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McGill University

Department of Diagnostic Radiology

Resident's Handbook

January 2010

Resident’s Manual

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Table of Contents 1 Introduction 4 2 Goals and Objectives 5 3 Details of Training Program 5 4 Call Schedule 7 5 Chief Resident Duties 9 6 Resident Coordinators… 9 7 Rules and Regulations 9 8 In-Training Evaluations 9 9 Resident’s Evaluations of Training Program 13 10 Committees 14 11 Calendar of Important Dates 15 12 List of Staff 17 13 Appendices 14 Appendix I – PGY requirements 22 Appendix II – Training Requirements 23 Appendix III Research Requirements 24

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McGill University Department of Diagnostic Radiology

Dr. J. Chankowsky Program Director

Residency Program

Dr. R. del Carpio-O’Donovan Vice Chair, McGill University Associate Director, MUHC

Dr. R. Lisbona Chairman, McGill University

Director, MUHC

Dr. R. Faingold MCH

Radiologist-in-Charge

Dr. M.Levental Director,

Undergraduate Education

Dr. R. del Carpio- MGH

Radiologist-in-Charge

Dr. M. Levental JGH

Radiologist-in-Chief

Dr. L. Stein RVH

Radiologist-in-Charge

Dr. D. Tampieri MNH

Radiologist-in-Charge

Dr. J. Glay St. Mary’s

Radiologist-in-Chief

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1. INTRODUCTION The McGill Radiology residents' manual was designed to serve as an outline of the training program detailing the goals and objectives and describing the educational methods, resources and facilities which are available. The program is designed to provide the tools necessary for residents to acquire the skills needed to function as a consulting radiologist. This is achieved through a process of observation, practical experience, daily rounds and academic activities including didactic lectures, research participation and presentations as well as hospital based journal clubs. It must be stressed, however, that the onus is on the resident to take advantage of all available resources in order to achieve this goal. There are five major teaching hospitals consisting of three general hospitals (JGH, MGH, RVH), a pediatric hospital (MCH) and a specialty hospital in neurosciences (MNI). In addition there is one affiliated hospital (St. Mary's) where approved electives in general radiology can be taken. The program is fully integrated with rotations in all five major teaching hospitals. The first year is a clinical year which is essentially divided into 5 to 6 months of surgery and 5 to 6 months of medicine. {Appendix 1}. This is known as the PGY1 year. Training in diagnostic radiology begins in the second or PGY2 year. See Appendix 2 for mandatory rotation requirements for PGY 2 – PGY 5 year of training.

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2. GOALS AND OBJECTIVES The primary goal of the Diagnostic Radiology Training Program at McGill University is to produce well-rounded general radiologists who have been exposed to all aspects of subspecialty training and have developed familiarity with all of the imaging techniques, procedures and technology. This will necessitate a thorough knowledge of the relevant anatomy, physiology and pathology as well as the essentials of medicine and surgery. Radiation physics and biology must be well understood so that the principles can be applied to every day practice. Residents who have completed the program should have an appreciation of the radiologist's active role in patient care, as an integral member of the patient care team. The importance of continuing medical self-education through up-to-date journal reading and attendance at meetings and conventions should be understood and accepted as a career-long necessity. Research participation is a requirement and this has been introduced without limiting the clinical content of the training program. This experience will aid graduating residents in critical evaluation of articles and studies reported in the medical literature. Specific goals and objectives on a yearly basis are as follows: PGY1 Year The PGY1 year is essentially a mixed internship year with 11 periods divided into surgically related specialties and medically related specialties (with one period vacation). Periods 12 and 13 are reserved for Float rotations in Radiology as well as the Epidemiology Course. {See Appendix l for division of rotations}. The purpose of this year is to give trainees the opportunity to improve and consolidate their clinical, technical and communication skills. Rotations have been selected where radiology plays a fundamental role in that clinical specialty. This will allow the trainee to understand the nature of the relationship between a referring physician and a clinical radiological consultant. During this year, residents will be under the supervision of both the Departments of Surgery and Medicine, abiding by the rules and regulations set by these departments, but ultimately the resident is the responsibility of the Department of Diagnostic Radiology. Residents are encouraged to contact the Program Director or Resident Coordinators in Diagnostic Radiology with regard to any problems. During this year, residents are encouraged to read a General Textbook of Radiology with Paul and Juhl's Text being strongly recommended. Period 12 consists of a combined Float rotation with the mandatory Epidemiology course. Period 13 consist of a Float period only. Residents will be scheduled at the Montreal General Hospital for their Float periods. Residents will take call with a more senior resident. As well, candidates will be expected to acquire basic training in computers if not already proficient.

