Dear MARNMP members,

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October 2018 marks the tenth anniversary since the beginning of post graduate training in Radiology in Malta. It's a good opportunity to look back and reflect.

 

What have we achieved in the past ten years? What does the future hold for radiology training in Malta?

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Ten years ago the Maltese health department embarked on a very ambitious project, ie that of establishing post graduate training programs in the various specialties. Until then, all doctors who wanted to specialize had to leave the island and do all their specialty training abroad. Positions of national postgraduate training coordinators (program directors) were issued and the specialty associations were invited to formalize training curricula and training documents.

This happened more or less a year after we moved from Saint Luke's Hospital to Mater Dei Hospital.

In October 2008 we took our first group of 5 radiology trainees. The curriculum was based on that of the British Royal College of Radiologists. The FRCR exam was incorporated as the formal, mandatory examination. General radiology training would be undertaken entirely at Mater Dei Hospital, the national hospital of the Maltese islands and post FRCR subspecialty training would be held at a centre of excellence abroad. At the beginning we had more questions than answers; more uncertainties than reassurances.
Since those early days, we have never looked back. With an intake of four or five trainees every two years we have kept a steady pace and a fine balance between our educational and logistic capacity and the departmental service and manpower requirements.
Twelve trainees have completed their training and a further ten are presently in training. We have recently interviewed for another five new training posts.

Radiology in Malta has benefited immensely from the local training program. Education, research and audit have clinical benefits that go far beyond their record on the trainees' curriculum vitae. Training to the FRCR standard, and experience gained from subspeciality fellowships at different centres of excellence abroad, provide an enrichment to the practice of radiology in Malta that exceeds our original expectations.

Over the past ten years we have seen radiology move from a general speciality to a specialised one. Radiologists with subspeciality training now form an essential and pivotal role in multidisciplinary teams. This is crucial in the provision of state of the art management of patients in both elective and emergency clinical settings. Despite the importance given to subspeciality training toward the end of the training program, we give great importance to core training in general radiology. This is essential in my opinion in order to keep a common ground that binds all radiologists, even if they delve deep into subspeciality work. It is also important to sustain on-call service in both diagnostic and interventional radiology.

So what does the future hold? What challenges will we be facing in the coming years? First of all, we need to keep pace with the changes happening in the various areas of medical imaging. Our training must reflect the demands of the future. At the same time, we must keep ourselves relevant as a speciality whilst maintaining a common ground amidst our diversified sub speciality practice. Training does not equate only to amassing knowledge and passing exams. Acquisition of knowledge is certainly a crucial component but it is not enough. We must ensure that our trainees have the necessary analytical and adaptive skills to face the challenges of the future. These challenges include keeping the right balance between general and subspeciality radiology; taking up managerial roles at both departmental and hospital levels; leading education and research in medical imaging; resolving and managing turf issues; maintaining a leading role in multidisciplinary clinical teams; embracing and making the best use of artificial intelligence; managing medical imaging resources appropriately; and doing all this whilst keeping a healthy balance between work and life. We must provide our resident radiologists with the skills necessary in order that they may face these and many other challenges that the future beholds for them.

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I would like to end my message by congratulating the Maltese Association of Radiologists and Nuclear Medicine Physicians and the Radiology Postgraduate Training Committee for the achievements attained during the past ten years. I would like to thank the Royal College of Radiologists, UK and the European Society of Radiology for their ongoing support with our radiology training scheme. I also extend my thanks and appreciation to all foreign hospitals and radiology departments that have welcomed our residents for subspeciality training over the past years. By training young Radiologists we strengthen the profile of our sister specialities and make sure that we sustain the relevance of both specialities in the years to come. Our ultimate aim is to achieve high levels of excellence and expertise in the practice of Radiology and Nuclear Medicine for the benefit and well-being of our patients.

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Adrian Mizzi
President of the Maltese Association of Radiologists and Nuclear Medicine Physicians.