MD - Radiology

TiTLE OF THE COURSE:

It shall be called Doctor of Medicine.

ELIGIBILITY FOR ADMISSION:

(a)Every student, selected for admission to postgraduate medical course shall possess recognized MBBS degree or equivalent qualification and should have obtained permanent Registration with the Medical Council of India, or any of the State Medical Councils or should obtain the same within one month from the date of his/her admission, failing which the admission of the candidate shall becanc elled.

(b) Completed satisfactorily one year's rotatory internship or would be completing the same before the date announced by the University for that specific year as per MCI rules after passing 3rd professional MBBS Part II Examination satisfactorily.
(c) In the case of a foreign national, the Medical Council of India may, on payment of the prescribed fee for registration, grant temporary registration for the duration of the postgraduate training restricted to the medical college/institution to which he/she is admitted for the time being
exclusively for postgraduate studies; however temporary registration to such foreign national shall be subject to the condition that such person is duly registered as medical practitioner in his/her own country from which he has obtained his basic medical qualification and that his degree is recognized by the corresponding Medical Council or concerned authority.

DURATION OF COURSE:
The course shall be of 3 years duration from the date of commencement of academic session.

PERIOD OF TRAINING:
The period of training for obtaining Post graduate degrees (MD/MS) shall be three completed years including the period of examination.

ATTENDANCE, PROGRESS AND CONDUCT:
(1) Attendance:
(a) 80% attendance in each course is compulsory. Any one failing to achieve this shall not be allowed
to appear in the University examination.
(b) A candidate pursuing MD/MS course shall reside in the campus and work in the respective
department of the institution for the full period as a full-time student. No candidate is permitted to run a clinic/work in clinic/laboratory/ nursing home while studying postgraduate course. No candidate shall join any other course of study or appear for any other examination conducted by this university or any other university in India or abroad during the period of registration. Each year shall be taken as a unit for the purpose of calculating attendance.
(c) Every candidate shall attend symposia, seminars, conferences, journal review meetings, grand rounds, CPC, CCR, case presentation, clinics and lectures during each year as prescribed by the department and not absent himself / herself from work without valid reasons. Candidates should not be absent continuously as the course is a full time one.

SPECIFIC LEARNING OBJECTIVES:

The objective of the program is to train a student to become a skilled and competent radiologist to conduct and interpret various diagnostic/interventional imaging studies (both conventional and
advanced imaging), to organize and conduct research and teaching activities and be well versed with medical ethics and legal aspects of imaging/intervention.

SUBJECT SPECIFIC COMPETENCIES: 

A. Cognitive Domain
A post graduate student on completing MD (Radiodiagnosis) should acquire knowledge in the
following areas, and be able to:
1. Acquire good basic knowledge in the various sub-specialties of radiology such as chest radiology, neuro-radiology, GI-radiology, uro-radiology, cardio-vascular radiology, musculoskeletal, interventional radiology, emergency radiology, paediatric radiology and women’s imaging.
2 Independently conduct and interpret all routine and special radiologic and imaging investigations.
3. provide radiological services in acute emergency and trauma including its medicolegal aspects.
4. Elicit indications, diagnostic features and limitation of applications of ultrasonography, CT and
MRI and should be able to describe proper cost-effective algorithm of various imaging techniques in a
given problem setting.
5. Decide on the various image-guided interventional procedures to be done for diagnosis and
therapeutic management.
6. Able to decide on further specialization to be undertaken in any of the branches in Radiodiagnosis
such as gastrointestinal radiology, uro-radiology, neuro-radiology, vascular radiology,
musculoskeletal radiology, interventional radiology etc.
7. Able to formulate basic research protocols and carry out research in the field of radiology- related clinical problems.
8. Acquire knowledge and teaching capabilities to work as a post graduate student/consultant in
Radiodiagnosis and conduct teaching programmes for undergraduates, post graduates as well as paramedical and technical personnel.
9. Interact with other specialists and super-specialists so that maximum benefit accrues to the patient.
10. Should be able to organize CME activities in the specialty utilizing modern methods of teaching and evaluation.
11. Acquire knowledge to impart training in both conventional radiology and modern imaging
techniques so that the post graduate student is fully competent to practice, teach and do research in the broad discipline of radiology including ultrasound, Computed Tomography and Magnetic Resonance Imaging.
12. Acquire knowledge of interventional radiology.

