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So um good eating all um medical students. Um Yeah, um newly qualified doctors in Nigeria, resident doctors and all my colleagues um present for this partner. My name is um Doctor Nu Kinsley and I am the Nigeria trainee representative of RA. And by the way, I would like to give a quick introduction to RA. Um RA is um Radiology Interest Group, Africa um is a nonprofit organization that um promotes education in radiology as well as research. Um So, um this is the first of our get into radiology series guest um webinar for, for Nigeria. And the topic of thing is radiology in Nigeria, overview, how to get in expectations and uh challenges. So, in the course of this lecture, we will get to know these four things. And so this webinar is probably um sponsored um and private brought to you by um radiology interest and um group um Africa. And so we want to get into it very quickly. Um So this is an outline of um the webinar today and we are going to look at an overview of RA ra in Nigeria and we get to see how medical students who are aspiring to become radiologist and newly qualified doctors, how they can get into radiolog in Nigeria, we are going to see expectations um that are um that are meant to be meant and we are going to see challenges um that you're likely going to face. And then I conclude, so it's going to be a very brief um webinar and it promises to be informative, especially to those who are thinking about radiology. And so by way of overview, radiology is a medical specialty that uses medical imaging to diagnose disease and guide treatment. And, and so this um definition is drawn from Wikipedia. Um is, is it a generalized or quite concise definition of, of radiology? Um Suffice to say that radiology is different, it's quite different from radiography. Now, a lot of people think radiology and radiography are the same but in Nigeria is not um white radiology is a medical specialty um that um are designed for doctors. So and radiologists are doctors, but radiography, it is also a head um um a head care um um specialty that um people who studied medical radiography get into. So both of them use medical imaging, you know, they work in medical imaging department. But why the radiologists are the doctors who report the images, you know, who um um guide the um medical imaging, you know, vet it justify it and report it. Radiographers are the ones who perform it. And so they operate the equipment. Um and um and get the acquired images. So medical radiography is different from radiology, radiologist, for doctors and medical radiography is for radiographers. So in some universities, radiography comes on that is full of sciences. But in some universities all are under the school of medical sciences. So but the difference should be clear, especially to people who are aspiring to become radiologist. So it's for doctors while radiography is for um radiographers. Now, what we are going to focus on is on radiological. So that's why I said this um webinar is designed primarily for medical students and in their 4th 5th 6 ta as well as newly qualified doctors that is those under undergoing their training and in in a tertiary hospital. So um ology is the key specialty in medicine. Yeah, I II suffices to say that it central you know, is like a forel every other specialty sends patients to radiology and what why do they send patients to radiology, for diagnosis, for treatment and for monitoring treatment? And what do radiologists do they use medical imaging to image the body of the patient? So as to find out what is really wrong with the patient, so to make a diagnosis uh and they also guide treatment as well as monitor treatment. So that's why radiologist is deemed by many um even medical colleagues as well as non medical colleagues to be the eye of medicine because they get to see what others um other um physicians do not see. Now what is the role of radiology? We we talked about it and one is to make a diagnosis, it could be provisional, it could be definitive. Now, if you're a medical student, provisional diagnosis is the working diagnosis. The first diagnosis that is made you know to to start um a line of treatment for patient. So in some cases, radiology get to make only provisional diagnosis. While in some cases, they get to make good provisional and definitive um diagnosis. So there are some pathologies that radiolog alone can help you know the diagnosis. But some um pathologies where radiology gives you a provisional diagnosis, especially in diagnosis that has to do with the soft tissue like cancer, gives you a diagnosis and then you do a biopsy for histopathological diagnosis. Now, in that case, the histopathological diagnosis is the definitive diagnosis. So, radiology also helps to make um helps to guide physicians to treatment. So, um for example, if um a professional diagnosis have been made by the radiologist, the physicians can request uh an image guided biopsy and and where they take out some tissue from the patient's body. For example, a patient who comes with a breast mass. So they take up some tissues and send to the histopathology lab where the def diagnosis is made. All these are in line with the treatment and sometimes the treatment could be drainage of abscess, image guided drainage of assay. For example, patient comes with liver abscess um that needs to be drained, you know, and um is guided by ultrasound. Um and, and, and those kind of um treatments are called interventions, but intervention is even wider. Uh in some vascular cases like uh aneurysms, um radiology can um interventional radiologist, vascular interventional radiologist can help to um embolize the aneurysm or, or or of um vascular malformation. So as to stop breathing, uh in such cases, radiology helps to guide the treatment uh of those um physicians that involved. Now it also helps to monitor treatment. Uh So a a patient comes with cancer, you know, uh undergoes a surgery, deking surgery and you perform um maybe CT scan or MRI scan to see if um there are leftover tumor masses or you perform a a pet scan to see if there are um um metastatic um deposits in other parts of, of the body, which can affect the prognosis to for, to help physicians say, ok, this patient is likely going to stay for extra five years um given the the pro progression of, of, of the treatment. So radiologist is quite key in me in medicine because um of these rules that it plays. And so it is appropriate called the Eye of Medicine. And now it is divided broadly into um two specialties, interventional and diagnostic radiology. Diagnostic radiology is also known as radio diagnosis in Nigeria. Um So, intervention and diagnosis often go