Meet Dr. Bulas
Dorothy I. Bulas, MD, FACR, FAIUM, FSRU, is a Professor of Pediatrics and Radiology and serves as the Vice Chief of Academic Affairs and the Fellowship Director for the Division of Diagnostic Imaging and Radiology at Children’s National. She is the section head of ultrasound and fetal imaging. She has served on the steering committee for the World Federation of Pediatric Imaging (WFPI), and is liaison to multiple radiology organizations to advocate for pediatric radiology worldwide. With over 30 years of experience participating in educational teaching missions to low and middle-income countries, Dr. Bulas has introduced and expanded access to pediatric imaging around the globe. She has contributed her pediatric radiology expertise to addressing the congenital zika epidemic. In 2018, she was recognized by the Society for Pediatric Radiology with their most distinguished honor, the Gold Medal. She received her medical degree from the Medical College of Pennsylvania, completed her pediatric residency at New York Hospital and radiology residency at Albert Einstein College of Medicine. She completed her Pediatric Radiology Fellowship training at Children’s National.
Dr. Bulas cites her upbringing as the motivation for her over 30 years of global health work. Both of her parents were immigrants who lived through World War II. Remembering their experience, Dr. Bulas notes the importance of sharing US resources globally. Beginning her global health work prior to her radiology training, she provided primary care at a site in Chile through the World Health Organization (WHO). Going into her radiology training, Dr. Bulas realized the logistical difficulties of international radiological care given the expensive and sensitive equipment essential to her profession. However, for Dr. Bulas, this obstacle to providing clinical care simply meant shifting her focus to education, systems advancement, and teaching. With these new goals in mind, Dr. Bulas has travelled repeatedly to Ghana, Eritrea, and Haiti, providing her expertise to these areas for years.
Early on in her career, Dr. Bulas was awarded a two week grant through the Radiological Society of North America to travel to Ghana. While there, Dr. Bulas taught and trained local providers on pediatric radiology and how to interpret radiological screenings. She taught at three different university centers there, pairing education, didactics, and hands on teaching with clinical care. Following this work, Dr. Bulas planned several clinical and education missions to Haiti. Attending one of these trips, Dr. Bulas was able to provide consultation to the local providers on the potential improvement of their equipment and treatment systems. Filling a similar role on trips to Eritrea, Dr. Bulas travelled through a grant from Children’s National, helping to plan a pediatric residency training program and serving as the radiology educator.
While there are undeniable difficulties due to failing or lacking equipment in low resource settings, Dr. Bulas has learned to make the best of it. In some cases, the necessary simplicity of care in these environments informs Dr. Bulas’s care standards and impacts her care back home at Children’s. However, the long term goal is to advance these care systems and have local hospitals be able to provide screening that is increasingly crucial to meeting care standards. Estimating that “about one billion children across the globe (are) without access to proper screening,” Dr. Bulas is helping to fill a critical need in pediatric global health. “In radiology…it’s beyond on the ground treatment,…you can’t just work in a vacuum, it is highly collaborative,” she remarks, “(and) with the advent of greater connectivity, it is even more clearly an important next step for global care.”
Increasingly advanced technology, such as portable ultrasounds, “has changed the nature of radiology in acute settings,” says Dr. Bulas, but there remain problems of inefficiency, as many providers in these low resource settings have not been trained on how to use this equipment. This is one reason Dr. Bulas is so focused on educating providers, and training future pediatric radiologists, a rare commodity even here in the US. To address this, Dr. Bulas has been“trying to merge a lot of different societies and organizations to collaborate and get the project(s) to be increasingly sustainable for long-term growth. “(The) more successful sustainable method is getting local partners in educational and training settings,” she says.
One way Dr. Bulas is enacting this change is through her many partnerships and leadership positions in globally focused radiological organizations. As part of the American College in Radiology, Dr. Bulas and colleagues partnered with a local Haitian hospital, where they re-started the local medical training program. Dr. Bulas reports that the first group of trainees graduated this year in pediatric radiology, a very exciting outcome with substantial implications for the sustainability of radiological care in Haiti.
As one of the founders of the World Federation of Pediatric Imaging (WFPI) and the Image Gently Alliance, Dr. Bulas has been focused on increasing safety and awareness of the potentially damaging effects of radiological screening. The question to answer, she says, is “how do you get all these pediatric radiologists worldwide to maintain safety procedures and current treatment protocols?” The answer? “Education, training, and advocacy,” she says “which have been a large part of our work.” WFPI has worked “very well,” she reports, and while “money is always an issue” the group has been able to provide funding for some local organizations, as well as some training opportunities. “One of our latest endeavors is establishing fellowships,” she says, “we have a fellow from South Africa going to Kenya this year.” In addition, they have worked to help start the African Society of Pediatric Imaging. An effort to “get people connected, and provide education materials for greater preparedness, guidance, and material resources,” Dr. Bulas enthusiastically adds that there is a “burgeoning interest from younger pediatric radiologists in global health work” for whom these resources are crucial.
In the future, Dr. Bulas hopes this outreach can be continued through a partnership between Children’s National and a sister hospital abroad. “This would really help us to build the whole system and work collaboratively. It is important for the hospital to recognize what is being done, and whatever it can provide in terms of funding and resources can really be a win win,” she says. At the end of the day, for Dr. Bulas, it’s really about figuring out how to advance healthcare for the greatest number of children around the world, and improving safety of and access to radiological care is a big first step.