McMaster University

McMaster University

Residency Program Description

The McMaster University Diagnostic Radiology Program is designed to produce strong clinical radiologists, who can perform, supervise and interpret a wide variety of imaging tests and procedures. The program fosters the development of general radiology skills as well as strong consultative skills. We strive to produce radiologists who will be lifelong learners, able to respond to the increasing demands of our exciting, rapidly expanding medical specialty. The program is designed to meet the specifications of the Royal College as well as address the Canadian Medical Education Directives for Specialists, commonly referred to as CanMEDS.

Training Sites

The residency training sites include Hamilton Health Sciences (HHS), consisting of the McMaster University Medical Centre, Juravinski Hospital, Hamilton General Hospital and the Juravinski Cancer Centre, as well as St. Joseph's Healthcare Hamilton (SJHH). The Hamilton hospitals are a tertiary referral site for the Central West region of Ontario, providing specialized healthcare services to a catchment population of over 2.2 million. The health system in Hamilton is organized such that each hospital has specialty expertise. There are strong Internal Medicine and General Surgery programs and subspecialty services, which support a busy tertiary level imaging practice. The HHS is amongst Canada's largest teaching hospitals.

Our residency program at McMaster is designed to take advantage of this system of health organization. Rotations are selected based on the patient population, volume of pathology and radiology faculty teaching strengths, rather than purely hospital-based. This permits flexibility in our program design - all residents are exposed to almost the identical rotation design. McMaster's large patient population and organized local healthcare structure ensures that residents are adequately exposed to a wealth of imaging pathology and faculty expertise.

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Imaging Resources

The diagnostic imaging services in the McMaster system set an excellent standard. There are 7 MRI scanners currently in operation at the McMaster, St. Joseph's Healthcare Hamilton, Juravinski and Hamilton General sites. With redevelopment at several sites, further investment of new equipment is anticipated.

In addition, there is a dedicated 3.0 T research magnet at St. Joseph's Healthcare Hamilton. There are 8 CT scanners in the city. The busy ultrasound departments at each site are equipped with high-resolution ultrasound equipment. All sites have PACS and voice-recognition software, ensuring that residents are trained for the future, in a filmless, digital environment. There is an active clinical PET scanning service at the McMaster University Medical Centre site, as well as an additional PET scanner at St. Joseph's Healthcare Hamilton.

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Resident Program Committee

The Residency Program Committee meets approximately 6 times in the year, and is actively involved in reviewing the residency program at McMaster. The Committee consists of faculty coordinators from each training site, the Program Director, Chief Residents, as well as an elected junior resident representative. At each meeting, the resident members provide a "Resident Report", updating the committee members regarding current issues for the resident group. The committee reviews all issues related to the residency including: rotations and curriculum; resident progress; methods of evaluation; work and on-call issues; site-related issues relevant to training and any other Departmental or University issues impacting residency training. Any major changes in the program or process of program function are reviewed and discussed at the committee level. The faculty members who sit on this committee play a key role as educational liaison persons for their hospital site. In addition, the site coordinators are in regular contact with the resident body and Chief Residents, with respect to any training issues or concerns, specific to their site. Committee members also play a pivotal role in the selection of new candidates for the program. The 4 resident committee members are active and respected members of the group, with resident feedback and suggestions given careful consideration by the other committee members.

Current members:

Dr. D. Landry Program Director
Dr. Kelly Ainsworth McMaster University Medical Centre
Dr. Scott Tsai Juravinski Hospital
Dr. Heba Takrouri Research Coordinator
Dr. Ian Moffat Hamilton General Hospital
Dr. Srini Harish St. Joseph's Healthcare Hamilton
Dr. Kathy Zhao Chief Resident
Dr. Amna Al-Arnawot Chief Resident
Dr. Natasha Larocque Elected Resident Representative
Dr. Cory Ozimok Elected Resident Representative
Dr. D. Koff Chair (Ex Officio Member)

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Summary of Each Postgraduate Year

PGY 1:

This year offers a comprehensive clinical experience, in order to round-out physician training post clinical clerkship. The rotations serve to enhance clinical material relevant to future training in Diagnostic Radiology, as well as review and consolidation of important content for the LMCC Part II examination. The year's design is reviewed annually by the Radiology Program Committee. The rotations are based at one of the four city hospitals.

