DUBAI RESIDENCY TRAINING PROGRAMME

The Department of Medical Education

SPECIALIST TRAINING PROGRAMME IN

Radiology (2012-2013)

Four Year Residency Training Program

Programme Administration

Programme Director

Dr. Amina Belhoul

TABLE OF CONTENTS
Title Introduction Mission Goals & Objectives Educational Objectives Administrative Structure Programme Sites Entry Requirements Number of Posts and Duration of Programme Trainee Responsibilities Program Structure Vacation On Call Duty Evaluation of the Programme The Certification Appendix(1) : o Rotation Duration o o o List of Radiology modality Training + Duration: PGY 1 System- based training + Duration: PGY 2,3 & 4 Syllabus Page 4 4 4 5 8 11 11 12 12 12 32 32 32 34 35 36 37 38

Appendix (2) : o Clinical Rotation Evaluation o Clinical Rotation Faculty Teaching Evaluation o Rotation In-Training Assessment (Resident) References

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I.

Introduction

The aim of the Radiology Residency Programme is to develop within the resident the interpretive, interpersonal and procedural skills necessary to perform as a competent radiologist and to encourage critical thinking applied to medical knowledge to allow development of a lifelong process for improvement of radiologic practices.

II.

Mission Statement

The mission of the programme is to develop and educate specialists in Diagnostic Radiology, who are highly capable and confident in managing the complete spectrum of Diagnostic Radiology. As well, the program strives to develop individuals, who practice the profession humanely, with the highest of ethical standard and integrity. The principles of evidence based medicine, self-evaluation and lifelong learning skills will be adhered to. Ultimately the goal is, to produce individuals, who will contribute to the community in providing excellent clinical care as well as areas of education and research.

III.

Goals and Objectives

The goals and objectives of the program reflect the Mission Statement above, and will be elaborated further in Educational Objectives.

General Objectives On completion of the educational programme, the graduate physician will be competent to function as a specialist in Diagnostic Radiology. This requires the physician to have the ability to supervise, advise on and perform imaging procedures to such a level of competence, and across a broad range of medical practice, as to function as a specialist to referring family physicians and specialists.

Communication skills, knowledge, and technical skills are the three pillars on which a radiological career is built, and all are dependent on the acquisition of an attitude to the 4

practice of medicine which recognizes both the need to establish a habit of continuous learning and a recognition of the importance of promoting a team approach to the provision of imaging services.

Residents must demonstrate the knowledge, skills and attitudes relating to gender, culture and ethnicity pertinent to Diagnostic Radiology. In addition, all residents must

demonstrate an ability to incorporate gender, cultural and ethnic perspectives in research methodology, data presentation and analysis.

IV.

Educational Objectives

Definition Objectives: Diagnostic Radiology is a specialty concerned with the use of imaging techniques in the study, diagnosis and treatment of disease, furthermore with the principles of radiation protection and its physical, biological and medical basic sciences. Imaging techniques include all different plain radiological modalities, cross sectional imaging -computed tomography (CT), magnetic resonance techniques (MRI), and ultrasound-, interventional radiology and Radionuclide.

The listed objectives are necessary for the fulfilment of a residents expectations, development and growth in the different areas.

Medical Expert/Clinical Decision-Maker

Understanding of the nature of formation of all types of radiological images, including physical and technical aspects, patient positioning, different contrast media. Knowledge of the theoretical, practical and legal aspects of radiation protection, including alternative imaging techniques and their possible harmful effects. Knowledge of human anatomy at all ages, both plain and cross sectional/multiplanar, with emphasis on radiological applications.

Knowledge of all aspects of clinical radiology, including understanding of pathology of diseases, appropriate application of imaging to patients, factors affecting interpretation and differential diagnosis, importance of informed consent, complications such as contrast media side effects and adverse reactions.

Understanding of the fundamentals of quality assurance in radiology. Understanding of the fundamentals of epidemiology, biostatistics and decision analysis. Competence in manual and procedural skills and in diagnostic and interpretive skills. Demonstration of the ability to manage the patient independently during a procedure, in close association with a specialist or another physician who has referred the patient. The radiologist should know when the patient's best interests are served by discontinuing a procedure, or referring the patient to another specialist.

Understanding of the acceptable and expected results of investigations and/or interventional procedures, as well as unacceptable and unexpected results. This must include knowledge of and ability to manage radiological complications effectively.

Understanding of the appropriate follow-up care of patients who have received investigations and/or interventional therapy. Understanding of a proper radiology report structure. Competence in effective consultation, conduct of interdisciplinary radiological-clinical conferences, and the ability to present scholarly material and prepare and lead case discussions.

Communicator
Ability to produce a radiological report, which will describe the imaging findings, most likely differential diagnoses in order of frequency, and, when indicated, recommend further testing and/or management. Understanding of the importance of communication with referring physicians, including an understanding of when the results of an investigation or procedure should be urgently communicated. Effective communication with patients and their families and a compassionate interest in them.

Recognition of the physical and psychological needs of the patient and their families undergoing radiological investigations and/or treatment, including the needs of culture, race and gender.

Collaborator
Ability to function as a member of a multi-disciplinary health care team in the optimal practice of radiology.

Manager
Ability to prioritize and effectively execute tasks through team work with colleagues and make systematic and rational decision when allocating health care resources. Competent in computer science as it pertains to the practice of radiology.

Health Advocate
Understanding and communication of the benefits and risks of radiological investigation and treatment including population screening. Recognition when radiological investigation or treatment would be detrimental to the health of a patient. Education and advice on the use and misuse of radiological imaging.

Scholarship
Competence in evaluation of the medical literature. Ability to be an effective teacher of radiology to medical students, residents, technologists and clinical colleagues. Ability to conduct a radiology research project, which may include quality assurance. Appreciation of the important role that basic and clinical research plays in the critical analysis of current scientific developments related to radiology.

Professionalism
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Ability of accurate assessment of one's own performance, strengths and weaknesses. Understanding of the ethical and medico-legal requirements of radiologists.

V.

Administrative Structure

A. Programme Director The Programme director is responsible for the overall conduct of the Residency Programme. The Residency Programme Director is responsible to the Director of Medical Education Department and to the Head of Academic Affairs, and is a member of the Specialty Training Committee of the Department of Medical Education of DHA.

B. Programme Site Co-Director The Programme site co-directors are responsible for the day to day functioning of the residency programme at each institution participating in the programme. The Programme Site co-directors are responsible to the Programme Director. There must be active liaison between the Programme Director and the Programme co-directors.

C. Residency Programme Committee The Residency Programme Committee assists the Programme Director in the planning, organization, and supervision of the Programme. The Residency Programme Committee must meet regularly, at least quarterly, and keep minutes. The Programme Director who is its executive officer chairs it. This committee includes A representative from each participating institution, The Programme Site Co-Directors A representative of each major component of the programme: Representatives of Residents in the Programme nominated and elected by their peers in the programme where numbers permit this representation should consist of at least one each from Dubai Hospital and Rashid Hospital.

