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Gaida KrūmiņaHead of Department of Radiology Riga Stradins University,Chief Radiologist of Latvian Ministry of Health
Baltic Congress of Radiology, October 8, 2010
Clinical diagnostic
Education
Research
• Investigations• Consultations, tutorials, interdisciplinary conferences
•Outpatient and out‐clinic councils
•Undergraduate• Postgraduate training•Doctoral programs• Continuing professional development
• Exchange programs for fellowship
•Undergraduate• Postgraduate•Doctoral• Projects of Latvian Academy of Science
• International grants
Baltic Congress of Radiology, October 8, 2010
Advantages
Multi profile hospital
Intensive patient’s flow
Concentration of advanced technologies
Academic team
Work in interdisciplinary command
Baltic Congress of Radiology, October 8, 2010
NeuroHead and neckChestBreastCardiovascularAbdominalGenitourinaryMusculoskeletalPediatricInterventionalEmergency radiology
Baltic Congress of Radiology, October 8, 2010
Prescription
Choice of protocol
Investigation
Imaging description
and preliminaryconclusion
Exchange of viewpoint
with clinicists
Consensus
Baltic Congress of Radiology, October 8, 2010
Doctors are ordering too many unnecessary imaging tests, raising the cost of healthcare and exposing patients to excess amounts of radiation
Some imaging procedures are not justified
Medical physicists, radiologists, radiation oncologists and educators have to identify and eliminate unnecessary imaging tests
Baltic Congress of Radiology, October 8, 2010
Payment mechanisms and financial incentives in the health care system
Practice behavior of referring physicians; self‐referral, including referral for additional radiologic examinations
Defensive medicine: doctors who order tests to protect against potential lawsuits
Missed educational opportunities when inappropriate procedures are requested
Patient expectations
Duplicate imaging studies
Baltic Congress of Radiology, October 8, 2010
Development of evidence‐based appropriateness criteria for imagingGreater use of practice guidelines in requesting and conducting imaging studies Better communication among doctors: non radiologists and radiologistsProviding physicians with decision‐making technologyEducation of referring physicians, patients, and the public
Baltic Congress of Radiology, October 8, 2010
HendeeWR at al, Radiology, Aug, 2010RSNA 2010
Common conception and quality standardsElaboration of optimal investigation algorithms, protocols, guidelines, its testing and implementationPrevention of duplication and unnecessary imaging testsImplementation of united PACSUnified planning of change or purchasing of new high technologiesPET/CT
Baltic Congress of Radiology, October 8, 2010
Education
Teachers
CPD
Courses
Congresses
Visiting scholarship
Publications Lectures
Expertises
Students
Undergraduate Postgraduate Doctoral CME
Baltic Congress of Radiology, October 8, 2010
Department of Radiology Riga Stradins university:ProfessorAssociated professor4 assistants24 invited teachers ‐ qualified, experienced radiologists with good teaching skills covering all main branches of diagnostic and therapeutic radiology
Baltic Congress of Radiology, October 8, 2010
Teaching program Medicine ‐ 6 years: preclinical phase 2 years, clinical phases 4 yearsRadiology: formal curriculum ‐ 3rd, 4th year, elective course‐ 5th yearYearly number of students 300‐360Classic teaching type: independent discipline with own examE‐ learning: special software produced by RSULecture and hands‐out topics: radiological anatomy, radiological techniques, radiation protection, radiology of diseases, interventional radiology, appropriateness criteria Teaching stuff: dedicated teachers, general radiologists, sub‐specialized radiologists, radiology traineesRadiological department, team meetings visiting Exam: orally and writing multiple choice testIndependent scientific work
Baltic Congress of Radiology, October 8, 2010
ESR Education Committee and ESR Working Group on Undergraduate TeachingStock of present state : survey on teaching
Integrated program throughout Europe – well timed, necessary stepUnified guidelinesSupport of teaching process from ESR: internet‐based exercises, teaching files on CDs, unified multiple choice control test samples
Baltic Congress of Radiology, October 8, 2010
Requirements of European Training Charter for Medical specialists in the EU (UEMS), specialty of general radiologyCertified as medical doctorCompetitive interviewLength of training 4 yearsObligatory formal teaching: lectures, seminars, multi choice tests, logbooks, independent clinical research work in the 2nd, 3rd, and 4th yearFirst year trainees: basic sciences, radiation biology, protection, anatomy, techniques; theoretical test , practical exam in conventional radiologyOn call responsibilities from the 2nd yearModular rotations: system basedClinically orientated diploma work and final written national exam
Baltic Congress of Radiology, October 8, 2010
Acceptation in the university doctoral program
Detailed annotation of the work, foreruns, publications, etc.Successful competitive interview
6 doctoral, 5 post doctoral students in radiology
Growing tendency of interdisciplinary promotion work themes: stomatology and radiology, orthopedic surgery and radiology, internal medicine and radiology, oncology and radiology, genitourinary, abdominal surgery and radiology
Baltic Congress of Radiology, October 8, 2010
ESR and UEMS guidelines: CME/CDP should ideally be organized by a single professional body and preferably the same professional body responsible for postgraduate training, as, from an organizational perspective, these areas are mutually supportive
CME – educational branch in Department of Radiology RSU10‐14 courses at basic and advanced levelsAdvanced spring course for foreign radiologists “CT and MRI of the Head, Spine, Joints, Chest, and Abdomen”Utilized credit points approved from national professional authoritiesProfessors ‐ lecturers at courses organized by ESR: postgraduate training programs during ECR, ERASMUS course etc.