hand in hand and under this um um first broad specialty, you have other subspecialties. Um you have vascular and interventional radiology, you have pediatric radiolog neuroradiology, gastrointestinal radi all the way down to breast radiological. So a person who specializes in radiology can choose to so specialize in any one of these um um source specialities. Now, the second broad um category of radiology is tradition, oncology or radio radiotherapy at, at some, at some college in, in some institutions. So this branch of um radiology is um for um the treatment of cancers, particularly cancers with um um radiation. So that is why it's called radiotherapy and so special is on that. This one is um um are politics, me and the nuclear medicine. Now, I want to quickly say that in Nigeria, interventional and diagnostic radiology is well, you know, um most accredited institutions and most um colleges um offer diagnostic and radiolog. So it's quite well developed for interventional radiology is growing in Nigeria. And so this is something that medical students um um who aspiring to become radiologist to really look into this. It's a very nice specialty, like really, really nice and um because it's growing, it's quite file and um one can um do groundbreaking things in interventional radiology here in Nigeria. Um So, ii know of interventional radiologists that are in Lagos and, and in Abuja and they are making waves of news. Um So professional radiology. Now we want to discuss radiology, how to um how, how to get um postgraduate training in radiology under two broad categories. One is professional radiology training, no professional regular training in Nigeria is seen by two postgraduate colleges. The West African College of Surgeons was and the National postgraduate Medical College of Nigeria MP. Now, for what training is? Three years and two years for membership and fellowship, residency training respectively. Now, if you do three years in membership, three years of residency training in ology under W you get M AM W means member West African College of Radio of Surgeon in the Faculty of Radiolog. Now FWA is after you've completed the five years, so you've done three years membership and you do additional two years. So when you do additional two years, when you write your fellowship exam, you get FWA, which means Fellow West African College of Surgeons in the Faculty of Radio. Now for National postgraduate Medical College of Nigeria, the training duration is also five years. But the difference is that the part one which is the junior residency training is for two years. White part two is for three years. Now, after completing the whole thing, part one and part two, what you get is F MCR filming Medical College of Radiology. So these are the qualifications that you get from undergoing professional radiology training in Nigeria. Now for academic radiology. Now those undertaking in investing is also available in Nigeria and is overseen by postgraduate Colleges of Nigerian Universities So m most Nigerian universities have postgraduate um colleges that oversee their postgraduate studies. Now, these postgraduate colleges that help um doctors get education in postgraduate education in academic radiology um are under the watch Overwatch of um Nigerian Union, um Nigerian Diversity Commission and M PCN. Now, what qualification do you get from undertaking postgraduate studies in academic ology? Do you get MSC and be his which are different from fellowship? So fellowship is professional. MSC phd is academic ni in Nigeria, MSC. 18 months to three years. Y phd is three years to five years. Now, this is highly dependent on a lot of factors naturally, it should have been 18 months but it could be dependent on the students if the student, if the student is um um sorry, um there is uh some light issue here. So if the if the student is um diligence, does um his um academic studies takes his academic studies seriously, he can finish it under 18 months or two years. But other factors also come into play such as um the, the um the how would I put the department? Uh So the availability of the lecturers, your supervisors if they are supportive and they gingerly, then you can finish it on the 18 months or two years. But if not, it can stretch all the way to three years or even more. Now, three well known schools that offer structured academic radiology, uh University of Ibadan in. So um Southwest NDEZ University in Southeast and Amanda Bello University in um not, I, I'm not sure whether a University of Port Court offers it but something one can always verify. Now, which one should you go into as a medical student or an I qualified doctor who is thinking of a, so a specialty, a medical specialty to choose? And you are thinking, oh, I want to go into radiology but you're not sure whether you want to do professional or academic radiology, how will you make the decision? Well, it depends on what you want in life. Now, if you want to become a consultant radiologist and work in hospitals, then if you undergo professional radiology training, that means you start residency training in an accredited um tertiary health institution. So that when you finish your training, you become a consultant radiologist and you are employed by the hospital and government to work as a consultant radiologist. Now, if you're thinking of academics, you want to lecture, you want to carry out researches, then you should definitely do academic radiology and become a professor of radiology and work in universities. But there are overlaps. So one can do professional radiology training, um become a consultant radiology, but also further his training to become a professor in radiology. So this overlap exists in Nigeria and and there are some great areas which um still exist but is being sorted out in years to come. It will be well developed and and um the great areas will diminish. Now, how do you get in into radiology, please? Um Just a minute. Ok. So how do you get into radiology? Now? For professional radiology training, the pathway is via residency training. Like I said, in a tertiary health institution that is accredited for radiology training, take notes um by either or both the West African College of Surgeons or the National Postgraduate Medical College of Nigeria. So these institutions um these colleges are credit a hospital to sponsor radiologic training. So this is um something that you should be mindful of. Now, you want to get into training in an institution that is accredited, it helps a lot. Now, these steps include, you have to complete your six years undergraduate education in medical school and acquire your M BBS degree. So if you're in four E, you're 50 then you have to