D. The Specialty Training Committee The Specialty Training Committee to coordinates, implements, and monitors the educational and training activities of the residency training programme in the domain of the specialty field. The Specialty Training Committee receives and operates within The Department of Medical Education (MED) policy.

1. Function of the Specialty Training Committee is: To advice and support the Programme Director in implementing Postgraduate residency training programme relevant to their Specialty To collaborate with the Programme Director in the local administration and delivery of specialist training within the regulations and guidelines of MED To deliver, through an appropriate panel. The Annual Records on in training assessment 2. The responsibilities and roles of the Specialty Training Committee will be: To oversee advanced training provided within the specialty training programme in accordance to MED education policy. To develop, review and amend curricula and teaching and learning processes for advanced residency training in line with policy and procedure developed by the MED. To develop the content of examinations and other modes of assessment in line with policy and procedures on assessment methods advised by MED. To recommend to the MED any necessary changes to policy and procedures in assessment, teaching and learning, for specialty training. To review reports from the Programme director the progress of trainees and their adherence to approved pathways and to manage any necessary remedial action or support required by trainees. 3. The Specialty Training Committee should comprise the following members: Chair of the committee Programme Director Programme co Director Trainee representative in advanced residency year A member with lead responsibility for assessment A member with lead responsibility for accreditation 9

Other member as judged essential by the specialty programme 4. Meetings: The specialty Training Committee will meet on an as needs basis to undertake work against an agreed work plan, to meet specific objectives, and from time to time to review and update requirement of the education and training strategy and its monitoring valuation in the specialty A quorum shall be a majority of the membership of the Specialty Training Committee. 5. Reporting: The specialty Training Committee reports to MED The Specialty Training Committee is accountable to the Programme director and its team for the integrity of implementation of education and training in line with policy and procedures of the MED and will participate in policy review and development

Responsibilities of the Programme Director The responsibilities of the Programme Director, assisted by the Residency Programme Committee include: Development and operation of the Programme such that it meets the standards of accreditation for a specialty programme in Radiology Selection of candidates for admission to the programme Evaluation and promotion of residents in the programme in accordance with policies approved by the Department of Medical Education Committee. Maintenance of an appeal mechanism. (see description of Appeal Mechanism) Establishment of mechanisms to provide career planning and counseling for residents and to deal with problems such as those related to stress in collaboration with the Residents Affairs An ongoing review of the Programme to assess the quality of the educational experience and to review the resources available in order to ensure that maximal benefit is being derived from the integration of the components of the programme. This review must include: o an assessment of each component of the Programme to ensure that the educational objectives are being met 10

o an assessment of resource allocation to ensure that resources and facilities are being utilized with optimal effectiveness o an assessment of the teachers in the Programme Further to those responsibilities listed above, the Programme Director must function as a resident advocate and aid in the organization of other educational opportunities. The Programme Director is responsible for assigning residents their rotation and service schedules. The Programme Director is responsible to the residents to train them well in a humane atmosphere. The Programme Director reports to Head of Academic Affairs Centre. The two sites for training are currently the Dubai Hospital and the Rashid hospital. Other services or units that are approved by the Accreditation Committee of the Postgraduate Medical Education Committee may be included in the future.

VI.

Programme Sites
Rashid Hospital, Dubai, U.A.E. Dubai Hospital, Dubai, U.A.E. Al Wasl Hospital, Dubai, U.A.E.

The residency training programme in Diagnostic Radiology will utilize the following sites:

VII.

Entry Requirements
Have to successfully complete basic medical training, leading to MBBS, MD, or MBChB from a recognized institution. Must have completed at least one year internship programme that includes one month of Diagnostic Radiology. Must be fully registered by a regulatory Authority to practice medicine in the United Arab Emirates.

Prospective candidates:

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Must be successful at an Evaluation Examination which may include an oral and/or written examination and an oral interview. The Academic Affairs Centre in collaboration with the Admission Committee will supervise the Evaluation.

Applications will be submitted online in response to advertisement.

VIII.

Number of Posts and Duration of Programme

The maximum number of posts per academic year is 6 residents, will be accommodated in all sites, with two resident per site. This number will reflect the available resources at the programme sites. The duration of the programme will be four years.

IX.

Trainees Responsibilities

Residents are required to document activities of the programme, diagnostic procedures and intervention, in a logbook. The logbook should be signed by the assigned radiologist in each rotation. At the completion of the rotation, all documents, the log book, and assessment / letter of recommendation from the responsible liaison member will be forwarded to the Residency Radiological Training Committee.

X.

Programme Structure

The Radiology Residency training is a four year training programme. 1st year Residency The 1st year will consist of lectures which will enable the resident to be familiar with the principles of the basic sciences in Medical Imaging, which include: 1. Physics in Medical Imaging. 2. Radiation Protection. 3. Radiological Anatomy. 4. Radiological technique & Radiographic positioning. 5. Contrast media. 12

6. Radionuclide & Radionuclide Imaging. Also it will include clinical rotations for radiological modality based training Physics An introductory course on basic radiation physics and radiation safety relevant to clinical radiology is provided during the first three months of training. 30 hours of formal tuition will be delivered, including the current ionizing radiation regulations related to ionizing radiation. This teaching is given by medical physicists. Candidates will be expected to supplement this tuition by a substantial amount of self-directed learning. Core knowledge The fundamental physics of matter and radiation Practical radiation protection International and UAE Federal Radiation Protection recommendations. The physics of other diagnostic imaging modalities such as Ultrasound & MRI, as well as physics of radionuclide and Radionuclide imaging. Radiological Anatomy, Radiological techniques and procedures In the first year of training the resident must obtain a sound understanding of Radiological Anatomy and begin to acquire some of the practical skills in Radiological techniques & procedures. Radiographic positioning In the case of Plain radiography, residents should become familiar with the various radiographic techniques even if they do not take the radiographs personally. Communication, interpretation and report writing In the first year of training the resident must begin to acquire some of the core interpretation, reporting and Communication skills. This will include discussing the management of patients with clinicians before and after a procedure has been performed. It will also include the discussion of procedures and their possible complications with patients. 13

By the end of the first year residents will have interpreted and formally reported the following under the supervision of the attended Radiologist. Core All core procedures and techniques performed by the resident during his assigned rotation. A selection of in-patient and out-patient radiographs

Overview: At the end of the first year residents should: Feel confident in their choice of clinical radiology as a career Have mastered the basic radiation physics and radiation safety required in clinical radiology. Be familiar with the concepts and terminology of diagnostic and interventional radiology. Understand the role and usefulness of the common diagnostic and interventional techniques in all age groups. Understand the responsibilities of a radiologist to the patient including the legal framework and the necessity for informed consent. Be familiar with the various contrast media, drugs , including administration of sedatives and monitoring used in day to day radiological practice, and be aware of indication, contraindications, doses (adult and pediatric) and the management of reactions and complications. Be competent in cardiopulmonary resuscitation. Understand the principles of radiation protection and be familiar with the legal framework for protection against ionizing radiation. Residents should also be able to demonstrate that they are capable of safe radiological practice Be familiar with safety requirements for imaging with ionizing & non-ionizing radiation. Have a sound understanding of basic radiological and radiographic procedures Have developed, under supervision, some basic reporting skills.

