Hospital and City: All India Institute Of Medical Sciences, Jodhpur.

Duration: 1 year duration. I did my fellowship in year 2020-2021.

Number of seats: 1 seat every year. Exam usually takes place in the July-August period every year.

Diagnostic exposure: The department is equipped with state-of-the-art equipment. There are 2 CT scanners (Siemens 128×2 – slice dual source dual energy FLASH and DRIVE), two 3T MRI scanners (Siemens Magnetom Vida 3T and GE Discovery MR750 Scanner). There are many high-end USG machines like supersonic aixplorer series, Philips Epic Elite, GE venue and GE logiq S8 machines. Few of these machines are compatible with contrast enhanced ultrasound, shear wave elastography, and volume probes (3D, 4D imaging).

During the tenure, there are monthly rotations amongst various postings. In general, CT posting is for 4 months, MRI for 2-3 months, USG posting for 2-3 months and fluoroscopy posting for 2 month. The fellow is expected to do all pediatric radiology related work and some other work in each posting. There is a bedside ultrasound required in neonatal/pediatric/pediatric surgery ICU which needs to be attended by the fellow in USG posting or when residents are in doubt. Fellows are expected to report all sub speciality cases in their respective postings, while focussing particularly on their own subspecialties. Approximately 100-120 CT studies are being performed everyday which usually includes pediatric thorax and abdominal cases along with pediatric cardiac CTs making up about one fourth of the total cases. Out of total 50 MR studies being performed daily, around 30 percent are pediatric cases. Cases written by JR’s are also to be checked by fellows/SR’s before getting checked by consultants.  In fluoroscopy, a wide variety of pediatric procedures are done like MCU, IVP, Retrograde urethrography, water soluble and barium contrast studies like swallow, enema, loopogram and genitogram in cases with ambiguous genitalia. Real time imaging is done under 2D-flouroscopy machine. There is ample availability of excellent quality personal protective equipment.

Intervention and hands on exposure: There is hands-on exposure to non-vascular interventions like pigtail insertions, CT and USG guided biopsies, liver abscess drainage, USG guided FNAC’s etc. No hands-on vascular interventions are done by pediatric fellows as it’s primarily a diagnostic fellowship; however observation of procedures is encouraged by the consultants.

Academic activities and multi-disciplinary meets: Weekly seminars are conducted every Monday morning, apart from weekly journal clubs and interesting cases discussion two times a week. Moderating the seminars of junior residents is also the fellow’s responsibility.

Pediatric fellows conduct and attend many multi-disciplinary inter departmental meets with departments of pediatrics, medical genetics, pediatric neurology and pediatric surgery departments.  Case to case discussion (if required) of any multiple pediatric sub-speciality branches is first done with the fellow before a consultant review. Various difficult and interesting cases are discussed by referring physicians/surgeons in MDTs as we discuss questions related to diagnosis, differential diagnosis, resectability, further investigations, management and follow up of previous MDT cases.

Duty hours and emergencies/on call duties: Official duty hours are from 9am to 5pm. You however have to be in the department till 8-9 pm for academic work and for completing reporting, especially in CT and MRI postings.

There are 2-3 call duties (24 hour) per month along with one JR on call, to be done by the fellow.

Fees, salary and leaves:

Fees 50,000 INR (one time). There is a two-lakh bond which has to be paid to the institute if you leave the course mid-way.

Salary – approximately 1,25,000 INR including HRA.

Leaves – 24 casual leaves are given to fellows in an academic year.

Accommodation provided or not: Accommodation is provided on the basis of availability; married candidates are preferred. If you live in the AIIMS campus hostel, HRA of ~12,000 INR will be deducted from the salary per month. Accommodation is not an issue even if hostel rooms are not available, with many furnished flats/PG’s are available within 2-3 km radius of AIIMS.

Tips on how to secure the fellowship: The notifications for entrance examinations are put on the AIIMS Jodhpur website https://www.aiimsjodhpur.edu.in/courses.php.

The entrance exam is a two-step process. The first step comprises of a written MCQ based test of 80 marks which is followed by a viva/interview (20 marks). Total 80 questions are asked in written MCQ exam, with almost 50 % questions from pediatric radiology including all systems and 50 % from general radiology. The MCQ books which were helpful to me were Grainger and Allison MCQ and Get through final FRCR part A MCQ books.

When do the interviews/exams happen: Exam occurs in the month of July/ August every year. MCQ exam and interview usually occur on the same day. Written exam takes place in morning (duration 1.5 hours), following which the exam result is displayed and candidates are shortlisted for an interview in ratio of 1:6 as per vacancy. The final result is displayed on the AIIMS Jodhpur official site after approximately 15 days of the exam.

Pros and cons:

Pros-   The foremost pro about doing pediatric radiology fellowship is that very few people have excelled in this subspeciality which gives you an edge over a general radiologist.  With this fellowship, you keep in touch with the general radiology as all the systems are dealt with on a daily basis. The working environment in the institute is very supportive and at the same time encouraging by being better at what you’re already good at. All the teachers are pioneers in their fields and are excellent at teaching also. All the difficult cases and interdepartmental cases are discussed with them thoroughly and every day is a learning experience. In addition to getting an additional qualification, you will also get one year teaching experience in an educational institute as a senior resident.

Since the fellowship has been evolving, the fellows junior to me have had the opportunity to learn the basics of pediatric echocardiography with increasing focus on antenatal anomaly scans and fetal MRI with postnatal MRI correlation whenever feasible. 

Cons- It is purely a diagnostic fellowship; there is negligible vascular interventional exposure. Every fellow has to do general reporting also in addition to the subspecialty fellowship related work. 

Your personal experience at the fellowship: My personal experience in AIIMS jodhpur has been a life changing experience. A “just here to get an additional degree” mind was moulded into a mind which now has hunger for knowledge. Work experience at a premier institute is, in my opinion, essential for everyone who is working in this field because it makes you realise the importance of the work a radiologist is doing and makes you realise it’s a field where it’s not just about making money but reaching a differential diagnosis, making a difficult diagnosis and finally feeling that adrenaline high when your diagnosis helps a patient get better.

Any additional comments/ does it add value over MD /DNB degree: It surely adds immense value to my curriculum vitae as I want to pursue the academic field. The everyday knowledge I gained at the institute from consultants, colleagues and juniors during my fellowship is invaluable in my day to day practice today. I am a better diagnostic radiologist with additional experience in pediatric radiology and more aware of the clinical aspects of radiology, the credit for which goes to my fellowship at AIIMS Jodhpur.

Dr Siddhi Chawla

MBBS, MD, DNB, Fellow Pediatric Radiology, AIIMS Jodhpur

Assistant professor,

Sardar Patel Medical College, Bikaner, Rajasthan

You can contact me for further information on my email id –siddhi.chawla870@gmail.com.