Hospital: Christian Medical College and Hospital, Vellore, Tamil Nadu

Head of Paediatric radiology sub-speciality: Dr. Sridhar Gibikote at present

Course details:

• Duration: 1 year. The fellowship starts at June end-July and ends at August every year.
• Number of seats: 1 per year
• Fees: INR 32000
• MCI/Tamil Nadu Medical Council recognition: Not recognised at present

How to apply:

1. Eligibility:MD/DNB.

2. Application: Online application which is usually available at the website https://admissions.cmcvellore.ac.in/ around the mid-February – March every year. One can apply for any two sub-speciality fellowship programmes. (Note that the dates of application and exam may differ this year considering the Corona pandemic. Keep following the website for details).

3. Entrance exam: This usually takes place in April /May. Step 1: Online MCQ based national exam at various centres across the country. Step 2: Interview of the selected candidates at CMC Vellore.

4. Interview: During the personal interview, years of experience and publications (especially in the paediatric radiology field, if any), as well as FRCR or other equivalent additional degree may add weightage to the selection process.

Note that at the time of online application, an NOC or bond release is not required. However, during TN medical registration, NOC from previous State medical council will be needed. They will assess the original certificates and bond release documents at the time of formal admission, so keep everything in order by then.

Exit exam: Yes, at the end of the fellowship, with practical and/or theory exams with external examiners.

Hands-on: TNMC registration is mandatory, after which there is usually no issues of not getting hands-on work.

Working hours: 8 am -5 pm from Monday to Friday. 8am-1pm on Saturdays. Sundays are off. Variable emergency on-call duties (3-5 per month) including Sundays.

Structure of the fellowship and spectrum of cases:

Cross sectional imaging rotation: Out of the 12 months, 8-9 months will be in cross-sectional imaging which covers all the systems of paediatric imaging from head to toe. This includes an excellent exposure to paediatric neuroimaging and cardiac imaging.

I would say that the paediatric neuroimaging spectrum we see at CMC Vellore is at par with prestigious international paediatric hospitals worldwide. It includes extensive weekly neurometabolic and epilepsy meetings, neurosurgery meets with paediatric neurologists and neurosurgeons to discuss the various options of management and surgical planning (which includes a vast spectrum of other aetiologies like spinal dysraphism and paediatric brain tumors).

There is also a very good exposure in reporting various complex congenital heart disease (CT and MRI), cochlear imaging (inner ear anomalies), paediatric onco-imaging, paediatric orthopaedic imaging, and other body imaging (ENT, thorax and abdomen)

Other rotations: Fellows get 2-3 months of dedicated paediatric USG exposure covering small parts as well as routine USG abdomen. It also includes 1 month posting for the neurosonogram in the NICU wards. There is also 1 month (variable) conventional imaging posting which includes pediatric barium and IVP procedures.

MDT / Inter-departmental meetings: Multiple inter-departmental meetings happen daily with various clinical teams including child health, paediatric oncology, paediatric orthopaedics, paediatric neurology, paediatric ENT, and genetics. On an average, there are around 15-16 meetings in a week. Fellows are encouraged to conduct these meetings either independently or under supervision. During those meetings, we get feedback and get to know what referring team wants from us in our report. Thus, even though taxing, these have significant learning value.

Projects/ thesis: Yes. Topics according to the fellow’s interest and/or mentor’s guidance.

Academics: Its mandatory to attend the daily common academic sessions of the department and the various academic discussions (interesting cases / journal club) of various sub-speciality teams. Besides, the fellow must take morning academic sessions (spotters / interesting cases for postgraduates, journal reading) for the residents which trains and strengthens our teaching skills. Fellows take classes for the postgraduates and the undergraduates who are posted in radiology as part of their curriculum.

Observership: Not mandatory; up to 2 weeks observer ship in other prestigious Indian hospitals with good paediatric exposure is permitted. The candidate can choose the hospital; this is worth doing and gives an added advantage over the exposure which a fellow gets at CMC Vellore.

Conferences / CME: Fellows are encouraged to attend the paediatric or neuro conferences or CMEs happening across the country or abroad (like RSNA). One must present a paper or poster to obtain conference leave.

Accommodation: Yes, generally provided (depends the available vacancy)

Leaves: 25 days of annual leaves, 7 academic leaves, 15 sick leaves

Stipend: Salary is~INR 45-48000 per month (at present in hand)

My take / What I felt during the course:

Pros: CMC is an open treasure of knowledge with highly academically oriented and down to earth humble professors who are prominent national figures and role models in the field of radiology. Despite the busy schedules and high workload, they are always available and approachable to solve trainees’ doubts and discuss cases. Also, many associate and assistant professors are keen in guiding the students if the students are interested in learning.

CMC Vellore radiology department is overall well organised and compartmentalised according to subspecialty, which adds more accuracy and structure-based learning of the subject. It gives you an extra edge as you learn from a subspecialty specific radiologist. You will learn a systemic way of cross-sectional imaging reporting and learn to remain up to date with the latest knowledge, with many guest lectures from international faculty as well.

PACS based archived data is available up to the last 20 years, which is very useful as self-learning material with access to the reports as well as outcome. We can access PACS round the clock, including holidays.

Finally, there is extraordinary exposure with endless variety of paediatric cases involving all the systems of the body. It also provides an excellent platform to express the knowledge and research at national and international conferences with the kind of enormous material and diversity of the common to rarest cases seen at CMC Vellore during fellowship.

Cons: As far as fellowship programme is concerned it is not as light as one thinks in diagnostic radiology. It’s exhaustive and stressful at times, but if you take in a positive way, at the end of the fellowship you would come up as stronger and more confident paediatric radiologist.

If someone comes from north India, the place and atmosphere at Vellore might feel difficulty initially (due to different culture) for a month or so, but eventually most of us get oriented to the system without any difficulty.

The salary which the fellow gets may be less compared to fellowships elsewhere, however the Vellore lifestyle is easy on the pocket and one can easily manage without problems. Also, the financial constraints for a year will be negligible compared to the knowledge we gain.

Since the prime focus is on cross section imaging, one may feel there is less exposure of paediatric conventional imaging (x ray and fluoroscope guided procedures). However, we can stay back and learn these if there is a strong desire to learn.

To be frank with you, paediatric radiology needs to be promoted more in India to be recognised as prominent subspecialty, and CMC Vellore is definitely the place which provides you those kinds of opportunities.

So, to conclude, I feel extremely lucky having got the opportunity to work under dedicated and ethical faculty of CMC Vellore who widened my narrow spectrum of radiology and taught me how to solve complex cases with a systematic approach. Also, I had huge positive impact as the ethos of the place teaches you to serve the people and be ethical in practice. In short, if you are interested in paediatric radiology, CMC Vellore is definitely one of the go to places in India.

Please feel free to contact me if there are any further queries.

Dr Hiren Panwala, MBBS, DNB Radiology, Fellowship in Paediatric Radiology (CMC, Vellore), member of ISPR society

Paediatric Radiologist at NH SRCC Children’s hospital, Mumbai

Ex Assistant Professor, CMC Vellore

Core member of “http://www.theradiologisteye.com/”: whose primary aim to provide knowledge to perform well in DNB (mainly)/ MD radiology practical exam

Email: drhiren1187@gmail.com