Radiology Transitions in the Lion City

Editor:

We thank Dr Lee for his insights and observations on our little Lion City, which appeared in the September 2015 issue of Radiology; sometimes it takes an outside perspective to highlight the blessings and the challenges facing us, which those inside the system may not see or verbalize as cogently (1). Like other nations, Singapore faces health care issues, including an ageing population, rising healthcare costs, and increasing expectations of radiologists.

Radiology practice in Singapore has benefited from our being at the crossroads of world cultures; as we transition from a British-type of training to American-style Accreditation Council for Graduate Medical Education residency programs and examinations, we hope to adopt the best practices from all systems. The strength of our radiology practice is its clinical orientation: Radiologists (especially in academic and restructured public hospitals) consult closely with referring clinicians. Every effort is made to prevent unnecessary radiation, and our entire medical education journey emphasizes the appropriateness of any imaging study requested and/or ordered. We have in the past struggled with a low ratio of radiologists per million population, but as our specialty progresses it is hoped that there will be enough radiologists to provide subspecialist expertise, quality improvement, education, and research (2).

Our role as clinical radiologists, however, is being challenged by an increasing expectation of an on-demand imaging service provider to answer questions quickly (3) and the inexorable rise of defensive medicine. To maintain high professional standards and training, the College of Radiologists Singapore and the Singapore Radiological Society are working hard to continuously improve the formal teaching curriculum and informal subspecialty interest group meetings. In learning from the best, perhaps partnerships such as multidisciplinary team conferences (4) and the American College of Radiologists’ Imaging 3.0 value initiative (5) might provide a way forward for radiologists in Singapore to be consulting physicians (6) who provide appropriate, timely, high-value, cost-contained imaging services that would benefit the health of our nation.

In his article, Dr Lee also mentioned many imaging features in our patients that are clinically interesting, and we look forward to exchanging these ideas at the appropriate fora. In the meantime, we wish him the best in finding good salads for lunch!