Report of Outreach Professor William P. Dillon, M.D.

ASNR Visiting Professorship: India January 2015
William P. Dillon, M.D.
Professor and Executive Vice-Chair
University of California, San Francisco

I was fortunate to be named the 2014 ASNR Outreach Professor for Mumbai, India. The Indian radiology community hosted me in each of four major teaching hospitals in Mumbai in January 2015:

Dr Sunita TibrewalaTN Medical College and BY Nair Hospital
Dr. Anagha JoshiTilak Medical College and Sion Municipal Hospital
Dr. Shilpa DomkundwarSir J.J. Hospital
Dr. Shilpa SankheKEM Hospital and GS Medical College

These facilities are municipal or government hospitals that are used by all segments of Indian society, but primarily by indigent in Mumbai. The number of patients seen by these facilities is overwhelming by our standards, and places tremendous pressure on health care providers, especially radiology, which is faced daily with many patients who are being screened for disease. Most of these hospitals have a single CT and MR scanner. By necessity the radiologists are superb at moving patients through these resources in an efficient and brisk fashion. Residents are a key component of this effort, working up to 12 hours a day 7 days a week with breaks only for holidays and summer vacation. CT typically is open 24 hours a day and 70-100 patients are scanned per day. The MR scanner is open until 11 pm; patients are scheduled at 30-40 minute per examination. Ultrasound is used primarily for screening, with up to 50 examinations daily performed by each of 5 residents. There is a robust and well developed private clinical and hospital sector, which many middle and upper class citizens use for health care and imaging. These resemble the best the U.S. has to offer, with excellent equipment and technological expertise.

The pathology I saw was amazing. Infections are frequent in the population, particularly meningitis, TB and cysticercosis, which is increasingly seen among vegetarians who eat contaminated raw or unclean vegetables. I was also shown quite a few pediatric congenital cases (India would be a great experience for pediatric neuroradiologists!).

My obligations included 2-3 lectures and one or two case conference per day. The residents also presented interesting or difficult cases to me, which was fun and challenging. The residents and staff were extraordinarily grateful for my teaching and the opportunity to share our experiences. Due to the overwhelming number of patients, teaching typically occurs on the fly, with few organized teaching conferences. 40-50 people attended my lectures and case conferences, and were very appreciative of the opportunity to listen to lectures and share cases. Residents take oral boards, and were very appreciative of the opportunity to take cases and discuss them in a conference setting. I also lectured, along with several ASNR colleagues, at the annual IRIA meeting held in Kochin, a southern city in the state of Kerala.

Our hosts provided hotel accommodations and the ASNR a modest stipend for costs of travel and incidental expenses.

The experience was enormously enjoyable for me and met the goals of cross-cultural teaching experience. Indian radiology is flourishing, and the residents and attendings are excellent. I hope India will continue as a site for our ASNR outreach professor program. We had a marvelous experience and enjoyed making new friends. Cross-fertilization would be great for trainees in both countries.