History of the Faculty of Radiologists

The Beginning
Irish Training and Accreditation in Radiology
Beyond Basic Training in Radiology
The Faculty and the Royal College of Radiologists
Other Faculty Activities
Honorary Fellowships of the Faculty
Postgraduate Research and Continuing Medical Education
The Faculty, Developing Countries and the Middle East
Support from Industry
History of Radiology in Ireland
Summary


Excerpt from “A Century of Medical Radiation in Ireland – an Anthology”
History of the Faculty of Radiologists, by Drs. DF Cantwell, JC Carr, N O’Connell and M Powell.
(Ed. Dr. JC Carr, The Anniversary Press, 1995)

Edited for the Faculty of Radiologists Web page by
Dermot E. Malone and James C. Carr

The Beginning

In 1960 the Radiological Society of Ireland, which had been established in 1932 to develop Radiology in Ireland, decided to set up a committee to examine the developing role of radiologists in education and training. It was decided to establish a Faculty of Radiologists, associated with the Royal College of Surgeons in Ireland. Dr. Bill McHugh states in a letter that “Dr. Des Riordan was the driving force behind the formation of the Faculty. He convinced the Council (he was a Member) that something like a Faculty or Training School should be formed. When he announced this at a Society meeting, there was uproar. Eventually he announced that the College was going ahead with the idea anyway”.

The initial meeting of the Faculty was held in the Royal College of Surgeons on the 3rd of May 1961. The first Dean was Dr. Riordan. He was a radiotherapist, Director of St. Anne’s Hospital, Dublin and a Fellow and Council Member of the College. Dr. S.J. Boland, senior diagnostic radiologist at St. Vincent’s Hospital, was appointed Vice-Dean, and Dr. Finbarr Cross, radiotherapist it St. Luke’s Hospital, was appointed Honorary Secretary.

The first academic involvement of the Faculty was the introduction of a series of lectures in radiology to undergraduates in the Royal College of Surgeons in Ireland Medical School. These lectures were given in radiological anatomy to first and second year students, and in clinical radiology to fourth and final year students.

Irish Training and Accreditation in Radiology

The new Faculty was primarily concerned with postgraduate training programmes and examinations in radiology. The first task was to design an examination structure. A Primary Fellowship examination (consisting of radiation physics, pathology, surgery, radiological anatomy and medicine) and separate Final Fellowship Examinations in Diagnostic Radiology and Radiotherapy were established. The first examinations of the Faculty were held in May 1966.

An Irish training programme in Radiology was then established. This was supported by the Department of Health and was a landmark in the development of Radiology in Ireland. Up to that time, an Irish graduate undertaking a career in diagnostic radiology had to obtain a training post in a recognised centre in the United Kingdom (U.K.) or North America. Most obtained initial training in the U.K. Now, for the first time, Radiologists could be trained in Ireland. Trainees were to be employed as house officers in radiology at the Mater, Meath, Richmond and St. Vincent’s Hospitals in Dublin and the Regional Hospital in Galway. The administrative work relating to the recruitment of candidates was to be handled by St. Luke’s Hospital but the actual training was organised and controlled by the Faculty. A committee was formed to co-ordinate the scheme. This included a radiologist from each of the participating hospitals and representatives of the Faculty. The Secretary was Liam Egan who represented St. Luke’s Hospital. Dr. M. Powell was Chairman and represented the Department of Health. Dr. DF Cantwell represented the Faculty and St. Vincent’s Hospital. The other hospital representatives were Drs. S. Douglas, M. Ryan, P. McCann and T. Eustace. It was fortunate that a number of recently trained radiologists, with fellowships from the UK or North America, had returned from abroad and they were admitted as Ad Eundem Fellows. This gave the Faculty a vast field of expertise to draw on, including subspecialties such as neuroradiology, paediatrics and cardiac radiology. The first trainees completed the course in 1972.

This was, in fact, the first structured medical postgraduate medical training programme in Ireland. The four-year course led to the qualifying degree of “Fellowship of the Faculty of Radiologists, Royal College of Surgeons in Ireland “(FFRRCSI). It is active and successful to the present day. Library and study facilities for students are regularly upgraded with investment in the American College of Radiology film museum, audio/visual aids and in the purchase of textbooks and radiological journals. At first, these were in the main College building. Since late 1991 they have been provided in the new Mercer’s Library.

In 1997 a Faculty of Radiologists trainee, Dr. W. Torregiani, was awarded the Gold Medals of both the Faculty of Radiologists RCSI and the Royal College of Radiologists, London, for his performance in the Part II examination – a unique achievement.

Beyond Basic Training in Radiology

The Council of Europe and the World Health Organisation offered travelling fellowships for postgraduate study abroad which were taken up by many of our fellows. In the 1960s and early 1970s most travelled to Scandinavia to study in hospitals in Stockholm, Malmo, Upsala and Oslo – the leading centres in angiography and neuroradiolocy techniques of their day. Subsequently, when ultrasound and computed tomography were developed in the 1980s, the main centres for postgraduate studies were in the USA and Canada.

