Through a program called Road2IR, I am planning to go to Uganda to help establish a self-sustaining interventional radiology (IR) training program. I have been involved with Road2IR since my residency, during which our group developed East Africa’s first IR training program in Tanzania. Our model consisted of sending IR physicians, nurses, and technologists to Muhimbili University in Dar es Salaam for several weeks at a time to train their counterparts. We published an overview of our model in the Journal of Vascular and Interventional Radiology in 2019 (https://www.jvir.org/article/S1051-0443(19)30687-6/pdf). Soon after, the curriculum was formalized with a Master of Science in IR degree program (https://medicine.yale.edu/news-article/yales-tanzania-interventional-radiology-initiative-approved-for-msc-program/). The first class of Tanzanian IR fellows graduated in 2021.
We are now hoping to replicate this training program in Uganda. In August 2023, Road2IR established a partnership with Mulago National Referral Hospital (https://observer.ug/news/headlines/78949-mulago-hospital-embraces-advanced-medi-care-radiology). The hospital is now offering IR services with the eventual goal to have its own Master of Science in IR program. As a resident, my involvement in Road2IR was primarily recruitment, logistics, and research. Now that I am an attending, I am thrilled to be returning to the program as a teacher.
The program most directly serves Uganda’s population of over 49 million. In practice, however, Road2IR has seen a greater regional impact. Alumnae of the program have returned to their home countries to build their own training programs. Dr. Ivan Rukundo, one of the inaugural IR fellows in Tanzania, returned to his home country of Rwanda following completion of his training to build an IR program there. The following year, Dr. Ofonime Ukweh, returned to her home country of Nigeria to do the same. With Road2IR’s expansion into Uganda, we hope to continue drawing trainees from across the continent.
The essential goal of Road2IR is to increase access to IR services in the developing world. Minimally invasive image-guided procedures have demonstrated numerous advantages over traditional surgical options. Common examples include percutaneous biopsy, abscess drainage, nephrostomy tube placement, and embolization of bleeding. However, these basic and fundamental services are unavailable across much of the world. According to the WHO, over 4 billion people lack access to diagnostic imaging, so the number of people without access to IR is presumably much greater. Uganda has a population of over 49 million people but no formally trained IR physicians. Our experience in Tanzania demonstrated that patients were willing to travel across the country to access IR services. Although it will take decades to make IR globally available, Uganda is a perfect next step.
During my two weeks in Uganda, I saw patients who had traveled across the country for consultations. As Mulago is the country's largest referral center, most of our patients were extremely sick. I helped the Ugandan fellows evaluate patients in clinic and guided them through procedures. Equipment was limited, so we had to be thoughtful and resourceful with what we had. The Ugandan fellows continually inspired me with their dedication to their patients and IR. Working in this environment is consistently challenging and is a reminder of how much we take for granted in the United States. I only wish I had more time in Uganda, and I look forward to going back.