complete it and get your M BBS degree. Now, after you get your M BBS degree, you need to do your one-year horsemanship training and require M DCN Medical and Dental Council of Nigeria full registration. You know, when you graduate, you're given provisional registration. So when you do complete your one-year horsemanship training, you now apply for full registration and become a fully registered medical practitioner in Nigeria. So you get a full registration and you get your license to practice. Now, after you've done your one-year housemanship, you do extra one-year National Youth Service um scan. So you do your N YC. How many years have we counted? Now? Eight years, so eight years for you to do your M BBS housemanship and N YC. Now, when you're done with that during your N YC, often during your N YC, you register and write your primary examination. Now you have to also check the eligibility criteria because the primary examination is hosted by West African College of Surgeon or the National um and Postgraduate Medical College of Nigeria. The Nigerian Me Postgraduate Medical College of Nigeria N YC is not mandatory. So during your N YC, you can a apply for the primary examination but for work N YC is mandatory. So you need to apply some time in July during your N YC so that you can um um um write the exam in October. Now after you pass the primary examination, start getting reference letter from your university lecturers, the university lecturers need to use the university letter heading and write a referee letter for you because you need this referee letter to apply for residency training. Once any hospital advertises like something that you have to look out for, you have to get the list of accredited incision and look and check whether this institution health issue that is advertising for resident training in radiology, whether they are accredited by wax and N PCM or whether they are working towards accreditation because that will help you a lot. If you start residency training in a in, in a non accredited center, there's no harm. But the thing is that at some point you may have to do outside posting. So it's going to be a lot more stressful. But because of, but you can um there are other factors to consider as well. Is it close to your home and things like that? So you can still use and for some people, they can still choose to start presenting training, you know, no, no accreditation center, especially if there are hopes that accreditation will, will come. Now, once you've applied for residency training, a hospital advertised and you apply for residency training, you have to start networking, you know, tell people that you applied here, show them that you are ready to undertake this radiology training. Uh and that you want to become a radiologist, you know, um you have to network. Now after network you prepare for um doing your network, you prepare for interviews. Usually most hospitals do interviews, select interview and you prepare, well, you get to read some few things in radiology. And so that when you ask a question, you can be able to answer. Well, that shows that you have an idea um a, a good background, a medical education background in radiology and that you want to really do this radiology training. So that's um helps you to get into radiology. Now, the thing is that um there are a lot of people get it when hospitals advertise And because the number of people who apply for residency training is decreasing and worse. Still, radiology is decreasing, there are high chances that you will get um um a slot and start your residency and training. So if you're employed as a resident doctor in the department of radiology by the hospital, you need to quickly apply for what is called surgeon in training. Sit of training. Now you have to choose which college you will go with. And some people decide to follow both colleges um to um register with both colleges because they want to write exam in both colleges. Some decide to, to choose one college. It's a personal decision you have to choose um which college you want to go with or affiliated with. And um uh what college do you want to write the exam and apply for your either surgeon in training or AFA. Now, by the time you get your AFAS number or your seat number, the college recognizes you as a resident doctor undergoing radiology training in an accredited institution. I hope this point is clear. So that seat or a number helps you to, to be known by either of these um colleges. Now, in, in, in past we applied for I or A S um much later into our training, but it is likely going to change. So that is the purpose of this webinar um to help those who are thinking of radiology to really get firsthand information So immediately you get employed, apply for either seats or offers or both of them so that you can get recognized because they may start introducing that your training, start counting from the time you applied for your seats or your offers. It may it, I don't know if it is happening now but it is likely going to happen in the future. So how to it may likely happen in the future? Sorry. So how to get in into academic radiology. The pathway is postgraduate studies at the Nigerian University that has been accredited by um N Nigerian University Commission for Radiology. Now, the traditional pathway is similar to that of a professional radiology. You do your six years M BBS oneyear Housemanship, oneyear and N YC. Then after N YC or during N YC, you apply for master's in radiology with your M BBS degree. Now, if you're not sure that you want to do MSC in radiology, you can also wait and finish your residency training in radiology before applying for um phd in radiology. Now, what you need is your um fail certificate. So you need F wax or your FM MCR. So when you get F WX or F MCR, what you'll be applying for is phd. But if you're using your M BBS degree, you're likely going to be applying for um MSC. Now, there is a, a new combined pathway um which I like to bring to your notice. And it's really interesting Now, if you complete two, if you complete two or three years for part one or membership training in radiology in any of the colleges, you can immediately apply for um phd in radiology in a Nigerian University that is accredited by NU for radiology. What you need is your part one statement of result or your NW certificate. So your part one from NM PCN or wax or your M wax for those who did membership in wax. So when you have this certificate, you immediately passed your part one or your membership exam, you apply for phd. Now what why this part way is, is very good for me is the best is because is a combined program. It helps you to acquire phd and F wax A at about the same time. So