If you know someone who might be interested in the job below, please contact Jeremy Day – jeremyday@doctors.org.uk


From Jeremy Day: I am looking for a neuroradiologist in Ho Chi Minh City in Vietnam. I can pay for a return flight (probably also for a partner), provide some reasonable but not luxurious accommodation, health insurance, but no salary unfortunately. But a fantastic city to come and spend a few weeks, with diverse pathology, and we are all very friendly! I would love someone to come for 4- 6 weeks but 3-6 month would be fantastic. This is the proposal I put to our local board here to get a bit of cash – I was hoping there might be someone who could be released from their job in their final year of training for a period to come and get tropical experience that would enhance their own unit back home as well as help us.


Brief Background:

A request for a radiological investigation is more than a request for a particular image to be taken (eg a brain CT) – it is actually a request for the opinion of a neuroradiologist on selecting, performing and interpreting an appropriate imaging test. This process is discursive. Accurate reporting of brain, spinal cord and other CT and MR scans are highly skilled activities. Correctly interpreted scans are key in generating differential diagnoses, and in instituting the best treatment.

The Hospital for Tropical Diseases (HTD) does not have CT or MR scanning facilities, but this is likely to change in the future. Currently scans are performed off site in commercial centres, where they are also reported. There is little or no dialogue between the referring and reporting doctors, and reports are often brief, limiting their usefulness. There is little on site expertise in reporting such scans in either HTD or Cho Ray Hospital. Therefore, we are not extracting maximum value from imaging investigations, and we are not developing local skills in interpreting these investigations, because it is not an iterative process. This is a serious limitation in our ability to provide best care to patients with CNS infections in Vietnam, and is a lost research opportunity.

CNS infections account for 6 million DALYS worldwide each year, and 4 million occur in resource limited areas such as Vietnam. CNS infections are both more prevalent and have worse outcomes than in rich countries. In the UK, neuroradiology is a sub-specialty of radiology, which is undertaken after the completion of 4 years of training in general radiology and after successfully completing the FRCR examinations. The additional training is for a minimum of 18 months, and more usually at least 2 years. A period abroad is encouraged by many training centres and an attachment in a pathology-rich environment such as Vietnam is likely to encouraged. Neuroradiology trainees are already competent general radiologists at the time of entry in to higher specialist training. We would like to invite one or two experienced neuroradiology trainees to visit OUCRU for 3-6 months to provide expertise in CNS imaging interpretation, to foster a more sophisticated approach to collaboration between physicians and radiologists, and to identify opportunities for research. Vietnam represents an excellent training opportunity for neuroradiologists because of the intensity and diversity of CNS infections, in addition to the chance to work in a vibrant research environment.

We are requesting funding from the core grant for accommodation, flights and health insurance. Salary would be met by the sending institution as part of training. Radiological supervision for the trainee would be through email, skype and teleconferencing. Day to day supervision would be through the Head of the CNS Group.

Purpose:

1.  Improve the care of patients with CNS infections at HTD/Cho Ray, particularly those enrolled in clinical trials

2.  Provide training for doctors based at HTD and Cho Ray involved in CNS infections in the interpretation of CNS imaging through attendance on ward rounds and in tutorials

3.  Identify research projects for future grant applications and to enhance clinical trials

4.  Develop a culture of joint physician/radiology meetings

5.  Foster relationships with the radiology departments in Cho Ray and HTD, and with commercial providers of imaging such as the Medic Centre with a view to further research collaborations

6.  Provide a training opportunity for a neuroradiologist in training, stimulate an interest in and further expertise in CNS infections

Importance:

Better interpretation of CNS imaging will improve patient care and will improve the accuracy of reporting causes of death in current CNS studies at OUCRU.

Primary Objectives:

As above in ‘Purpose’. Primary responsibilities will be aimed at CNS group studies and interests at HTD and Cho Ray. However, it is highly likely that there will also be time for involvement with work at Pham Ngoc Thach hospital and in children with EV71 at HTD and other sites.

Secondary Objectives:

Eventually establish a regular rotation of visiting radiologists to foster research and training collaborations with Vietnam and OUCRU.