

ME: We can see the posterior fat pad.

He was impressed and then asked me, “So – what is you diagnosis?”

My answer (insert thinking pause here), “There is a problem”.

Chuckles followed. PROF: “Correct!!! That’s all you need to know!”)

And that kinda sums up why I did Radiology. You learn to see the serious things that you cannot handle yourself.

For which kind of medical student would you recommend an elective in Radiology?

For anyone who feels their knowledge or confidence with regards to interpretation of imaging is lacking. Unfortunately patient contact is limited, so best avoid it if you are the type of person that craves patient interaction. I missed it but found that the sheer intellectual conversations with regards to disease processes, anatomy and possible diagnosis was a nice change.

Do you think a sound knowledge of radiology is important for a future general practitioner, or only for certain prospective specialists? Which aspects of radiology do you think need more emphasis in our medical training?

I think as a GP you MUST be able to diagnose common pathology in your local hospital ER. You will need to be able to at least identify that there is a pneumonia, possible cancer, problem with a soft tissue component or a bleed in a place where there shouldn’t be. Common head injuries and the patterns they cause on CT will be very important when you are working on an MVA case in trauma.

The nice thing is – I realised what NORMAL looks like. From there it is easier to say, “I don’t know what the problem is, but I need to refer this.”

You did your elective at your medical school, while many students see it as an opportunity to get as far away as possible. What was your rationale behind the move, and are you glad you did it that way?

Our training Hospital is a tertiary Hospital, and all sorts of random, wonderful and weird cases gather here. I was afraid that in a private hospital I might not see as many developed pathologies as I could see here. I call it “tertiary pathology”. We certainly did see amazing things; things I’m sure a private or a secondary public hospital could not have offered me.

And: I live on campus, so why sit in traffic every morning? I just rolled out of bed 🙂 no petrol fees!

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