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End of PGY2 The resident will: 1. Understand the nature of the formation of radiographic images, including physical and

technical aspects, patient positioning and contrast materials; 2. Understand fundamental aspects of radiation protection; 3. Have a sound knowledge of human anatomy with emphasis on radiological applications,

both conventional and cross sectional; 4. Have read from core textbooks in all general areas of radiology; 5. Have learned to discuss radiologic cases in the presence of peers, teachers and clinical

colleagues; 6. Have developed a sound and systematic style of reporting. End of PGY3 The resident will: 1. Have studied to exam readiness in certain areas, depending on rotations (this process will

be complete by year three); 2. Have gained experience and skills to the point of being regarded as a useful junior

consultant by clinical colleagues; 3. Be competent in the manual skills in all the rotation areas that have been covered; 4. Have demonstrated some competence in evaluation of the medical literature; 5. Have started an investigative project, such as clinical review or a research project, ideally

to be completed by the end of year three. End of PGY4 The resident will: 1. Have completed the core rotations as required by the Royal College; 2. Have studied all aspects of radiology, including Physics, to an exam ready state; 3. Have achieved consultative skills, and the ability to lead case discussions or present

scholarly material near the level of a qualified general radiologist; 4. Have achieved diagnostic and clinical skills at the level of a qualified general radiologist; 5. Have played a substantial role in the teaching of junior residents. End of PGY5 The resident will: 1. Have gained wide practical experience in all aspects of imaging, have had an opportunity

to pursue some areas of subspecialty interest, and have developed good skills in teaching junior residents and in consultations;

2. Have the knowledge and skills for independent practice of radiology, including the fundamentals of Quality Assurance;

3. Be prepared by training and outlook to embark on a career-long program of continuing self-education.

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3. DETAILS OF TRAINING PROGRAM a) Rotations {Appendix 2} The first 27 periods will be divided evenly into 9 periods in each of the three base hospitals, JGH, MGH and RVH. This division will allow for an even distribution of the trauma call and will provide for a sufficient period of stability and familiarity so that the teaching staff may work closely with each resident and permits a gradual increase in responsibility. During this period basic rotations are taken in chest, GI, GU, musculoskeletal radiology, neuroradiology, ultrasound and CT. Each year is divided into 13 four-week periods. At least one period of training in chest, bone, and GI must be taken at each base hospital. Four periods of pediatric training are required at the MCH. One period is to be done during the PGY 3 year (latter half of the year) and the remaining 3 periods can be done any time after the 27 months. All residents are required to do two periods of neuroradiology training in the first 15 blocks, an additional two blocks of neuroradiology at either the MNI or the MGH. Other requirements are two periods of MRI training (R 4 and R 5 level only), three periods of training in angiography (traditionally at least two of these periods are done at the base hospital), and 2 periods of training in mammography. At least six periods of ultrasound training is required with obstetrical ultrasound included. Echocardiography is optional. Electives: A total of nine (9) or thirteen (13) periods of elective time is given depending on the number of nuclear medicine periods taken. A total of 2 elective periods are allowed outside of the McGill network during your training McGill policy for electives is as follows: Electives can only be done after 2 years of training in the Program; the Faculty requires a minimum of 3 months notice for elective requests outside of the McGill network. Electives, however, subject to approval by the program director and may be used for remedial purposes in rotations where residents are deemed to be deficient. No electives will be granted during “crunch”, i.e. periods 1, 2, 7, 11, 12 and 13. Research – 3 elective periods can be used to complete a research project b) AFIP The Armed Forces Institute of Pathology (AFIP) in Washington, D.C. gives several six week courses per year in radiologic-pathologic correlation. This course is not mandatory but highly recommended as it is a remarkable learning experience. This will be considered as 1 1/2 periods of elective time. The course includes both live and videotaped lectures and case seminars presented by the AFIP Staff Radiologists, AFIP Pathologists and visiting lecturers. The daily schedule runs from 7:50 a.m. until noon and lectures from 12:30 p.m. until 3:30 p.m. No housing is provided through the AFIP, however, there are accommodations in private homes around the Walter Reed Army Medical Centre and apartments are available in nearby Silver Springs. The course fee at the moment is $l,500.00 U.S. and is paid by the Department of Radiology. As a pre-requisite for attendance, residents must submit one radiology case accompanied by pathologic material. Interested residents should contact Ms. Cathy Torchia with regard to available dates, with senior residents being given priority. As positions are limited, an opportunity to attend this course should not be missed as the positions then become available to the more junior residents. More detailed information regarding the AFIP can be obtained from each departmental secretary (AFIP information package). Attendance during summer months is not permitted.

