Institute: Cardiac Imaging Fellowship, Amrita Institute of Medical Sciences

Duration: 1 year

No. of seats: 1 per year

Eligibility: MD/DNB/DMRD

Entrance exam: No entrance exam; there is a fellowship interview instead. Topics asked in the interview pertain to cardiovascular imaging and further interests in career. Otherwise there is no specific questionnaire or list of questions which can be asked

Fellowship application: Mar-July, variable. Send your CV through email for application: rajeshkr@aims.amrita.edu.

Exam/Thesis: Yes, there is an exam on course completion and sometimes even a model exam may be conducted midterm or before the final exam.  

Working hours: Average 8 hours daily; Night duties will be shared with other fellows and senior residents in general radiology shifts.

Accommodation: No, but hostel / PG accommodation facilities are available in the campus and in nearby areas.

Hands-on: Excellent hand-on work with a structured cross–sectional posting schedule is available.

Non-Cardiac work: Yes; one gets to report non-cardiac cross-sectional imaging as well

Accredited: No

Leaves: On request (approximately 1 day per month)

Fees: No

Salary: ~INR 60,000 per month (in 2021)

My experience: Amrita institute of medical sciences is one of the most academic and premier medical institutes in the country. Dr Rajesh Kannan, one of the primary mentors, is a great teacher and is a well-known academician in the fields of cardiovascular imaging, neuroradiology and interventional radiology.  One of the biggest plus points to be added is the wide variety of pediatric cardiology cross sectional cases one gets to work up. Amrita medical college is one of the very few places in India catering to the complete spectrum of paediatric cardiology and cardio-thoracic surgery.   

Workflow: The institute caters to all medical imaging modalities and multisystem imaging. It devours almost the entire spectrum of radiology, oncological imaging and interventions. Reporting of cardiac and non-cardiac cross sectional cases (CT/MRI) wherever one would be posted along with other faculties. One Sunday duty as faculty on call per month demands all the CT/MRI’s to be reported by the concerned faculty by next day. There is a double check system for cardiac work in the beginning, which means a primary/provisional report is followed by a second proof read by mentor. Later, one can start finalizing cases as and when the fellow gradually develops confidence. Daily discussions with cardiologists and registrars happen on a case-to-case basis. In cases where one of the cardiologists or cardiology registrar has done the primary reporting, the fellow might be asked to do a second check, which is also a big learning curve, if done promptly and by protocol. This also provides us invaluable opportunity to get post treatment/procedure follow up and long term monitoring. However the non-cardiac reporting is usually given with a single read and only doubtful cases may be kept for further discussion with senior faculty.

Expectation from a fellow:  The fellow will be in CT/MRI posting on a rotational basis and has to try and complete maximum number of non-cardiac cases in the respective posting, where post graduates do the primary reporting. All cardiac cases have to be reported by the fellow and presented to the mentor, after which discussions and guidance happens. Seminars and academic presentations may happen periodically, when time permits.  National and regional cardiac imaging conferences and online webinars can be attended.   

Amount of work and daily schedule: Daily duties are usually 8 am to 5 pm; however, they are highly variable depending on the pending work.  On an average, a fellow would do proof reading for about 400 CT’s or about 300 MRI’s a month depending on the posting. There are approximately 20-30 Coronary CT’s, 30-40 Pediatric Cardiac CT’s, 50 -60 adult CMR’s, 8-10 pediatric CMR’s in a month. The institute has a state of the art PET fusion MR and boasts of amongst the highest PET cardiac MR studies done in the country.   

Intervention and hands on exposure: Fellow will usually be posted for a month in a dedicated interventional posting rotation (along with 11 months of cross-sectional imaging). Besides that, there will be a lot of non-cardiac interventions happening like CT guided and USG guided biopsies, FNAC and drainage procedures, CT guided nerve blocks, liver and renal ablations, USG guided biliary (PTBD) and renal (PCN) drainage and stentings, diagnostic and therapeutic angiography, embolizations, TAE, TACE and TARE and catheter insertions such as PICC, chemo ports and lines etc.

Academic activities and research/publications: There is excellent scope for research activity within the department as large volumes of long-term patient data is available through the integrated EMR, HIS and PACS. No specific teaching sessions happen, but a lot of learning happens on a case-to-case basis along with case presentations/seminars. Case-based discussions with cardiologists take place at the institute giving a clear insight into the management protocols and peri-operative decision making process. As far as research activities and publications are concerned, usually one project is allotted to the fellow, which is expected to be accomplished within the year. Poster and case reports may also be allotted as and when the occasion arises.

Take home message: At the end of the tenure, one is confident enough to report and answer the most complicated queries of the referring physician. Also, the positive name of Dr. Rajesh Kannan in the national sub speciality portfolio is a big plus when settling into practice subsequently. Take it from me, this definitely adds value to your CV.

Downside: Absolutely nil. It helped me to not just stay in touch with but also improved my general radiology and interventional skills over the course of fellowship, and that’s exactly the way it is needed in a practical working setup.

All the best for the future! Please feel free to contact me for any queries:

– Dr. Nidhin James K

Lead consultant Cardiac imaging and Consultant General Radiology, Mar Sleeva Medicity Palai, Kerala

Fellow in Cardiovascular Imaging, (Amrita institute of medical sciences, Kochi, Kerala)

Contact no: 8594072000

Email : knidhinj@caferoentgen