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Have mastered and been assessed in basic communication skills and relationships with patients, especially issues around respecting confidentiality and obtaining consent

2nd, 3rd & 4th year Residency The framework for Residency training during the 2nd, 3rd and 4th year will consist of clinical rotations with formal lectures which should give appropriate experience in the areas identified below. System-based Training: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Note: Emergency and Oncology imaging will be included in each relevant system rotation. Technique-based training (CT, MRI, US, interventional and Radionuclide): Are incorporated within each system-based module and are no longer defined separately, but are defined in this document for reference. System based training objectives The following sections delineate the training objectives (knowledge, skills and experience) that will be acquired during Years 2-4. Cardio-thoracic imaging Gastrointestinal and abdominal imaging Musculoskeletal imaging Neuroradiology imaging Head and neck imaging including ear, nose and throat/dental Paediatric imaging Obstetric and gynaecological imaging Uroradiology imaging Vascular imaging Breast imaging Radionuclide imaging

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Each component of the training program will have a clearly defined structure for the supervision of the resident by the assigned Radiologist. The assigned Radiologist will be assumed overall responsibility for the training given during that period, including the techniques performed and preliminary radiology reports issued by the resident. Generic competencies Core knowledge Secure knowledge of the current legislation regarding radiation protection. able to offer advice as to the appropriate examination to perform in different clinical situations Knowledge of infection control, child protection, nutrition, sedation and other generic issues that could apply to radiological interpretation and procedures. Participation in clinic-radiological/multidisciplinary meetings. Core skills participation in reporting plain radiographs which are taken during the general throughput of the normal working day of a department of clinical radiology performing any routine radiological procedure that might be booked during a normal working day performing and reporting on-call investigations appropriate to the level of training with the appropriate level of supervision attendance and conducting clinico-radiological conferences and multidisciplinary meetings competence at reviewing studies on a workstation and familiarity with digital image manipulation and post-processing Provision of a good standard of practice and care, treatment in emergencies writing reports, giving evidence and signing documents Working with colleagues: treating colleagues fairly working in teams arranging cover

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 Probity -

taking up appointments sharing information with colleagues

Relationships with Patients obtaining consent respecting confidentiality maintaining trust good communication

dealing with problems in professional practice handling complaints and formal inquiries

System- based Training 1. Cardiac imaging Core knowledge knowledge of cardiac anatomy and clinical practice relevant to clinical radiology knowledge of the manifestations of cardiac disease demonstrated by plain radiography familiarity with the application of the following techniques: Core skills reporting plain radiographs performed to show cardiac disease and postoperative appearances Attending reporting session of common and relevant cardiac conditions shown by CT and MRI Optional experience observation of relevant radionuclide studies ,CT , MRI performed to show cardiac disease observing coronary and cardiac angiography and interventional procedures 17 Radionuclide CT MRI angiography, including coronary angiography

2. Thoracic imaging Core knowledge knowledge of thoracic anatomy and clinical practice relevant to clinical radiology knowledge of the manifestations of thoracic disease as demonstrated by plain radiography and CT knowledge of the application of radionuclide investigations to thoracic pathology with particular reference to radionuclide lung scintigrams knowledge of the application, risks and contraindications of the technique of imageguided biopsy of thoracic lesions Core skills reporting of plain radiographs performed to show thoracic disease supervising and reporting radionuclide lung scintigrams supervising and reporting CT of the thorax, including high-resolution examinations and CT pulmonary angiography drainage of pleural space collections under image guidance Core experience Observation of image-guided biopsies of lesions within the thorax Optional experience Catheter angiography

3. Gastrointestinal and abdominal imaging (including liver, pancreas and spleen) Core knowledge knowledge of GI and biliary anatomy and clinical practice relevant to clinical radiology knowledge of the radiological manifestations of disease within the abdomen on plain radiography, contrast studies (including ERCP), US, CT, MRI, investigations and angiography knowledge of the applications, contraindications and complications of relevant interventional procedures Core skills reporting plain radiographs performed to show GI disease performing and reporting the following contrast examinations: 18 radionuclide

swallow and meal examinations small bowel studies enema examinations

performing and reporting Tran abdominal US of the GI system and abdominal viscera Supervising and reporting CT of the abdomen. supervising and reporting certain MRI examinations of the abdomen (e.g. MRCP) performing: US-guided biopsy and drainage CT-guided biopsy and drainage

Core experience experience of the following contrast medium studies: sinogram stomagram

experience of the current application of radionuclide investigations in the following areas: liver biliary system GI bleeding abscess localization assessment of inflammatory bowel disease

experience of the application of angiography and vascular interventional techniques to this area experience of the relevant interventional application: percutaneous biliary procedures

Optional experience observation of ERCP and other diagnostic and therapeutic endoscopic techniques performing T-tube cholangiography performing percutaneous cholangiography experience of the relevant application of the following interventional procedures: balloon dilatation of the oesophagus/stent insertion 19

porto-systemic decompression procedures

4. Musculoskeletal imaging Core knowledge knowledge of musculoskeletal anatomy and clinical practice relevant to clinical radiology knowledge of normal variants of normal anatomy, which may mimic trauma knowledge of the manifestations of musculoskeletal disease and trauma as demonstrated by plain radiography, CT, MRI, contrast examinations, radionuclide investigations and US Core skills reporting plain radiographs relevant to the diagnosis of disorders of the musculoskeletal system including trauma reporting radionuclide investigations of the musculoskeletal system, particularly skeletal scintigrams supervising and reporting CT of the musculoskeletal system supervising and reporting MRI of the musculoskeletal system performing and reporting US of the musculoskeletal system supervising CT and MRI of trauma patients

Core experience experience of the relevant contrast examinations (e.g., arthrography) Optional experience familiarity with the application of angiography Observation of discography and facet joint injections observing and performing image-guided bone and soft-tissue biopsy

5. Neuroradiology imaging Core knowledge knowledge of neuro-anatomy and clinical practice relevant to neuroradiology knowledge of the manifestations of central nervous system disease as demonstrated on plain radiography, CT, MRI and angiography

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awareness of the applications, contraindications and complications of invasive neuroradiological procedures familiarity with the application of radionuclide investigations in neuroradiology familiarity with the application of CT and magnetic resonance angiography in neuroradiology

