GLOBAL PERSPECTIVES Tanzania IR Initiative: Training the First Generation of Interventional Radiologists Fabian M. Laage Gaupp, MD, Nadia Solomon, MD, Ivan Rukundo, MD, Azza A. Naif, MD, Erick M. Mbuguje, MD, Anish Gonchigar, MD, Minzhi Xing, MD, John D. Prologo, MD, Douglas D. Silin, MD, and Frank J. Minja, MD ABSTRACT Despite a population of nearly 60 million, there is currently not a single interventional radiologist in Tanzania. Based on an Interventional Radiology (IR) Readiness Assessment, the key obstacles to establishing IR in Tanzania are the lack of training opportunities and limited availability of disposable equipment. An IR training program was designed and initiated, which relies on US-based volunteer teams of IR physicians, nurses, and technologists to locally train radiology residents, nurses, and technologists. Preliminary results support this strategy for addressing the lack of training opportunities and provide a model for introducing IR to other resource-limited settings. ABBREVIATIONS FNA ¼ fine needle aspiration, JKCI ¼ Jakaya Kikwete Cardiac Institute, MHN ¼ Muhimbili National Hospital, MUHAS ¼ Muhimbili University of Health and Allied Sciences, PGY ¼ postgraduate year INTRODUCTION In the developed world, interventional radiology (IR) has risen into high demand based on its minimally invasive treatment options for a broad range of indications and numerous advantages over more invasive surgical options (1,2). Access to IR services in many parts of the devel- oping world, however, is lacking or absent: according to the World Health Organization, 4 billion people around the world lack access to diagnostic medical imaging (3), let alone IR. Tanzania is an East African nation with a current population of just under 60 million, expected to exceed 100 million by 2040; it is classified as a low-income country based on an annual gross domestic product of under $1000 US dollars per capita (4). In the United States, there are more than 100 radiologists per 1 million people, of which approximately 8.5%–11.5% may be considered interventionalists (5). In contrast, in Tanzania, there is currently only 1 diagnostic radiologist per 1 million people, which cannot meet current or future needs of a growing population (6,7). As of 2017, there were no IR services and not a single doctor identifying as an interventional radiologist (formally trained or otherwise), to serve a population equivalent to that of California and New York combined (8). Although several outreach projects initiated over the past decade have improved worldwide access to diagnostic im- aging (7,9), there are few examples of successful IR-specific global health projects, limited literature on the topic, and no central organizing body connecting interested IR physicians (10,11). To address these deficits, Kline et al created, and in 2017 published, an IR Readiness Assessment tool for use in global health settings (12). In 2017, the senior author was approached by leadership at the Muhimbili National Hospital (MNH), Tanzania's largest public tertiary medical referral center, to help establish an IR service. Muhimbili University of Health and Allied Sciences (MUHAS), affiliated with MNH, offers physician training and a diagnostic radiology training pro- gram, with recent incoming class sizes of 11 in 2016 and 25 in 2017. The combination of urgent need for IR services at From the Department of Radiology and Biomedical Imaging (F.M.L.G., N.S., A.G., D.D.S., F.J.M.), Yale New Haven Hospital, 20 York Street, New Haven, CT 06510; Department of Radiology (I.R., A.A.N., E.M.M.), Muhimbili Uni- versity of Health and Allied Sciences, Dar es Salaam, Tanzania; and Depart- ment of Radiology (M.X., J.D.P.), Emory University, Atlanta, Georgia. Received September 12, 2018; final revision received July 23, 2019; accepted August 4, 2019. Address correspondence to F.M.L.G.; E-mail: fabian.laage-gaupp@yale.edu; Twitter handle: @road2ir None of the authors have identified a conflict of interest. From the SIR 2018 Annual Scientific Meeting. © SIR, 2019 J Vasc Interv Radiol 2019; 30:2036–2040 https://doi.org/10.1016/j.jvir.2019.08.002