that time you'll be doing your um fellowship training, your extra three years in wax and M PCN to acquire fellow fellowship. You can also use it to acquire phd. So your, your dissertation which you used to get F ones can be used as your phd thesis. So this is a combined and program which is new and I will encourage anybody, especially those doing heart job that are contemplating radiology to do this pathway. Now, what are expectations, their expectations, they are money, food, there are personal expectations, there are expectations from the affiliated colleges, universities and hospitals and then there are government expectations, there is things government expect from you. Now, let's take them one by one personal expectations, things that you expect to accomplish. Well, the first thing is that you, you, you want to earn a living, doing your job. Yes, you love radiology. You, you, you, you love the training, but you also want to earn a living. So you want um the hospital and government to pay your salary. Um So you want to be enrolled into um the medical resident training fund so that you can get that as well and other allowances. So you want to earn a living widening radiology. Another expectation people have is that they want to be thoroughly grounded in the field of radiology. Now, suffice it to say that radiology is quite vast is um when I was about to start, I made inquiries, I asked people which specialty I wanted, I had so many things I was thinking about. So many factors I was considering um I didn't want to be spending time in theater and things like that personal decision. But one of the things I was told by my mentors were that radiology is quite vast, is quite voluminous. That apart from pathology, radiology is the next because you get to, you have to know the things. Um others um physicians know you have to be at that level for you to give them quality reports. So you need to read, you will read radiology is like another six years. So you read and read. Now the next thing is that the next expectation is that you hope to complete your residency training or your education, whichever one, whether professional academic in five years or six years maximum. So I would encourage anybody who is trying to enter radiologic to aim to complete it in five years or six years and finish the program and go with your F wax or your MF MSC R. And another thing is for your phd. And another thing is that you expect to subspecialized in one of the many, many subspecialties in radiology. So this is this is growing, you know, there are now many societies that host different subspecialties in Nigeria, pediatric um radiology in Nigeria, you know, surgery, radiology in Nigeria, breast radiology in Nigeria. So it is expected that you so specialize in, in one of these um So specialties, another thing is is that you expect to accomplish is that you hope to become a cause of radiology when you finish and or a professor in radiology. And then lastly, you want to be able to set up your own private practice uh or become a researcher. So if you become a consultant, radiologist, you may want to maybe be expecting to set up your own um practice. It's a file ground. The um specialty is, is um the field is growing. So there are a lot of um um um demand for radiologist and uh private practices. So you may consider setting up your own um private practice or you, if you did um academic radiology, you will want to be getting grants that can help you um become a, a well renowned researcher. Now, a expectations from colleges, universities and hospitals and Ecologist expect you to do your residency training in an accredited center. That is their expectation. They hope that you do reserve your, your recent training in an accredited center because that's one of their criteria to write exams. So if you are in an in an AED center, you may have to do postings to, to show that you acquire some competencies in some imaging modalities to be able to sit for the exam. Now, the list of a great center is on their website. So you can check that um out or ask any um radiologist who is in training or who is in the college to help you out so that you know, which um um tertiary health institution to apply to when um their vacancies open. Now, the colleges also expect you to apply for seats or offers immediately you start your residency training. So this um is an avenue to get to know this because you may not really hear this um on and on. So you, you need to apply for your seat or offers if you want to do radiology training here in Nigeria. Now, the hospital expects you because you are affiliated to the college, but you're working for the hospital. So it's something that needs to be clear on one's mind. So the hospital expect you to quickly train your eyes. You know, that's what we call it here. You need to acquire the knowledge, to be able to know what you're saying. When you say a pathology, you quickly identify what it is. You say what it is, you know, and help deficients treat in that way. So it's called training, one's eyes. When you start radiology training, it will feel like you're not seeing anything. You don't understand what you're saying. But the more you learn, the more you read things become clearer. So it's like training your eyes. The hospital expect you to train your eyes quickly and acquire skills like scanning, doing Doppler or performing um radiological investigations like HS GMC G and all of that as well as communication, soft skills like communication or, or organizational skills. They are very important. Uh They are as important as the heart skills, you know, able to communicate, able to relate with um radiographers, radiologists, your seniors, juniors, those are your levels so that you'll be able to render radiology services to the hospital patients. You know, the hospital is there to render services to patients and they employ you to help them do that. So when do you start, they want you to learn quickly so that you'll be able to render this service. Now, the college expects you that as you render this service in the hospital that you feel and regularly object. The logbook, there is what we call logbook is a list of, um, things that you've done. For example, you can say I've done an abdominal scan, I've done a Doppler of the right leg. I've done an A scan. These are list of investigations that build up your competencies. So there are evidence of competencies that you've acquired. For example, if you've done 100 or color scan, you can, you, you can say that you're quite competent in a color and scans. So the hospital, the college expects you to fill the law books for some colleges. The law book is filled manually for some colleges. The law book is