Hospital/Imaging Centre and City: Max Super-Specialty Hospital, New Delhi

Duration: 1 year

Diagnostic exposure: The fellow is posted is at Max Smart Superspeciality Hospital, Saket, which is a speciality orthopedic, OBG and pediatric wing of Max Hospital, Saket, New Delhi. It is the responsibility of the fellow to pre-read all musculoskeletal cases (MRI, CT and X-rays) of Max Smart superspeciality Hospital as well as Max Superspecialty Hospital, Saket, which will be cross-checked by MSK faculty. In addition, there are multiple centers across India and abroad that send the musculoskeletal scans for tele-reporting. The fellowship also has an excellent hands-on exposure of musculoskeletal ultrasounds covering the entire spectrum of musculoskeletal radiology. The average daily work that a fellow gets to report or assist is around 10 MSK USGs, 10-20 cross- sectional studies, and 100-150 X-rays.

Intervention and hands-on exposure: This is a diagnostic-heavy fellowship. However, the fellow does get to assist initially and eventually independently perform many US-guided interventions like intra-articular injections, bursal injections, diagnostic joint aspiration, barbotage, tenotomy and soft tissue biopsies. The bone biopsies and radiofrequency ablations are done by Interventional Radiology team, which the fellow can assist in his/her free time.

Academic activities and multi-disciplinary meets: There are academic presentations once a month for the DNB students’ teaching. The tumor board meeting is held once a week, where the fellow gets exposure to all the cases which present to the hospitals with imaging done elsewhere. There are also quarterly meetings with the Upper limb orthopedic team, discussing unique pathologies of shoulder, elbow, hand, and wrist. There is a very frequent interaction with the rheumatology team which consists of their consultants and fellows. Other than that, one-to-one discussion with the referring physicians is quite frequent.

Duty hours and emergencies/on-call duties: Normal duty hours are 9 am-5 pm but the fellow is expected to be present 9am-9pm. The emergency calls are 5-6 per month. The call duration for fellows is longer than other non-academic SRs, which is around 11 am – 9 am (next day). Like most Delhi hospitals, the fellow gets a complimentary day off after a night call. Over and above this, it is expected from the fellow to contribute to the non-MSK departmental duties like portable USGs in ICUs, and some department USGs when the workload is more.

Fees, salary, and leaves: The annual fee is 1,23,000/- INR.  The salary is 1,20,000/- INR per month. The number of leaves granted is 21 per year.

Accommodation provided or not: Accommodation is not provided by the hospital. It is advisable to rent a house near Saket, Delhi as the work hours are quite hectic.

Tips on how to secure the fellowship: The fellowship starts in June. There is an interview that occurs 2-3 months before the start date. It is advisable to meet the HOD and the course guide in advance or e-mail them. It is not expected that the candidate has a very good knowledge of MSK during the interview.

When do the interviews/exams happen (if applicable): There is no fixed date as of now. It is usually 2 months prior to the completion date of the previous fellow. Advertisement for the same in released on the Max hospital website. Interested candidate can also mail Max hospital academic wing and enquire.

Pros and cons: The pros of this fellowship include the workload, the spectrum as well as hands-on across all modalities. The fellowship faculty is very enthusiastic in teaching and will always keep the fellow on their toes. The salary is also quite decent.

Cons include long and hectic work hours and frequent night calls. Sometimes, the non-MSK work can be overwhelming. There is not much hands-on for CT-guided biopsies as you rarely get time during your routine duty hours.

My personal experience at the fellowship: Having studied and worked in a Government hospital, working in a corporate setup was a novel experience which I thoroughly enjoyed. At the end of the fellowship, I could confidently report CT, and MRs and do MSK USG independently. There are very few MSK fellowships in India, which offer such comprehensive coverage. It was a great experience working with specialist doctors, with highly specific subspecialty interests. In Max, there are teams of expert hip surgeons, arthroplasty surgeons, hand surgeons, and foot surgeons. The onco-ortho, rheumatology and plastic surgery teams are also very good. In my opinion, the discussions and multidisciplinary meetings with clinicians were more valuable than reading any book or article. After the fellowship, I feel my reporting is more refined and relevant to the referring physicians’ perspective.

Any additional comments/ does it add value over MD /DNB degree: Sub-speciality practice in Radiology is still niche practice in India, but it is gaining favor in metro-cities and big corporate hospitals. This fellowship will definitely help in corporate/private practice. Even if one does not intend to work in such setup, the knowledge gained during the fellowship will help in private practice as MSK cases form a major bulk of routine scans. Since Max is a private hospital, the fellowship/experience does not add much value to one’s profile to secure a position in government job.

Dr Ami Jani,

MD, DNB, FRCR, EDiR