by Dr Evelyn Ho Lai Ming

was once asked if I was a radio deejay because I had said, I was a radiologist. That really amused me initially, and it made me think of the many times where people would wonder what it was I did!

Was I a technician? Most would be surprised that I am, indeed, a medical doctor. The implication is that many in Malaysia, might have used the services of a radiologist sometime in their lifetime but would never have realised it or known it. As some would say, they have never seen the “face” of the radiologist that reported their x-ray examination!

The title of “WHAT is a Radiologist?” is intentional because it reflects the lack of information on this branch of Medicine that perhaps was ‘born’ with the discovery of X-rays in 1894. 

The Masters course (as the degree is awarded by a university, in our case University Malaya, University Kebangsaan Malaysia and University Sains Malaysia), is a structured 4 year course with tough written, oral, and practical examinations. Examiners will include local and foreign examiners from recognised radiology teaching institutions.

The radiologist also undergoes training in physics, radiobiology and radiation protection. They will have to pass examinations in these subjects and therefore are able to weigh the benefit-risk consideration when it comes to procedures requiring radiation. In the absence of medical physicists, they will be in charge of radiation protection in a radiology department. As such, you can be reassured that they use and treat all procedures involving radiation with respect. Radiologists in Malaysia also adopt the principle of ALARA, which means, “ As Low As Reasonably Achievable”.

After graduating from their course in Radiology, they have to serve another 6 months under supervision in recognised centres before they are gazetted (recognised as specialists) by the Ministry of Health. If the radiologist is trained overseas, he/she will have to work in a recognised hospital in Malaysia for 1 year and then, a further 6 months for gazettement. If they have worked in a recognised centre overseas they may be given exemption by the Ministry of Health, on a case-by-case basis.

Therefore, the radiologist would have gone through many years of training. As in other fields of medicine, the radiologist will have to continue to update, improve, upgrade their knowledge through Continuous Medical Education programmes. In some countries (this has already been proposed in Malaysia), subspecialisation into the various fields in Radiology is available.

As Malaysia has relatively few radiologists, we have not seen an explosion of subspecialties in Radiology. In the more developed countries, as the field grows even larger with the newer imaging studies, radiologists have become even more specialised. Now there are neuroradiologists, ultrasound, MRI and CT specialists, mammographers, GI radiologists and others.

Currently, most radiologists in Malaysia are “general” radiologists with special interests in fields such as mammography, interventional radiology, neuroradiology (specialising in the central nervous system ) and paediatric radiology (specialising in imaging in children). 

A radiologist may act as a consultant to another doctor caring for the patient or act as one of the doctors in the care of a patient. They may have an active role to play in a team approach for the patient, such as in the management of breast cancer. They may be integral in the management and treatment of a patient in interventional radiology.

Radiologists interpret X-ray images called radiographs, Ultrasound, MRI, CT, perform imaging procedures and procedures requiring imaging guidance as well as other special procedures. They are responsible for supervising all procedures in the radiology department. They may also interpret Nuclear Medicine tests, although most would have undergone further training in Nuclear Medicine Imaging if they manage the department of nuclear imaging.

The important and emerging field of interventional radiology places specially trained radiologists in a position that is somewhat like the surgeon’s. General radiologists may perform the simpler procedures such as draining fluid collections and biopsy lesions with needles. However, more specialised training is essential for the more complex and important areas such as the brain, complex procedures such as dilating arteries, placing stents across “narrowed” structures, blocking abnormal blood vessel lesions and treating large inoperable tumours.

Estimated cost of training per year (4-year course) for Masters of Medicine in Radiology in Universiti Sains Malaysia, Kubang Kerian, Kelantan is as follows:
 

Yuran tidak berulang (non-recurring fees)
 

Masters of Medicine in Radiology, University of Malaya, Kuala Lumpur
The estimated cost is about RM2,500.00 per year and this is a 4 year course. The total cost for the course is about RM10,000.

• Radiologist
• Specialised physicians who can perform basic imaging functions such as ultrasounds. An example is an obstetrician who performs a routine ultrasound on a pregnant woman.
• Technologists, who are specially trained to perform specific imaging techniques and have obtained certification. Technologists include radiographers, and sonographers.
  Technologists work under the direction and supervision of the radiologist.
• Other specialists (such as internal medicine physicians) can take the Nuclear Medicine course and then, become qualified to interpret nuclear medicine scans as well.

• hospital-based radiology departments
• free-standing radiology clinics/centres
• specialised centres (i.e day care centres)

Although in general, doctors may be able to interpret chest x-rays, orthopaedic surgeons can read bone x-rays, just to cite a few examples, there are very few that have become “expert” with the newer modalities of ultrasound, CT, and MRI. In addition, because the radiologist is able to utilise imaging modalities to the best advantage, they would best be able to advise what imaging technique and what procedures would help your doctor to get to the root of the diagnosis.

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Last Updated:
Thursday, 21 August, 2003