IR Fellowship, PGI Chandigarh

Duration: One year. Course starts from 1st July

Number of seats :02 : 1-General category 1- Sponsored (see details on sponsored seat here)

Accreditation: No

Entrance exam pattern: It is a 2-step examination with a theory exam comprising of 60 questions,30 from general radiology and 30 from interventional radiology. 50% marks are required in theory to be eligible for the interview. The interview comprise of interventional spotters and a table viva. All the information of the exam dates and pattern is available on the official website of PGIMER, Chandigarh

Interventions and Hands-on experience: The entire course can be broadly classified into vascular and non vascular interventions. The vascular interventions can further be classified into onco-interventions and other vascular interventions.

Non Vascular interventions:  (5 months including a month of Breast interventions)

  • These comprise of pigtail drainages: abscesses, collections, pleural and ascitic fluids under USG and CT guidance.
  • Diagnostic- FNAC and Biopsy: On a typical day, one would do anything between 15 to 20 FNACs; both USG guided and CT guided are done. A total of 5-6 biopsy of either  liver, kidney, other tumors, or TRUS guided prostate  biopsies happen in a day .
  • Biliary drainages: PTBD catheter drainages placement and management (7-8 cases per day on an average.
  • Biliary stenting and balloon dilatation
  • Breast interventions (One month): Biopsy, marker placements in tumor and drainages

Vascular Interventions (5 months):

  • Sclerotherapy of AVM/vascular malformations
  • Coiling /Embolization of bleeding visceral and peripheral pseudoaneurysms. Uterine embolization for PPH and also trauma embolization of spleen, pelvic bleeds etc.
  • Transjugular liver biopsy, IVC filter placement
  • Percutaneous stentings and venoplasty in Budd Chiari
  • Onco interventions: TACE, TARE, Preoperative RCCembolization.

Non Vascular Onco-interventions (part of  the vascular intervention posting)

  • Ablations of liver and renal lesions. RFA and MWA (microwave ablation) are frequently used. PGIMER also has IRE and cryoablation equipments. So all the modalities of ablative treatment are available under one roof.
  • On an average, a minimum of 2 TACE are done each day. We can do more cases if no other cases are booked for the day
  • RFA/MWA of HCC at least 4- 5 are planned for each week

Hands-on experience in non-vascular interventions is freely given with the consultants available whenever required. In vascular interventions, fellows initially learn under the consultants; once they learn the trick of the trade, the procedures are freely given if the fellow shows initiative and confidence under the guidance of the consultants.

Academic activities: There are weekly vascular intervention rounds where the best and most interesting cases of vascular interventions are discussed. A Radiology-Pathology meet is also done weekly. Journal club presentations happen by fellows and residents. Regular discussions happen with clinical departments including gastroenterology, urology, hepatology and trauma teams for daily emergent cases. Fellows are also expected to teach and help the senior residents posted with them in non-vascular intervention postings. Publications and presentations are part of the curriculum of fellowship and one month is given to do the same during the tenure. This posting is usually given in the month preceding the exam so no there is no official posting in the roster; however emergency cases in DSA needs to be attended. This month also includes the preparatory time for the exit exam.

Duty hours:  9 am-5 pm is the official duty hours. However, you will be on call during the vascular intervention postings (a total of 5 months) daily. Works ethics in the entire department are very strong and the fellows have to emulate them sincerely. There are a lot of emergency cases because of the high caseload in the institute, so the fellow has to be ready to give prompt treatment especially for emergency vascular interventions. We need to be prompt in evaluating the need for intervention and providing it as soon as possible without looking at the watch. During the non-vascular intervention postings, you are helped by a senior resident so the emergency calls are equally shared. Emergency cases are a norm and not an exception; so be prepared for the day to extend till night if you are on call because the emergency department will send biliary drainages and pigtails for abscesses for sure.  Even during the days not on call the fellow is responsible if the second SR needs any assistance. These duties may be considered hectic but we have to remember we are actually doing 3-years worth of case load (especially now that DM IR course has started) and learning it all in one year. It is also during your emergency calls that you get maximum hands-on experience, which substantially builds your confidence. It is also worth mentioning that the on call consultants are available round the clock and any help sought by the fellow is provided quickly.

Please note that from June 2020, a DM course in Interventional Radiology will commence and so the fellowship will be discontinued henceforth. But the quality and quantity of work will remain the same, and you can assume the schedule will be similar as well.

