THE HOSPITAL FOR
SICK CHILDREN
General Pediatric Radiology Fellowship – CanMeds Goals and Objectives
DEFINITION OF GENERAL PEDIATRIC RADIOLOGY
General pediatric radiology is the organ/system-based subspecialty of Diagnostic
Radiology dedicated to diagnosis of disorders and diseases in children utilizing different
imaging techniques.
TRAINING YEAR SPECIFIC OBJECTIVES
1) Medical Expert:
1.1) Involved with the daily review/interpretation of pediatric imaging examinations.
1.2) Involved with a variety of imaging techniques and pathologies specific to the
investigation of pediatric diseases of neck, chest, abdomen, musculoskeletal
system, vascular system, and neonatal brain.
1.2.1) Techniques and methods in pediatric imaging:
1.2.1.1)
Sedation.
1.2.1.2)
Risk factors – contrast agents, radiation.
1.2.1.3)
Ultrasonography of the neonatal brain.
1.2.1.4)
Ultrasonography of the neonatal and pediatric neck, chest,
abdomen, pelvis, musculoskeletal system, and vascular
system.
1.2.1.5)
Fluoroscopic studies of the neonatal and pediatric patient.
1.2.1.6)
CT and MRI of the neck, chest, abdomen, pelvis, and
musculoskeletal systems, with sequences adapted to the
pediatric patient.
1.2.1.7)
Imaging protocols adapted to the neonate, young child and
older child.
1.2.1.8)
Advanced imaging techniques applied to pediatric
diseases.
1.2.2) The neonatal and infant brain:
1.2.2.1)
Normal development in prematures and infants.
1.2.2.2)
Hypoxic ischemic encephalopathy.
1.2.2.3)
Neonatal intracranial hemorrhage.
1.2.2.4)
Congenital anomalies of the brain.
1.2.3) Skeletal and visceral manifestations of non-accidental trauma
1.2.4) Genetic syndromes in children:
1.2.4.1)
Neurofibromatosis 1.
1.2.4.2)
Tuberous sclerosis complex.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
Revised: August 21, 2007
Page 1 of 4
1.2.4.3)
Beckwith-Wiedemann syndrome and hemihypertrophy
syndromes.
1.2.4.4)
Osteochondrodysplasias.
1.2.4.5)
Cystic fibrosis.
1.2.4.6)
Chromosomal aberrations.
1.2.5) Trauma in children:
1.2.5.1)
Bony and visceral trauma in infants, including nonaccidental trauma.
1.2.5.2)
Bony and visceral trauma in children.
1.2.6) Tumors:
1.2.6.1)
Tumors of the face, skull and base.
1.2.6.2)
Tumors of the neck.
1.2.6.3)
Tumors of the chest.
1.2.6.4)
Tumors of the abdomen and pelvis.
1.2.6.5)
Tumors of the musculoskeletal system.
1.2.7) Infections:
1.2.7.1)
Intracranial infections in neonates.
1.2.7.2)
Infections of the neck.
1.2.7.3)
Infections of the chest, abdomen, pelvis and
musculoskeletal system.
1.2.8) Vascular disorders in children:
1.2.8.1)
Stroke.
1.2.8.2)
Thrombosis of the venous and arterial systems.
1.2.8.3)
Arterial and venous diseases.
1.2.8.4)
Vascular malformations.
1.2.9) Pediatric genitourinary system:
1.2.9.1)
Congenital malformations of kidney, bladder, genital tract,
and pelvis.
1.2.9.2)
Vesicoureteric reflux.
1.2.9.3)
Hydronephrosis.
1.2.9.4)
Tumors and infections of the genitourinary system.
1.2.10) Pediatric gastrointestinal tract
1.2.10.1) Congenital malformations, including malrotation and
atresias.
1.2.10.2) Inflammatory bowel disease.
1.2.10.3) Hirschprung disease and colonic atresia.
1.2.10.4) Pyloric stenosis.
1.2.10.5) Diagnosis and treatment of intussusception.
1.2.10.6) Appendicitis in children.
1.2.10.7) Gastroesophageal reflux.
1.2.10.8) Tumors of the gastrointestinal tract.
1.2.10.9) Pediatric swallowing disorders.
1.2.10.10) Trauma.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
Revised: August 21, 2007
Page 2 of 4
1.2.10.11) Placement of enteric feeding catheters.
1.2.10.12) Bowel obstruction in neonates, infants, young children and
older children.
1.3) Initially look at studies, provide a preliminary report and then review case
material with the attending radiologist daily.
1.4) Responsible to generate and sign off an official report for those cases after
staff review.
1.5) Responsible for arranging and interpreting emergency cases during the
workday.
1.6) Involved in the protocols for, and performance of, CT and MRI examinations;
performing ultrasound, radiographic and fluoroscopy studies.
1.7) Gain competence in evaluating appropriateness of examination requests and
make decisions as to the most appropriate imaging test for each situation.
1.8) Learn about availability of resources and the role of triage.
1.9) Act as a consultant and provide stat verbal reports for the clinicians.
1.10) Provide night and weekend on-call coverage for imaging cases, including
preliminary reports for emergent body studies (CTs, MRIs, ultrasounds,
fluoroscopic studies) after hours with the close supervision of attending staff.
Second call to the resident for neuroradiology CTs and MRIs.
1.11) For intussusception reduction, the trainee will be responsible for obtaining
informed consent prior to the procedure, performing the procedure under the
supervision of the attending radiologist and ensuring proper patient care post
procedure.
2) Communicator:
2.1) Trainees will be responsible for explaining the procedure to the patient/family,
including the risks and possible complications, and answering questions.
2.2) Will be responsible for generating clear, concise reports and for providing
verbal reports whenever necessary.
3) Collaborator:
3.1) Gain experience in reviewing pediatric cases brought to attention by clinicians
on a daily basis.
3.2) Use appropriate history to guide decisions regarding the best imaging
modality for a given clinical condition or issue.
3.3) Responsible for communicating with imaging technologists and nurses to
ensure optimal patient care.
4) Manager:
4.1) Gain experience in screening and protocoling of CTs and MRIs in the
pediatric context.
4.2) Learn how to prioritize studies.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
Revised: August 21, 2007
Page 3 of 4
4.3)
4.4)
Gain expertise in the proper steps in the imaging investigation of various
pediatric pathologies.
Become increasingly responsible for individual body imaging subsections,
including the proper delegation of authority to residents and technologists.
5) Health Advocate:
5.1) Gain expertise in guiding referring clinicians to the imaging study or studies
most appropriate for their patients.
5.2) Consider and advise on the benefits/risks of imaging procedures, in
consultation with referring doctors.
6) Scholar:
6.1) One academic day is assigned per week for trainees to pursue research
projects.
6.2) Research activity done at The Hospital for Sick Children.
6.3) Publish scientific papers.
6.4) Present work at local, national and international radiology meetings.
6.5) It is required that the resident prepare at least one manuscript for
presentation and/or publication. He/she will actively participate in the
teaching of radiology residents and residents from other clinical services.
6.6) Attend and present at various Sick Kids clinical rounds, including:
6.6.1.1) Oncology.
6.6.1.2) NICU.
6.6.1.3) General surgery.
6.6.1.4) Chest.
6.6.1.5) SCAN.
6.6.1.6) Interesting Case Rounds.
7) Professional:
7.1) Incorporate ethical practice, professional regulation and high personal
standards of behaviour.
The Hospital for Sick Children
555 University Ave, Toronto, Ontario
Canada M5G 1X8
www.sickkids.ca
Revised: August 21, 2007
Page 4 of 4