Core skills reporting plain radiographs in the investigation of neurological disorders supervising and reporting cranial and spinal CT, including trauma supervising and reporting cranial and spinal MRI

Core experience observation of cerebral angiograms and their reporting observation of carotid Doppler ultrasound experience in MR and CT angiography and venography to image the cerebral vascular system Optional experience performing and reporting cerebral angiograms experience of CT perfusion techniques performing and reporting carotid Doppler ultrasound performing and reporting trans-cranial paediatric US observation of interventional neuro-radiological procedures observation of advanced MR techniques, including magnetic resonance spectroscopy experience of functional brain imaging techniques (radionuclide and MRI)

6. Head and neck imaging including ear, nose and throat/dental Core knowledge knowledge of head and neck anatomy and clinical practice relevant to clinical radiology knowledge of the manifestations of Head and Neck disease as demonstrated by plain radiography, relevant contrast examinations, US, CT and MRI awareness of the application of US with particular reference to the thyroid and salivary glands and other neck structures 21

awareness of the application of radionuclide investigations with particular reference to the thyroid and parathyroid glands

Core skills reporting plain radiographs performed to show Head and Neck disease performing and reporting relevant contrast examinations (e.g. barium studies) performing and reporting US of the neck (including the thyroid, parathyroid and salivary glands) supervising and reporting CT of the head and neck diseases supervising and reporting MRI of the head and neck Head and Neck disease Reporting radionuclide thyroid investigations

Optional experience Performing biopsies of neck masses (thyroid, lymph nodes etc.) reporting radionuclide parathyroid investigations performing and reporting of sialography

7. Paediatric imaging Core knowledge knowledge of paediatric anatomy and clinical practice relevant to clinical radiology knowledge of disease entities specific to the paediatric age group and their clinical manifestations relevant to clinical radiology knowledge of disease entities specific to the paediatric age group and their manifestations as demonstrated on plain radiography, US, contrast studies, CT, MRI and radionuclide investigations The management of suspected non-accidental injury and the recognition of features of child abuse. Core skills reporting plain radiographs performed in the investigation of paediatric disorders including trauma performing and reporting US in the paediatric age group supervise and report cranial CT studies, particularly in the setting of acute trauma

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performing and reporting routine fluoroscopic procedures in the paediatric age group, particularly: contrast studies of the urinary tract contrast studies of the GI system

Core experience supervising and reporting CT, MRI and radionuclide investigations in the paediatric age group Optional experience the practical management of the following paediatric emergencies: neonatal GI obstruction intussusception

8. Obstetrics and gynaecology imaging Core knowledge knowledge of obstetric and gynaecological anatomy and clinical practice relevant to clinical radiology knowledge of the physiological changes affecting imaging of the female reproductive organs knowledge of the changes in maternal and foetal anatomy during gestation awareness of the applications of angiography and vascular interventional techniques awareness of the applications of MRI in gynaecological disorders and obstetrics

Core skills reporting plain radiographs performed to show gynaecological disorders performing and reporting trans-abdominal and endo-vaginal US in gynaecological disorders, including possible complications of early pregnancy (e.g. ectopic) Performing and reporting routine obstetric US including identification of common foetal abnormalities. supervising and reporting CT in gynaecological disorders supervising and reporting MRI in gynaecological disorders

Core experience

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Performing and reporting hysterosalpingography

Optional experience Observation of angiography and vascular interventional techniques in gynaecological disease 9. Uroradiology imaging Core knowledge knowledge of urinary tract anatomy and clinical practice relevant to clinical radiology knowledge of the manifestations of urological disease as demonstrated on plain radiography, US, CT and MRI familiarity with the current application of radionuclide investigations for imaging the following: Core skills reporting plain radiographs performed to show urinary tract disease performing and reporting the following contrast studies: intravenous urogram retrograde pyelo-ureterography nephrostogram ascending urethrogram micturating cysto-urethrogram renal structure renal function vescio-ureteric reflux

awareness of the application of angiography and vascular interventional techniques

performing and reporting transabdominal US to image the urinary tract supervising and reporting CT of the urinary tract reporting radionuclide investigations of the urinary tract in the following areas: renal structure renal function vesico-ureteric reflux 24

Core experience observing nephrostomies drainage of renal abscesses and peri-renal collections observation of percutaneous ureteric stent placement observation of endorectal US performing image-guided renal biopsy under US and/or CT guidance MRI applied to the urinary tract experience of angiography and vascular interventional techniques experience of antegrade pyelo-ureterography

Optional experience urodynamics performing nephrostomies percutaneous nephrolithotomy lithotripsy

10. Vascular imaging Core knowledge knowledge of vascular anatomy and clinical practice relevant to clinical radiology familiarity with the indications, contraindications, pre-procedure preparation (including informed consent), sedation and anaesthetic regimens, patient monitoring during procedures, procedural techniques and post-procedure patient care familiarity with procedure and post-procedure complications and their management familiarity with the appropriate applications of the following techniques: US (including Doppler) digital subtraction techniques CT and CT angiography MRI and MR angiography intra-arterial angiography

Attending vascular interventional sessions.

Core skills imaging 25

reporting plain radiographs relevant to cardiovascular disease performing and reporting lower limb venography (contrast medium and/or US) Supervising and reporting CT examinations of the vascular system including image reformation. performing and reporting: US (including Doppler), venous and arterial

Optional experience imaging femoral artery puncture techniques and the introduction of guide wires and catheters into the arterial system venous puncture techniques both central and peripheral and the introduction of guide wires and catheters into the venous system (e.g. central venous access) performing and reporting the following procedures: lower limb angiography arch aortography abdominal aortography digital subtraction angiography

selective angiography (e.g. hepatic, renal, visceral) pulmonary angiography alternative arterial access (brachial/radial punctures etc) upper limb venography portal venography pelvic venography via femoral approach superior vena cavography inferior vena cavography

Optional experience interventional angioplasty and stenting techniques, including endografting embolisation thrombolysis caval filter insertion

11. Breast imaging 26

Core knowledge knowledge of breast anatomy, pathology and clinical practice relevant to clinical radiology understanding of the radiographic techniques employed in diagnostic mammography understanding of the principles of current practice in breast imaging and breast cancer screening awareness of the proper application of other imaging techniques to this specialty (e.g. US, MRI and Radionuclide) Core skills mammographic reporting of common breast disease Core experience Participation in mammographic reporting sessions. participation in breast multidisciplinary meetings performing ultrasound of the breast observation of breast biopsy and localization

Optional experience performing breast biopsy and localization

12. Oncology Core knowledge knowledge of oncological pathology and clinical practice relevant to clinical radiology familiarity with tumour staging nomenclature familiarity with the application of US, radionuclide investigations, CT and MRI, angiography and interventional techniques in oncological staging, and monitoring the response of tumours to therapy familiarity with the radiological manifestations of complications which may occur in tumour management Core skills reporting plain radiographs performed to assess tumours

