Applied Radiology

Dr. Mirvis is the Editor-in-Chief of this journal and Professor of Radiology, Diagnostic Imaging Department, University of Maryland Medical Center, Baltimore, MD.

When I entered the medical profession, it seemed that the general impression of teachers and colleagues was that American medicine and training were the best in the world and the envy of physicians in most other nations. I carried this notion well into my professional career. Over time my perceptions have changed. There were a lot of foreign-trained medical graduates in our hospital and other hospitals I had worked in. I could not genuinely see, with the exception of a few individuals, that there were any overt differences in knowledge or medical judgment between these folks and U.S. medical school graduates.

In the past decade, I have been fortunate enough to be able to travel as a visiting speaker to a number of countries at various levels of technologic development. I believe I have become acquainted with the skills and level of performance of radiologists and trainees in several nations. My current perception is that the level of medical acumen currently achieved in many other nations is in no way inferior to what I have generally experienced in the United States. True, many nations lack the wide distribution of the high-end imaging equipment and networks we typically enjoy in the U.S., but they certainly make full and inventive use of the equipment they have available.

This past year, my section was honored to have a research fellow join us from Japan. Junichi was, as I have come to expect from all our visiting foreign fellows, an extremely astute radiologist, incredibly devoted to his work, and quite innovative and resourceful as well. My experience with fellows from other nations in Europe and Asia has been similar. Of course, I realize there is some "selection bias" in who gets to receive an all-expenses-paid U.S. fellowship.

Still, my strong impression has evolved to appreciate that there are indeed a great many very capable radiologists beyond our shores (and, I assume, nonradiologist physicians as well). I believe most non-U.S. trained radiologists that I have worked with would do just fine in the U.S. in both private and academic settings. The ever increasing percentage of non-U.S. scientific presentations at the RSNA is evidence of the growing strength of the academic prowess from non- U.S. medical centers. ¹

While many American academic radiologists are used to visiting foreign countries to offer our "expertise," I think that the number of invitations to our non-U.S. colleagues to teach here is far less common, though the number is probably increasing steadily. The growing trend toward "internationalization" of traditionally U.S. medical societies is an excellent development that will tap into the substantial level of medical skill available abroad. Collaboration across the oceans will stimulate a higher quantity and quality of radiology research.

There is much to learn about radiology from foreign radiologists. U.S. radiologists clearly have no monopoly on novel and innovative approaches to practice, or technological and research advances in our specialty. There is gold to mine in knowledge available from foreign shores and we should enthusiastically "globalize" our approach to improving the quality of medical imaging in America.