Rotation in radiology

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Acknowledgement

I would like to thank Patience, Hope and Dark Room in aiding the production of thismini-publication.

After all, if an x-ray is poor, there is a chance that injuries could go undetected or

diseases could go undiagnosed-Charles W. Pickering-

Introduction

During our final years in medical school, we get to choose any specialty we'd like spendextra time in with an aim to polish up your skills. Radiology was one of my choices and Iwas to attend a 4 weeks rotation with the team.

This little booklet is not meant to be a crash course book. I'd say it'll serve merely as aguide as to how you are to get around in the Radiology Department should you choose to

accept it. A further reminder, this booklet is produced based on the views of a medicalstudent. Therefore, I apologize in advance for any inaccuracies or weak interpretationsof events that may have been picked up by the more experienced others.

1. Why I chose Radiology?

I was aiming to benefit from the variety it provides. Life was not all sitting in the darkroom all day. Radiologists do scans, interventions, interact with fellow physicians etc. Iwanted to know what the job description was and most importantly I wanted to feelconfident in interpreting at least the chest X-Ray.

Role of radiologist:From what I've gathered, they;

Interpret the film or scan Design the investigation requested by other clinicians how much exposure, what

settings to use to highlight the desired problem, use what sort of contrast. Perform some interventional procedures especially if it's radiology based.

As far as training is concerned, full insight can be found here : Radiology - sBMJ

2.Activities in Radiology Department

Here is roughly what my initial 4 week timetable looks like;
http://student.bmj.com/issues/01/09/careers/329.phphttp://student.bmj.com/issues/01/09/careers/329.php


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Later on, additional personal teaching sessions were added. Looking back, I wished Icould have improved on certain things to properly benefit from my rotation.

1. Take proper histories from patients who underwent procedures2. Brush up my anatomy, pathology and physiology on the common clinical

conditions.3. When obesrving a procedure, think about how its done, the indications andcontraindications to procedure, the intended benefit including the risk andcomplication. Also explore the effects of local and general anaesthetic in mind as Iwatch the procedure.


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A special note about MDT;MDT stands for Multi-Disciplinary Team and the meeting done every week bycertain groups of physicians has great benefit to the patient's care. Instead of theGP having to be the focal point of referral, a patient can be referred rapidlybetween specialties and save up precious times. The patient wouldn't have towait for 2 weeks or so before being called into the system and get referred allover again.Most medical students think that MDT meetings are boring and a waste of time.However,I believe that if we could put that time to good use, then..'there is no

day in which you learn something is a complete loss'. Here are my personal tipsin attending a meeting.

1. Know the patients Your department is obviously involved. Check the listof patients and understand their condition that led their case to bepresented to the MDT. If this is not possible, sit in the MDT with your earsopen. LISTEN carefully to the presenting complaints , what investigationshave been done and make sure at the end of it, you know what the nextplans are.

2. Identify key specialists involved This is a great time for you to seek outother learning opportunites. If you introduce yourself as a medical studentfrom this and this department and said that you want to observe aparticular procedure being done because the patient was presented in theMDT, I'm sure the consultant would allow it. It is like 'follow-up' right?

3. Active listening - sit with good view. Being attached to the radiologydepartment, you'd see a film or a scan differently. It's not a matter of onlysaying that the lesion looks benign etc. you'd have to give 2 or 3 reasons asto why it is benign. Hence it is vital for you to hear your consultant

describe the lesion on the film as he/she presents it. For instance, identifythe key features as to why something is called asbestosis and others just abenign peural disease.

4. Bring some brain food Some MDT meetings are ususally done duringlunchtime. If you see other people bringing in food /drinks.. might as welldo the same. The meeting might take a long time.


