Dear MARNMP members,

 

I hope that despite the COVID-19 pandemic, you have had time to take a break during this Summer.  Most have opted to spend their holidays in Malta perhaps, although the respite with low number of local COVID cases was indeed quite short. The uncertainty factor remains high, as we witness a new local surge of COVID-19 cases after the government lifted pandemic restrictions and with the consequent re-opening of air travel and entertainment venues in early July.  Many argue with hindsight that things could have been done better.  Although a second wave was probably inevitable, political foresight could perhaps have kept the numbers of COVID-19 low. How could the policy makers even conceive to hold large mass gatherings, mixing tourists and local people, with no precautionary measures whatsoever during a world-wide pandemic?  Pandemics are akin to a haemostatic or endocrine system.  No gland can function on its own account.  If a gland malfunctions and produces too much hormone C-19, the other glands respond by suppressing its activity.  Many European countries have now placed travel restrictions on neighbouring countries with a significant per capita rise in COVID-19 cases, including Malta.

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The Maltese Association of Radiologists and Nuclear Medicine Physicians has supported the Maltese Medical Association in its calls to the government to stop mass events and in the industrial action that followed.  Let us hope that common sense prevails, and that public health takes precedence during this time of difficulty.

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World-wide COVID-19 cases keep rising and the pandemic shows no signs of relenting.  Upcoming autumn and winter season will surely bring new challenges.  We must make treasure of our early experience to keep morbidity and mortality as low as possible, while awaiting the outcome of vaccine trials.  Since the first wave of COVID-19 cases, we have seen the introduction of several new hospital practices, including social distancing, wearing of masks and re-organization of services aimed at protecting patients and staff.  Medical Imaging Department (MID) provided a sterling service during the first wave.  This included re-organization of service provision to ensure patient and healthcare worker’s safety, including the provision of several hundred chest CT scans with around the clock hot seat reporting service. The important role of CT in the diagnosis of COVID-19 pneumonia (especially in patients with high index of suspicion and an initial negative swab result) is highlighted in the most recent updated hospital policy on PPE. Hats off to Mater Dei Hospital and MID management teams and to all of you who kept diagnostic and interventional emergency services going during the lockdown period and who continue to provide these invaluable services at present.

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Amid all the COVID crisis, we need to try and establish some degree of normality to help us steer through this complex period. We should try and safeguard our mental well being as much as possible – both at work and at home. I recommend the book by Dr Paulann Grech.

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Another excellent write up on radiologists wellbeing can be found in this article, published recently on Medscape.

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Education and training

Three of our higher specialist trainees are starting final year fellowships in the United Kingdom.  We wish them all the best. 

In June, we held interviews for a new intake of Radiology trainees.  The new batch of basic specialist trainees should be starting anytime soon, and I take this opportunity to auger them all the best.  For the first time, MARNMP has collaborated with University of Malta (UoM) to incorporate an MSc Radiology course as an essential part of the training curriculum.  We have therefore updated our Radiology Curriculum and Training Document which you can access online here.

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Our curriculum will continue to be based on the curricula of the European Society of Radiology and Royal College of Radiologists, while incorporating the UoM MSc Radiology course.  I believe that by combining academic and clinical aspects of training, we bring together two important aspects of medical training and open new horizons to our future radiologists.

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No FRCR exam sittings were held in April and June 2020 because of COVID-19.  FRCR part 2 examinations in October and December 2020 will be limited to UK trainees only, to cater for the backlog.  We remain hopeful that the FRCXR examination situation normalizes in 2021 and that international candidates can apply once more.  In the meantime, I am pleased to announce that for the first time, MARNMP has organized a local sitting of the European Diploma in Radiology (EDiR) and both our candidates have been successful.  I wish to applaud our local organizer as well as the trainees who took the exam with successful outcome.  There will be more sittings in the future and potential candidates are encouraged to approach MARNMP to set an exam date.

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Since onset of COVID-19 pandemic, we have switched all our teaching to Microsoft TEAMS.  Most lectures and tutorials have proceeded normally using the online platform and we foresee to continue using this method of learning in the future.  With onset of social distancing, we have discovered other innovative ways of teaching/learning.  Trainers are encouraged to include trainees in all their clinical email consultations and to use online platforms for all learning opportunities. 

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Despite that all major international conferences have been cancelled, there remains a lot of opportunity for online learning and continued medical education.  ECR was held in July on a significantly reduced scale. Online participants had the opportunity to participate in a daily case-based quiz.  Most other international conferences were or will be held online, including RSNA 2020.  The Royal College of Radiologists is providing a program of online CME activity to its members.

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British Society of Interventional Radiology (IR) is organizing an online webinar every fortnight, covering the most important aspects of IR.  Webinars can be viewed retrospectively by members. 

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I am sure that you can all find online material to keep you up to date with your general and subspecialty radiology interests and keep on track with CME.

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MARNMP hopes to re-introduce its regular evening CME activities in the coming months.

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Conclusion

COVID-19 is not going away anytime soon.  The better we foresee what is coming up next, the higher our chances are at reducing morbidity and mortality.  We are slowly learning that there is no quick fix to this problem. We remain hopeful that a successful vaccine is on the horizon.  Even in the advent of a successful vaccine, the challenges will not go away quickly, and we must keep learning and adopting during these difficult times.  By working together as a team, we stand a better chance. I encourage you all to stay alert and to keep yourselves informed.  Make sure to keep up to date with evolving hospital policies and protocols regarding COVID-19 pandemic.  I wish you all to keep safe.
 

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Adrian Mizzi
President of the Maltese Association of Radiologists and Nuclear Medicine Physicians.

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