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c) Physics & Radiation Biology A course in Physics and Radiation Biology is given by the Department of Medical Physics, coordinated by Dr. G. Hegyi. The course is intended for all residents and is given on a one day per month basis during the academic year. A course syllabus is provided. Attendance is mandatory. The course will largely be based on the textbook ''Essential Physics of Medical Imaging'' by Bushberger et. al. Other texts dealing with the subject matter are found in the list below. Recommended Text Books: 1. Christensen's Introduction to the Physics of Diagnostic Radiology. Publisher: Lea &

Febiger 2. Introductory Physics of Nuclear Medicine, Chandra, Publisher: Lea & Febiger 3. Basic Radiation Biology. Pizzarello, Publisher: Lea & Febiger d) McGill Radiology Residency Research Program The aim of implementation of research as an integral part of residency is the development of objectivity and critical appraisal in reviewing the literature. The experience achieved through writing protocols, collection of data, and the final writing of the manuscript will give the resident better insight about the new information in the radiology literature. A research project is MANDATORY during the radiology residency. Research Requirements 1. Completion of one approved project is required . 2. All research proposals must be submitted to the Research Committee (RC) for approval one

(1) year prior to presentation (ex; must be approved by research day of PGY 3). 3. A yearly progress report on the status of each project is to be sent to the RC. 4. The project must be completed and presented by Research Day of his/her PGY 4 year 5. The resident is required to submit the project as an abstract to a local or national/international

meeting (ex: CAR, SCFR, RSNA, ISMRM, ARRS) 7. Residents may be granted up to three months research elective pending approval by the RC

and Program Director. At the end of any period of research time the resident is required to present the results/work produced during that elective time.

8. At the annual research day, an award will be given for the best resident paper.

e) Research and Research Day A research project is mandatory and must be completed and presented by Research Day of his/her PGY 4 year. Residents who do not complete their project at this time, may not be able to commence their PGY 5 year of training (promotion withheld).

Research day is held annually in early Spring of each academic year and is coordinated by the Research Committee of the Department.(see Appendix 3 for details) At this time residents are expected to present their projects. As well, the attending staff may present current work in progress.

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f) Visiting Professors' Program & Radiology Grand Rounds The Visiting Professors' Program is coordinated by Dr. Robert Hanson. Five to six renowned radiologists per year are invited to lecture to our residents and staff. This program is usually held on Mondays and Tuesdays. Residents are relieved of their clinical responsibilities and are expected to attend all sessions. McGill Residents also attend the V.P Program organized by the University of Montreal As well, there is an Inter-Hospital Visiting Professors' Program involving McGill attending staff. These are held every 2nd Wednesday (alternating with Physics lectures). Wednesday afternoons are protected teaching time. . 4. CALL SCHEDULE Residents will take solo call beginning in period two. Call will be equalized in all hospitals, so that despite uneven numbers of residents rotating to individual hospitals, residents at hospitals with reduced numbers will not be required to take call more frequently with the exception of the MCH, where more concentrated call is desirable during pediatric training. Residents at RVH will cover both RVH and MNH. The schedule will be drawn up by all three hospital chief residents and the program chief resident. Residents are required to remain in-house but may leave the department after 10:00 p.m. provided that there are no studies pending. On weekends, call begins at 8:00 a.m., but residents are not required to be in-house until called. At JGH since all ER films are read by the radiology resident, residents should appear no later than 10:00 a.m. Residents must be available by phone or Bellboy until 8:00 a.m. on the morning following call. Post Call Policy It is at the discretion of the resident in a post call situation whether he/she can work

following call the next morning. If the resident has not been called into the hospital during the

night, he/she will be expected to attend his/her regular rotation. Residents who are called in after

midnight can take the morning off to recuperate. Residents on-call at the RVH or JGH are to call in

the department secretary or administrative coordinator (Cathy) at 3:00 a.m. for example to inform

us that he/she is in the hospital and will not be at work in the morning. The resident is expected to

be back at work no later than 1:00 p.m., but preferably by 12PM in order to attend lunchtime

rounds.

5. CHIEF RESIDENTS' DUTIES AND RESPONSIBILITIES A program chief resident is chosen by peer vote. This chief resident will represent diagnostic radiology residents in the McGill system at all teaching hospitals. Each hospital will have a chief resident. This resident is generally chosen by the residents on the basis of seniority and continuous presence for a minimum six month period. The hospital chief resident will be responsible for the supervision of other residents and will have authority in conjunction with attending staff in matters relating to departmental coverage (daytime, nighttime, weekends and holiday coverage), and performance of radiological procedures.

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The chief resident will have the following responsibilities: 1. Making a monthly departmental on-call schedule; 2. Assigning residents to cover procedures requiring resident participation when a specific

resident is not assigned to a particular rotation; 3. Maintain a record of vacation and other time taken off by residents (other than sick days); 4. Be responsible for organizing staff scheduling for daily conferences as required by

individual hospitals. 5. Introducing new residents rotating to hospitals for the first time, to key departmental staff

(both medical and technical), and to the physical layout of the department, as well as other relevant areas in the hospital.

6. Take responsibility in initiating solutions to interpersonal problems either between

residents, or between residents and staff by acting as liaison between residents and resident co-ordinators, or the program director.

7. Take initiative in improving problem rotations by bringing these problems to the attention of the resident co-ordinators or program director.