filled online. So you send um if um the log and the consultant who supervised, you approves the log that you actually did this um investigation. So it will be approved for you. So you need to acquire a lot of competencies during the course of your training to be able to sit for the college exams. Now, this is very, very important because it builds your portfolio. So law book is very important. If you're already in training you a resident doctor listening to me, now be filling your logbooks the earlier the better so that you can use the time you have close to the exam to really prepare for the exam rather than filling notebooks. Now, the college expects you to register for her membership or part one and fellowship and part two exams after 23 years or 56 years. Yes, this is what the colleges do. They regulate the exams. So they expect you to register for these exams. Now, the university, if you're in academic radiology, especially if you do the combined program, the university hopes that you will be able to pursue your MSC or your phd. So, since there is a combined program, it's something that if you're new in radiology, like your recent daughter preparing for part one, please don't fail to take um jump in on this combined program. II think it's the best thing I've ever had. It's just that we didn't start early a during that time and some of us cannot do it now. But if you are yet to write back home key into this combined program and get your phd and efforts, why they offer last, we don't know whether the regulations will change in the future because these things keep changing. Now, all affiliated institutions, college hosp universities and hospitals, they expect you to undertake and publish quality research as your dissertation. So you need your dissertation to see for the college exams, you need your dissertation to um pass your phd as your, as your thesis, the hospital wants you to do the dissertation because if you do the quality research, it's um it brings glory to the hospital. No, all a affiliated institutions also expect you to abide by code is code of conduct. If you're on call, you do the call, you know, you are respectful, you to your colleagues and to patients as well. You know, you avoid anything that is incriminating, you are diligent and they also expect you to continually develop yourself. So um during the course of your training, the colleges or universities will organize um continuous professional development um program or courses, we call them update courses. So the last update course organized by wax I think was in gastroenterology. So how to manage malignancies and how to make the diagnosis on fluoroscopy. So e every week, every year, the colleges organize 4 to 6 update courses. So they are aimed to um improve uh updates the knowledge of uh resident doctors in training. So they, they are necessary as your CPD S as a continuous professional development. And it's something that each year, once you start residency, aim to go for at least one CPD, you can start with radiological physics, CPD and update course in your first year of training. And then you do the clinical update courses in your 2nd and 3rd days so that there will be um quite fresh um and and close to the exam so that you can be eligible for the exam that are not the courses are um part of the eligibility criteria criteria that must be met before you write your um membership or fellowship exam. So the college seeks out the rule um eligibility criteria that you meet for example, wax, you need um at least two clinical updates and radiology physics updates. One, at least one must be from wax. One clinical must be from wax. Yes. So and the radio physics can be from either college M PCN or wax but uh is one clinical fro must be from wax. The one organized by wax. So you need to have three of these, of the courses to be able to apply for membership exam and, and wax. And then for fellowship, you need to have at least one clinical update along with your dissertation and other um CPD courses that we call health management, ethics, research methodology. And um and uh uh yes, another one that has to also do with research. So these CPD S are very necessary. Like it's something that each year a resident doctor should try to um attend at least all now expectations from government, it could be that you are employed in a state government hospital or you're employed in a federal government hospital. The the government expects you to use your knowledge as skill to render radiology services to each citizens or states um citizens um where the hospital is um affiliated hospitals located. So if the hospital is in an the hospital, the government expects you to use your skills to serve um an um um citizens and even citizens from other country, um other states and possibly other countries. So the government employs you to work. Now. The government says expect you to teach and train younger generations to become radiologists like you. So in your salary, you see that the government pays you what we call teaching allowance. So they expect you to teach junior residents and medical students, you need to groom them to become radiologists like you. So so as to continue the continuation, you know, continuation of the training, continuation of the profession in in Nigeria. So this is something they expect you to do because they are and paying you once for that, the government also expects you to pass your pa one membership exam in 2 to 4 years. Now, when I got my employment letter, my employment letter read that I need to pass my part one or membership exam one year if I fail the first one within one year, if I failed the first one. So if I attempt the membership exam, which is which I qualify for three years after three years. Uh from the time I began training, you know, from the time I began training to the time I'm registering for the exam, I must have stayed three years. Now, this needs to be very clear from the time you started residency training in radiology to the time you are applying for the exam not to the time of the exam, it should be very clear to the time you are applying for the exam, I must have stayed three years. Now, when I write the exam. The government expects me that if I fail the exam that I need to pass for me to stay in the residency training, I need to pass the exam within one year. So I have like two more attempts to make, you know, so that is amounting to four years. So they expect you to pass part one or membership exam in four years. Now, they expect to pass fellowship in, I think 3 to 4 years. Now, if fellowship is two years now, two years again is from the time I passed part one or membership exam to the time I'm registering for fellowship exam, it