Development of the first fellowship training program in neuroradiology in North America.

Subspecialization in radiology was essentially nonexistent in the decade of the 1950s. The emphasis was on general radiology, and on the idea that all radiologists should perform and interpret all radiologic examinations. In the early 1950s, these consisted of chest films; upper and lower gastrointestinal examinations; excretory urograms; examinations of the skeletal system, gallbladder, paranasal sinuses, mastoids, and skull; and tomography. In many hospitals, myelograms were interpreted by the radiologists , but they rarely injected the contrast material. In a few institutions, pneumoencephalography also was performed and usually interpreted by the neurosurgeon or the neurologist, although the radiologist submitted a written report. The use of cerebral angiography was slowly increasing. However, in the few institutions where it was carried out, the injection and interpretation of findings invariably were performed by neurosurgeons, and sometimes by neurologists. Some radiologists were interested in learning something about the interpretation of angiograms and tried to generate intelligent reports . Nuclear medicine procedures were essentially unknown at that time. If one considers the staffing situation in the 1950s, it becomes clearer why there was no consideration of subspecialization within radiology. For one thing, the number of radiologists was increasing slowly, and many more positions were available than there were trained radiologists to occupy them. Consequently, radiology residents in training were not exposed to the possibility of subspecializing in a given area. Although radiologists in some private hospitals received a percentage of the gross charges for radiology services, the