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performing and reporting US, CT, MRI and radionuclide investigations (including PET/CT) in oncological staging and monitoring the response of tumours to therapy performing image-guided biopsy of masses under US and CT guidance

Core experience Participation in multidisciplinary meetings

Technique-based Training The core training objectives for the following technique based training - CT, MRI, interventional radiology and Ultrasound all have been incorporated into the system based modules and listed below for reference. 1. Computed tomography Core Knowledge of the technical aspects of performing CT, including the use of contrast media. knowledge of cross-sectional anatomy as demonstrated by CT practical experience in supervision including vetting requests, determining protocols, the examination, and post processing and reporting of the examination in the following anatomical sites: brain head and neck chest abdomen and pelvis musculoskeletal vascular

experience in performing CT-guided procedures, e.g. biopsy and drainage familiarity with the application of CT venography and angiography familiarity with post-image acquisition processing

2. Magnetic resonance imaging Core 28

understanding of current advice regarding the safety aspects of MRI knowledge of the basic physical principles of MRI, including the use of contrast media knowledge of the cross-sectional anatomy in orthogonal planes, and the appearance of normal structures on different pulse sequences experience in supervision including vetting requests, determining protocols, the examination, and post-processing and reporting of the examination in the following anatomical sites: brain head and neck chest abdomen and pelvis musculoskeletal (e.g. hips, knees, shoulders, and extremities)

experience of the application of magnetic resonance angiography and venography familiarity with post image acquisition processing

3. Radionuclide radiology Core secure knowledge of the relevant aspects of current legislation regarding the administration of radiopharmaceuticals knowledge of the technical aspects of radionuclide radiology relevant to optimising image quality knowledge of the radiopharmaceuticals currently available for the purposes of imaging organs and locating inflammatory collections, tumours and sites of haemorrhage knowledge of the relevant patient preparation, precautions (including drug effects), and complications of the more commonly performed radionuclide investigations knowledge and understanding of the principles and indications of the more commonly performed radionuclide investigations and how these relate to other imaging techniques, in particular knowledge of the radionuclide investigations in the following topic areas: cardiology endocrinology 29

gastroenterology and hepato-biliary disease haematology infection lung disease nephro-urology nervous system oncology paediatrics skeletal disorders

understanding the significance of normal and abnormal results knowledge of the strengths and weaknesses of radionuclide investigations compared to other imaging modalities experience in supervision and reporting of radionuclide investigations an appreciation of functional /anatomical imaging including hybrid technologies such as PET-CT and SPECT-CT o a knowledge of the role of PET-CT in the staging of the common malignancies (lung, colon, etc) o an understanding of the role of PET-CT in other tumour groups and its potential use in cardiology and neurology

4. Ultrasound Core knowledge of the technical aspects of US relevant to optimising image quality knowledge of the cross-sectional anatomy as visualised on US experience in performing and reporting transabdominal US examination of structures in the following anatomical areas: general abdomen (including vessels) pelvis (non-obstetric) small parts (scrotum, thyroid, neck structures) upper abdomen (including lower chest) 30

experience of performing Doppler US imaging (e.g. leg veins, portal vein, carotid artery) performing US of the breast performing US-guided interventional procedures (e.g. biopsy and drainage) knowledge of infection control and probe cleaning

Optional obstetric USS performing Tran cranial paediatric USS Performing musculoskeletal USS.

5. Interventional radiology Core familiarity with the equipment and techniques used in vascular, biliary, and renal interventional techniques familiarity with the indications, contraindications, pre-procedure preparation including informed consent, patient monitoring during the procedure and post-procedure patient care familiarity with procedure and post-procedure complications and their management US-guided interventional procedures (e.g. biopsy and drainage) CT-guided interventional procedures (e.g. biopsy and drainage)

Optional performing nephrostomies Observation of angioplasty and stenting techniques observation of the spectrum of interventional procedures currently performed in the following systems: vascular system (including neurovascular) urinary system biliary system GI and abdominal system musculoskeletal system

experience of MRI-guided interventional procedures 31

XI.

Vacation

Each year will include four weeks of vacation that may be taken at any time in the programme with the approval of the programme director and the supervisor of the affected rotation. Every effort will be made to avoid significantly impacting the educational experience in any single rotation that might occur should a prolonged period of leave be taken within a single rotation.

XII.

On-Call Duty

Each resident will participate in an appropriate on-call Rota in order to be exposed to acute and emergency radiology, in which he/she will be responsible to the assigned Radiologist. This should commence during the third year of training, although on-call experience at an earlier stage also provides valuable training opportunities.

XIII.

Evaluation of the Programme

Assessment of Resident Performance: Supervision of Residents

Policy: 1. Clinical teaching staff (Programme Directors, Programme Co-Site Directors, Educational Supervisors and Trainers) is essential and important to the successful implementation of the Dubai Residency Training Programme. 2. Clinical teachers are expected to be familiar with the goals and objectives of the programme as well as of the rotation for which they have responsibility. 3. Clinical teaching staff is expected to provide a direct and appropriate level of clinical supervision to all residents during clinical rotations. 4. Clinical teaching staff is expected to foster an effective learning environment by ensuring that the (a) residents share responsibility for decision-making in patient care under supervision, (b) residents have constructive feedback from the concerning clinical skills at diagnosis and management (c) participation of residents in patient care adds to the effectiveness, appropriateness and quality of care. 32

Procedures 1. Clinical responsibilities must be assigned to the residents in a carefully supervised and graduated manner, so that the resident assumes progressively increasing responsibility in accordance with their level of education, ability, and experience. 2. Teaching staff supervision must include timely and appropriate feedback to the residents. 3. The residents clinical involvement must be in fulfilment of the programs written educational curriculum. 4. Teaching staff must demonstrate concern for each residents well-being and professional development. 5. Teaching staff who supervise the residents have overall responsibility for patient are and are the ultimate authority for final decision. 6. Teaching staff schedules must be structured to ensure continuous supervision of residents and availability of consultation. 7. All decisions regarding diagnostic tests and therapeutics, initiated by the residents will be reviewed with the responsible Consultants or educational supervisor during patient care rounds. 8. Patients will be seen by the team of residents, interns and medical student and their care will be reviewed with the Consultant or educational supervisor at appropriate intervals. 9. The residents are required to promptly notify the patients Consultant physician in the event of any controversy regarding patient care or any serious change in the patients condition. 10. In clinics and consultation services, the Consultant or supervising physician must review overall patient care rendered by residents. 11. In the operating theatres, the Consultant or supervising physicians are responsible for the supervision of all operative cases. Consultants or supervising physicians must be present in the operating room with residents during critical parts of the procedure. For less critical parts of the procedure, the Consultant or supervising physician must be immediately available for direct participation.

