A Medical Student’s Perspective on Imaging the World

How does working with Imaging The World--a global health organization--affect medical student learning?

My name is Asya Mu’Min. I am currently a 4th year medical student at the University of Vermont College of Medicine (UVM COM). My personal, work and academic experiences have led me to make the decision to pursue a medical career in Pediatrics. At the time I decided on this career path, I had yet to align myself with Imaging The World (ITW) and had not fathomed how a short duration of research could affect my medical school training. As a 4th year student, it was my obligation to select and arrange my schedule for the last year of my medical training. The purpose of this year is to expose each burgeoning physician with access to individual interests and learning experiences that were previously minimal or lacking in the initial academic and clinical years. These months are also utilized to solidify training experiences and acquire a foundation of additional skills.

There are a few requirements for each 4th-year medical student at the UVM COM to complete prior to graduating with sufficient accreditation. These requirements include completing an Emergency Medicine rotation, an acting internship in Internal Medicine and an acting internship in the specialty of choice. The flexibility of designing the year in conjunction with these stated academic requirements was a great benefit. The effort then became making the 14 month schedule well-rounded, diverse, a sufficient and adequate learning experience that would prepare me for the next phase of my medical training, residency.

I have spent the month of September 2012 assisting Imaging The World, through its collaboration with the medical school and affiliated hospital, Fletcher Allen Health Care. The objective of this organization is to bring radiologic technology to developing countries and regions of the world that lack these tools. The ultimate intent is to improve medical outcomes for the indigenous populations.

My duties and responsibilities with the organization have involved promoting a sonographic research protocol that compares the accuracy of images acquired by minimally trained laypersons—such as myself—using only anatomic landmarks to those that can be attained by professional sonographers. The validity of the protocol would allow for ultrasound guided treatment in regions of the world that are impoverished and have very little access to higher tier radiology, such as computerized tomography and magnetic resonance imaging. Currently, this protocol has been employed with obstetrical patients in Uganda, with wonderful results.

ITW employs ultrasound imaging as its primary tool. In my time with the organization, I have discovered that ultrasound is a simple yet remarkable device. Ultrasound allows for diagnostic images to be acquired from multiple anatomic sites, quickly, and may be used with a wide patient population. This is done with no radiation or necessity for sedation. It is also portable and relatively inexpensive.

Ultrasound technology has advanced from simple 2-dimensional images to multi-dimensional depictions that provide immediate diagnosis of pathology and impart accurate knowledge for treatment options. With these advancements in ultrasonographic technology, it is feasible to imagine this instrument will become the premier tool worldwide for medical imaging. As a future pediatrician, this technology will play a lead role in diagnostics.

During the 4 years of medical school training, students are not clinically instructed in using ultrasound. We are taught the diagnostic uses for ultrasound and descriptors for ultrasound images. Practical application remains the job of the trained sonographer. In my time with Imaging The World, the goal was not to instruct me in expert utilization of the ultrasound machine. The purpose was for minimal training. However, in this time, I became comfortable with the nuances of holding the transducer, proper placement of the wand on anatomic landmarks, application of necessary pressure, inputting patient data into the computer and changing settings that would impact the quality of images. I developed an appreciation for the difficulty in acquiring images with different ages and with a variety of body habitus.

As a medical student, I have found that invaluable learning experiences can be had working with nurses, technologists, and other allied health professionals who perform complementary work and studies that doctors are not expertly trained to perform. During my time working on the ITW research project, I had the great fortune of working with several phenomenal professional sonographers. They were always eager to provide impromptu tutorials on imaging pathology to include carotid stenosis, lymphoma findings in a patient with horseshoe kidney and left upper quadrant pain, ovarian cysts and normal bladder and renal findings in multiple women with recurrent UTIs. These encounters increased my appreciation for allied professionals who have other than medical degrees. I believe every medical student, resident and physician needs to be reminded of our limited scope of knowledge and appreciate that there are trained ancillary staff that allow us to do our jobs effectively and efficiently.

This research experience was an individual choice that I made as part of elective offerings. However, as I neared completion of the rotation, it became apparent that all medical students—no matter what ultimate field of pursuit--would benefit from working with Imaging The World. I became certified through the Institutional Review Board to participate in human research studies. I also learned the proper process for attaining informed consent from patients. Irrespective of the medical specialty or subspecialty, all practicing physicians at some point in their career will require that skill set. Not only does the organization expose students to the utilization of ultrasound technology, it is also an organization that builds a repertoire of career-long medical skills.

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