Resident perspectives on global health imaging in canadian radiology training: A national survey.

Abstract

Rationale and objectives: Radiology plays a critical role in healthcare but is marked by stark global inequities. Low- and middle-income countries have far fewer imaging resources and trained personnel compared to high-income countries. As global health interest grows among trainees, understanding Canadian radiology residents' perspectives on global health imaging (GHI) is essential. This study aimed to assess their prior experiences, perceived barriers, and recommendations for integrating GHI into residency training.

Materials and methods: A bilingual, anonymous survey was developed and distributed to residents across all 16 Canadian radiology residency programs from May 2024 to April 2025. The questionnaire included items on demographics, prior global health involvement, interest in GHI, perceived preparedness, institutional opportunities, and barriers to international engagement. Respondents were also asked to identify preferred approaches for integrating GHI into training programs.

Results: Fifty-one trainees responded from 14 different programs. 64.7% reported prior work in developing countries, with 54.9% perceiving an unmet need for medical imaging in those settings. Nearly half (47.1%) expressed plans to engage in GHI. On-site collaboration and education of local staff (47.1%) and residents (49%) were the most preferred methods of contribution. However, 78.4% felt unprepared or unsure to get involved in GHI. 45.1% reported no GHI opportunities in their current program. Major barriers included call coverage (94.1%), lack of funding (90.2%), and limited infrastructure (90.2%). The top proposed solutions were international electives (86.3%), teleradiology (60.8%), and case presentations focused on diseases highly prevalent in developing countries (51%).

Conclusion: Canadian radiology trainees show strong interest in global health imaging but face systemic barriers. Curricular integration of electives, teleradiology, and global health education, along with improved access to funding, could bridge the gap between interest and participation.