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In his excellent introduction to digital X-ray systems, (August 2001 JRSM, pp. 391-395), Dr Shaw reveals many of the advantages of the picture archive communication system (PACS). An additional area of potential benefit is in the teaching of radiology. This idea has been discussed since PACS was in its infancy1, but it deserves emphasis in view of the limited amount of radiology taught to medical students today. Basic image interpretation is usually taught on the ward, by sporadic and isolated demonstrations of radiological signs. PACS would allow call-up of images from other patients, to emphasize a particular feature, as well as radiological changes on follow-up. Studies on the role of PACS in teaching in the USA have yielded promising results. One report revealed that an electronic final examination for medical students, prepared with images downloaded from PACS or digital teaching collections, was feasible, easy to prepare and cost-effective, and it provided an excellent display of test images2. Additionally, teaching in how to prepare and deliver electronic presentations of radiological cases downloaded from PACS was well appreciated by the students3.
In a hospital equipped with PACS, teaching of radiology can be improved with little additional hardware or software. Use of PACS and PACS-derived teaching files could make a big difference to student confidence and ability in interpretation of radiological images.