A Comprehensive Approach to Ultrasound

Education in Emerging Countries

Diagnostic ultrasound is a rapidly developing medical imaging technology that is widely used in both industrialized and developing countries. For certain applications, ultrasound has replaced other commonly utilized radiographic modalities as the method of choice and it is well established as the primary diagnostic imaging modality in obstetrics and gynecology. Ultrasound equipment tends to be less expensive and more widely available than other medical imaging equipment and does not use ionizing radiation. The World Health Organization recommends that all medical students should receive an introduction to the principles and uses of US. General physicians should receive further Level I training to enable them to perform and interpret basic ultrasound exams, and specialty training should be available to those interested in focusing their careers in ultrasound practice. This combination of factors including low cost and sustainability has resulted in the proliferation of ultrasound units and, in some cases, their use by individuals without proper training.

In the early stages of US education in the United States training was largely through apprenticeship with a mentor or expert in the field. As use of US expanded, increasing numbers of academic and commercial short-course programs became available to meet the growing need. As the field became more established, US training was incorporated into formal medical education programs (radiology, cardiology, obstetrics & gynecology etc.) at both the residency and fellowship levels. Today, there is a wide array of educational resources available to US practitioners throughout North America, Europe and Australia, ranging from conferences and short courses to globally available Internet-based resources. In Latin America some countries provide specialized US training to newly qualified physicians, as well as advanced specialization programs, and national societies offer extensive educational content as part of their society meetings. A similar pattern characterizes other industrialized regions of the world. However, in emerging countries the picture is often quite different. Training resources may be limited or unavailable. Even if donated instrumentation is accessible, the operator-dependent nature of ultrasound imaging and the lack of trained individual to utilize available instrumentation may result in poor quality diagnoses. This lack of trained operators may lead to abandonment of ultrasound in favor of more costly but less operator-dependent diagnostic modalities.

In 1992 the Jefferson Ultrasound Research and Education Institute (JUREI) was established to consolidate and strengthen the Thomas Jefferson University education and research programs in ultrasound. A major focus of JUREI was development of programs that could address the needs of physicians and sonographers in the United States as well as emerging nations and underserved regions of the world.

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