Hospital: Rajiv Gandhi Cancer Hospital and Research Centre (RGCIRC), New Delhi.

Duration: One year fellowship program.

No. of seats: 1 seat in diagnostic onco-radiology/year. Session starts in January.There are also Primary and Secondary DNBs in the department. Preferences are given to Sponsored candidates (Sponsored candidates are on permanent post in other institute and draw their salary from parent institute and are not eligible for any stipend from RGCIRC).

Accreditation: Fellowship program is recognized by Indian Medical Association (IMA) Academy of Medical Specialties, Hyderabad. Completion certificate is provided at end of course by RGCIRC and IMA.

Eligibility: MD/DNB Radio-diagnosis. Candidate must be life time member of any branch of IMA.

Fellowship application process: Advertised online in November on https://www.rgcirc.org/academics/fellowship. Form has to be filled and submitted by hand in hospital or by post. There is a formal interview scheduled in last week of December which comprises basic questions regarding onco-radiology to assess understanding of various imaging assessment criteria including BIRADS, TIRADS, LIRADS and Response assessment criteria including RECIST, mRECIST and basic interventional procedures.

Thesis/Paper publication: One research paper is compulsory.

Exit exam: There is no formal exit exam.

Fees: Draft of Rs.25, 000/- is to be deposited at the time of joining, favoring IMA, Hyderabad. An application form fee is 1500 rupees which has to be deposited as a draft.

Salary and leaves: Stipend is Rs.1 lakh per month. 30 all-purpose leaves are granted annually.

Equipments in department: 1.5T MRI(Siemens), 3T MRI (under installation), Twin beam dual energy128-slice CT Scanner (Siemens), High end digital mammography with Breast tomosynthesis, Stereotactic breast biopsy under mammographic guidance, VABB (Vacuum Assisted Breast Biopsy) for guided biopsies and therapeutic procedures for fibroadenoma.There is an in-house built CAD for breast mammography, MR mammography and lung nodules. There is targeted prostate biopsy by PROFUSE software and intraoperative tumor localization aiding in robotic surgeries. There is also a well-established Cath Lab with cone beam CT facility.

Working hours and night duties: Timings are normally 9 am to 5.30 pm; sometimes evening shift can be scheduled for timings 11.30 to 8 pm. On call duties are variable for males and females. Females are assigned day duties on Sundays and public holidays. Male candidates have to do 3- 4 night duties per month. There is no post duty off.

Accommodation and campus life: Accommodation has to be arranged by candidate as no accommodation is available in institute. Apartments are available in nearby residential areas for rent. Meal facilities are available in doctors’canteen and cafeteria, on payment at prescribed rates.

Postings: There are monthly rotational postings for Reporting, Special procedures, Mammography, Ultrasound, CT reporting, MRI reporting, with additional opportunity to learn ultrasound and CT guided procedures. A well-established PACS system is available for reporting for residents and fellows with elaborate CPRS system to access clinical details of patients including radiotherapy, chemotherapy and surgical procedure details, clinical complaints and lab reports including histopathology reports. USG and X-rays can be reported, validated and approved by fellows through their PACS access. CT and MRI reporting are validated by residents and fellows and are approved by faculty. Fellows can also finalize the reports.

Academic activities: Multidisciplinary meetings are held five days a week and cases are discussed from medical oncology, radiotherapy, surgical oncology, pathology and interventional point of view for various systems including breast, Gastro-Intestinal system, Neuro-oncology, chest, Gynae-Oncology. Multidisciplinary meetings are very helpful in framing patient treatment and to get insight of necessary details to be included in radiology reports, pertinent clinical details and suspected complications can also be easily discussed. Academic seminars are also conducted in tumor boards.

Seminars and journal clubs are being conducted on a regular basis in the department for radiology residents and fellows.

RGCIRC encourages research activities with easily available data from PACS and CPRS. Radiology faculty, fellow colleagues and hospital medical fraternity are very supportive in collection of data and conducting various studies, with good interdepartmental coordination. There is a well-established research department in the hospital with efficient statisticians.

There are ample opportunities to attend national and international conferences with constant encouragement for paper presentations in conferences. Radiology faculties are active members of many oncological societies and are frequently involved in organization of CMEs and conferences.

Personal Experience and Pros and Cons: RGCIRC is a sort of complete and extensive package for insight into Onco-Radiology with considerable exposure to CT, MRI andinterventions. Senior faculty is very helpful and has extensive learning experience in their respective fields. I enjoyed my 1 year of fellowship, learning radiology, framing clinical approach and gaining knowledge about multimodality treatment options.

Reporting rooms in radiology department are well equipped with many reporting consoles, efficient backup and mammography specialized monitors. Being an efficient onco-care center, there is a high case load with good spectrum of cases. Many of the high-risk patients are enrolled for cancer screening with facilities available for genetic testing and mutation analysis.

The hospital has efficient medical oncology, hematology and bone marrow transplant teams with extensive spectrum of response assessment and immunotherapy response assessment. We can also get familiar with radiological manifestations of few infections and spectrum of chemotherapy related complications. Interdepartmental multidisciplinary team interactions are helpful in knowing approach of clinicians and bit of treatment planning, which help you grow as clinical radiologist.

Radiotherapy department in the hospital is a state-of-the-art establishment with all modalities from EBRT, IMRT, IGRT and SBRT, covering extensively the spectrum for radiological manifestations of radiotherapy, be it head and neck, lung, spine, pelvic or brain tumors. Constant feedback from colleagues encourages the improvement in reporting.

Nuclear medicine department is well established for both therapeutic and diagnostic purposes. There are nuclear ablative therapy options available for thyroid malignancy, neuroendocrine tumors, and prostate. Functional assessment for neuroendocrine (DOTANOC) and prostate (PSMA) are also done. PET images are also freely accessible on PACS.

There are ample head and neck MRIs for evaluation of fresh cases and post treatment changes, with frequent follow ups and availability of data.

The few limitations I felt were lack of vascular and biliary intervention exposure as there is a dedicated interventional fellow, although free hand is available for CT and Ultrasound guided biopsies. Secondly, there are a limited number of MSK cases to learn from.

I really loved and enjoyed my fellowship in spite of the hard times due to the ongoing COVID-19 pandemic. It was a great opportunity to learn all the facets of Onco-radiology; one which will be of great benefit me in my future radiology work.

Dr Geetika Sindhwani,

DNB (Radiodiagnosis), Fellow (Onco-Radiology),

Assistant Professor (Radiodiagnosis),

VMMC and Safdarjung Hospital, New Delhi.