8. Attend all Postgraduate Training Committee meetings or assign a delegate if unable to attend.

6. RESIDENT CO-ORDINATORS Each hospital shall have a staff member who will serve as liaison between the residents and the attending staff. The resident co-ordinator will serve as an advisor to the residents at the individual hospital and will be responsible for reviewing the residents' schedules to insure that the required rotations are done and will also be responsible for compiling and reviewing the six-monthly evaluations. Each hospital resident co-ordinator is the representative to the Residency Program Committee and, as such, the resident co-ordinator will also serve as the liaison between the individual hospital attending staff and the Residency Program Committee. The Administrative Coordinator for resident training is Mrs. Cathy Torchia, who can be reached at 934-8084 at the MGH, Room C5 118. 7. RULES AND REGULATIONS A preliminary schedule for the following academic year will be made during the month of December by the chief residents. Apart from unexpected circumstances, changes have to be requested two months ahead. i) Vacation Four weeks, or 20 working days of vacation during the academic year July 1 to June 30. There are “black out” periods during the month of July and Christmas. Periods 10 & 11 are reserved as study time for the senior residents.. Residents are expected to cover all their call regardless of the number of vacation days requested. If a resident is taking 2 or more weeks off, they are expected to pay back the call within 2 months. In addition, an extra week is granted during the period of Christmas/New Year (50% of resident staff during each week).

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Vacation policy for MCH and MNH There is no longer any rotation which is protected from vacation except under special circumstances. A minimum of 11 weeks is required at the MCH for educational purposes so vacation is strongly discouraged. However, if more than 1 week is required you may be granted this vacation with the stipulation that you “borrow” one week from your next rotation so that you will complete the 11 weeks in Pediatrics.

For the MNH rotation, it is agreed that the resident exposure to the Neuroradiology expertise at that site should be maximized, but the resident contract is non-negotiable and the residents have a right to expect that it be enforced. The Residency Committee agrees that the residents should avoid vacation while rotating for 1-month period, but we cannot refuse the request (as per the letter of the law). Any resident who is absent for more than 25% of the rotation may be asked to return for extra time to complete his/her requirements at the MNH (or elsewhere). To facilitate planning for all residents' vacation leave, requests must be submitted by July 1 of each academic year. Vacations are granted only after the following steps have been followed: - Completion of a vacation form by the resident; - Signature obtained from the chief resident of the hospital involved; - Signature obtained from either the chief of the department or the staff responsible for the

rotation involved; - Signature obtained from the program director. Common sense indicates that vacations should not be left for the end of the year. They should be spaced out during the course of the year, as much as possible. PGY2, PGY3, and PGY4 residents must take their vacation before May 1, since PGY5 residents are usually away at this period preparing for examinations. ii) Sick Days Residents must notify the department's administrative coordinator (Cathy Torchia) and rotation supervisor of days off due to illness. If you cannot speak with Ms. Torchia directly, please leave a message on the voice mail. iii) Time for examination Two extra weeks (ten working days) of time off are granted to PGY5 residents in order to prepare for their written and oral examinations for board certification. One week is granted for each part of the examination. Time off is only granted for the period immediately preceding the examination. Residents are expected to be back in their department the day after their examination. Residents in their final year are expected to attend their final rotation (period 13) in its entirety to June 30. Failure to do so will result in a pay reduction, and certification may not be granted. iv) Interviews A maximum of five working days is granted to PGY4 residents who have to take time off for interviews for fellowship. Time off, during their PGY5 year, or time off for job interviews is to be taken from vacation time.

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v) Leave for Congresses Visiting Professor Program: Except under exceptional circumstances, all residents are granted time off to attend viewing sessions and lectures. All residents must attend all of the Visiting Professor sessions (unless on approved vacation). Any resident may, after consulting with the resident coordinator of their hospital, opt to continue working in their current clinical rotation instead of attending the Visiting Professor session. Any resident absent without good reason will loose the privilege of attending Visiting Professor sessions for an indefinite period of time. Residents are granted an additional week (five working days) to attend a meeting of their choice during each academic year. In addition to this week, during either their PGY4 or PGY5 year, they are allowed to attend another meeting (five working days). Attendance to the Visiting Professor program at other Universities is considered as attendance to a meeting. In addition, residents presenting a paper at a meeting will be granted additional time off to attend the entire meeting at which they present. Time off for meetings is contingent upon the same approval procedure as for vacation time. vi) Funding for meetings McGill University provides no funding for residents to go to meetings. The McGill Department of Diagnostic Radiology has established a uniform funding policy. During the four years of training there is a total of three months for research activities, but a maximum of one month per major research project. Reimbursement will be given up to a maximum of $1,500.00 per resident presenting at a meeting during their four years of training. Prior to any meeting presentation, a request for funding must be submitted by the resident to the Research Committee for approval. vii) Rotations The schedule printed at the beginning of the year is final and no changes are expected except for valid reasons. Changes of rotations are to be requested in writing. The request must indicate the reason for the change, and must bear the signature of: - the chief resident(s) concerned; - the staff responsible for the rotations involved; - the program director. Changes have to be requested at least two months ahead of the rotation to be changed. In addition to the rotations outlined above, two electives are allowed outside the McGill orbit during the course of the four years. (For residents joining the McGill program after their first year, one outside rotation is granted for two years of residency done at McGill). These electives have to be planned ahead of time and be part of the annual schedule.