Residency training programme committee The residency training programme committee under the leadership of the programme director will be responsible for the on-going evaluation of the programme. This will include an 33

evaluation of the strengths and weaknesses of the programme and the recommended improvements. As well, all residency education sites, including elective experiences will be evaluated. The committee should also undertake a formal evaluation of all teaching staff, affiliated with the programme. Discussion regarding the programme will occur at all residency training programme committee meetings, and a formal evaluation of the programme accompanied by a report should occur on a yearly basis.

Internal review The internal review is intended as a mechanism to assist the sponsor in maintaining the quality of residency programme and providing the programme administrators with information about the strengths and weaknesses of the programme so that necessary corrective measures may be taken. The internal review should be initiated by the Head of Academic Affairs Centre and the team should include: a programme director from another programme, a staff member from another discipline who is experienced in postgraduate medical education, and a resident from anther discipline. A series of interviews should take place with the programme director, teaching staff, members of the resident group, and with the residency programme committee. Visits to individual sites should occur when indicated. The internal review team should review all residency education sites and elective experiences. There should be a careful assessment of the quality of the programme and the degree to which it fulfils its goals and objectives. The written report of the internal review should include the strengths and weaknesses of the programme and specific recommendations for continued development and improvements. This report should be submitted to the Head of Academic Affairs, chair of the department, the programme director, and members of the residency programme committee.

External review The programme should undergo an external review every 5 years. The process of the external review is similar to that of the internal review with the exception of the make-up of the review committee. The external review is imitated by the Head of Academic Affairs for medical education and the team should include: a representative of an accrediting body in Radiology, a programme director from another Radiology programme accredited by the aforementioned body, a faculty member form another discipline who is experienced in postgraduate medical education, 34

and a resident from an accredited external programme. The external review committee would generate a report that should include the strengths and weaknesses of the programme and specific recommendations for continued development and improvements.

XIV.

The Certification

Residents who are eligible can set for the fellowship (FRCR) and the Arab Board examinations.

35

Appendix 1: Rotation Duration

Sep R1

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

12wks Plain Radiography (RH,DH), 8wks Fluoroscopy contrast studies + IVU (RH,DH), 8wks Ultrasound (RH, DH), 4wks CT (RH ), 4wks MRI( RH) , 4wks DSA & interventional (RH) , 4wks Nuclear medicine (DH ) Part 1, Arab Board First Fellowship (FRCR) Exam.

R2

16wks Cardiothoracic Imaging(RH,DH), 8wks G.I.T Imaging(RH,DH), 8wks Neuroradiology Imaging(RH), 12wks Musculoskeletal Imaging (RH) Final Fellowship (FRCR) Exam Part A (Modules based Exam)

R3

8wks Neuroradiology Imaging(RH), 8wks Uroradiology Imaging(DH), 4wks Vascular Imaging(RH), 8wks G.I.T Imaging(RH,DH) , 8wks Head & Neck Imaging (DH, RH) , 8wks Paediatric Imaging(AWH). Final Fellowship (FRCR) Exam Part A (Modules based Exam)

R4

8wks Breast Imaging(RH,DH), 12wks Obs/Gyn(AWH,DH), 8wks Radionuclide Imaging(DH), 8wks Vascular Imaging (RH) Part 2, Arab Board Final Fellowship (FRCR) Exam Part A&B

36

List of Radiology modality Training + Duration: PGY 1

The Training Programme Plain Radiography Fluoroscopy Contrast Studies + Intravenous Urography Ultrasound (including Doppler) Computerized Tomography (CT) Imaging Magnetic Resonance (MR) Imaging Digital Subtraction Angiography (DSA) including diagnostic & therapeutic procedures Nuclear Medicine Imaging

Duration 3 Months 2 Months 2 Months 1 Months 1 Months 1 Months 1 Months

37

System- based training + Duration: PGY 2, 3 & 4

The Training Programme Cardiothoracic Imaging G.I.T. Imaging Musculoskeletal Imaging Neuroradiology Imaging Head & Neck Imaging Paediatric Imaging Obstetrics & gynecology Imaging Uroradiology Imaging Vascular Imaging Breast Imaging Nuclear Medicine Imaging

Duration 4 Months 4 Months 3 Months 4 Months 2 Months 4 Months 3 Months 2 Months 3 Months 2 Months 2 Months

Note: Emergency and Oncology Imaging will be covered during each relevant rotation.

38

Syllabus

1. Anatomy and Techniques Syllabus 2. Physic Syllabus

Final FRCR Examination: Detailed Anatomy and Techniques Syllabus

1. MODULE 1: Thorax and Cardiovascular Anatomy
o

Anatomy of the heart, coronary arteries, aorta, great vessels, vascular structures of the thorax and mediastinum, as demonstrated by radiography, contrast studies and cross sectional imaging

Anatomy of the lungs, including segmental anatomy, bronchial tree and pleura, as demonstrated by radiography, bronchography and cross-sectional imaging

Anatomy of arterial, venous and lymphatic systems of the whole body

Techniques Knowledge is required of the techniques listed below

o

Plain film techniques for imaging the thorax, with knowledge of how variation in exposure factors influences the final image

Basic knowledge of bronchography, coronary angiography, magnetic resonance angiography and radionuclide techniques

CT and MRI in the thorax, including high resolution CT (HRCT) and CT pulmonary angiography (CTPA)

Angiographic techniques for imaging the aorta, great vessels and peripheral vascular system, with a knowledge of common interventional procedures

o o

Contrast venography of arms, legs and central veins Ultrasound imaging of the heart, arterial and venous systems, including uses and applications of Doppler, colour Doppler and power Doppler imaging

Imaging of the lymphatic system, especially with radionuclide techniques

39

2. MODULE 2: Musculoskeletal Anatomy

o o

Anatomy of the skull and facial bones Anatomy of the skeleton, including knowledge of the major ossification centers with times of fusion and the common anomalies and variants that may mimic disease

Anatomy of the muscles and other soft tissues, as demonstrated by ultrasound, CT and MRI

Techniques Knowledge is required of the techniques listed below

o

Plain film techniques for imaging the skeletal system, including specific projectional techniques

Ultrasound, CT and MRI techniques for the examination of the skeletal system and soft tissues

o o o

Arthrographic techniques, including CT The use of radionuclide imaging in the skeletal system Interventional techniques

3. MODULE 3: Gastro-intestinal Anatomy

o

Anatomy of the oropharynx, oesophagus, stomach, duodenum, small bowel and colon, as demonstrated by radiography, contrast studies and cross-sectional imaging

Cross-sectional anatomy of the liver, gall bladder and biliary tree, pancreas and spleen, as demonstrated by ultrasound, CT and MRI