Baltic Congress of Radiology, October 8, 2010
Knowledge of basic elements of scientific methods and evidence base, including statistics is critical for assessment and understanding of published papers and promotion of personal research
Undergraduate level. 5th and 6th year students ‐ participation in clinical research trials or an independent scientific studyPost graduate training. Elaboration and presentation of an independent clinically orientated study at the 2nd, 3rd and 4th year is mandatoryDoctoral themes are a part of the general university research directions, national and international scientific projects headed and supervised by academic staff
Baltic Congress of Radiology, October 8, 2010
Functional MRI in follow‐up of glial tumors
Baltic Congress of Radiology, October 8, 2010
Doctoral work, author Dr. Anvita BiezāSupervisor Prof. Gaida Krūmiņa
Brain perfusion disposition in acute stroke with known atherosclerosis
Baltic Congress of Radiology, October 8, 2010
Doctoral work, author Dr. Maija RadziņaSupervisor Prof. Gaida Krūmiņa
Aorta remodelation after endoluminal aortic aneurysm repair using sac anchoring endoprosthesis
Baltic Congress of Radiology, October 8, 2010
Pre treatment
Post treatment
Doctoral work, author Dr. Jānis ŠavlovskisSupervisors Asoc. Prof. Dainis Krieviņš, Asoc. Prof. Igors AksiksConsultant Dr. Med. Kārlis Kupčs
Brain ageing and early cognitive disturbances
Baltic Congress of Radiology, October 8, 2010
National project of the LatvianAcademy of Science “Humanity ageing”Head and coordinator Prof. G.Krūmiņa
CSF flow patterns in patients with hydrocephalus and Chiari I malformation
Baltic Congress of Radiology, October 8, 2010
Doctoral work, author Dr.Med. Henrijs OzoliņšSupervisor Prof. Gaida Krūmiņa
Stereotactic body radiotherapy in the treatment of liver cancer
Baltic Congress of Radiology, October 8, 2010
National project of the Latvian Center of Oncology Riga East Clinical University hospital Head and coordinator Dr. Med. Olga Utehina
Transrectal US in prostate cancer detection
Baltic Congress of Radiology, October 8, 2010
B‐mode USPower DopplerUS
Contrast‐enhanced US
Doctoral work, author Dr. Arta StrazdiņaSupervisor Prof. Gaida Krūmiņa
Influence of liver fibrosis and steatosis to hepatic vein blood flow in patients with chronic virus hepatitis C
Baltic Congress of Radiology, October 8, 2010
Initial fibrosis Severe fibrosisDoctoral work, author Dr. Pēteris PriedītisSupervisors Prof. Gaida Krūmiņa, Prof. Ludmila Vīksna
MRI in myelodysplastic syndrome, aplastic anemia and evaluation of autologous allogeneic transplantation results
Baltic Congress of Radiology, October 8, 2010
Doctoral work, author Dr. Anita Jansone‐LaizāneSupervisors Asoc. Prof. Ardis Platkājis, Prof. Sandra Lejniece
Before treatment After treatment
TMJ morphology in patients with severe dentofacial anomalies
Dimensional morphology of masticator muscles in patients with skeletal malocclusions
Baltic Congress of Radiology, October 8, 2010
Doctoral work, author Dr. Zane KrišjāneSupervisors Prof. Ilga Urtāne, Prof. Gaida Krūmiņa Doctoral work, author Dr. Katrīna Zepa
Supervisors Prof. Ilga Urtāne, Prof. Gaida Krūmiņa
Radiological analysis of risk factors in recurrent hip dislocation after primary total hip replacement
Baltic Congress of Radiology, October 8, 2010
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Doctoral work, author Dr. Pēteris LīkumsSupervisors Prof. Gaida Krūmiņa, Dr.Med. Pēteris Studers
Education
InnovationResearch
Baltic Congress of Radiology, October 8, 2010