Radiology

 

• Section 1: Information about the writer

 

Dr Hassan Elhassan

Dr Ahmed Elzein Mohamed

Oxford radiology trainees.

Section 2: Scope of Practice in the UK

Radiology as a is relatively is one of the newest specialities. It is different in a way it is a combined imaging and clinical speciality. It requires both technical and clinical knowledge. The fact that it is an expanding speciality makes it very challenging with massive potential.

Most of the patients management and diagnosis nowadays depends on imaging interpretation. This creates a lot of jobs and opportunities in both academic and clinical pathways. The demand for radiologists in UK has been expanding in the last few decades.

UK has many leading world renowned training programs supervised by the Royal college of radiologists.

 

Section 3: Type of Training/ Route to Training

The route of training to radiology is slightly different to other clinical specialities. It is unlikely to have a formal training experience prior to the start of the higher radiology training in UK. This makes the preparation for the interview unique.

There are two main pathways before starting the training:

• After foundation: The high demand for radiologists pushed  the royal college toward recruiting more trainees. Trainees will apply during their second training year and start radiology two years after obtaining MBBS. This is a short pathway that has advantages and disadvantages. The main advantage is that it is a short pathway to CCT and giving more time for sub specialty. It is controversial if the lack of post foundation clinical experience affect the radiological clinical judgment. The other talked about disadvantage is the early burnout after being a consultant. The average age for the consultants through this pathway is early thirties which allows to practice as a consultant for about thirty years.
• Traditional pathway post other speciality experience: Old school radiologists believe in experience prior to starting radiology. Most if the senior radiologists practicing now had a previous life in other speciality this could have been surgery, medicine, paediatrics etc. Recently this pathway has been criticized a being a route to radiology for a underachieving radiologists who wants to escape to radiology. This should be in consideration when preparing for the interviews. The candidates should show commitment to radiology and as well show they are able to pass the royal college exams. It is almost mandatory to have one of the royal college memberships if applying through this route.

Radiology training is unique in a way that it is purely training in the first years and the service part starts at later stages. Most of the radiology trainee clinical work is closely supervised until very late in training.

The training could be broadly divided into two stages.

1. The first three years where the trainees get the knowledge to manage the general emergencies independently. This is further divided into first year trainees where the expectations are to get familiar with the radiology department work model and the radiology technology. The requirement for this stage is to pass the FRCR part one Physics and anatomy modules. After the first year, the trainee will get involved in the on-call work supervised by a senior registrar and a consultant all the time. Third year the trainee would start to take the on-call responsibility independently with the availability of the consultant for complex cases. At this stage, the trainee is expected to be able to report at most of the routine CT, perform ultrasound lists independently and perform the basic emergency intervention procedures e.g chest drains.
2. The second part of the training is focused in attaining more focus training in an area of interest. This would be for the fourth and fifth year. The trainee is expected to attain the FRCR at this stage. Further fellowship training is optional. Trainees can seek another year in an area of interest.

 

The training progress is continuously assessed through the following:

• Work based assessment and followed with the eportfolio.
• Audit Assessment
• Teaching Observation
• Radiology Direct Observation of Procedural Skills (Rad-DOPS)
• Mini-Imaging Interpretation Exercise (Mini-IPX)
• Research Evaluation
• MDT Assessment

 

Yearly ARCP session is conducted to ensure appropriate progression of the trainee and address any issues.

https://www.rcr.ac.uk/clinical-radiology/specialty-training/workplace-based-assessment

 

Section 4: Subspecialties

Radiology is an expanding speciality with emerging subspecialties every year. Trainees can finish their training as general radiologists or seek further training in one of the many subspecialties by doing a fellowship.

 

Section 5: Application Process

The application process is like the other specialities. The application is through ORIEL website.

Recently the RCR introduced the Specialty Recruitment Assessment (SRA) test in 2016. All applicants were required to sit the SRA at a test centre. The SRA was used to shortlist-out only the lowest scoring applicants.

*The time table for 2016 application process was as follows:

Timeline 2016-2017 Recruitment

Advert released	3 November 2016
Applications open (10am, UK time)	9 November 2016
Applications close (4pm, UK time)	1 December 2016
Longlisting completed by	14 December 2016
SRA invitatoins circulated by	20 December 2016 (latest)
SRA Assessement Window	7 – 14 January 2017
SRA results published	w/c 23 January 2017
Invitations to interview circulated	w/c 23 January 2017
Interviews	16,17,20,21 February 2017
Initial offers circulated	By 5pm 2 March 2017
Holding deadline (1pm, UK time)	9 March 2017
Upgrading deadline (4pm, UK time)	16 March 2017

Section 6: Requirements To Get Into Training (Person Specification)

The eligibility criteria published by the RCR in 2017

https://www.pathway.oriel.nhs.uk/Web/Sys_Documents/bfd6e64f-5274-46cf-acb1-426d7b9f734c_Clinical-Radiology-ST1-PS-2017-2.pdf

This is almost similar to the other specialities except that there is no requirement for previous radiology training.