Anatomy of the peritoneum and retroperitoneum, as demonstrated by crosssectional imaging

Anatomy of the biliary tree, as demonstrated by direct cholangiography and ERCP, ultrasound and MRCP

Anatomy of the vascular supply of the upper abdominal viscera, as demonstrated by ultrasound, CT, MRA and angiography 40

Techniques Knowledge is required of the techniques listed below

o o

Plain film radiography of the abdomen Contrast studies of the intestinal tract, including video studies of the upper gastrointestinal tract and sialography

o o

Techniques for imaging the biliary tract, including ERCP and MRCP Common techniques for cross-sectional imaging of the gastro-intestinal tract and upper abdominal organs

Optimisation of cross-sectional imaging for specific applications by manipulation of physical variables, e.g. ultrasound frequency, CT pitch

o o o

Use of contrast agents in cross-sectional imaging of the abdomen Common diagnostic and therapeutic interventional procedures. Common radionuclide imaging techniques

4. MODULE 4: Genito-urinary, Adrenal, Obstetrics & Gynaecology and Breast Anatomy

o

Anatomy of the urinary tract, adrenal glands, male and female genital tracts, including the pregnant uterus

o o

Anatomy and dating of the developing normal fetus Anatomy of the female breast

Techniques Knowledge is required of the techniques listed below

o o

Plain film radiography of abdomen and pelvis Common contrast techniques for the examination of the renal tract, including intravenous urography, antegrade and retrograde pyelography, cystography, urethrography and nephrostogram

o o o

CT and MRI examinations of the kidneys, adrenals and male and female pelvis Radionuclide techniques for evaluating renal function Ultrasound techniques for examining the renal tract and male and female genital tracts, including endocavity examination of prostate and female pelvis and Doppler techniques 41

Ultrasound of early pregnancy complications, e.g. ectopic pregnancy

Ultrasound and contrast hysterosalpingography

o o

Mammography, ultrasound and MRI of the breast Nephrostomy insertion, ureteric stenting, renal biopsy procedures, angiographic and vascular interventional techniques

Breast biopsy techniques

5. MODULE 5: Paediatrics Anatomy

o

The normal anatomy and changing appearances of the growing child, including epiphyseal ossification and common variants that may mimic disease. (Detailed knowledge of appearance of ossification centers is not required.)

Techniques Knowledge is required of the techniques listed below

o o o

Plain radiographic techniques of chest, abdomen and skeleton Contrast studies of the gastro-intestinal and urinary tracts Common paediatric ultrasound techniques, including cranial, musculoskeletal, abdominal and pelvic studies

o o o

CT and MRI examinations of the child Radionuclide imaging techniques Interventional techniques

6. MODULE 6: Central Nervous & Head and Neck Anatomy

o o

Anatomy of the skull, facial bones and spine Anatomy of the brain, spinal cord and meninges, including cerebral and spinal vascular anatomy

o o o

Anatomy of the thyroid, parathyroid and salivary glands Anatomy of the paranasal sinuses, teeth, pharynx and larynx Anatomy of the orbit, including the lacrimal apparatus

42

Techniques Knowledge is required of the techniques listed below

o o o

Plain radiography of the skull, facial bones and teeth Cross-sectional imaging with CT, MRI and ultrasound Imaging of the intracranial circulation, including intra-arterial angiography and CT and MR angiography

o o o

Radionuclide imaging Contrast examinations, e.g. barium studies Interventional techniques

SYLLABUS FOR PHYSICS IN CLINICAL MEDICAL IMAGING Submitted by: The Medical Physics Section / Dubai Health Authority (DHA)
1. Basic Radiation Physics and Radiation Protection
Matter and Radiation

o Structure of Matter o Radioactivity o Production of X-rays o Interaction of X-rays and Gamma Rays with Biological Tissue o Filtration of X-ray Beams
o

Luminescence

Basic Radiation Dosimetry and Biological Effects of Ionizing Radiation

o Radiation Exposure (X), Absorbed Dose (D), and Kerma (K) o Equivalent Dose (H) and Effective Dose (E) o Units of Patient Dosimetry in Diagnostic and Interventional Radiology o Biological Effects of Ionizing Radiation on Soft Tissue
Regulations, International Standards, and Radiation Protection

o The Regulatory Framework of the UAE: FANR*, UAE Radiation Protection Regulations o The International Commission of Radiological Protection (ICRP)

43

o Principles of Radiation Protection: Justification, Optimization, and Dose Limits o Practical Radiation Protection: Time, Distance, Shielding
* FANR: Federal Authority of Nuclear Regulations FANR is the regulatory body in the UAE in charge of: 1. Developing regulations and Safety Standards; 2. Licensing of Radiation Users; 3. Inspecting Radiation Facilities; Enforcing the UAE Regulations

2. Radiography with X-rays

Basic Operational Principle of: Film Radiography, Computed Radiography (CR), and Digital Radiography (DR) Production of X-rays: X-ray Tube and X-ray Beam Image Receptors for CR and DR Effect of Scattered X-rays and X-ray Grids Image Quality in Radiography Dual Energy Radiography Mammography Brief Overview of Patient Doses in X-ray Radiography Dose Reference Levels in Radiography The Example of UK

3. Diagnostic and Interventional Fluoroscopy

Basic Operational Principle of Fluoroscopy Image Intensifier and Flat Panel Image Quality in Fluoroscopy Contrast Media Digital Subtraction Angiography (DSA) Interventional Cardiology (IC) Brief Overview of Patient Doses in Diagnostic and Interventional Fluoroscopy Dose Reference Levels in Fluoroscopy The Example of UK. The International Campaign Image Gently TM for the Protection of Children in Interventional Cardiology.

44

4. Computed Tomography (CT)

Basic Operational Principle of a CT Scanner Multi-Slice Scanners Image Quality in Computed Tomography CT Angio and Gated Imaging CT Perfusion Brief Overview of Patient Doses in Computed Tomography Dose Reference Levels in Diagnostic Computed Tomography The Example of UK The International Campaign Image Gently TM for the Protection of Children in Computed Tomography

5. Radionuclide Imaging [Nuclear Medicine]

Radiopharmaceuticals Diagnostic Imaging Tomography with Radionuclides Cardiac and Non cardiac Studies Image Quality in Radionuclide Imaging Brief Overview of Patient Doses in Diagnostic Nuclear Medicine Diagnostic and Therapeutic Studies for Blood Diseases

6. Imaging with Ultrasound (US)

Brief Overview of Physics of Ultrasonic Waves Interaction of ultrasound with Living Tissue A-Mode Ultrasonic Imaging B-Mode Ultrasonic Imaging Image Resolution Artefacts Doppler Ultrasound Patient Safety Considerations