must be two complete years in an accredited center. Now, the government expects that if I fail the first fellowship exam, the first sitting that within 18 months, that is within 18 months, I should have passed my part two for me to remain in the in the training. That is what my employment letter carries. And I think it is supported by the Medical Residency Training Act. So the government wants you to pass the exam because they are paying you in the residency um program. They are sponsoring you kind of in the residency program. Now, the government also expects you to undertake and probably and groundbreaking researches. Yes, because it promotes the country, it creates innovation in the country. So it's an expectation from the from the government apart from your dissection, if you can join all research groups and, and things like that and perform researches and the ones that can change, um, mode of operation, the government will, for the better the government will, will really, um, um, um, I appreciate that. And if that, if the co saw you, um, um, your, your research, now, the government expects you to pay your annual practicing license to MDC, your tax to the States, you know, collected by federal government or limited to the state and other se and security funds like um housing fund and other things. So the government expects you to abide by it um um laws to pay these um things as well as to abide by the medical Residency Training Act, which includes exiting the program six months after your fellowship. That that is what my employment letter specifies that after six months of passing fellowship, I should exit the program now. Um um So this is the normal thing that is expected but um because of the shortage, there might be some, some, you know, allowances, you know, uh because of the shortage of uh radiologist. So usually within these six months, the hospital might convert you to become a consult radiology or you find um a radiology post elsewhere. Now, what are the challenges of radiology in Nigeria? We discuss them under a few heavens. The first one is walk now because there are fewer doctors applying for residency training is decreasing. There is brain drain. People are are looking for greener pastures overseas. So the number of people applying for residency training is decreasing. Now, what still the number of people applying for postgraduate training in radiology is decreasing. So you can have one and g like 1 21 50 people applying for. But in radiology, you have like um 30 or 40 people applying for primary primary exam or, or say 60 I don't know what the figures are, but usually the people applying into to, to go into radiology is fewer than people applying to go into um surgery or um or or NG or pediatrics. So this makes the workload to be a little bit greater, you know, you might take course more calls during training because um um of fewer people that are into radiology. But I want to quickly say that radiology gives you one of the work-life best work-life balance. You know, if you are in an institution where there are a lot of people in training, you have very good work life balance. You know, uh if when, when there are not enough people, you know, some uh you still have the the way the roster is scheduled, you still have good worklife balance. So and that is one of the beauty of radiology. It gives work-life a very great work-life balance compared to other specialties. Now. Um residency, drugs for radio are also limited. So some hospitals might take um 20 residents in 1 g but take maybe 5 to 10 residency doctors for radiology. So all these things contribute to the increase in workload. Um And if you enter a decision where they have maybe two cities or three MRI s, you see that the number of reports that you have to write will be quite many. So it can. So if you're on call, you really be on call, you do a lot of reporting. Now, another challenge of radiology in nature is equipment, radiology equipments are very costly. So the red is cap intensive. So you can imagine maybe an ray machine um let's just take an ultrasound machine, an ultrasound machine, a quality 1 may be around 5 to 10 million. I'm I'm just, I don't know the price. I'm just saying for 5 to 10 million just to acquire a quality ultrasound machine. No, no, you can imagine what um C would be like and or MRI these equipments which fill one room. So it is quite cost um um um sensitive and these equipments are sensitive to power supply. In fact, a city needs to have a dedicated or an MRI, they need to have dedicated power supply. And if the power supply is not good, it can damage the equipment and you spend millions repairing the equipment. So because of that, a lot of institutions do not have um these big equipments like CT MRI pet scan and, and things like that because they cost is um they are capital intensive now, the funding is not really available. There is need for government intervention because it's a lot of money. So there is need for government intervention or food, private resources. It's not something one person can do alone, you know. So you have to enter an enterprise, a private enterprise where you have people who um come together to pull resources to set up a private uh center. That, that is the in thing now for people who are finished um training and have gathered some money after their fellowship. So um you enter into an agreement with people and you know, um set up private practices or some private people set up practices within um government established centers. Now. Um That's so because of the equipment, it leads us to the next point. Accreditation. So health institutions and universities are created for or education are limited, you know, they are limited because these imaging modalities are are costs cap intensive. And so because not everybody have it. So not every institution will get full accreditation and it's even easy to lose accreditation. Let's say your your center had accreditation when, when it started. But something maybe one bad power outage spoiled the power supply to the city, you know, and the accreditation is ending, let's say um 2024 you know, maybe with the city is very difficult to apply for re accreditation because the city is not there functional. So it's quite easy to use accreditation during the course of a training. And once you use accreditation, it means that if you've not completed your training for the required number of months required for the exam, you may need to do as I and it's really not easy to do as I posting. So it requires a lot of planning, you know, some um bre paperwork and things like that. Um some net networking and begging, you know, to get to do your as I posting to be able to write your