B. Affective Domain:
1. Should be able to function as a part of a team, develop an attitude of cooperation with colleagues, and interact with the patient and the clinician or other colleagues to provide the best possible diagnosis or opinion.

2. Always adopt ethical principles and maintain proper etiquette in dealings with patients, relativesand oth er health personnel and to respect the rights of the patient including the right to information and second opinion.
3. Develop communication skills to word reports and professional opinion as well as to interact with patients, relatives, peers and paramedical staff, and for effective teaching.
C. Psychomotor domain

Practical Training will include two major aspects:
A) Interpretation of images, and
B) Skill in performing a procedure.
C) Interpretation of images:
The student should be able to interpret images on all imaging modalities of diseases of following
organs:
1. Musculo-skeletal System - Interpretation of diseases of muscles, soft tissue, bones and joints including congenital, inflammatory, traumatic, endocrine and metabolic, neoplastic and miscellaneous conditions.
2. Respiratory System - Interpretation of diseases of the chest wall, diaphragm, pleura and airway; pulmonary infections, pulmonary vasculature; pulmonary neoplasm; diffuse lung disease; mediastinal disease, chest trauma; post-operative lung and X-ray in intensive care.
3. Cardiovascular System - Interpretation of diseases and disorders of cardiovascular system
(congenital and acquired conditions) and the role of imaging by conventional radiology, ultrasound, colour Doppler, CT, MRI, Angiography and Isotopes Studies.
4. Gastro-intestinal tract and hepato-biliary pancreatic system - Interpretation of diseases and disorders of mouth, pharynx, salivary glands, oesophagus, stomach, small intestine, large intestine, diseases of omentum, peritoneum and mesentery: acute abdomen, abdominal trauma. Diseases and disorders of liver, biliary system and pancreas.
5. Urogenital System - Interpretation of various diseases and disorders of genitourinary system. These include: congenital, inflammatory, traumatic, neoplastic, calculus disease and miscellaneous conditions.
6. Central Nervous System (C.N.S.) - Interpretation of diseases and disorders of the head, neck and spine covering, congenital, infective, vascular, traumatic neoplastic degeneration metabolic and miscellaneous condition.
7. Imaging in Emergency Medicine.
8. Imaging in Obstetrics and Gynaecology.
9. Imaging of Breast and interventional procedures.
11. ENT, EYE and Dental Imaging.

12. Imaging of endocrine glands and those involved with metabolic diseases.
13. Clinical applied radionuclide imaging.
14. Interventional Radiology

B) Skills in performing a procedure:

The student should be able to perform the following procedures:
1) GIT contrast studies: Barium studies (swallow, upper GI, Follow through, enema); fistulogram;
sialogram; cologram/ ileostogram,
2) GU: Excretory urography, MCU, RGU, nephrostogram, genitogram,
3) Ultrasound: Studies of whole body including neonatal transfontanelle studies, Doppler studies,
4) CT scan: should be able to position a patient, plan study as per the clinical indication, do
reconstruction of images, perform triple phase study, perform & interpret advanced applications like CT enterography, CT angiography etc.
5) MRI: plan and perform MRI studies of whole body
6) DSA: should be able to describe the techniques, do (if available to student) transfemoral puncture and insert catheter, help in angiographic procedures both diagnostic and interventional.
7) Radiography: should be able to independently do radiography of common and some important uncommon views of different body parts. This includes positioning, centring of X ray beam, setting of exposure parameters, exposing and developing the films. The student should be familiar with not only conventional radiography but with CR and DR systems.
8) Interventional radiology: The student should be able to perform simple, common non- vascular procedures under ultrasound and fluoroscopy guidance e.g., abscess drainage, drainage catheter placement, nephrostomy, biliary drainage etc. The student should have knowledge of common vascular interventions e.g., structure dilatation using balloon catheters, embolization with gel foam and other agents, names of common catheters, handling of intravenous contrast reactions; techniques, indications and contraindications for various procedures;

