The Evolving Landscape of Radiology Training In NSW – The Rising Role of SRMOs & Teleradiology

The landscape of radiology training in New South Wales (NSW) is witnessing a significant transformation, marked by the growing emergence of Senior Resident Medical Officer (SRMO) roles and the adoption of teleradiology in public hospitals. These advancements are reshaping the future of radiology, offering new opportunities for training and redefining work practices in the field.

The Senior Resident

In a shift from traditional prevocational training pathways, major training centres throughout NSW are increasingly offering SRMO positions in radiology. These roles are not only designed to provide a more relevant stepping stone for those aiming to secure an accredited training position, but also aim to support the department by alleviating some of the expanding duties and responsibilities of registrars.

What exactly does a SRMO do?

In diagnostic radiology, an SRMO’s responsibilities include protocoling and scheduling imaging studies, handling consultations, working closely with radiographers and preparing multidisciplinary team meetings. In many centres, SRMOs are also able to practice reporting studies, which are then verified by a consultant, providing early and valuable experience. As a bonus, they are able to easily engage in relevant research projects, clinical audits and departmental teaching, which is beneficial to their CV development.

In interventional radiology, SRMOs play an integral role throughout the patient’s treatment journey. Their responsibilities span from receiving consults and organising procedures, to performing or assisting in various interventions. They are also involved in the post-procedural care and follow-up of interventional radiology patients on the ward.

Why not just create more accredited training positions?

The number of accredited training positions a site is permitted is determined in part by the number of consultant specialists able to supervise trainees. The trainee-to-consultant ratio is decided by RANZCR. Additionally, in NSW at least, there is also the issue of limited rotation positions to subspecialty sites such as paediatrics which is a current bottleneck for registrars progressing smoothly in their training program. Increasing registrar training numbers without addressing this issue may only compound it.

Teleradiology

Teleradiology, the practice of reporting studies remotely via the internet, is another major development in NSW’s radiology sector. Simply put, this technology allows consultant radiologists from around the world to report after-hours studies from the comfort of their homes, often obviating the current need for overnight registrars.

What impact has this had on radiology departments?

For radiology registrars, it first and foremost removes the strain of working overnight shifts. This leads to increased supervised training time a registrar has with their consultants, and improved rostering flexibility which enables greater ability to take leave.

For consultants supervising registrars, it removes a substantial and growing workload of overnight registrar-reported studies which then need to be verified the following morning. Outside of the hospital, it provides a limitless and flexible opportunity to generate an additional stream of income. Importantly, it allows both private and public radiology sectors to work together to improve the timely delivery of their service for patients across the state.

What impact has this had on referrers?

For referrers, teleradiology can expedite the delivery of after-hours radiology reports by consultant specialists which is beneficial in time-critical situations such as trauma. Additionally, it provides an avenue for outsourcing the mounting backlogs of unreported studies across many major tertiary hospitals, which have received increasing attention in recent times.

Whilst teleradiology comes with several advantages, it can also present challenges in communication between referrers and teleradiologists. In some instances, it can lead to reports that are limited to the amount of clinical information accessible remotely by the teleradiologist.

Nonetheless, the evolving landscape of radiology in NSW, with its forward-thinking adaptations in training and service delivery, presents an incredibly promising and dynamic environment. It’s an exciting time for current and future professionals in the field, promising not only enhanced career development opportunities but also the potential to significantly improve patient care across the state.