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viii) Working Hours Most services begin at 0800 hours and finish routine work by 1700-1800 hours. However, earlier starting times and later finishing times may be necessary from time to time and the residents are expected to comply. 8. IN-TRAINING EVALUATION OF THE RESIDENTS This will be completed by the staff involved in the particular rotation. At the end of each rotation the resident should discuss their evaluation with the staff person involved. This meeting should be initiated by the resident. Six-month evaluation This will be completed by the resident coordinator at the hospital where the resident spent the majority of the six-month period. This evaluation will be based on the evaluations from individual rotations and other factors and should reflect the resident's overall standing in the program at that particular time. Discussion of this evaluation will be initiated by the resident coordinator. The Faculty of Medicine has issued a document on rules and regulations regarding evaluation and promotion of residents. Copies are distributed yearly by the Faculty of Medicine. A copy is also available in Residency Program Office office at the Montreal General Hospital. Annual In-Training Examination (A.I.T.E.X.) This oral examination will be held in February of each year for PGY5 residents and in May or June for all other residents. The results of this examination will be evaluated within the context of the residents' overall performance within the program. The following guidelines have been adopted. 1. Residents who fail the A.I.T.E.X. two consecutive years will be brought before the

Postgraduate Training Committee to review the resident's performance. If the results of the A.I.T.E.X. combined with poor evaluations warrant, residents may be placed on probation for a six-month period.

2. Residents who have failed one A.I.T.E.X. and have shown poor performance on their in-training rotation assessments will be brought before the committee. If the results of the A.I.T.E.X. combined with poor evaluations warrant, residents may be placed on probation for a six-month period.

3. Residents who have failed one A.I.T.E.X. but whose in-training performance has been within acceptable standards will meet their resident coordinator to discuss their current status.

4. Residents who fail three consecutive A.I.T.E.X.'s may be required to complete an additional year of residency training before being admitted to their oral certification examinations.

ACR In-Training Examination - February of each year

All PGY2-4 residents will write this multiple choice examination.

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Final In-Training Evaluation Report (F.I.T.E.R.) This evaluation, completed by the Program Director (with the help of the resident coordinators), allows the resident to be admitted to the Royal College oral examinations. In order to remain in the program, the resident must demonstrate: 1. High moral and ethical standards; 2. Good rapport with patients and staff; 3. Adequate performance in daily duties; 4. Adequate performance in the in-training written and oral exams. The departmental Postgraduate Training Committee will try to determine within the first year of training whether the resident is suitable to remain in the program or not. However, if necessary, this decision may also be made later in the program. 9. RESIDENTS EVALUATIONS OF TRAINING PROGRAM At the end of each rotation residents are asked to complete forms which evaluate the quality of the rotation. An internal review is conducted every two years by various members of the attending staff and one resident representative. Interviews are conducted with residents and teaching staff with a view to identifying weak areas in the various rotations so that improvements can be made on a continuing ongoing basis. 10. COMMITTEES {Appendix 6} The department is headed by the Chairman. There are several committees which report to the Chairman. The Executive Committee is made up of the chiefs of the individual hospitals, the Chairman of the Nuclear Medicine training committee, the organizer of the Visiting Professor Program, and the Program Director who is in charge of the Diagnostic Radiology training program, and who also chairs the Postgraduate Training Committee. The Postgraduate Training Committee consists of the Program Director, the Research Director, the resident coordinators at each hospital, the chief radiology resident, and the chief resident from each hospital. The program promotions committee is a subcommittee of the Postgraduate Training Committee. This committee is composed of the Program Director, who chairs the committee, and the five resident coordinators. The Chairman of the Department and the Associate Dean of Postgraduate Medical Education are ex-officio members of the Postgraduate Training Committee and the Promotions committee. There is a Research Committee composed of the representatives from each hospital as well as from the Department of Epidemiology and Biostatistics. There is also an Undergraduate Education Committee.

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11. CALENDAR OF IMPORTANT DATES At the beginning of the academic year a list of important dates for coming events for the academic year is sent to all residents. Included are the dates for visiting professors, examination dates including Board examinations and in-training examinations both oral and written, Physics Course and Research Day. When changes are made during the year this calendar is revised and circulated to all residents 12. CERTIFICATION EXAMINATIONS Format of the Royal College Certification Examination in Diagnostic Radiology: The examination in Diagnostic Radiology is a comprehensive objective examination (COE). The written, oral, and objective structured clinical examinations (OSCE) are integrated into a single examination process. The examination process for each candidate will last approximately eight and one-half to nine hours. Candidates must remain in the examination city for either three or four consecutive days. This depends, of course, on the day scheduled for the oral component of the examination. (a) Written Component The written component consists of one three-hour paper of multiple choice questions on the basic sciences (including anatomy, physiology, pathology), clinical medicine and surgery related to diagnostic radiology, as well as on the theoretical and practical aspects of the clinical practice of diagnostic radiology. (b) Oral Component Each candidate will be examined for three hours (either in the morning or afternoon) by examiners in radiology. Candidates will be expected to have relevant knowledge of clinical and laboratory aspects of cases that will be presented to them. The examination will be arranged as follows: 1. Two examiners will conduct a one-hour session on the interpretation of imaging studies of

