TRANSITION TO RESIDENCY (TTR)
SELECTIVES (YEAR 4 MEDICAL STUDENT U OF T)
MEDICAL IMAGING SELECTIVES
About the TTR Course
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Making productive use of the end of the MD training period, TTR will be characterized by:
o less structured learning, in preparation for PGY1 where workplace learning is predominant;
o increasing responsibility for students' own work in clinical settings, commensurate with near-graduate status;
o self directed learning with respect to needs and to resources obtained to accomplish learning goals;
o learning goals which are integrative and holistic across multiple settings and experiences; and
o consolidation of learning that has occurred in different settings in previous years.
Students will learn content relating to the “real world” and “real work” of doctors - with direction to be provided through centralized learning in the two Central
Weeks, and consolidation provided through clinical experiences. (“Clinical” here is defined as any experiences in the real world of physician work, and not necessarily
restricted to experiences with patients.) Centrally produced content will be delivered in the two Central Weeks and students will be directed to look for opportunities
to apply it in each selective. Students will be directed to focus on understanding the community they are in, the associated resources, and how they can work there in
a socially responsible way.
Selectives have been developed with guidance from the central committee, but rely substantially on local resources and innovation in their actual delivery. Selectives
provide an environment for students to begin to work at a pre-PGY1 level, regardless of the content area of the Selective. Interdisciplinary content is to be
encouraged, both in terms of physician specialties, and in terms of interactions with other health care providers. The rationale for this is to encourage the students to
acquire/develop knowledge, skills and attitudes relevant to broad areas of future practice. Diversity of contexts means going beyond the usual sites for students’
clinical experience. Community sites (here defined as non-TAHSN associated sites) must comprise at least one of the Selectives. The Selectives catalogue was
produced through departmental contacts, the former ACE course particiants, and the Rural Ontario Medicine Program. Well-defined global health opportunities are
also eligible.
Students are expected to produce evidence of learning as assessed through diverse formats, in order to successfully complete this course. Assessment of students in
Selectives will be based upon their supervisors' observations of their work in the Selective environment; the other components of the students' assessments are
centrally administered. WEB SITE FOR MORE DETAILED INFORMATION
https://sites.google.com/a/kenlocke.org/faculty-development-for-transition-to-residency/
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SELECTIVES IN MEDICAL IMAGING
OBJECTIVES:
 Educate the medical student on the types of imaging modalities and their cost effective and safe utilization in diagnosing disease
 Teach the student the interpretation of basic imaging studies where appropriate to the residency program (Abdominal plain films , plain films of bone
, CXR, Brain CT)
TYPES OF MEDICAL IMAGING SELECTIVES:
The medical imaging specialty is not conducive to a full 6 week selective period, except in special residency programs where image interpretation could be an
important component of daily clinical work – i.e. Family Practice & Emergency Medicine
Medical Imaging (MI) is best suited to be an integral part of other Specialty Selective programs, such as orthopedic surgery residency, where a short term
exposure in medical imaging is sufficient to equip the medical student of nuances of medical imaging algorithms used and basic image interpretation skills.
The Medical Imaging SubSelective would be an integral part of the Selective being pursued by the student, hence the Clinical Portfolio, would include a MI
component to reflect the experience gained during the MI Sub Selective.
MI SELECTIVES:
Such selectives would be important for students entering following residency programs
- Family Practice
- Emergency Medicine
FORMAT:
- This would be a full 4 week to gain maximum learning
- Could be part of the Clinical specialty or a full 6 week selective in Medical Imaging
- There would be On-Line teaching tools, formal group seminars including a Pre and Post Selective test (to gauge knowledge prior to and that gained
post selective)
MI SUBSELECTIVES
Such SubSelective would be important for students entering following residency programs
- Orthopedics
- Anaesthesia/ICU/Respirology
- General Surgery
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- NeuroSurgery/ENT
- Pediatrics
- Cardiology/Thoracic surgery
FORMAT OF SUBSELECTIVES
- The sessions would be a minimum of 2 full week block to ensure maximum learning
- The Clinical Portfolio would include a Medical Imaging component related to the specialty (e.g. a presentation on Breast screening guidelines for
family practitioner)
TEACHING:
- On Line teaching tools will be used ( MI University of Toronto Portal site)
- Residency specific CPC Specialty and Radiology Resident weekly rounds
- Formal Interactive seminars (delivered by respective specialty radiologists)
o Specialty related and general radiology seminars
o With a minimum quorum of 5 students
EVALUATION:
- Using standardised evaluation objectives
- Full attendance of all sessions including participation in teaching rounds and Pre and Post Selective test
- Contributions to the On-Line Teaching Site
- Contributions into the Clinical Portfolio of the knowledge gained
- (due to short time period of the SubSelective, vacations will not be allowed, to ensure the Selective Objectives are fulfilled)
MEDICAL STUDENTS ENTERING RADIOLOGY RESIDENCY
- Such students should be encouraged not to take a SubSelective in medical imaging
- Should be encouraged to take on clinical specialties such as Pathology, and or clinical medicine to strengthen their clinical skills for their PGY1 year
- Last part of PGY1 year is spent in Medical Imaging (Physics)
Prepared by Dr Nasir Jaffer & Dr Robert Bleakney November 16, 2011
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SUBSELECTIVES IN MEDICAL IMAGING FOR TRANSITION TO RESIDENCY (TTR)
The following SubSelective in Medical Imaging will be offered
No
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TITILE OF PROPOSED MEDICAL IMAGING
SUBSELECTVES
IMAGING DIVISION (Most Responsible)
DEPARTMENT OF
PHYSICIAN OFFERING
EMERGENCY FILM READING, CHEST,
ABDOMEN, NEURO, MSK
JDMI (MSH,UHN,WCH)
Medical Imaging for Emergency Medicine
Medical Imaging for Family Practice.
