Consultant in Radiology, Saigon Medical School
HISTORY:The history of Radiology in the medical curriculum has scarcely begun.Our contemporaries will recall a student experience of Diagnostic Radiology which included the cursory discussion by clinical teachers of the radiographs of patients under study, displayed in the wards under poor viewing conditions at a distance from the student, and an occasional lecture by a radiologist faced with the formidable task of explaining "Radiology" to up to a hundred and fifty students in an hour.If we ever wondered how these radiographic images were produced, how they represented in two dimensions the three dimensional structures, normal and abnormal, within the patient, how they could, or whether they should be translated again in our minds into a three dimensional concept of these structures, and what information we could reasonably expect them to give us about these structures, we were left wondering.The place of Diagnostic Radiology in physical diagnosis was never mentioned. Could it ever provide "Proof"? (or was this a prerogative of pathology alone?). How did it complement and supplement other diagnostic methods? Were there times when it had little to offer? What price had to be paid by the patient for the information it provided, in treasure, radiation hazard, discomfort or trauma? How did it compare with other diagnostic methods in these respects? Such questions were neither raised nor answered.We would have been interested to be told that Diagnostic Radiology was a useful model of physical diagnosis, that the same skills of observation a n d interpretation were demanded by both, and we would have been surprised and very interested to hear, after so many years of information ingestion and regurgitation, that our major professional activity for the rest of our lives was to be the hitherto unfamiliar exercise of problem solving, and that Diagnostic Radiology offered US marvellous practice at this. But these facts were withheld from us, not because of any perversity of our hard-working and dedicated teachers, but because radiology had not yet grown up, and these matters were but poorly understood.Then, and unfortunately in some places now, the major instruction of a young doctor in Diagnostic Radiology was received in his junior resident year, from residents one or two years senior, similarly instructed in the preceding years. Thus misconception and error became conviction, and were incorporated into the conventional medical wisdom of the time.Since then advances, and in particular the work of the great correlators of Radiology with Physiology and Pathology, Kerley, Fleischner, Simon, Steiner, and many others, have raised radiology from a "Technical Field" to an accurate diagnostic discipline relevant to almost all areas of medicine. The change has been rapid and profound. Most of these giants are still alive, and the full significance of their work still escapes universal recognition.During the same period investigations into the nature of the roentgen image, and the pro...
