Hospital: Tata Medical Center, Kolkata
Duration: Two year fellowship program.
No. of seats: 6 intakes per year.
Accreditation: This is not a university accredited fellowship. However, TMCK provides a certificate of fellowship at the end of the program.
Eligibility: MD/DNB Radio-diagnosis.
Fellowship application process: Online application followed by two rounds of interviews. In the interviews, fellows are expected to answer questions related to standard radiology including CT and MRI protocols and use of contrast. It is good to know some oncoimaging topics such as response criteria in oncology (RECIST), LIRADS, PIRADS etc. and basic interventional radiology. Online applications are usually out in Jan/Feb and June/July every year. One may also send their CVs and cover letter by email anytime during the year and the HR may contact you depending upon the vacancies on possible ad hoc basis. Visit the website www.tmckolkata.com for more information on the application addresses.
Thesis/Paper publication: Thesis is not compulsory. At least two publications are expected within the two year tenure.
Exit exam: There are no exit exams. The fellowship is granted on completion of the course period and submission of the thesis/publications.
Fees: No fees.
Salary and leaves: Expected stipend is between 70,000-80,000/- INR per month.
30 all-purpose leaves are granted annually at the discretion of the head of the department.
Working hours and night duties: 8.30 am to 6.30 pm. On call duties are usually 3- 4 nights per month and 1 Sunday every 2.5 months (as of now). There is no post duty off.
Accommodation and campus life: Accommodation is not provided. But for the first 15 days, Tata guest house accommodation may be provided (depending upon availability) until you find an apartment. There are residential areas with apartments available for rent close to the hospital on a single/sharing basis. The HR department will assist in finding an appropriate accommodation. More than 100 fellows are working in different departments of Tata Medical Center and stay within a radius of 5 km of the hospital. Public transport is easy to avail. There are two good staff canteens on campus with options for both vegetarian and non-vegetarian food. Language is not a problem as the staff is well versed in English and Hindi. Most patients too can comprehend and speak Hindi and English.
Postings: Rotational postings are provided in X-ray and special procedures, ultrasonography and guided procedures, mammography and guided procedures, diagnostic CT reporting and CT guided procedures, diagnostic MRI reporting and DSA lab, with supervised reporting and hands-on experience in most procedures. A log-book is to be maintained detailing day-to-day activities over the two-year tenure. Ultrasound rotation is divided between diagnostic ultrasound, portable ultrasound and procedures. A separate posting at the CT and MRI console is provided in the first six months of the tenure to make dealing with day to day challenges of image acquisition easy. Reporting is done directly through PACS and RIS. Fellows can independently report USG and X-rays through their individual PACS IDs. CT and MRI reporting are initially supervised and later authorization rights are provided. DSA postings begin in the second year of fellowship.
Academic activities: Academic sessions are held thrice a week between 8.30 am to 9.30 am on recent diagnostic and intervention related topics and journal club meetings are held on Saturday afternoons.
All fellows are expected to participate in the tumor board meetings of various departments on rotation basis such as GI, GU, Neuro, Pediatrics, Chest, Breast, Gyne-onco, Head and Neck and Sarcomas. These meetings are very useful to gain a holistic approach in patient care with the medical, surgical and radiation oncologists and pathologists on the team, and get to understand how to make your reports more clinically relevant for the physicians to interpret and act upon.
Attending national & international conferences and presenting papers or posters is encouraged. The department organizes several CMEs and courses and fellows participate in organizational activities.
Fellows are also required to teach nursing and radiology technician students as and when needed.
There is excellent scope for research activity within the department as long term data of patients are made available through the integrated EMR, HIS and PACS. Current areas of research in the department include whole body MRI, arterial spin labeling, MR perfusion in neuro-oncology, MR Elastography of liver and texture analysis.
Opportunities also exist for fellows interested in research to collaborate for projects with the Tata Translational Cancer Research Center (TTCRC) which is a state of the art laboratory consisting of a team of reputed research scientists from India and UK leading the research into biomarkers and developing indigenous therapeutic solutions.
Personal Experience and Pros: I thoroughly enjoyed my fellowship in TMC trying to learn as much as I could in diagnostics and also in interventions. I found all the senior faculty and teachers extremely helpful on both professional and personal grounds. Since this is a one of its kind tertiary oncology center in all of Eastern India, the hospital caters to patients from not only India but also neighboring countries like Bangladesh, Nepal and Bhutan. The hospital buildings are swarmed with patients; hence there is exposure to a large number and wide variety of cases during the fellowship program.
All patient data is available on the EMR, including previous imaging and histopathology reports and excellent integrated HIS and PACS services are in place. There is a strong follow-up system in place and other departments consistently give feedback on their cases. Reporting rooms are open throughout the day and night so you can look back at cases and work any time of the day or night. This allows ample opportunity to follow up on all reports and broaden one’s case based knowledge.
The mammography unit is excellent with a full field digital mammography unit combined with high end ultrasound including elastography (SWE) and stereotactic biopsy system. The average caseload of mammography is about 300 cases/month.
The Nuclear Medicine department is integrated with imaging services and one can get to see a large number of FDG / DOTA PET CT, SPECT CT scans etc over the two year tenure.
The intervention radiology services are extensive and range from USG and CT guided biopsies, FNAC and drainage procedures, CT guided bone biopsies, nerve blocks, liver and renal ablations, ultrasonography guided biliary (PTBD) and renal (PCN) drainage and stentings, diagnostic and therapeutic angiography, embolizations using coil, glue and PVA particles, TAE, TACE and TARE and catheter insertions such as PICC, chemo ports and adult and pediatric Hickman lines etc.
There is a Tata Lecture Series (TALES) that is conducted every Monday morning from 8 am – 9 am which is chaired by the Director and the Deputy Director and the sessions are taken by Consultants and Fellows from all departments on rotation. Eminent international faculties are also invited to speak at these lectures. Attendance to Monday morning TALES is compulsory for all fellows.
A free access digital library is available on campus.
On successful and satisfactory completion of training, the department can assist the fellow in a short term placement abroad or in a tertiary center in India. The expenses will have to be managed by the fellow.
Best thing about the department is they make you feel home even when you are away from home because all the fellows and consultants are very cooperative.
Cons: It is not a recognized fellowship, but two years of dedicated oncoimaging and interventions can add a lot of value to your career in specialized radiology practice, keeping in mind the pace at which cancer management is advancing in India and worldwide.
Since it is a dedicated oncoimaging center, one might feel that they are missing out on general radiology practice including obstetric ultrasound, peripheral artery Doppler, general musculoskeletal cases and neuroradiology cases.
Peripheral vascular intervention procedures such as stenting and angioplasty are not done in the department due to the lack of demand from the clinical service teams.
There is no primary surgical neurology department in the hospital due to which there are very few numbers of diagnostic scans done for primary brain tumors. Most of the neuroimaging is done in the post-treatment setting but you get to see a large number of MRI of the brain including perfusion, diffusion and spectroscopy to assess for treatment response, radiation induced changes and recurrence.
All the best for the future! Please feel free to contact me for any other related queries that I may have not addressed in this article.
Dr. Ketul K Pathak,
Freelancing Interventional Radiologist,
Read another review of the fellowship here.