In the late 1960’s, as standards in Radiology became more formalised, the Faculty decreed that 5 years training in Radiology was necessary for consultant appointment. This was accepted by the Department of Health and subsequently by Comhairle na Ospideal.

In 1973, the Royal College of Radiologists, London, established the requirement of a Fellowship in Radiology, or its equivalent, and a minimum of five years in a recognised centre as requirement for accreditation in Radiology in the United Kingdom also.

In 1985 the Faculty began issuing Accreditation certificates, in accordance with the recommendation of the Postgraduate Medical and Dental Board, to suitably qualified Fellows applying for consultant and other senior posts. The Medical Council, the statutory body controlling medical education and training in Ireland, recognises the Faculty as the body charged with confirming that satisfactory Higher Specialist Training in radiology has been completed.

Recent European Community rules for specialist accreditation now require five years of approved postgraduate education. In the past it was customary for trainees, on completion of 3-4 years on the National Training Programme, to complete their further years abroad; mainly in the U.K., U.S.A, Canada, other European countries or Australia. In 1996 the Faculty formally established a 5th year of training, involving rotations through diagnostic and / or interventional radiology services. Most graduates of the Training Programme still leave Ireland at the end of their fourth or fifth year and undergo further training in North America, the U.K. or Australia. They become established specialists in these countries. Some settle permanently abroad. Many have returned to consultant posts in Ireland.

There are now four Professorial appointments in Dublin and one in Galway. In 1994, Professor MJ Lee (Royal College of Surgeons and Beaumont Hospital) became the first graduate of the Faculty’s training programme to be appointed to a Chair of Radiology in Ireland.

The Faculty and the Royal College of Radiologists

In the mid 1970s, the Board decided that formal links in training and examinations should be established with the Royal College of Radiologists, London, and that the Primary Examinations of the Faculty should be equivalent to the First Examination of the London College. The Final Examination remained an independent Faculty examination and included sections on medicine and surgery as related to radiology.

Discussions were held with the Warden of the London College, Professor Robert Steiner, who was a Graduate of University College, Dublin. Dr. Donal O’Sullivan, the then Dean, received an invitation to act as observer on the Education Board of the London College and the London College nominated extern examiners for the Irish Primary. Discussions continued and in 1976 the then Dean, Dr. Dermot Cantwell, achieved reciprocal recognition for the Primary examination. It was also agreed that while the Part 11 should remain a separate examination it would be ex-equa with the London Fellowship. This event was of major significance to the Faculty. It formally recognised Irish academic standards in Radiology and enabled Irish radiologists to be appointed to Consultant Posts in the United Kingdom.

Other Faculty Activities

A broad range of other activities developed within the Faculty. Committees dealing with education, radiation protection, EEC developments, alternative methods of imaging, career structures and overseas training were established. The range of problems and questions dealt with each year are summarised in the Annual Report of the Faculty –  recent editions can be read here.

Honorary Fellowships of the Faculty

The development and conferring of Honorary Fellowships of the Faculty strengthened overseas associations. The first were conferred in June 1962 on Sir Peter Kerley, Dr. E. Ronan Williams and Sir Frank Montgomery. Peter Kerley, a distinguished British Radiologist, was a graduate of University College, Dublin, and Director of Radiology at the Westminster Hospital. He will be long remembered for his description of Kerley A. B & C lines in the lung. Ronan Williams was a highly respected British radiologist and Director of Radiology at St.Mary’s Hospital in London. Frank Montgomery was a well-known Belfast radiologist and had made a major contribution in the establishment of radiotherapy services in Northern Ireland. He was an active member and past President of the Radiological Society of Ireland. A list of the distinguished radiologists from Europe and North America who have been conferred with Honorary Fellowships of the Faculty can be found here.

Postgraduate Research and Continuing Medical Education

Over the years our Fellows have performed research projects in Ireland and abroad, and attended and contributed scientific papers to many national and international meetings. These include the International Congress of Radiology, the Radiological Society of North America, The American Roentgen Ray Society, the European Congress of Radiology and specialist meetings in neuroradiology, paediatrics, abdominal, chest and bone radiology (to mention but a few).

In 1955, five years prior to the foundation of the Irish Faculty, the Annual General Meeting, and scientific meeting of the Faculty of Radiologists (London) was held in Dublin, under the Presidency of Sir Peter Kerley. Between then and 1990, three further combined meetings have been held in Dublin with the Royal College of Radiologists, The first was in 1971, when Dr. McHugh was Dean and was with the London Faculty which preceded the establishment of the Royal College of Radiologists. The second was in 1981 when Dr. Ryan was Dean and celebrated the 21st Anniversary of the Faculty. The third, held in 1991, when Dr, Daly was Dean, was attended by over 600 delegates which was the highest attendance at a Faculty or College meeting up to then. Further combined meetings were also organised with the British Nuclear Society, the University of Columbia and the University of Connecticut.

The Faculty organises several CME meetings each year (see Meetings section of this website). These comprise a mixture of workshops, lectures and scientific presentations and posters.