The two overriding broad objectives of this clinical year are:

1. To provide the opportunity to experience clinical medicine and broaden your medical background

2. To gain a better understanding of the relevance of diagnostic imaging for a variety of medical disciplines.

This basic clinical training year is designed to meet the requirements of the Royal College of Physicians and Surgeons Objectives of Training and Specialty Training Requirements in Diagnostic Radiology. Please also refer to the McMaster BCT website information:

//fhs.mcmaster.ca/postgrad/pg_basic_clinical_training.html

The PGY 1 year of our residency training program consists of a basic clinical training year (BCT), during which residents rotate through a number of core medical specialties. Currently the year consists of:

ROTATION DURATION
General Surgery 2 blocks
Internal Medicine 2 blocks
Obstetrics and Gynecology 1 block
Anatomical Pathology 1 block
Emergency Medicine 2 blocks
Pediatrics 1 block
Orthopedic Surgery 1 block
Radiation Oncology 1 block
Anatomy/Radiology 1 block (June)
Neurology 1 block

The final block (June) of the BCT year is dedicated to Imaging Anatomy and an introduction to the basics of ultrasound imaging. The overall aim of this one-block rotation is to review and enhance anatomical knowledge, as it applies to diagnostic imaging. The major focus is on cross-sectional imaging anatomy with ultrasound and CT. The rotation format consists of small group learning sessions with Anatomists in the anatomy lab, as well as with ultrasound faculty members and technologists. In addition, a substantial component of the rotation includes self-directed independent learning, in order to achieve the outlined anatomical objectives. Residents also commence radiology "buddy call" during this time, exposing them to cross-sectional anatomy in practice. As well, this serves as an introduction and orientation to "on-call" in radiology.

PGY 2:

The PGY 2 year begins with an introductory two-block rotation. This consists of short introductory rotations in Emergency Radiology, Neuroradiology and CT. These rotations are designed to introduce the resident to areas of imaging frequently encountered on-call. During this time, the resident will learn radiology terminology, as well as how to structure a report. A key component of this introductory time includes learning the basics of PACS, image manipulation and communication skills.

The remainder of the PGY 2 year focuses on the "building-blocks" of radiology. Rotations include:

2 blocks: Intro, MSK, Chest, US or CT

1 block: ER/Trauma, US Intro, CT Intro, General, Neuro CT

 

 

PGY 3:

The PGY 3 year concentrates on further building of resident knowledge and experience in cross-sectional imaging. The knowledge gained in the PGY 2 rotations is enhanced and integrated into these rotations. This year also includes a solid and comprehensive experience in vascular/interventional radiology. Residents at McMaster have ample experience for "hands-on" exposure to interventional techniques, during these rotations.

The typical rotations design for this year includes:

2 blocks: GI/Body, CT/US, MRI, Interventional

1 block: General, Breast, Neuro CT, Neuro MR, Nuclear Medicine

 

 

 


PGY 4:

The PGY 4 year includes a dedicated 3 block Pediatric rotation at the Hospital for Sick Children in Toronto. Residents receive a travel stipend to cover transportation costs during this rotation. There are additional rotations in MRI. This year also includes content in Nuclear Medicine and Breast Imaging

Residents attend the 4-week Radiology/Pathology course at the Armed Forces Institute of Pathology (AIRP), in Washington D.C. Financial support is provided to attend this meeting. Residents will also complete a community elective block to experience radiology outside of the academic setting. The typical rotation design for this year includes:

1 block: Interventional, General, Nuclear Medicine, AIRP (elective), MRI, Community Elective
2 blocks: OB/US, Breast
3 blocks: Peds

 

PGY 5:

This year consists of one-block rotations through GI/Body, Chest, Nuclear Medicine, Breast and Musculoskeletal and Cardiac/MR. The remainder of the year includes Junior Staff rotations and 3 blocks of electives. This "back to the basics" design, offers rotations which review the core radiology knowledge. This is intended to round-out senior resident consultancy skills, as well as to serve as a foundation for review of content relevant for examination and certification purposes. Residents are able to provide significant input into their rotation design, including order of rotations, as well as choice of site for placement. This year includes "Junior Staff" rotations. During these rotations, residents can tailor their rotation design to those areas that best suit their personal learning objectives and future career direction. This permits the PGY 5 resident flexibility in designing their year, best suited to their educational needs. These rotations serve to consolidate consultancy skills in Diagnostic Imaging, as they permit graded responsibility and independent reporting, fostering a "ready for practice" model for completion of the PGY 5 year. During these blocks, the senior resident target is to carry the responsibilities and workload of a Junior Staff Radiologist. It is during these rotations that our residents are able to review core material for exam preparation, by "on the job" exposure to important imaging material, including plain radiography.


Our program design adheres to the Royal College of Physicians and Surgeons of Canada Specialty Training Requirements for Diagnostic Radiology. For more specific information, visit the Royal College website: www.rcpsc.org

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Graded Resident Responsibility & On-Call Duties:

There is a hierarchical structure to the learning process which:

(1) Allows the residents responsibility commensurate with training and ability.
(2) Permits different levels of teaching and learning through teaching.

PGY 2 and 3 residents are the most closely supervised. They review imaging studies on their own and then each exam is reviewed with them by the attending staff person. The resident issues the report, which is then checked by the supervising staff person. If the Education Committee and rotation supervisor are satisfied with a resident's performance, then by their PGY 5 year, they can review cases and report independently. Junior residents learn procedures under close supervision of a staff person, and as they become more senior and skilled, they graduate to performing procedures on their own, with supervision as appropriate.

All residents have a responsibility for teaching each other, residents from clinical specialties (for example, during informal consultations in the department or on working rounds), clinicians, technologists, and nursing staff.

The most senior resident in the hospital at any one time has some administrative responsibilities. They function to assist in the supervision and teaching of junior housestaff and clinical clerks, organize and ensure the maintenance of educational rounds and other educational events. They also assist in liaison between resident staff and consultant staff.

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On-Call Duties

In their PGY-2 year, residents perform on-call duties from the beginning of the program year. For the first 5 to 6 months, PGY-2 residents are paired with more senior residents, during which they transition from a largely observational role to the primary contact person, or "first call" resident. Following this orientation period of "double-call", most residents are capable of independent call, with fellow or staff back-up.

Our program has designed a "Call Centre" model for after-hours imaging coverage. Two residents are on-call for the city, covering requests from all four teaching hospital sites. They are both housed at the Hamilton General site and cover the Juravinski, MUMC and St. Joseph's Hospital sites remotely. This model facilitates a more team-based approach to call in radiology, as no resident is on alone. In addition, it permits a more equal distribution of the on-call workload. The model has been well-received by the residents and was designed with input from the resident body. There is no interventional call for residents, but they can be involved if they are interested.

At the General Hospital Campus, the resident is an integral member of the Trauma Team.

The on-call Staff Radiologists are always available to consult by phone or come in as needed.

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For further information, please contact:

Cheney Matteliano
Program Assistant
Department of Diagnostic Imaging
Hamilton Health Sciences
McMaster Site – Room 2S23-1
1200 Main Street West
Hamilton, ON L8Z 3N5

Tel: 905-521-2100 EXT 75294
Fax: 905-521-1390
Email: matteliach@hhsc.ca

www.hamiltonhealthsciences.ca
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