Syllabus: 
Course contents:
Anatomy:
Gross and cross-sectional anatomy of all the body systems.
Pathology:
Gross morphology of pathological conditions of systemic diseases affecting all organ systems.
Radiology Course:

This would cover imaging and interventions of diseases affecting all the body systems:
- Chest
- Cardiovascular system
- Musculoskeletal including soft tissue
- Gastrointestinal system
- Hepato-biliary-pancreatic system
- Urogenital (genito-urinary) system
- CNS including head and neck
- Obstetrics and gynaecology
- ENT, eye, dental, breast
- Endocrine and metabolic system
- Clinically applied radionuclide imaging

Radiological Physics:
1. Introduction of general properties of radiation and matter: Fundamentals of nuclear physics and
radioactivity
2. Interaction of x-rays and gamma rays with matter and their effects on irradiated materials
3. X-ray Generating Apparatus
4. Screen-film radiography
5. Film processing: Dark room, dry processing, laser /dry chemistry cameras, artifacts.
6. Fluoroscopy: Digital including flat panel units, fluoroscopy cum radiography units
7. Digital radiography: Computed Radiography, Flat panel radiography
8. Other equipment: Ultrasound including Doppler, CT, MRI and DSA
9. Contrast Media (Iodinated, MR & Ultrasound) - types, chemical composition, mechanism of action,
dose schedule, route of administration, adverse reaction and their management
10. Nuclear Medicine: Equipment and isotopes in various organ systems and recent advances
11. Picture Archiving and Communication System (PACS) and Radiology Information System (RIS)
to make a film-less department and for Teleradiology
12. Radiation protection, dosimetry and radiation biology
13. Image quality and Quality Assurance (QA)

14. Recent advances in radiology and imaging

The student should have knowledge of the following physics experiments:

• Check accuracy of kVp and timer of an X ray unit
• Check accuracy of congruence of optical radiation field
• Check perpendicularity of x ray beam
• Determine focal spot size
• Check linearity of timer of x ray unit
• Check linearity of mA
• Verification of inverse square law for radiation
• Check film screen contact
• Check film screen resolution
• Determine total filtration of an x ray unit
• Processor quality assurance test
• Radiological protection survey of an x ray unit
• Check compatibility of safe light
• Check performance of view box
• Effect of kVp on x ray output

Radiography and processing techniques: 

1. Processing techniques: includes dark room and dry processing.
2. Radiography of the musculo-skeletal system including extremities.
3. Radiography of the chest, spine, abdomen and pelvic girdle.
4. Radiography of the skull, orbit, sinuses.
5. Contrast techniques and interpretation of GI tract, hepato-biliary tract, pancreas, etc.
6. Contrast techniques and interpretation of the Central Nervous system.
7. Contrast techniques and interpretation of the cardiovascular system including chest.
8. Contrast techniques and interpretation of the genito - urinary system including Obstetrics and
Gynaecology.
9. Paediatric radiology including MCU, genitogram, bone age.

10. Dental, portable and emergency (casualty) radiography.

TEACHING AND LEARNING METHODS: 

The training is spread over 3 years and includes following components:
1. Physics related to imaging
2. Rotational posting in various sub-specialties.
3. Seminars, case discussion, journal club.
4. Research methodology and statistics.
5. A log book should be maintained by the student and will be checked and signed regularly by the faculty-in-charge during the training program.
6. The postgraduate students shall be required to participate in the teaching and training program of undergraduate students and interns.
7. The postgraduate student would be required to present one poster presentation, to read one paper at a national/state conference and to submit one research paper which should be published or accepted for publication or sent for publication to a peer reviewed journal, during the period of his/her postgraduate studies so as to make him/her eligible to appear at the postgraduate degree examination.
8. Department should encourage e-learning activities.