exam. So it is really not easy but not to fear. Um good number of institutions, health institutions are getting accreditation now and government interventions are are coming. So um um there will be enough institution to apply to do your residency training in radiology if you want to do here in Nigeria. No, um which is encouraged now. Um research and that challenge is research. No, just like the equipments are costly. Um doing research in radiology is also cap intensive. Um because um is it you have to involve two or more specialties and um you know, uh so you may have to pay for some things. So it's really mentally, physically and financially um tasking. But if everyone does it, um you can do it. So it's not something that you should shy away from. It is there is a challenge but is um it can be crossed now, research societies and organization in radiology are quite few and to the best of my knowledge. Now this, this web, it is more from a private um perspective, you know, um like, I'm not like um a member of the college or something but um just from my perspective, observation and, and, and, and training, um now if, if, if you, um let's say you're in ong there are a number of also uh societies and organizations that perform cardiac researches in um ong obstetrics and gynecology. Um um um and teams or topics, but there are not so many in radiology. So um getting involved into research is not really that easy in radiology. So um um but these organizations are, are coming up as well. Now, the exam. Yes. So this is something that you should know if you're a medical student or resident doctor um or um a house officer now, even as a reason doctor, no primary and part one exam in radiology involves general and radiological physics. Yes. You heard me right now, a lot of people want to run away from physics, you know, um and they, they feel after medical school they have nothing else to do with physics. You will join it again if you want, if you want to do radiology training. So you do general physics. Some of the questions in part one and primary exam involve general physics. So you, you have to um we read or brush up your general physics and then when you not enter into the training or radiological physics. Uh radiological physics is often a rate limiting step. So it's something that once you start your training, you need to start reading radiological physics. One of the best books for it is far and um physics. So uh medical physics, so you need to start reading it early so that you can be well grounded in it so that you pass your um radiological physics exam one step, um one in one sitting, you know, and fly. So, but after part one, usually there is no more physics but the knowledge stays with you and you keep applying it. So um physics can make it difficult. But when you start most of us um past diseases, if we, you know, get ourselves involved, be diligent, you know, and do the normal with um discussions in at our training institutions. Now, the fellowship exam curriculum is quite broad. And so um I if you, if you go to wax website, you see that the curriculum is quite big all the way from physics to different different specialties. M SK musculoskeletal pediatrics. So all those things that is done in order um specialties, you need to know them in radiology. So it's quite vast. So that's why radio is said to be one of the top three most vast specialty in medicine, you know, uh like I said at the outset, like my mentor told me after pathology, radiology is the next. So you need to know a lot of things. Um, uh, so radiology is mentally stressful. If you get what I mean, the surgery is physically stressful. So, in surgery, you do surgeries, you stay, stand in the theaters and all of that. In radiology, you get to sit down in a world, um, equipped room with ac and packs and computer where you report your, um, where you quickly scan and, or a, a and report your, um, report, you may need to stand so much or walk about so much, but your brain will be um will be walking around the clock, you know, to hit the diagnosis and make differentials, you know. So um me leg is not common here in Nigeria, but there are growing cases of mega um cases um against radiologists overseas, you know, a missed diagnosis. Um um miss the pathology and things like that. It's not so common in Nigeria, but it's something to be aware of, especially for those who want to go outside. But hey, there is no cause for alarm, just know your radiology very well, you know, follow guidelines and you'll be fine as well. Uh Then by way of conclusion, um I want to quickly say that radiology is one of the best specialties ever met. And for me is radiology or nothing. So radiology is very, very nice. I mean, if I have to do it again, I will choose radiology. In fact, I will go into A I in radiology. So II it is, is, is, is uh for me is the best but for others is one of is one of the best. You know, I brought you in. Well, the work life balance is OK and you can set up your private institution though its capital intensive but it can be with other people. Um II love the part that radiology is I get to see the in, in inner workings of the body, you know, um get to see inside the body. I love the part that radiology is the eye of medicine. Uh I love, you know, when I look at something I tell you this is this, this is fibro adenoma, take it or leave it, you know, I love that um thing about radiology able to pin the diagnosis, you know, and make life easy for everyone else, you know. So radiology is growing and evolving at the same time in Nigeria is growing, is expanding more special. So specialties are coming up, you know, it is also evolving, you know, in Nigeria, interventional is coming up, you know, there are now um um institutions that do brachytherapy, they've been there, but more are coming up, then A I teams are coming up in, in um abroad is faster, is air, it seems is faster ability to make diag help radiologist guide them, making a diagnosis with air and things like that. Um So uh it's, it's evolving and it is growing and so now is the best time to grow with it and evolve with it. Something that is usually growing and evolving is quite fertile. You know, you can, you can distinguish yourself easily, you know, and make yourself known and become a renowned um radiology. Something to do a is to become an interventional radiology um which is growing in Nigeria. So something to quickly get into the training, try to start specialize in interventional um so that you um um get to train under those that are not making waves in Lagos or apo and um and start making ways um as well or set up your own private practice. And even if you want to get into academic radiology, make groundbreaking