45

7. Magnetic Resonance Imaging (MRI)

Brief Overview of Physics of Radiofrequency Waves Interaction of RF Waves With Living Tissue Basic Operational of MRI systems Magnets and Coils Specialized Imaging Techniques MRI Image Quality Artifacts Advantages of MRI Brief Overview of Patient Safety in MRI

For the Medical Physics Section: - Sara Buhumaid, Head of Medical Physics Section (MPS) - Abderrachid Zitouni, Consultant Medical Physicist / MPS

46

DHARadiologyResidencyProgram ClinicalROTATIONEvaluation
Resident Name: (optional)__________________Rotation_________________________ This Form is designed to provide resident feedback to Programme Administrators concerning strengths and areas to improve in the variety and organization of clinical exposures provided in the different clinical rotations of the Surgery Programme. The forms will be given to the rotation supervisor of each rotation at the end of the rotation. Please feel free to be candid and objective. All comments will not be traceable to the resident completing the form by the immediate supervisor.
Rank the following statements whether you Strongly Agree (S/A), Agree (A), Disagree (D), Strongly Disagree (S/D) or Can Not Judge (N/J)

Evaluation Scale

S/A

S/D

N/J

Organization of the Rotation

The overall workload of the rotation was appropriate (please make a comment in comments section as to if workload was too light or too heavy) Reporting sessions provide an adequate opportunity to learn a systematic approach to the film, radiological terms, reporting structuring . The amount of scut in the Rotation was appropriate The clinical material I saw provided a good exposure to the field of practice of the rotation I was given clinical responsibilities appropriate for my level of training (please make a comment in comments section as to whether too much or too little was expected of you)

Teaching
The academic activities of the division provided good learning opportunities There was adequate access to internet

47

resources and books if I needed to look something up The reporting session teaching was very good I received my evaluation before the rotation ended I received feedback about my performance throughout the rotation

Organization
There was adequate space for me to complete my work The secretarial support was good The supervising staff were available for back up and consultation if needed The rotation was arranged in such a way that I was able to attend other Teaching Activities

Resident Faculty Interactions

I felt that my contributions to the departments clinical activities were valued My opinions were respected and I felt like a member of the team.

Overall
Overall this rotation allowed me to meet most of the rotation specific educational objectives

Comments:

48

DHARadiologyResidencyProgram ClinicalRotationFACULTYTeachingEvaluation
Resident Name: (optional) __________________Rotation_________________________ This Form is designed to provide resident feedback to Programme Administrators concerning strengths and areas to improve in the quality of training by providing an assessment of teaching staff in the Emergency Medicine Programme. The forms will be given to the resident at the end of each rotation. Please feel free to be candid and objective. All comments will not be traceable by the faculty in question to the resident completing the form.
Rank the following statements whether you Strongly Agree (S/A), Agree (A), Disagree (D), Strongly Disagree (S/D) or Can Not Judge (N/J)

Please Rate the Faculty Members teaching style and capacity to function as a role model. Clinical Teaching Faculty: _______________ Rotation: _______________ (Note: Use a separate sheet for each supervising Faculty Member)

Evaluation Scale

S/A

S/D

N/J

Medical Expert
Upto-date in area of practice, scientific and clinical knowledge Promotes development of trainees judgment and decision making Supervised the teaching of procedural skills

Communicator
Role model for effective & compassionate communication with patients & families Clear written communications documentation

Collaborator
Role model for care in interdisciplinary setting Respectful interaction with trainees/ other colleagues in clinical situations Provided appropriate graded responsibility to the resident during the

49

rotation

Manager
Role modeled the use of health care resources cost effectively Organization of work and time management

Health Advocate
Role-modeled just advocacy for his/her individual patients

Scholar
Promoted critical appraisal skills in teaching and clinical work Enthusiasm for and effectiveness at teaching

Professional Role modeled and promoted the values of:

The highest levels of integrity and honesty Sensitivity to and respect for diversity Compassion and Empathy Recognition of own limitations Application of the principles of medical ethics to clinical situations

Comments:

50

DHARadiologyRESIDENCYPROGRAM ROTATIONINTRAININGASSESSMENT(RESIDENT)
Name: Period of Training Resident: Site: Rotation: Rank the following statements whether Unacceptable (U/A), Needs Improvement (N/I), Competent (C), Advanced (A) or Outstanding (O/S) I FROM: II III IV TO:

Evaluation Scale

U/A

N/I

O/S

Medical Expert
General medical knowledge

Can incorporate medical knowledge to patient problems Gather essential and accurate information about patients Make informed diagnostic and therapeutic decisions Develop and implement patient management plan Ability to recognize and recruit appropriate personnel to assist with, witness or supervised the procedure Perform competently essential medical procures Clinical judgment & decision making

Communicator
Demonstrate effective interpersonal and communication skills Elicit and provide information using multiple skills Explain rational for test and treatment, obtains patient's consent, educate/counsel regarding management

51

Collaborator
Work effectively with others as a member or leader of health care team or other group professional Delegates effectively

Manager
Demonstrate awareness of and responsiveness to the system of health care Incorporate cost awareness in decisions Organizes work & manages time well

Health Advocate
Assure patient advocacy with high quality while using limited medical resources advocate for the community health

Scholar
Demonstrate understanding and use of EBM in providing patient care Shows ability in teaching other peers, junior colleagues and students Use information technology to manage information Motivated to acquire knowledge even without asking

Professionalism
Commitment to professional responsibilities Residents attitudes, behavior and interpersonal skills in relation to patients, their families and other health care professionals Respect and Sensitivity to diversity Compassion and Empathy Commitment to excellence and on-going professional development Commitment to ethical principles

Overall
Resident accessibility all the time and during on-calls Resident overall clinical competence in the rotation

52

COMMENTS (Including Strengths, Weaknesses and Need for Special Attention). _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ ________________________________________________________________________ _ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ ________________________________________________________________________ _ ________________________________________________________________________ _ ________________________________________________________________________ _ ________________________________________________________________________ _ ________________________________________________________________________ _ ________________________________________________________________________ _ _________________________________________________________________________ ________________________________________________________________________

Signature of Supervisor

Date

Signature of Trainee

Date

53

XV.

References
Dubai Residency Training Program-Department of Medical Education-Dubai Health Authority Education Board of the Faculty of the Clinical Radiology, the Royal College of Radiologists (January 2007), Structured Training Curriculum for Clinical Radiology, Royal College of Radiologists, London

The Arab Board for Medical Specialties ,Specialist Training Programme in Diagnostic Radiology, Four Year Residency Training Programme (March 2008) Farr's Physics for Medical Imaging, 2007 Ed. Authors: Penelope J Allisy Roberts, Jerry Williams- Publisher: W.B. Saunders Company- Available at: Medical Physics Section / DHA

Royal College of Radiologists / UK Curriculum and Information, 2009.Physical Principles in Diagnostic Medical Imaging -Copy of the Document is Attached

54