NAME OF
RESPONSIBLE
PHYSICIAN
ST MICHAELS
SUNNYBROOK
EMERGENCY FILM READING, CHEST,
ABDOMEN, NEURO, MSK
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JDMI (MSH,UHN,WCH)
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
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Medical Imaging for General Surgery,
ABDOMEN
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
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Medical Imaging for Orthopedics,
Rheumatology, Rehab Medicine
MSK
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
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Medical Imaging for Thoracic Surgery/
Respirology / Anaesthesia
CHEST
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
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Medical Imaging for Obstetrics &
Gynaecology
ULTRASOUND, MRI, HIGH RISK US
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
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Medical Imaging for Neurology,
Neurosurgery.
NEURO
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
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Medical Imaging for Urology.
ABDOMEN
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Medical Imaging for Laboratory
Medicine
Medical Imaging for ENT
Interventional Radiology and All
Modalities Radiology
ST MICHAELS
SUNNYBROOK
JDMI (MSH,UHN,WCH)
ST MICHAELS
SUNNYBROOK
ENT
JDMI (MSH PMH)
(NOT OFFERED DURNG THE A1 PERIOD OF SELECTIVES )
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TRANSITION TO RESIDENCY SELECTIVES IN MEDICAL IMAGING
ORIENTATION FOR 4TH YEAR MED STUDENTS
DAY 1:
1. Register with respective Hospital (Academy) Medical Education Office
2. Orientation with JDMI Transition To Residency Supervisors – Dr Nasir Jaffer & Dr Robert (Bob) Bleakney
3. Teaching Sessions: (Radiology Residents to conduct the sessions if more than 5 Selectives students per site)
a. Whole group
i. Review of Approach to Chest CT, Abdomen CT (by residents)
ii. How to order Imaging studies
iii. How Imaging requests are protocolled
b. Self Review: On Line Teaching materials (On Portal)
i. Passwords same as UTORID
TRANSITION TO RESIDENCY MEDICAL IMAGING SLECTIVES
SEMINAR SERIES
INTRODUCTION TO REVIEWING IMAGING STUDIES
A 60-90 minute session' An Approach to CT Chest and Approach to CT Abdomen
The Objective:
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Teach” How you review a normal CT scans of the Chest and Abdomen (using PACS).
Discuss the importance of adequate history for triaging imaging studies
Review the various protocols used for Chest and Abdomen CT Imaging
a. Using examples of cases
i. Abdomen: Appendicitis, Diverticulitis, Ischemia, Bowel Obstruction, renal colic
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ii. Chest: Pulmonary Embolism , Aortic dissection, High resolution CT
The Format:
Using the PACS, review a normal CT of abdomen, and briefly teaching why we use different window level to look at different organs etc (find cases for you from
our PACS
Discuss the importance of history required for us to protocol and report the studies appropriately
The Venue: MSH Radiology seminar room (already booked from 8-10am on
March 5 2012)
Start Time : 830am
OTHER TEQCHING MATERIALS ON “APPROACH TO REVIEWING IMAGING STUDIES:
(posted on our Undergraduate Medical Imaging Web site)
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CT of Brain (Narrated)
Approach to CXR (narrated)
Approach to COPD
Approach to Plain films of Abdomen
DAY 2 ONWARDS
c. Rotation with Technologists – CT , MRI and Ultrasound (half day)
d. Multidisciplinary Rounds
i. Teaching rounds held in specific residency programs
1. List of various rounds will be provided
4.
Rotations on Specific Divisions in Medical Imaging
a. Schedule devised to fit your objectives outlined/Choice of residency program
5.
Mid Rotation review/feedback
a. Meeting to discuss:
i. the students feedback
ii. requests for changes in rotation schedules
Final feedback
a. Meeting to discuss final feedback
b. Hand in Selectives Logbooks
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SUBSELECTIVE IN MEDICAL IMAGING: TTR STUDENT ACTIVITIES
SUBSELECTIVE OBJECTIVE
OBJECTIVE IMPLEMENTATION
1.
