Course: Fellowship in Diagnostic Neuroradiology (Cross sectional) at Seth G.S. Medical College and K.E.M. Hospital, Mumbai.
Duration: One year.
No. of seats: 2 seats per year
Eligibility: Post Graduate degree (MD / DNB) in Radiology.
Fellowship Application & Selection process: Online notification and application form around the month of December on MUHS (Maharashtra University of Health Sciences) website: https://www.muhs.ac.in/. Details are best given at the website.
Fees: Approximately 1-1.25 lakh rupees for the entire duration of fellowship.
Stipend: Rs 50,000-55,000 per month [as per the SR scale fixed by BMC].
Accommodation: On campus is difficult; usually not provided by hospital.
Leaves: Officially 12 leaves during the fellowship as per the MUHS.
Equipment: The institute has two CT scan machines and one MRI machine (1.5T Siemens Aera)
Thesis: The course requires you to do a comprehensive thesis on a topic of your choice. You are allocated a guide who will mentor you through the process. Although thesis may sound boring, it is actually fun as KEM has a wide spectrum of cases. One year may not be such a short time to collect some good cases and come up with a decent study which you can later on publish too. Neuroradiology is I think the most fascinating subset of radiology so I’d recommend don’t play too safe. Select a topic that is recent and it will help you grow in terms of knowledge and skill. Also you will have a short viva on your thesis during exit exam so you should be very well versed with your thesis.
Exit exam: Practical exams are conducted at the end of academic year. The exam is conducted by one external and one internal examiner allocated by MUHS. It comprises of the usual practical exam cocktail of one short case, one long case, clinical viva, 20-30 spotters and a brief viva on your thesis.
University Recognition: The fellowship is recognized by Maharashtra University of Health Sciences (MUHS).
Diagnostic exposure: As you can imagine, KEM hospital has an array of cases. I am not exaggerating by saying that you will end up seeing a lot of rare classic textbook cases and sometimes also see some of those once-in-a- lifetime-for-a-radiologist kind of cases too.
KEM hospital gets the cream of good neuro cases as it is one of the top tertiary referral centres. This is a huge plus point as you will eventually develop a good eye as a diagnostician. The fellowship makes you proficient in MR with exposure to most areas of neuroradiology, including pediatrics, functional MRI, diffusion tensor imaging, spectroscopy, CSF flowmetry, head/neck, MR angiography, and spine imaging. Specialty imaging protocols for ongoing interdepartmental studies like neuroendocrine or neurosurgery are included.
Note that the spectrum is not restricted only to neurology and you have to do all scans done in MRI, which include other possible body and MSK MRIs. This may seem a drawback for some but I think it is better as you do not lose touch with the rest of radiology and restrict yourself to an end branch early in your career.
Intervention and hands on exposure: This is strictly a diagnostic cross sectional fellowship. There is no exposure or posting in neurointervention which is a separate fellowship.
Academic activities and multi-disciplinary meets: Weekly/monthly interdisciplinary conferences enable the clinical interactions with Neurology, Neuroendocrinology, Neurosurgery and other related specialties. The fellowship assists us radiologists in becoming independent, competent contributors to the investigation of neurological disease. You are free to attend as many interdepartmental meets, workshops and conferences as interested. These are usually monthly meets and most of the departments in KEM have it. Pertaining to neuro, the neuroendocrine and neurology departmental meet, you may be expected to attend sometimes as a fellow. A lot of fully worked up cases are discussed here, but it is not compulsory to attend. I did try to attend at least once in a month. Sometimes seminars on stroke, epilepsy are conducted which again you can attend. You are expected to participate in the Teaching Files meet and other neuro conferences. Publishing case studies or educational exhibits is upto you and how much extra efforts you are willing to put in.
Duty hours and emergencies/on call duties: The initial month of your stint will be a houseman posting. In this, you are basically expected to learn performing an MRI scan. By the end of the month, you should be well versed with planning any MRI which not only includes MRI brain but all other MSK and body scans. There can be associated clerical work too as it is in any government institution. You will do night duties as a houseman. Initially this may seem a little frustrating, but we as radiologists tend to ignore the fact that it is indeed important to know how to plan a scan and instruct your technologist in the future. Familiarity with various post-processing neuro 3D softwares, DTI etc is also essential for the modern neuroradiologist and the initial month dedicated to console duty helps you do that. After your initial housemanship, you start as a clinical fellow. The day is divided into shifts which are not very hectic timing wise. A neuro fellow spends most of his/her fellowship duration in MRI. You will be posted for approximately nine months in MRI and three months in CT. As a fellow, the usual day involves reporting pending OPD/inpatient scans and emergency reporting. The complex cases are always checked by the consultant for opinion which is a good learning experience. There is only one chief consultant in MRI, who will also be your mentor and guide. As a neuro fellow you are posted for a shorter duration in CT. CT posting will involve doing calls on Sundays and other holidays too. There are approximately 100 CTs done in a day. A good and varied spectrum of cases is seen, however it is not limited to neuro cases. An exquisite spectrum of abdominal cases is what you will see the most in your CT stint and this is quite a bonus according to me.
Your personal experience at the fellowship: Honestly there is not much to complain or criticise. My stint of one year was fulfilling and enriching an experience. If you are ready to put in effort, there is a lot you can gain from it. Being a busy hospital with considerable work load, you eventually end up developing a short and to the point reporting style. There is more stress on a precise diagnosis than giving a list of confusing differentials which I really liked. There are a lot of things I learnt which I have tried to carry forward with me.
I was lucky enough to send a few exhibits and papers to RSNA, of which two got accepted that year. Also interacting with other departments helping me gain a wider perspective. There is good opportunity to participate in TF meet and other neuro conferences. The fellowship definitely sharpened my skills as a radiologist. However one year is not enough to learn everything. Doing the fellowship is only the first step as there is a long way to go if you want to subspecialise in this field and gain expertise.
What I liked:
– Wide spectrum of Neuroradiology cases
– Good exposure to Tumor imaging, functional MRI, DTI and recent advances
– Paediatric and neuroendocrine spectrum is good
– Not losing touch with non-neuro aspect of radiology
– Healthy work environment with very sincere and knowledgeable co-fellows/SRs and residents.
– Training and Mentorship under very good expertise.
What I did not like:
I am not the optimistic glass half full types but honestly there are not too many negatives according to me.
To name a few-
– Clerical work during houseman posting
– Not strictly neuro work, if you count it as a downside
– Overall faculty is less.
Any additional comments/ does it add value over MD /DNB degree: This is an MUHS degree so yes it is an added value especially when you are working in Maharashtra. Having done a fellowship already can be a brownie point while applying for further full time or visiting international fellowships.
Dr. Mansi Jantre,
MD, Fellowship in Diagnostic Neuroradiology, 2016-17
Junior consultant radiologist, Jupiter Hospital, Thane