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3. Resources:These are not complete. Just bits and pieces of material I used over the rotation.

a.Books1. Complete Self-assessment for medical students Patel & Patel2. Abdominal X-Rays Made Easy James Begg

b.Internet Resources1. Anatomy by Diagnostic Imaging has accessible lecture slides.2. Undergrad Radiology Teaching File, University of Toronto .3. Human Anatomy, DarthMouth Medical School.4. http://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Procedures/Proc

edures_f.htm anatomy shown in the form of scans or on xray film.5. Student BMJ Imaging.6. LearningRadiology.Com.7. Introduction to Chest Radiology .

8. Radiopaedia.Org.9. E-Radiography

4.Personal Safety

When I entered the field in July 1958 I believed what they told me about radiation

risks. I spent much effort reducing the dose to patients in radiology-John Cameron-

Other than ensuring the patient's safety, it is vital that we take care of ourselves too.1. Make sure you are not pregnant2. Radiation use lead coverings for the body and thyroid3. Interpreting an Xray may require a dark room but it doesn't mean you'd have to

read books in the dark as well.4. If the scanning department is at the basement or something, do walk in well-lit

areas.5. Make sure no radioactive spills come on you as you hang out in the nuclear

medicine department. If in doubt, request for a check using one of thoseghostbuster like radioactive machines.

I end this booklet with the Pearls of Wisdom in the Radiology Department.These are theexact words of some of my consultants and doctors within the team.
http://medinfo.ufl.edu/year1/rad6190/http://medinfo.ufl.edu/year1/rad6190/http://icarus.med.utoronto.ca/imaging/radiofile/index.htmhttp://icarus.med.utoronto.ca/imaging/radiofile/index.htmhttp://www.dartmouth.edu/~anatomy/http://www.dartmouth.edu/~anatomy/http://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Procedures/Procedures_f.htmhttp://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Procedures/Procedures_f.htmhttp://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Procedures/Procedures_f.htmhttp://student.bmj.com/topics/clinical/imaging_techniques.phphttp://student.bmj.com/topics/clinical/imaging_techniques.phphttp://www.learningradiology.com/toc/tocsubsection/toclectures.htmhttp://www.learningradiology.com/toc/tocsubsection/toclectures.htmhttp://www.med-ed.virginia.edu/courses/rad/cxr/index.htmlhttp://www.med-ed.virginia.edu/courses/rad/cxr/index.htmlhttp://www.radiopaedia.org/index.php?title=Main_Pagehttp://www.radiopaedia.org/index.php?title=Main_Pagehttp://www.e-radiography.net/radiology/radiology.htmhttp://www.e-radiography.net/radiology/radiology.htmhttp://medinfo.ufl.edu/year1/rad6190/http://icarus.med.utoronto.ca/imaging/radiofile/index.htmhttp://www.dartmouth.edu/~anatomy/http://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Procedures/Procedures_f.htmhttp://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Procedures/Procedures_f.htmhttp://student.bmj.com/topics/clinical/imaging_techniques.phphttp://www.learningradiology.com/toc/tocsubsection/toclectures.htmhttp://www.med-ed.virginia.edu/courses/rad/cxr/index.htmlhttp://www.radiopaedia.org/index.php?title=Main_Pagehttp://www.e-radiography.net/radiology/radiology.htm


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We've got to die of something

Life without contrast is boring

You're not paid for what you do for the patients. You're paid for what you know

EDUCATION is what you've got left, after what you've been taught and forgotten

What is good in practice, must be good in theory

You can't see what you dont' know

Q: Is it a concern for you that you will be in a speciality with not much patientcontact?A: So far, nobody has stopped me from seeing me the patients and taking ahistory of them. If I want to see patients, I can always see them at the wards

Radiology is one of the ROADs to happiness

Patients have no idea what we are willing to do in providing them with the bestcare (with reference to himself being a subject to try out the new scans)

Have Fun,Minci Yazumin 2007

Any questions/comments or suggestions can be forwarded to my email.
mailto:[email protected]?subject=minci-ken:%20radiologymailto:[email protected]?subject=minci-ken:%20radiology

Rotation in radiology

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