 

Section 7: Important CV/Portfolio Perks (How To Achieve Them)

Preparing the CV to radiology interview has special requirements. The main thing is to get your CV geared towards radiology training. It is good to have great achievements in another speciality but if the commitment to radiology is not clear from the CV it is very unlikely to get a training number.

The interviewers are radiologists who would like to select someone with commitment to radiology and looking at them as good colleagues to work with. They know that the candidate has no previous radiology experience, but they need be see if the candidate has what it takes to be a competent safe radiologist.

Preparing a good radiology CV is a hard work and needs dedication but it worth it.

Major categories that need to be addressed in radiology application CV

1. Taster week and exposure to radiology department: It is mandatory to have at least a taster week in a radiology department prior to the interview with a stamped evidence from the department and hospital. It will add more if there is a written summary of what the candidate learned during the week supported with a written reflection. Candidates should start contacting the radiology departments in their hospitals for a taster week early as most departments will be full close to the interview time.
2. Being the first author in a published radiology peer reviewed article will add many points to the CV. This part requires a lot of dedication to get the paper accepted and published prior to the interview. It dosn’t need to be published in the Lancet but it should be peer reviewed journal. Being a second author counts but not as much as the first author. It will be great if the candidate gets involved in radiology research project while doing the taster week, the radiologists will be very supportive.
3. At least one radiology audit with evidence of re-audit and presentation in a radiology meeting or conference poster. Completing the audit cycle is mandatory, this means the candidate should start working on it as early as possible. Attending audit short courses will add to the CV.

RCR Auditlive is a great resource for  radiology audit

 

8. Teaching experience preferably in a  radiology related topic. Teaching experience with no documented evidence and reflection adds zero points to the interview process.
9. Royal college exams add a lot to the CV. If the candidate is applying after F2 ideally they need to have at least part one of a membership exam. If applying after practicing in another speciality full membership is needed to ensure the exam points are added. More points will be achieved if the membership is obtained within four years of MBBS.
10. Attending radiology courses and conferences  has always been an advantage and everyone applying has at least a radiology related conference or course evidence. Presenting at a radiology conference will add valuable points.
11. Attending radiology courses specifically designed for radiology is mandatory.
12. Evidence of membership with radiology societies will add points. Few links to recommended societies are added at the end of this document.

 

Section 8: The Interview

The interview process has been changing over the last few years. The main stations are :

• Preparation station: Candidates will typically be given ten minutes to prepare their documents. There might be a small task to prepare as a short audit to criticize or a short form to write the radiology related achievements in points. Previously there was a radiology skills station where candidates given short radiology cases to discuss.
• Portfolio station: It is about ten minutes where the candidate provides all the radiology related achievements. It is a point based station, the candidate should be ready with all the evidence supporting radiology commitment. Ten minutes is actually a very short time to present achievements and gain the needed points. Candidates are strongly advised to practice this station as much as they can. There is nothing more painful than working in a an audit without showing the interviewers it’s evidence.

 

There are some good websites for interview preparations as

https://www.radiologycafe.com/interview-application/improve-your-cv

Highly recommended course register early as most of the places are filled few months before the interview.   http://www.radiologyinterviews.com/

Section 9: Competition Ratio

2016 data total number of applicants was 963 and the posts available were 249.

 

Section 10: Offers and Visa Issues and HEE

It is very difficult to get a training number without EU status.

 

Section 11: Speciality Exams

The new exam format is

• FRCR part 1 anatomy and physics taken at the first year.
• FRCR 2 A 2 days exam single best answer taken by year 3.
• FRCR 2b (Final exam) divided into rapi reportin, VIVA and long cases.

 

Section 12: Speciality Courses

There are plenty of radiology courses the famous courses are :

1. http://www.radiology-courses.com/courses.php?id=8
2. http://www.oxradcourses.com/

 

Section 13: Rotations

The rotations are divided into 3 months rotations over 5 years.

 

Section 14: Ranking of Deaneries

As one of the senior radiologists says, wherever you train in UK you will be a great radiologist. There are new radiology academies which have their advantages and disadvantages.

A nice article comparing the academies to the traditional training.

 

Section 15: Wages / Take Home Cash

Salary depends on the banding. First year radiology registrars do not do oncalls, so they have no banding. Otherwise pay is the same as other specialities.

 

Section 16: MTI

Full details for the MTI are available on the RCR web site.

Section 17: Experience of Sudanese Doctors (Personal Experience)

There is a very high demand for radiologists everywhere even in UK. The number of practicing radiologists in Sudan is very low and estimated to be less than 100/30 million.

 

Section 18: Important Links and websites

RCR website:

ECR website:

https://www.radiologycafe.com/interview-application/improve-your-cv

http://www.radiologyinterviews.com/