DAILY ACTIVITIES
SELF STUDY TEACHING
ORGANISED TEACHING:
SEMINARS
STUDENT CONTRIBUTIONS
(OPTIONAL)
STUDENT EVALUATION
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Observe the respective Division Film review and reporting
sessions.
Interact with Medical Imaging Residents during their film review
Observe (and participate where appropriate) medical imaging
procedures (interventional, biopsies etc)
Review assigned teaching files in the respective area:
1. On University of Toronto Medical Imaging Portal web site.
2. Current studies on PACs (prior to review with resident/staff
radiologist)
3. Review a Pre-set of teaching files (using PACS) covering wide
range of diseases
Group Seminars for all Medical Imaging SubSelective TTR students on:
1. General topics such as radiation in imaging studies
2. Utility and appropriateness guidelines for medical imaging tests,
3. Approach to interpretation of imaging studies
Assigned to contribute:
1. Teaching material to current On-Line and pre-set Teaching files
2. Prepare presentations on assigned topics to peers (optional)
Evaluation to consist of
1. Log of daily activities
2. Most responsible radiologist to submit final evaluation
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ASSIGNED ROTATIONS FOR SELECTIVES STUDENTS (3 WEEK ROTATION)
TRANSITION TO RESIDENCY MEDICAL IMAGING SELECTIVES –
week MARCH 12
Monday
Tuesday
Wednesday
STUDENT A
STUDENT B
STUDENT C
STUDENT D
STUDENT E
STUDENT F
week 2
STUDENT A
STUDENT B
STUDENT C
STUDENT D
STUDENT E
STUDENT F
WEEK 3
STUDENT A
STUDENT B
STUDENT C
STUDENT D
STUDENT E
STUDENT F
RESIDENTS ON
SERVICE
MSH CHEST
MSH CHEST
MSH MSK
Thursday
MSH
MAMMO/ABD
Friday
TGH CHEST
MSH ABD
MSH US
TWH MSK
MSK MSK
Monday
TGH CHEST
MSH ABD
MSH US
TWH MSK
TGH ABD
Tuesday
TGH ABD
MSH US
MSH CHEST
TWH MSK
TGH ABD
Wednesday
TGH ABD
MSH US
MSH CHEST
TWH US
TGH US
Thursday
TGH US
MSH CHEST
MSH MSK
TWH US
MSH MAMMO
Friday
MSH ABD
MSH CHEST
MSH CT/MRI
PMH CT /MRI
TWH NEURO
MSH MSK
TWH NEURO
MSH MSK
TGH CHEST
MSH CHEST
MSH MSK
TGH US/ABD
WCH US
MSH CHEST
TGH US/ABD
WCH US
MSH CHEST
MSH US
Monday
TGH CT/US
SINAI MRI/CT
TWH MRI/US
TGH GEN
RAD/CT
Tuesday
MSH US/GEN RAD
TGH US /GEN RAD
TGH GEN
RAD/MRI
MSH GEN RAD/US
TWH CT/GEN RAD
TGH MRI/US
Wednesday
MSH ABD
Thursday
MSH ABD
Friday
MSH VIR
TWH NEURO
MSH CHEST
MSH VIR
MSH ABD
TGH US/ABD
TWH NEURO
MSH ABD
MSH HYDRO
MSH ABD/NUC
TGH CHEST
TWH ABD
MSH MURRAY ST
MSH US
MSH VIR
TGH CARDIAC
TGH VIR
sinai msk
MSH MSK
MSH MSK
MSHNUC/ABD
TGH VIR
tgh chest pf
MSH ABD/NUC
MSH MSK
TGH CHEST
TGH VIR
TGH CARDIAC
MSH NUC/ABD
MSH ABD
MSH ABD
sinai msk resident ()
western msk resident
()
twh neuro residents ()
twh body resident (
sinai chest resident ()
tgh chest ()
same residents as
week before
twh neuro residents
twh body
sinai msk resident
twh msk residents )
sinai chest resident (
Cardic Radiologist:- Dr
Andrew Crean
YELLLOW HIGHLIGHTED SESSION WITH TECHNOLOGISTS IN THE IMAGING ROOMS
LEGENDS
MSH = MOUNT SINAI HOSPITAL 5TH FLOOR
TWH =TORONTO WESTERN HOSPITAL 3RD FLOOR
TGH= TORONTO GENERAL HOSPITAL MAIN FLOOR LEFT OF TIM HORTONS
PMH = PRINCESS MARGARET HOSPITAL - 3RD FLOOR
WCH = WOMEN'S COLLEGE HOSPITAL 3RD FLOOR
LEGENDS FOR ROTATIONS:
ABD = GI AND ABDOMEN CT
MSK = MUSCULOSKELETAL
VIR = VASCULAR INTERVENTIONAL
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US = ULTRASOUND
MAMMO = MAMMOGRAPHY
NEURO = NEURORADIOLOGY
NUC = NUCLEAR MEDICINE
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