Progress in Improving Radiology Residency Training in Finland

Abstract

i t i e l a w c t ( b a Radiologists in Finland, as in the other Nordic countries, have always followed advances in radiology training abroad, particularly in the United States and central Europe. The training requirements are determined not by the radiology community but by committees from the ministries of education and health, which tend to be dominated by surgeons and internists. Nevertheless, training requirements in radiology steadily increased to a total of 5 years of radiology and 1 year of general practice in the 1980s, in response to the challenges of CT, ultrasound, interventional procedures, and the advent of MRI. Because radiology training in Finland is very much service oriented, with considerably less formal teaching than inUSresidencyprograms, this extra time was considered necessary. Local governments own nearly all hospitals in Finland. Compared with the United States, radiologists in these public hospitals have more modest salaries, but a thriving private sector enables most to supplement their incomes substantially through part-time fee-for-service arrangements. Residency programs are exclusively offered in public hospitals, and 50% of the rather modest salaries paid to residents comes from the government. Despite this subsidy, residents are expected by their employers to spend most of their time providing services rather than in study.Undertheserestrictions, thefifth year of specialty training has been considered necessary because the intensity of training is not as high as in the United States. A major setback occurred in 1996, when the Finnish authorities unilaterally decreased the training requirements in radiology, pathology, and a few other specialties to only 4 years of training plus 1 year t of general practice. Despite repeated requests from the radiology community, the government agencies refused even to consider any change in these new requirements. The specialty board examination, administered by the chairs of the 5 university radiology departments, served to guarantee that those for whom 4 years of training were insufficient did not pass until they had undergone additional training.