Morgan McLuckey is a current resident in her final year of training in the Department of Radiology at Indiana University. Through the AMPATH partnership, she traveled to Eldoret, Kenya, to work alongside physicians and residents (called registrars in Kenya) in the Department of Radiology at Moi Teaching and Referral Hospital (MTRH) in January 2024.
My short time in Kenya proved to be a transformative experience full of both professional and personal development, as well as mutual teaching and learning, which I anticipate will influence my career to come. I’m incredibly grateful to those who made this possible.
Teaching occurred in both instructional settings and in the reading room. I came to MTRH prepared with lectures on radiology topics that I understand well and was able to share these with the registrars in the form of a morning lecture series. I was impressed by the level of engagement with these sessions. It became clear to me that the registrars have a strong desire for this type of teaching through the many questions that were asked during the sessions, as well as the feedback given afterwards. I was told that one of the first-year registrars, after a lecture about the shoulder, felt prepared enough that she is “ready to report all shoulder x-rays now.” I was also actively engaged by both registrars and consultants in the reading room, who would ask me to sit with them or beckon from across the room to ask my opinions on tough or interesting cases. This part of the experience felt somewhat like a capstone to my residency, where I could see the value of my residency training in providing meaningful assistance in challenging diagnostic cases.
There was, of course, an enormous amount of learning during my time at MTRH as well. I experienced wholly new cultures, a medical system facing different and unique challenges from my own, and pathology rarely encountered in my own practice (particularly in the realm of infectious disease). One of the most impactful experiences that I had was a morning spent with one of the registrars in the newborn intensive care unit. She, very thoughtfully, invited me alongside her to perform ultrasound examinations requested by the neonatologists. As I will soon be a pediatric radiologist, it was a valuable experience for me to see and practice performing neonatal head ultrasounds (a study that I will often read, but almost never perform, at home). On this morning, as well as many other mornings during my trip, I learned hands-on ultrasound skills from the Kenyan radiologists who routinely perform these scans themselves. I also felt honored that this registrar elected to welcome me alongside her, to show me new parts of her hospital, and to teach me what she knew.
While in many ways my broad education at IU had prepared me for what I would see in the radiology department at MTRH, there were many instances in which I was surprised by the differences in practice. Most of these surprises related to differences in information technology and imaging availability. For example, MTRH currently has a 0.3T magnet (with plans to one day install a 1.5T magnet) with which limited exams are performed for imaging of the brain and spine. This is in contrast to MRI use in the US, which we also frequently use to image the chest, abdomen, pelvis, and musculoskeletal system, in addition to the brain and spine. I used a lightbox, for the first time, to read these studies on film. It was a challenge to pick up my first such brain MRI just as the neurology team walked in hoping to discuss the case, and to work my way through the study without many of the images that I am used to the luxury of having when practicing in the U.S. This is all in stark contrast to the practice of radiology in the US, where digital imaging systems allow the quick navigation of thousands of images, including access to prior imaging, and where more imaging is almost always a possibility.
As it has been less than a month since my return home, I am still discovering how this experience will impact my future career and practice. In both the short and the long term, I hope to continue to cultivate personal and professional relationships with our colleagues in Kenya. I exchanged contact information with several of the registrars and we have been regularly sending interesting learning cases we encounter back and forth. I hope to coordinate a virtual case conference between the IU residents and Kenyan registrars both to share knowledge and to foster interest in the AMPATH Kenya experience amongst IU residents. A few IU residents are already planning on visiting MTRH next year. IU Radiology faculty are currently engaged in periodic virtual teaching with our Kenyan colleagues, and we hope to encourage increasing faculty in-person participation at MTRH in the future.
Finally, this trip has also pushed me to think more about how to expand and improve radiology care globally. While it is of course enormously important to innovate in ways that advance our diagnostic and treatment capabilities in radiology, it is also a significantly important endeavor to think about how to translate these advances to improve radiology care globally.