Institute: InnoVision imaging

Mentors: Dr Aditya Daftary and Dr Malini Lawande

Duration: 1 year

No. of seats: 3 per year

Eligibility: MD/DNB/DMRD

Entrance exam: No entrance exam; there is a fellowship interview instead. No specific questionnaire or list of questions which is asked

Fellowship application: Oct-Dec, variable. Send your CV on their email for application: cases@innovisionimaging.com.

Exam/Thesis: No for both

Working hours: Average 10 hours daily; no night duties

Accommodation: No

Hands-on: Variable; ensure you are MMC registered to be able to handle the USG machine

Non-MSK work: Yes

Accredited: No

Leaves: On request (approximately 4 weeks)

Fees: No

Salary: ~INR 75,000 per month (at present)

My experience at InnoVision: InnoVision is one of the top institutes for musculoskeletal radiology training in our country. Dr Aditya Daftary, being trained in Yale University and Hospital for special surgery, US, and Dr. Malini, from Singapore, offer an in depth insight and understanding of the most complex as well as the commonest of common cases. One of the biggest advantage of the fellowship is interaction with India’s Who’s Who of Orthopaedics just across the corridor, giving an unmatchable clinical input.

Workflow: The institute caters to multimodality and multisystem imaging. It drains a wide spectrum of cases including sports injuries and post-operative scans. The work is divided in to MSK and non MSK parts. Reporting of radiographs, performing MSK ultrasound examinations, image guided interventions and CT/ MRI similar to any routine centre. There is a double check system for the MSK work, which essentially means a primary report is followed by a second proof read. The musculoskeletal imaging is almost always cross checked by one of the two stalwarts. In case, one of them has done the primary reporting, the fellow has to do the secondary check, which is also a big learning opportunity, if done in the right manner. The non MSK work is predominantly handled by the three fellows and is a single read method without a second person going through the scan.

Expectation from a fellow:  A fellow’s role is to first finish up the non – MSK work and the radiographs, and then report as many as MSK scans on the list

Amount of work and daily schedule: Daily duties are usually 8am to 6pm or 10 am to 8pm slots; however, they are extendable depending on the pending work.  On an average, a fellow would do primary reporting of around 130-150 non MSK cases (CT and MRI), 50-60 MSK cases and 8-10 ultrasounds in a month. As far as 2^nd reading of the musculoskeletal cases is concerned, an average of 70-80 scans is the monthly workload per fellow. Second read means, one of the two bosses have already dictated the scan and the fellow needs to go through it and sign it off.

Intervention and hands on exposure: The intervention procedures commonly performed include CT guided transforaminal nerve blocks and facet joint injections, bone and soft tissue biopsies, ultrasound guided joint, bursal and tendon sheath injections and miscellaneous procedures like calcific tendinosis barbotage. Dr. Daftary does guide the fellows through these. The procedures are usually done by fellows on a rotation basis and on an average a fellow would approximately get 20-25 procedures a month.

Academic activities and research/publications: No specific teaching sessions, but lot of learning happens on case to case basis.  Case based discussions with orthopedic surgeons often takes place at the institute giving an invaluable insight in to the management algorithms and importance of our imaging findings. As far as research activities and publications are concerned, usually one project is allotted to the fellow, which is expected to be accomplished in the year however, is not compulsory for the completion of the fellowship.

Take home: At the end of the tenure, one is confident enough to report and answer the most complicated queries of the referring orthopod. Also, the positive name of Dr. Daftary and Dr. Lawande in the orthopaedic community is a big plus when settling into practice subsequently.

Downside: Well, to be true, there is absolutely no drawback to the fellowship. Some may consider the need to report non MSK cases as a negative point. However, it helped me stay in touch with general radiology as well over the course of fellowship, and that’s the way to look at it, as this would likely remain true in your subsequent career as well.

– Dr. Chinmay P Mehta

Fellow in Interventional Musculoskeletal Radiology, (Innovision imaging, Mumbai and Nuffield orthopedic center, Oxford, UK)

Consultant Interventional Musculoskeletal Radiologist, Pulse group of centers, Mumbai