Fee and Salary: The salary is the same as a third year senior resident, which comes out to be roughly 1.15-1.20 lakhs/month approximately.

Accommodation: Provided in the hostel in campus if required

Leaves:  30 casual leaves in a year

Tips on how to secure the fellowship: Know both general radiology and theoretical aspect of interventional radiology thoroughly. Kaufmanns Interventional radiology is a good starting book for fundamentals. Study the images provided in the book and also see images on the internet for various interventional procedures, which is helpful in the interview spotter and table viva part.

Pros: Plenty of cases in both vascular and non vascular procedures, enough to give you a good grasp of the subject. A separate interventional OPD is run where you can see the cases first-hand and see how decision regarding management in onco-intervention is made. The biggest strength of the program is definitely the guidance by so many able interventionists present in the department, with special mention to Dr Naveen Kalra who is one of the pioneers in HCC interventions. He is an astute teacher, guide and mentor.

Cons: It is an action packed one year of fellowship, and you have to be physically and mentally prepared for all the work. For some days, you may find 24 hours to be less keeping in mind the amount work.

Personal experience: To summarize, my year of fellowship was one of the most action-packed year of all my training till then. The experience can be described as thrilling, joyous and packed with knowledge. I always loved interventions from the first kidney biopsy I performed during my first year of residency and building up on that, the fellowship in PGIMER was just the kind of qualification I needed to give me a well-rounded experience. I learnt an entirely different aspect of radiology with direct patient contact. Helping out patients with emergent non-vascular and vascular procedures gives you a sense of satisfaction and makes you a part of the solution of patient’s health problem. The work was addicting because it was never tiring; I learnt so many new procedures and polished the ones I already knew during the whole year. I learnt the correct techniques and the right approach to deal with cases. Just remember you are entering into a field where correct diagnosis and prompt management is the difference between life and death in emergency cases. The extensive hands-on experience helps you become confident in performing majority of the IR procedures. If you are interested in IR then PGIMER fellowship is a very good course. It is a worth investing a year of your career to learn from so many good teachers.

– Dr Tejeshwar Singh Jugpal

Fellowship –Interventional Radiology (2018- 2019)

Currently Consultant IR – Indus International Hospital, Mohali

TEJ

9 thoughts on “IR Fellowship, PGI Chandigarh

  1. Pingback: Radiology Fellowships, DMs and Super-Speciality DNBs in India – Cafe Roentgen

    1. Tejeshwar Singh Jugpal

      Neuro intervention is separate from body intervention and is a part of DM Neuroradiology curriculum ( also available in PGI)
      Case loads will never be an issue in PGI . Rest assured you will definitely do and see a lot of cases in the three years you are there. The cath lab of neurointervention Is separate with latest biplane DSA machine and excellent DM Neurorad trained consultants as part of faculty

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    1. Tejeshwar Jugpal

      IR is a skill set which needs to be learned from the first step especially vascular interventions . Consider it to be a surgical branch.
      Since i dont personally know what is happening in each and every course the workload and skill teaching all i can say is try to find the answers to these questions regarding any course you wish to pursue be it a year long fellowship or a DM three year course

      1. Total number of cases coming to the department
      2. Hand on experience you will get (very important – you need to DO and not just SEE )
      3. Well trained faculty
      4. Different Variety of cases – onco , trauma cases, visceral bronchial artery embolization, peripheral angioplasty …. the list is big find out what all is happening
      5. Modalities available – especially Good cath lab, Ablations if being done
      6. Academics especially Radio – clinical deptt meets- makes a huge impact if you can be part of the discussion regarding decision making of the cases
      7. The time you want to invest ( comes last but you need to keep this in mind)
      Someone with a good few years of experience after PG may find three years DM course a bit too much investment, but a fresh pass out may be more willing to invest time
      Therefore it is better to be prepared, know beforehand regarding what is happening in the course you want to join
      Talk to someone who is already there because they r going to give you the ground reality
      Hope this helps
      Best of luck

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    2. Dr.manideep

      Sir, please tell an institute where i can learn both neuro and body interventional radiology as a single DM course.. thank u sir

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      1. We dont think there is any such course to the best of our knowledge. One option though is to do two separate fellowships in body and neuro intervention in the 3 years instead of a DM, if you wish to subspecialize in both.

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