the chest, breast, and cardiovascular system. 2. Two examiners will conduct a one-hour session on imaging studies related to the abdomen

and pelvis. 3. One examiner will conduct a thirty -minute session on the central nervous system and neck.. 4. One examiner will conduct a thirty-minute session on imaging of the musculoskeletal

system. N.B. Residents must apply to the Royal College for preliminary assessment of training at least one year prior to the exam. International medical graduates at least 18 months prior. Tel: (800) 668-3740 Application deadline for Examinations – April 30.

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(c) OSCE Component The OSCE component will last three hours. Candidates will be examined during 130 minutes; the remaining 35 minutes will be for coffee break and rotation between stations (two minutes between each station). Each candidate will receive his/her schedule of the OSCE before the examination. The multiple choice component of the exam will account for 20% of the final mark, the oral component 50% and the OSCE component 30%. Regarding the specialty examination for certification in Quebec, candidates must have completed required training, succeeded at the licensure examination, be a Canadian citizen or a landed immigrant and have a working knowledge of the French language. Details of the examination requirements can be obtained by writing directly to the Collège des Médecins du Québec, 2170 René Lévesque Blvd. West, Montreal, Quebec H3H 2T8. Telephone: (514) 933-4441. Regarding the American Board of Radiology written and oral examinations, details can be obtained by writing directly to the American Board of Radiology, Inc., 54415 East Williams Tucson, Arizona 85711. Telephone: (520) 790-2900

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15 LIST OF STAFF

Jewish General Hospital

340-8233 Dr. M. Levental (Radiologist-in-Chief) 5361 Secretary, Ms. Franca Giannini 5348 Secretary, Ms. Clara Scemany 5346 Dr. E. Camlioglu ` Dr. J. Cassoff 4749 Dr. A. Constantin Dr. D. Discepola Dr. R. Forghani Dr. H. Le Dr. M. Levental – Director, Undergraduate Education 5348 Dr. A. Lisbona Dr. A. Mandalenakis Dr. M. Palayew 5345 Dr. V. Pelsser Dr. M. Pinsky 5358 Dr. L. Rosenbloom Dr. M. Rosenbloom 5352 Dr. R. Satin – Resident Coordinator 5657 5349 Nuclear Medicine Staff Dr. C. Rush 5942 Dr. J. Stern 5942 Dr. J. Laufer Dr. S. Probst

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Montreal Children's Hospital

412-4450

Dr. R. Faingold, Radiologist-in-Charge Secretary, Ms. Manon Roy 22130 Dr. P. Albuquerque 22450 Dr. L. Carpineta 22450 Dr. G. O’Gorman 24450 Dr. C. Saint-Martin 24450 Nuclear Medicine Staff

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Montreal General Hospital

934-8003 (Radiology) Dr. Raquel del Carpio, Radiologist-in-Charge 43222 Secretary, Mrs. Maria Cattafi 43222 Dr. R. Lisbona, Chairman of the Department 934-8084 Administrative Coordinator, Ms. Cathy Torchia 934-8084 Dr. A. Aldis 48003 Dr. G. Artho 48003 Dr. G. Artho 48003 Dr. A. Assaf 48003 Dr. G. Belley 48003 Dr. J. Casullo 48003 Dr. J. Chankowsky (Program Director) 48003 Dr. R. Hidvegi 48003 Dr. G. Kintzen 48003 Dr. V. Khoury 48003 Dr. M.H. Martin 48003 Dr. C. Reinhold- Director, Fellowship Program 48003 Director, Research Committee Dr. H. Rémy 48003 Dr. J. Taylor 48003 Dr. M.Tsatoumas 48003 Nuclear Medicine Staff Dr. L. Rosenthall 943-8081

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Montreal Neurological Hospital

398-1910 Dr.. D. Tampieri,- Radiologist-in-Charge 1908 Secretary, Ms. Micheline Hrycaj 1908 Dr. M. Cortes 1910 Dr. D. Melancon 1910