um researches. And so it's, it's growing here in Nigeria. So it, it's quite fatal and I will advice everybody uh anyone who loves me imaging, who loves the idea of this is this, who loves the idea of seeing things, you know, to get into radiology now. So you, you to do that, you need to be able to understand clearly what is expected of you in this lecture cannot cover everything. You know, it's from a perspective of of a person undertaking radiologic training in Nigeria, not like from uh an established, a renowned radiologist. No, so it's more of a just to guide people um guide younger ones and help them make the best decision and informed one. So you need to understand the expectations, your own expectations, the expectations of the college and universities, hospitals and you need to understand what government expects of you to. So these expectations are not difficult to fulfill. We've been doing it. A lot of people did it before me. And so you too can fulfill it. Now, don't let the challenges dissuade you and the medical legal. No, do what you ought to do. You'll be fine. Um um The work-life, remember I told you the work-life balance is OK. Um You uh salary was almost at the same here in Nigeria, but I brought you even earn more. So don't let the challenges dissuade you many have successfully undergone the training and education to become professional radiologist um or professors in radiology. I know without a doubt that you will love radiology. Radiology is like the first. Now these are my references and I would like to quickly say that this is not the end of um get into radiologic um um series and that um webinar series that is sponsored uh sorry, that is um hosted by Reg Af um There are other ones coming up the exam series. Now, if you are a house officer, you will need to key into this um login and, and listen to these webinars, you need to, the first one will have the next one will be how to ace your West Africa College of Surgery and Radiology primary exam. You know, the primary exam is the exam that gets you into radiology. Now it's coming up in September 2024. So um the time and the dates will be um and you know, spread to us so that we can join and see, get tips on how to pass primary exam. Now, the next one after that will be how to pass part one exam. We also see tips and approach from people who have done it and done it excellently well. So it's going to come up in February, sorry, it should be 2025. Sorry for that mistake. I will require it later. So February 2025. So I will encourage us all medical students um especially um house officers and and uh um junior registrars to um be part of this um exam series, the next two so that um they can benefit maximally. So thank you. Thank you so much for um coming and attending this uh webinar. Now, if you have questions, I am, I'm really available to answer any questions that you might have. Um So just quickly put your questions in the chat box and I will answer them. Thank you. OK. OK. So someone is asking a question. Um So thank you sir for the class, please. I want to know is echocardiography under radiology. Also outside the country is radiology separate from radiography. Interesting questions. Yes, radiology. Um echocardiography should actually be on the radiology. Uh It it should actually be on the radiology, but it's usually performed by cardiologists here in Nigeria. So people that perform two D echo, 3d echo are cardiologist, but radiologist can acquire the skill abroad. You can acquire the skill here in Nigeria or in abroad and perform it. There is nothing wrong with acquiring the skill but the so specialty itself in Nigeria, I think is on cardiology. You know, they are the ones that perform echocardiography here in Nigeria outside the country like in UK, radiology is separate from radiography. Yes. So like for example, in UK United Kingdom, you register as a radiographer with H CBC. While you register as a radiologist with GMC, you register as a radiologist with GMC. So they are different and everywhere elsewhere. So radiologists are doctors, radiography uh for other health sciences, they are called allied health practitioners. So radiologists are doctors, the radiographers are called allied health practitioners. So they are regulated by an entirely different body. But in those other developed countries, radiographers are now being trained to report some investigations like X ray. So you have diagnostic radiographers, those who report um x-ray because because radiology is evolving and more equipments are coming up. You have CT you have MRI, you have beds, you have beds, you know, because of more equipments coming in, radiologists are shifting attention to reporting multimodality. Um um images, multiplanar images like computed tomography like seeds, um MRI magnetic resonance imaging pet and things like that while they um they leave diagnostic radiographers to now report um x-rays uh and even perform scans sometimes when the the x-rays are are difficult to make a diagnosis, they send to radiologist to report them. So, but here in Nigeria, radiologists um perform scans and reports and report x-rays and things like that. Um So um they are quite different but they both um special uh both um fields are on medical imaging and so there is some um overlap. Uh yeah. So um echocardiography is under mm cardiology here in Nigeria. But like I said, you can acquire the skill, for example, you can go to UK and do MSC in medical echocardiography, learn how to do echocardiography and become um um a professional in performing echocardiography with your certificate as a radiographer or as a radiology, you can apply to do that. Um MSC II, hope I've answered your your question. So I is there any other question, any other worries or things you like to know um as regard um radiology in Nigeria. So you can, you can always um feel and take a moment to fill out the feedback form and claim your attendance um certificate. Um This certificate can help you in the future. You don't know um where you might be needing just certificate to show that you attended a course uh a webinar. So just um fill the, the feedback form and uh claim your um certificate. OK. Is there any other question? So I want to thank um interest group Africa for um this um webinar and we hope that more um will be able more will come and educate more people. Um So, for those who attended, please let others know about radiolog interest in group Africa so that they can um join the webinars and l for their personal groups and get information that can help them make um um inform the decision. So, thank you, thank you. Thank you for attending in the absence of any other question. Um We'll be ending the webinar here. OK.