Global health in Canadian radiology residency training: Program directors' perspectives and the current state of implementation

Radiology is integral to global health, yet low-resource settings face major workforce disparities. Global health radiology (GHR) seeks to improve imaging access, quality, and training in underserved regions, and faces increasing interest among Canadian trainees. However, limited data exist on Canadian radiology program directors' (PDs) perspectives, which are central to shaping educational policy. This study explored PDs' views on GHR relevance, resident and faculty engagement, barriers to integration, and future directions. A bilingual online survey was distributed to PDs of all 16 accredited Canadian radiology residency programs. The survey assessed attitudes toward GHR, teaching practices, faculty involvement, barriers, and resident interest. Descriptive statistics were used for quantitative analysis, complemented by qualitative responses. Fourteen PDs responded (87.5 %). Most (72 %) rated radiology's contribution to global health as essential or very important, and 79 % considered GHR a valid academic career path. While 86 % deemed formal GHR training at least moderately important, only 29 % of programs included it in curricula, and 21 % offered GHR electives. Faculty involvement was limited, with 50 % reporting some engagement, typically less than one half-day per week. Resident interest is rising, with 57 % of PDs noting increased demand over the past five years. Barriers included lack of faculty expertise (71 %), curriculum time constraints (64 %), and absence of national guidelines (57 %). Canadian PDs recognize the importance of GHR but implementation remains limited. Expanding faculty capacity, embedding GHR themes into existing curricula, and developing national frameworks may help bridge the gap between interest and practice, advancing socially responsible radiology training in Canada.