Radiology training courses benefit patient care in South Africa

While South Africa possesses some of the best medical infrastructure in southern Africa, the health-care situation remains critical outside of its major cities and especially in public health care that serves 84% of the population. 

The challenge is historical. Although South Africa’s social systems have improved significantly over the past 20 years as the country transitioned to democracy from autocracy, its healthcare system continues to grapple with infectious and noncommunicable diseases, ongoing social disparities, scarcity of trained staff and violence. The extreme poverty of most of the population generates a severe lack of access to vaccinations, clean water, proper nutrition for children and adolescents, effective sanitation and other essential needs.[1,2]

Spanos, who is 32, achieved an intercalated degree consisting of a Bachelor of Medicine and Surgery, followed by a Honors Degree. He then performed his community service in the Ditsobotla Subdistrict in the North-West province, finding it as demanding as the conditions on the ground. He had to drive up to an hour to reach remote areas to see patients. Yet he was more than willing to make the trips. “You play a crucial role in people’s lives, stepping out of your routine, facing new challenges, and making a significant impact,” he reflects. 

Ultimately, these experiences reinforced his decision to remain in the public health sector. It was an uncommon choice since in South Africa’s inequitable two-tiered health system, roughly 80% of doctors work in the privileged private sector.[3]

So, how can someone make the most of limited resources? For Spanos, the crucial moment came during his community service. “In these rural areas, radiographers were unavailable. There was no CT scan or digital x-rays. All you had was an old projector to view the images, so you interpreted your own imaging. It showed me the importance of being self-sufficient,” he explains. 

It also sparked a decision to enhance his radiological skills so he could interpret diagnostic images independently and review existing diagnoses to achieve optimal triage and maximize available imaging resources.

Spanos sought and found a training program offered by the Australian global charity Radiology Across Borders (RAB). Founded in 2010, the nonprofit aims to address gaps in healthcare access by training radiologists and other medical professionals in underserved communities globally. It partners with academic entities like the University of British Columbia (UBC) to offer high-quality, multimedia-based training programs, that meet the specific needs of emerging nations and go beyond standard knowledge transmission. Siemens Healthineers became a Foundation Partner to RAB in 2016, as the organization was seeking financial support to further their impact.

Spanos was among 35 participants who completed a comprehensive 44-week online course offered by RAB and UBC, the ‘International Certificate of Radiology Fundamentals’ (ICRF). It encompassed eight vital radiology modules that provide a solid foundation. “It’s the entire spectrum of radiology; every system, every form of imaging,” he notes.

"We get loads of requests for CT scans and nine times out of 10, you have to say ‘no’ because no indication exists for a CT scan,” he explains. For instance, a patient who has had a seizure needs time to awaken and the focal signs likely will disappear, eliminating the need for a scan. 

Sometimes, he adds, medical professionals want to examine a patient’s brain stem but it doesn’t show up well with the CT scanner. “In these situations, it’s better to refer the patient for an MRI,” he says, adding that often there's no need to proceed because it wouldn't change the patient’s care management. However, a decision like this needs to be made carefully, since transferring a patient for a scan takes an ambulance out of the remote area where they are on call.

Spanos’ primary motivations were to spend more time with patients and to deliver improved, personalized care. They’ve proven successful. 

And that’s what the efforts to integrate effective health-care models from other African countries into South Africa is all about: combining individual successes with larger initiatives such as reforming and preparing for a national health insurance system.[6] Ultimately, these endeavors promise sustainable health-care system improvements for patients and stakeholders alike.