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Royal Victoria Hospital

843-1545 Dr. L. Stein, Radiologist-in-Charge 34377 Secretary, Ms. Louise Call 34377 Dr. L.M. Boucher Dr. M. El Khoury 31545 Dr. R. Hanson – Chairman, Visiting Professor Program 34619 Dr. E. Kao - Resident Coordinator 34868/35668 Dr. J. Kosiuk 34614/31514 Dr. B. Mesurolle 31545 Dr. A. Semionov 23649 Dr. S. Petitclerc 31545 Dr. T. Powell 31545 Dr. A. Roy 34620/35668 Dr. C. Torres 35666 Dr. D. Valenti 35666 Nuclear Medicine Staff Dr. R. Lisbona, Director - Nuclear Medicine 31501 Secretary, Mrs. Angela Gualtieri 31501 Dr. V. Derbekyan 31501 Dr. M. Hickeson 31501 Dr. J.A. Novales-Diaz 31501

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REQUIREMENTS FOR PGY1 YEAR (13 PERIODS) Appendix 1

Surgery: (For periods 1-6) General Surgery 2 periods SICU 1 period Orthopaedics 1 period Emergency 1 period Elective 1 period (Obstetrics/Gynecology or Urology) (For periods 7-11) General Surgery 2 periods SICU 1 period Orthopaedics 1 period Emergency 1 period Medicine: (For periods 1-6) CTU 1 period Emergency 1 period GI 1 period Neurology 1 period Pediatrics 1 period Respirology 1 period (For periods 7-11) CTU 1 period Emergency 1 period GI/Neurology/ 1 period Pediatrics 1 period Respirology 1 period Vacation: 1 period Period 12 Epidemiology & Float Period 13 Float (revised- December 2009

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Appendix 4

DETAILS OF TRAINING PROGRAM ROTATIONS

GI/GU 3 periods (2 GI’s , 1 GU @JGH) Bone 5 periods Cardiac Imaging 1 period (MCH and MGH/RVH) Chest 5 periods (including Chest CT) Angiography 3 periods Pediatrics 4 periods Nuclear Medicine 4 or 0 (4 periods for American Boards) CT scan 3 periods ER 1 period (MGH) Neuro 4 periods MRI* 2 periods ENT* 1 period Mammography 2 periods Ultrasound 6 periods (includes obstetrical US) Electives2 8 or 12 periods (includes AFIP, Echocardio and Research1) *Offered at the R 4 and R 5 level only

4 years x 13 periods = 52 periods 1 3 months of research can be taken during the residency

2 2 electives periods are permitted outside the McGill network.

Revised: December 2008

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SPECIALTY TRAINING REQUIREMENTS IN DIAGNOSTIC RADIOLOGY

These training requirements apply to those who begin training on or after July 1, 2009. MINIMUM TRAINING REQUIREMENTS

The five years of approved training require closely supervised practice, with the opportunity for increasing responsibility in the final years, so that the resident near the end of training can function as a general radiology consultant. The residency may be followed by one or more years of fellowship training in a subspecialty discipline, as the residency training is not intended to provide a subspecialty level of expertise.

Five (5) years of approved residency training in Diagnostic Radiology. This period must include: 1. One (1) year of basic clinical training taken as a junior resident

The purpose of this year is to give the resident a degree of independent responsibility for clinical decisions; an opportunity for further development of the skills required in making effective relationships with patients; the consolidation of competence in primary clinical and technical skills across a broad range of medical practice; and an understanding of the nature of the relationship between a referring physician and a clinical radiological consultant. This training must include:

A minimum of ten (10) months of broad based medical experience relevant to Diagnostic Radiology, selected from Internal Medicine, surgery, Pediatrics, Obstetrics and Gynecology, Emergency Medicine, Neurology, Family Medicine or any combination of these, and not to exceed more than six (6) months in any one element A maximum of two (2) months selected from the following: Diagnostic Radiology Nuclear Medicine Basic sciences related to Diagnostic Radiology Research related to Diagnostic Radiology Four (4) years of approved residency training

Training in medical imaging integrates training in the imaging modalities and in the imaging of organ systems. This training must include adequate experience in imaging of adult and pediatric patients in inpatient, emergency and ambulatory settings. Resident training must include minimum training time as specified in the following organ systems and must include experience in general radiography, fluoroscopy, interventional procedures, ultrasound, CT, MRI and nuclear medicine as relevant to the following organ systems. For the purpose of this document, a block of training is equivalent to 4 weeks of training . Minimum of six (6) blocks of thoracic imaging, including general radiography, fluoroscopy, basic interventional procedures, CT, MRI and nuclear imaging of the respiratory and cardiac organs . Minimum of thirteen (13) blocks of imaging of the abdomen and pelvis, which must include a minimum of eight (8) weeks training in obstetric ultrasound and fetal imaging. This training must include experience in general radiography, fluoroscopy, basic interventional procedures, ultrasound, CT, MRI and nuclear imaging . Minimum of three (3) blocks of vascular and interventional imaging to include basic vascular and non-vascular procedures, ultrasound, CT and MRI . Minimum of six (6) blocks of musculoskeletal imaging to include general radiography, basic diagnostic and interventional procedures, ultrasound, CT, MRI and nuclear imaging