The Faculty, Developing Countries and the Middle East

In the early 1970s, the Council of the College commenced programmes for training in developing countries. The Faculty was active in these programmes and organised undergraduate teaching in radiology in Libya, Saudi Arabia and Kuwait.

In recent years, increasing numbers of doctors from abroad with recognised primary medical degrees have been trained by the Faculty in Ireland and obtained both the Irish and UK Fellowships.

In 1984, the Faculty established Fellowship training programmes and examinations in Kuwait. Dr. H. O’Flanagan initiated the Faculty’s involvement in Kuwait. He had, when the Registrar of the Royal College of Surgeons in Ireland, established the first Surgical Fellowship examination in Kuwait. He asked the Faculty to consider establishing a training programme for radiology there. Dr. N. O’Connell and Dr. J. Carr visited Kuwait for negotiations. In 1984 a decision was taken to establish Part I and Part II training programmes. Dr. D. Legge was the first Co-ordinator of the Teaching Programmes. The Faculty sought and received the co-operation of the Royal College of Radiologists. A Primary Examination, with reciprocal recognition by the Royal College and the Faculty, was set up in Kuwait. The first examination was held in 1987 and since then, regular Primary and Final Fellowship Examinations have been held. The course was interrupted by the 1990 invasion of Kuwait. Several trainees escaped from Kuwait and continued their training in Ireland under the auspices of the Faculty. The Faculty recommenced their programme in Kuwait after liberation. To date, fourteen doctors from the Kuwait project have obtained the fellowship qualification in radiology.

More recently, by arrangement with the Maltese government, Maltese doctors have been training in Radiology in Ireland. When trained, these radiologists will return to work in Malta. In 1998 an innovative web-based educational project designed by an Irish and a Maltese registrar (Dr. M. Blake and Dr. M. Schranz of St. Vincent’s Hospital, Dublin) won the prestigious Silver Medal award of the American Roentgen Ray Society. This site can be visited at http://www.mcqs.com/.

These efforts of the Faculty have answered, in a small way, the constant requests from many countries for assistance in the training of radiologists and postgraduate teaching in specialist areas. Thus, a Faculty in existence for less than 26 years has contributed significantly to training programmes abroad.

Support from Industry

Commercial firms have helped the Faculty a great deal over the years with contributions to the Academic Fund. This supports the Faculty Postgraduate Training Programmes. Firms also assist and support the scientific meetings. Some have helped in specific ways. Kodak and Agfa-Gevaert have endowed a visiting professor from overseas to provide extra teaching to our trainees on a twice-yearly basis. Nycomed provide the Travel Fund, applicable to Post-Primary Trainees to assist them in presenting scientific papers at meetings abroad and also provide funding for the Annual Nycomed Lecture. Schering underwrites the Annual Refresher course every March. Merck supports the professorial Fund. Agfa-Gevaert established a Fund to award a prize to the candidates in the Primary and Final Fellowship examinations who had attained a defined high mark. They also cover the expenses for the Haughton Lecture delivered each year at the Annual General Meeting. Picker traditionally sponsored the Imaging Meeting.

The Faculty gratefully acknowledges this support.

History of Radiology in Ireland

Excerpt from the Foreword to “A Century of Medical Radiation in Ireland – an Anthology” (Ed. Dr. JC Carr, The Anniversary Press, 1995) by Dr. G Hurley.

“The approach of the Centenary of the discovery of X-rays by Conrad Roentgen prompted the Faculty of Radiologists to commission a history of medical radiation in Ireland. Dr. James Carr, a former Dean of the Faculty, undertook the co-ordination of this task with typical enthusiasm. His considerable powers of persuasion resulted in a number of contributions from radiology, radiography, physics and industry. These form the basis for this anthology. The authors have been generous in their work and research in charting the development of radiology in Ireland from the modest beginnings of the enthusiasts shortly after Roentgen’s discovery to the present day. Over the past century there has been a generally steady growth in the development of radiology based on the materials and ingenuity of modern science adapted to the needs of modern radiology. This progress has been achieved against a background of profound political, social and economic change in Ireland. While the improvements and pace of change in radiology over the last thirty years have been very great, we are still indebted to the pioneers of radiology for their tenacity and enthusiasm in developing the speciality and bringing the benefits of radiology to patient care. The Faculty are most grateful to the authors.”

To buy a copy of this book, write or fax to:

Faculty of Radiologists,
Royal College of Surgeons in Ireland,
123 St. Stephen’s Green,
Dublin 2,
Ireland.
Fax: (01) 402-2466
Price: € 20.00

Summary

Radiology is now an integral part of medical teaching for both the undergraduate and postgraduate student in Ireland and radiologists participate in the teaching of anatomy and pathology as well as the clinical specialities. The Faculty’s reasons for existence are the training of radiologists and continuing medical education. This ensures the maintenance of high standards and establishes common ground with other national radiological bodies worldwide. The Faculty organises continuous training courses at home and abroad as well as organising meetings, symposia and lectures. Welcome to our web site.