All the radiology departments in Mumbai have a lovely culture of holding a common Teaching Files Meet every few months, where one 1^st, 2^nd and 3^rd year resident as also a senior resident from every hospital come and present an interesting case each which has one or more specific teaching points to highlight. The presentation is supposed to be 4-5 min long, with a few minutes of Q and A subsequently. It is a prestigious event, and my residents work hard preparing for it. They present the case to the faculty at least once or twice, and then also practice with their friends, before finally actually presenting at the Meet. The practice is not for them to understand the nuances of the case itself; it is simply to fine tune their presentation and performance. And they have usually done well, with Tata winning some prize or the other every Meet. This of course is not an exception. Everyone prepares and practices before taking a talk or presenting a poster.

The long and short case vivas are in a sense also a performance. Your knowledge obviously is tested during these vivas. But the manner in which you describe the case and answer the questions is also important. The same answer given fluently and with confidence will have much more impact than if given in a half-mumbling hesitant tone. Furthermore, there are also residents who are fluent with radiology but unfortunately not with English. This is where practice becomes very important.

Most of you will get some time between getting the long and short cases and actually going for the viva. You will of course try to recall (or read up) details on the entity you get in the case, its differentials, imaging techniques etc etc. But I would suggest that you also spend time practicing aloud the description and answers to some common questions. Imagine going upto to the examiners; first give a confident smile and wish them a good day. They will usually ask you to describe your case. You must do this flawlessly, with no ummms or errs in between. Practice the entire description aloud if possible (else in your mind) multiple times, starting from ‘these are axial contrast-enhanced CT plates of a 63-year old gentleman’ and moving on to smoothly describe the findings, the impression, the differentials, and your recommendations. Give this entire description in one go. Do not pause in between; if you do so, you are inviting a question which could completely take the discussion tangentially. Stop only if the examiner asks you to stop.

Similarly practice answers to common expected questions. If you get a focal hepatic lesion as your long case, practice answering on liver CT and MRI protocols, use of hepatobiliary phase, imaging findings of common lesions, LIRADS etc etc. If the examiner asks you these, you should again take off with a bang.

If you can practice these aloud with each other while waiting for the viva, it would be perfect. Catch a partner who agrees to this and indulge in role-play so that s/he asks you questions like the examiner would and vice versa. If you cannot do that as you are the first one to go for the viva, practice them in your mind.

I cannot stress the impact a confidently speaking resident can make on the examiner compared to a mumbling jumbling one. I am sure you have all read everything there is to read and attended everything there is to attend in the past few months. So my only suggestion for everyone is to practice your case description and answers before the viva. I am sure it will help.

All the best!

– Akshay Baheti, Tata Memorial Hospital