The medical profession has had a difficult relationship with IT recently. Yet, away from the media spotlight, there has been a quiet computer-led revolution in the world of medicine. Janet Husband explains

E-learning enables students to log-on and learn at a pace and in a location that suits them. It is particularly prevalent in my specialty, radiology.

Like many specialties, radiology came under enormous pressure in the late 90s to deliver more consultants. Unlike other specialties, though, we faced a unique problem. Imaging technology was becoming so effective that it was beginning to take central stage in patient management. The better we became, the more we were needed. But as the demand grew, there was a limit on how many of us could be spared to teach new radiologists.

A few wise souls knew we needed a radical solution and one that would not be found by lowering standards or building more schools. The answer was staring us in the face.

Just as the dot com bubble was bursting, a unique collaboration began between the Royal College of Radiologists, the Department of Health and the NHS - the radiology integrated training initiative. It set out how radiologists could learn online, and also what and when they would learn.

Leap forward

Protocols were designed, curricula debated, content delivered and three years on we are training around 20 per cent more radiologists every year. Teaching standards are up across the board and we have built knowledge database for an entire speciality.

Now if a trainee is doing a module on a complicated tumour, for example, it is not by luck that they get the best professor with the best set of images or the liveliest lecture - all our trainees can access that all the time - online.

E-learning takes students through modules at a pace they control. If they do not understand it, they can go back. The next time they cover the subject, the e-learning software will remember how they fared in their self-assessment, what they need to look at again and then take them to the next stage.

There have been some big lessons learned by tutors too. E-Learning works best when it is blended with meaningful contact with patients. We know it delivers knowledge, but we know too that computers cannot teach skills. Our first e-learning students will not graduate until 2010, but with less time getting lost in textbooks, they have had more time getting hands-on experience. Anecdotes suggest they are already asking tougher questions of their tutors. That is because they know more.

Growing movement

If radiology, with its reliance on images, lends itself particularly well to the opportunities of e-learning, a recent report by the Academy of Medical Royal Colleges showed others are catching up fast.

The Royal College of Surgeons introduced its online surgical training education programme last year. It offers a range of web-based resources, including a question bank, procedure-based assessments and even a 'case of the month' with images and a link to a discussion board.

The Royal College of Psychiatrists is focusing on the continuing professional development aspects of e-learning. It hosts 27 learning modules and audio files that can be downloaded to an mp3 player.

The Royal College of Physicians ofEdinburgh,meanwhile, have been running video-linked teaching sessions inthe Middle andFar East.While doctors might miss the air miles, the savings in time alone makes this a certainty for the future and that is before anyone mentions carbon footprints.

The bigger picture is even brighter. E-learning offers the chance to deliver high-quality training to doctors the world over, at a fraction of the usual cost. If you can log-on and learn inLiverpool,why not do the same fromLagos? And as the high-speed internet goes global, there is no reason why theUKcannot lead the world in delivering global healthcare training.

As e-learning begins to cut across healthcare boundaries, those entering the profession will look at us a decade from now and ask how we ever managed before.