#1 In Radiation Protection
Yun Wang works for the leading radiology department in China. He explains the role of technologists in Peking Union Medical College Hospital (PUMCH) taking the lead in China’s nationwide radiology ranking.
radiology.bayer.com (rbc): Which role do technologists play in making PUMCH excellent?
Yun Wang (YW): PUMCH is indeed one of the leading hospitals, and we work at the highest level in the country. We manage a very high patient throughput every day, and our major role is the support of radiologists. We serve the patients from a different angle.
rbc: What exactly are your responsibilities?
YW: There are three major aspects for a technologist:
The first point is the daily work to serve the patient; doing the scan, the technical perspective.
The second one is self-education and self-improvement. A technician should always keep improving himself, studying all the time to improve his skill levels and techniques.
The third is scientific exchange with others to represent PUMCH, which stands for the highest radiology level in China.
rbc: Where do you represent PUMCH?
YW: Basically we cover all levels. We attend congresses here in the Beijing region, but also domestically, for example the Chinese congress of Radiology.
We also do exchanges within the APAC area; with Japan, Korea, Thailand, Hong Kong – the most economically developed APAC regions.
And from a global point of view we attend ECR and RSNA; the annual meeting of the global technologist society, which will be held in Costa Rica in 2018.
High Moral Standards
rbc: Who meets your standards?
YW: Three points are important to me, but the first is the most important: very high ethical and moral social morals. We pay great attention to this here at PUMCH.
The second aspect is professional ability. The third is teamwork ability. He or she should get along very well with other team members. And he or she should also bring something new and fresh into the team.
rbc: Social morals does not usually come first. Can you specify that a little bit?
YW: With this ethic level I mean that an employee should have a loving heart, be very tolerant to others and really love his work. He should love his responsibility from his true heart. Only then will he play very well with the other team members and bring something new into the team.
I know that other hospitals might name professional abilities as the most important trait, but here we pay the greatest attention to this ethical level.
rbc: How would has radiology changed at your institution during your career?
YW: There have been huge changes in radiology along with the economic development in China, of course. This has meant large improvements for the technical equipment.
The same is true for the educational system: For technologists, there was no system at all at the beginning. Knowledge was passed on in private sessions between the master and his students. Now we have an official and very developed education system and continuous medical education. Technologists have career development opportunities as well.
rbc: How exactly does technologist education work?
YW: There are two parts. You start at a special radiology technical school or university – it is not the usual medical school. You study mostly theory for four or five years, a bit like in the US.
The second part begins with your hospital job. You do the daily clinical work and concentrate on developing your skills and techniques. Technologists are usually quick in getting used to most advanced equipment.
rbc: Do technologists usually subspecialize?
YW: Here at PUMCH every technologist does rotations during a total time of four to five years. They will be in all departments – CT, MRI, angiography, emergency radiology and so on, and they will do all body parts and whole body scans. After that they can choose whatever they want to be. It depends on their interest, and, of course, on the open positions at that time.
The younger technologists will take a higher patient load, the older ones gradually take less.
rbc: Where do you still see room for improving education?
YW: The education levels between universities for technologists still differ very much. They are using different curriculums, and the technological knowledge they are teaching is often outdated. Many do not resemble the current clinical work anymore, and there is no unique standardization. All this needs to be improved.
rbc: What does it take to become a good radiology technologist?
YW: I have three points and none of them is easy to achieve.
First of all, a good technician should love his job form his true heart. He will be facing a lot of challenges, so he must love what he is doing, try to extend his career and have a sense of achievement. The second aspect is skill. The third is being open for improvement and continuous medical education, otherwise he will be out-dated very soon.
rbc: How does CME work in real life at PUMCH?
YW: Once a technologist here at PUMCH has settled down his subspecialty after his five years of training, he is required to publish at least one to two scientific papers in a domestic medical journal. He has to attend a local congress in the Beijing area at least once a month.
If he gets a chance to collaborate with foreign experts, we strongly encourage him to do so to get the chance to publish in foreign journal, maybe one to two times per year. We also encourage technologists to pursue higher academic titles like bachelor or doctor. One technologist from my team is currently applying to become a bachelor student of Professor Jin, our department chair. This combination and this good collaboration between radiologists and technologist might be the best in the whole country. I think we are setting up a very good example here.
rbc: If you had a son or a daughter who would want to be a technician and have an excellent international career, what would your advice be?
YW: I would be very happy if my child would follow my footsteps. I would encourage him to attend a professional technologist university in Europe or the US.
A diploma is currently the highest academic title for a technologist in China. If a technologist wanted to pursue a bachelor’s degree directly, he couldn’t, because there is no special exam for that. He would have to pass the medical bachelor’s exams first and then apply for the bachelor’s degree for technicians, so the exam is more difficult for them.
rbc: What will be the challenges of the future for your profession?
YW: I would not call it a challenge. It is more of an opportunity. Because radiology depends on technological development, big data and artificial intelligence will bring a lot of new opportunities.
First of all, technologists will have to adapt their knowledge to this. They will have to engage more in multidisciplinary teamwork, and we should encourage this kind of cooperation. Thirdly, radiology might be the first specialty requiring even more professionalism from technologists, in new private imaging centers, for example. We will have more responsibilities, and we will need more knowledge.
We should engage in the development of new equipment and techniques. With new technique like PET-CT and PET-MRI, we have a perfect chance to be part of this development.
Contrast and Radiation Protection
rbc: Which role do contrast agents play in your work?
YW: Contrast media are irreplaceable in CT and MRI. Accurate diagnoses should be made with the help of contrast media. There is nothing to replace it. The issue right now is safety and the right dose.
rbc: Which role do generic products play?
YW: We are using generics here, but not a lot. For normal patients with easy indications I do not find big differences between generics and brand contrast agents. From the price perspective, generics usually have an advantage. In our health insurance system, cost for patients does play a role.
However, for highly difficult cases, we use brand contrast agents. Cardioangiography is an example, where we would use foreign products.
rbc: How important is radiation protection?
YW: Regarding the protection of medical staff, we are doing quite well here in China and at PUMCH – we are following all the governmental regulations for radiation protection. Every staff member carries a dosimeter; a neutral organization measures each single employee.
Regarding patient protection, we engage in active and passive protection. For active protection, we providing a lot of education – we cover vulnerable body parts or tell someone to leave the room, if radiation is involved.
It is a fact that the Chinese population is not well informed about radiation protection. They may hear some rumors from the internet, but they usually do not get the right picture.
We are following the national standard in all of this. Of course, diagnostic requirements always come before safety.
rbc: Do you document the individual radiation dose?
YW: Individual radiation protection is something I am pursuing right now. As far as I know, there is no profiling for the total radiation dose of every patient in Europe and the US. I am trying to build up such a profile for China. We are facing a lot of problems, but that is one direction we are taking.
rbc: With a personal card or documentation?
YW: With documentation – so the clinical doctors would get an alert about the total radiation dose the patient has already had within this year.
rbc: How do you do this?
YW: By connecting the software of all departments within PUMCH.
We have done a good job so far. The radiation doses of our patients have been the lowest of all hospitals in Beijing for five years in a row. There is a wide gap between us and the other hospitals. Patients at PUMCH receive six to seven times less radiation.
About Yun Wang
The Bayer representatives and the reporter team got together for a group photo after listening intently to PUMCH chief technologist Yun Wang (center), who talked about his department’s radiation protection plans.
Yun Wang is the chief technologist at Peking Union Medical College Hospital (PUMCH). PUMCH is the top referrer hospital in China. Regarding staff, it is one of the most selective institutions in China, for medical doctors and for technologists.