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. Minimum of six (6) blocks of neuroimaging including head, face, neck, and spine to include general radiography, basic interventional procedures, CT, MRI, ultrasound and nuclear imaging . Minimum of four (4) blocks of breast imaging including mammography, ultrasound, MRI, and interventional procedures under ultrasound and MRI guidance, and nuclear imaging . Minimum of four (4) blocks of pediatric imaging to include general radiography, fluoroscopy, basic interventional procedures, ultrasound, CT, MRI and nuclear imaging 3. Ten (10) blocks of approved residency consisting of any combination of the following as long as these

are appropriately integrated and approved by the Residency Training Committee: Thoracic imaging Body imaging, which may include abdominal, pelvic, obstetric or fetal imaging Vascular imaging which may include imaging for interventional procedures Musculoskeletal imaging Neuroimaging Breast imaging Pediatric imaging Nuclear medicine Research project relevant to medical imaging

Maximum of three (3) blocks of training in pathology (including training at the Armed Forces Institute of Pathology - AFIP) or other clinical specialty relevant to the practice of medical imaging NOTES: In view of the amount and variety of medical imaging to be covered, and the skills required to be prepared as a general imaging consultant, it will seldom be appropriate to spend the entire 10 blocks (40 weeks) in any one of these areas. REVISED - 2009

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REQUIREMENTS FOR

for RADIOLOGY RESIDENTS RESEARCH PROJECT DEPT. OF RADIOLOGY

McGill University

A - Definition of a Research Project for Radiology Residents A project that is intended to b e undertaken by a resident. The project must be completed and presented at Research Day by the PGY 4 year. He/she will be expected to submit a description of the project, along with a reasonable timetable. The research committee will be responsible for approving the proposal. An annual progress report should be submitted to the research committee (see progress report form). The supervisor should review the proposal and needs to sign it off prior to the resident submitting the proposal to the research committee. The research committee is able to help with methodological and statistical issues. It is the supervisor’s responsibility to obtain Ethics Committee approval for the project. B - Criteria for acceptance by the Research Committee: 1. To be submitted to the Research Committee for approval at the beginning of the project. 2. The project must have the potential of adding to knowledge or understanding, or the project will potentially result in a useful device or technique being introduced clinically. 3. There is the likelihood of a full peer-reviewed journal article resulting from this work. 4. Ethics committee approval must be demonstrated, if applicable. 5. Case reports are not acceptable. The general format of the proposal should be 3 to 4 pages and contain the following information: Title: Supervisor: Background Theory: Provide background information detailing the significance and justification for undertaking the proposed research project. This background information should lead up to the hypothesis. The background information should be based on a detailed literature review. This review should be of sufficient depth to identify potential confounders and effect modifiers and to determine areas where new knowledge is needed. The literature review might encompass relevant animal and human experiments, clinical studies, vital statistics, and previous epidemiologic studies. A Statement of Research Objectives, Specific aims, and Rationale: Research objectives describe the kinds of knowledge or information to be gained from the study. Specific aims list the measurements to be made, and any hypotheses to be tested. The protocol must distinguish between a priori research hypotheses and ones that have been based on knowledge of the data. The rationale explains how achievement of the specific aims will further the research objectives. List the main hypothesis(es) to be investigated within the proposed project. Materials & Methods: Description of experimental design (prospective, retrospective, randomized, blinded etc), number of patients and/or animals if applicable and power calculations, inclusion and exclusion criteria, imaging techniques, parameters measured, details of imaging review, statistical approach, etc. This should include a description of, or reference to, methods used to control, measure, or reduce various forms of error -- e.g., bias due to selection, misclassification, reviewer, or confounding -- and their impact on the study. Pretesting procedures for research instruments and any manuals and formal training to be provided to interviewers, abstractors, coders, or data entry personnel should be described or referenced. Results: Preliminary data, if available. Discussion: References: Proposed study tasks, milestones, and timeline: Supervisor’s signature:

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C - Final Report: 1. One abstract with a research report in which the candidate is the principal author and main contributor would be presented at the research day. The research report should be written following the guidelines on the progress report form. 2. A manuscript to be submitted to a peer-reviewed journal (e.g. original article in Radiology) in which the resident is one of the principal contributors. The manuscript should include the following subtitles: a. Introduction b. Materials & Methods c. Results d. Discussion to include conclusion and proposed future work

Please use format such as the structured abstract with the following typical headings: OBJECTIVE State your intention or hypothesis. DESIGN Describe the kind of study you have undertaken. PATIENTS (subjects) State the number of patients (experimental subjects/ animals/methodological models) you have done to date. METHODS & MATERIALS State the techniques/equipment used. MEASUREMENTS State the measurements you have made. RESULTS State your findings to date. CONCLUSIONS Discuss the results you have found to date. NEXT STEPS Describe proposed suggestions for future work. • Your summary should not exceed two pages. • You may append published articles or abstracts arising from your work

PROGRESS REPORT FORMAT RESIDENT'S NAME: _______________________ Start Date: __________________

Expected Completion Date: __________________

DATE: ____________

Final Report

Interim Report