Radiologic skills for internal medicine specialists

Dr Julian Dobranowski is a professor and chair of the Department of Radiology at McMaster University, chief of diagnostic imaging at Niagara Health, and provincial head for the Cancer Imaging Program at Cancer Care Ontario.

What are the basic radiologic skills that all internal medicine specialists should know?

Julian Dobranowski, MD: There are several basic skills that an internal medicine specialist should know.

I think the most important one relates to when to order the examination and what kind of examination. I am talking about appropriateness of the test itself. Here the most important thing to remember is that if you are ordering a chest x-ray, or any x-ray examination at all, you are dealing with radiation, and you really want to avoid that if you can. So you do not want to order an examination unless it is going to impact the patient’s outcome in some way. It is very important that there is an understanding of why that patient needs the test and why that test is going to make a difference in the patient’s life.

Also, if the internal medicine specialist is doing primary reads—which means that they are interpreting the x-ray on their own, perhaps in the middle of the night, where there is no radiologist—[it is important] that they can make a diagnosis and do it comfortably and accurately.

I think those are the two main areas where the skill is necessary.