Hot topics in Radiology
HOT TOPICS FOR RADIOLOGY INTERVIEW
Written by Dr. Raj Chari (SpR Radiology Mersey School of Radiology)
Structured Training Curriculum for Clinical Radiology:
Its important to know the regulations for radiology training, please note that the regulations change quite often and make an effort to be abreast with the latest curriculum. It is also worth including a copy of the curriculum in your portfolio.
Further reading at http://www.rcr.ac.uk/docs/radiology/pdf/Curriculum-CR-Jan2007.pdf
Good radiologist and duties of a radiologist:
This can be your opening question, to make a good impression do some back ground reading, follow the link http://www.rcr.ac.uk/docs/radiology/pdf/Stand_self_assess.pdf
I cant emphasis enough the importance of GMC guidelines for Good Medical Practise. The RCR has issued guidelines in the same regard,
http://www.rcr.ac.uk/publications.aspx?PageID=310&PublicationID=193
Pregnancy and Radiation Exposure:
Usually asked as a tricky question at interviews, if you know the RCR recommendation then it is not a difficult question to answer. Further reading is available at http://www.rcr.ac.uk/docs/radiology/pdf/HPA_Diagnostic_Pregnancy.pdf
NAI and Radiologist:
With the changing society NAI is a hot topic and you should know the role of radiologist in NAI.Further reading is available at http://www.rcr.ac.uk/docs/radiology/pdf/RCPCH_RCR_final.pdf
Gadolinium (MRI contrast) and Nephrogenic Systemic Fibrosis:
A fairly new complication from using Gadolinium under frequent review, it can be asked at the interviews. Further reading is available at http://www.rcr.ac.uk/docs/radiology/pdf/BFCR0714_Gadolinium_NSF_guidanceNov07.pdf
Radiation Protection Issues (IR(ME)R 2000):
Radiation protection questions are among stock questions, to read it in detail go to the link,
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_064707.pdf
There is also a very nice PowerPoint presentation to summarise IRMER, follow the link http://www.did.stu.mmu.ac.uk/commercial/dysphagia/PostBasicDysphagia/IMER%20PRESENTATION%20Radiation%20protection%20powerpoint.ppt
Skills Mix in Radiology (Workload/Workforce Challenges):
Very important topic, try not to criticise the role of reporting radiographers if asked at the interviews.
The shortages of radiographers, radiologists and oncologists and the increasing pressures on service are well recognised. The governments commitment to develop more staff, and new grades of staff, to address these pressures for the benefit of patients was set out in the both the NHS and Cancer Plans.
In 1999, at a Downing Street Cancer summit, agreement was reached on the development of a new model of service delivery within radiography. This introduced for the first time the concept of a new role, with the development of assistant practitioners across all specialisms and modalities. Three discrete
service areas were prioritised and set against service and infrastructure investment plans. The three areas in order of priority were:
• breast screening;
• therapeutic radiography;
• diagnostic radiography (including ultrasonography).
Further reading at
Patient Consent Issues Particular to Radiology:
As radiology department is a big team, you should know your responsibility in consenting patients. Know the indications for written consent, what is prudent doctor, express consent, implied consent etc. Further reading at http://www.rcr.ac.uk/docs/radiology/pdf/CRpatientconsentweb.pdf
Iodinated Intravascular Contrast Agent Administration:
A hot topic in the interviews and you cant mess this one as you are expected know the basics of contrast property and complications. A sub section in this topic is 'patients on Metformin', follow the link to find answers for everything you have to know. http://www.rcr.ac.uk/docs/radiology/pdf/IVcontrastPrintFinal.pdf
Teleradiology / Radiology Outsourcing:
A very important topic, usually asked as advantages/disadvantages or future of teleradiology. It can also be asked as radiology outsourcing.
1.http://www.rcr.ac.uk/publications.aspx?PageID=310&PublicationID=195
2.http://radiology.uiowa.edu/MoreRAD/Teleradiology/Tele.html
3.http://www.diagnosticimaging.com/display/article/113619/1190917?verify=0
4.http://content.nejm.org/cgi/reprint/354/7/662.pdf
Clinical Audit:
It is a standard question, 8 out of 10 times you will be asked about audit. There are various documents you can read to understand the basics. NICE guidelines is one of them http://www.nice.org.uk/media/796/23/BestPracticeClinicalAudit.pdf
There is a multimedia on-line course to outline basics and difference between Audit and Research, I think you have to pay to register but worth your money. http://www.clinicalaudit.mvm.ed.ac.uk/
To start an audit related to radiology you can contact a radiologist or radiology trainees in your hospital, alternatively if you want ideas to kick start your audit visit Auditlive section of RCR website, http://www.rcr.ac.uk/audittemplate.aspx?PageID=1016
Research:
As important as audit, again a stock question. You can spend your life time trying to find out what is research. Even if you don't have interest in participating in clinical research you are expected to have a broad knowledge about research and practise evidence based medicine.
http://www.nhs..uk/Conditions/Clinical-trials/Pages/Introduction.aspx
Evidence Based Medicine:
Based on research, it is the duty of all the medical practitioners to adopt changes in their practise based on the research evidence.
1.http://www.cebm.net/index.aspx?o=1914
2.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8555924
European Working Time Directive for trainee doctors:
Standard question, the essence of your answer must be "training is my responsibility and the number of hours at work will not have a direct implication on my training", people might disagree with this but I believe it is a fair argument. Read the article for further understanding, http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_093943.pdf
Probity questions:
You will be asked questions to probe your personality and there is no text book to read for this as you have to answer these as an individual. It is advisable to sound natural in your answer, not arrogant/over confident. This is the time to show your passion for radiology and also demonstrate that you are a safe doctor and will be a good consultant colleague to work with. The examples of questions asked are,
1. Why do you want to do radiology?
2. What qualities do you have to become a good radiologist?
3. What have you done so far to deserve training in radiology?
4. Why do you want to train in this deanery?
5. Are you a team player, tell us your team player/leader experience?
6. Questions asking examples like..... when you were stressed? when you were criticised? when you were rewarded? when you did a mistake? etc.
7. Drunken colleague question. (This is primarily to assess your awareness of the situation and your knowledge about trust organisation)
8. How should radiologists teach medical students?
9. Few deaneries have asked questions about your management skills
Clinical Questions:
This section is widely to assess your clinical ability what ever is your background. Popular questions are,
1. NICE guidelines for CT head, http://www.patient.co.uk/doctor/CT-Head-Scanning-Indications.htm
2. BTC guidelines for CTPA, http://www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Pulmonary 20Embolism/Guidelines/PulmonaryEmbolismJUN03.pdf
3. CT colonography, http://www.radiologyinfo.org/en/pdf/ct_colo..pdf
I have attempted to collate most of the hot topic in one article so that it is easy to refer. Hope this article will give an idea to start your preparation for the interview and good luck. Mersey School of Radiology also runs a course called "How to get into Radiology" every year which will give you a good insight into radiology.
