Curriculum

NBEMS Diploma

Radio Diagnosis
Objectives of The Programme

Teaching and Training Activities

Syllabus

Competencies

Posting

Log Book

Recommended Textbooks and Journals

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Curriculum for NBEMS Diploma in Radio Diagnosis PAGE 2 OF 15

 INDEX
S. No Contents Page No.

I Objectives of The Programme 5

II Teaching and Training Activities 6

III Syllabus 7

IV Competencies 9

V Posting 10

VI Log Book 13

VII Recommended Textbooks and Journals 13

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 I. OBJECTIVES OF THE PROGRAMME

1. Programme Goal
• To make the trainee understand & implement the knowledge regarding the
role of various imaging modalities, helpful in the management of different
clinical conditions. At the end of his/her training, he/she should be capable of
provide high quality health care and take up a career in radiology at a
diagnostic centre, district hospitals, etc.
• Aimed at imparting training in both conventional radiology and modern
imaging techniques so that the candidate is fully competent to practice, in the
broad discipline of radiology including ultrasound, and Computed
Tomography. Candidate should be well versed with medical ethics,
consumer protection act and the Pre Conception and Prenatal Diagnostic
Technique (PC-PNDT) Act.
• To orient and train student in various aspects of diagnosis.
• Ultimate goal will be to provide quality education for the post graduates and
quality diagnostic care for different sections of the society.

2. Programme Objectives
• Demonstrate understanding of basic sciences relevant to Radiology.
• Acquire basic knowledge in the various sub-specialties of Radiology such as
Chest Radiology, Neuro-Radiology, GI-Radiology, GU-radiology, obstetric
and Gynaecological cardio- vascular- Radiology, musculoskeletal,
Interventional Radiology, emergency Radiology, and Paediatric Radiology.
• Independently conduct and interpret all routine and special radiologic
procedures and imaging investigations.
• Provide radiological services in acute emergency and trauma including its
medico- legal aspects.
• Understand indications, diagnostic features and limitations of applications of
conventional radiology, ultrasound and computed tomography for
management of common problems including emergencies, in adults and
children.
• Recognize conditions that may be outside the area of specialty/competence
and to refer them to proper specialist or ask for help.
• Update oneself by self-study and by attending courses, seminars, conferences
and workshop which are relevant to the field of Radio-Diagnosis.
• Provide basic lifesaving support service in emergency situations.
• Undertake complete patient monitoring including the care of the patient.
• Interact with other specialists for the maximum patient benefit

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 • Capable of undertaking further sub-specialization in the field of Radiology
• To conduct teaching program for undergraduate medical students,
paramedical and technical staff.
• Should be able to understand proper cost effective algorithm of various
imaging techniques in a given problem setting.
• To develop communication skills to write report and professional opinion as
well as to interact with patient, care giver, peers and paramedical staff.
• Adopt ethical principles in all aspects of his/her practice. Professional honesty
and integrity to be fostered.
• Be humble and accept the limitations of his/her knowledge and skills and to
ask for help from colleagues/ seniors when needed.
• Respect patient rights and privileges including patient’s right to information
and right to seek a second opinion.

II. TEACHING AND TRAINING ACTIVITIES

In addition to conducting and reporting of routine and special investigation in the area
of posting under direct supervision, formal teaching sessions to be held on working
days. These include seminars in physics and general radiology, journal clubs, case
presentations; Interdepartmental meets, Film reading sessions etc.

The suggested departmental teaching schedule is as follows:

• Film Reading
• Case presentation
• Journal club
• Inter department meet
• Seminars
• Statistical meetings: Weekly/ monthly
• Mortality meetings
Note:

• All sessions will be co-ordinated by the faculty members.

• All the teaching sessions to be assessed by the consultants at the end of session
and graded
• Attendance of the Residents at various sessions should be at least 75%
The training program would focus on knowledge, skills and attitudes (behaviour) and
all essential components of education. It is being divided into theory, clinical and
practical in all aspects of the delivery of health care.

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III. SYLLABUS

1. Physics related to Radio diagnosis

• Introduction to general properties of radiation and matter. Fundamental of
nuclear physics and radioactivity.
• Production of x-ray
• X-ray generators
• Interaction of x-rays and gamma rays with matter and their effects on
irradiated materials.
• Measurement of x and gamma rays
• Interaction of x-rays with the patients
• Radiographic image
• The image receptor
• Radiation protection & Radiation hazard
• Picture archiving and communication system (PACS) and Radiology
Information system (RIS)
• Image quality and quality assurance Screen film radiography
• Screen Film Radiography
• Computed Radiography, Digital Radiography.
• Computed tomography
• Principles of diagnostic ultrasound and Doppler
• Contrast media & contrast reactions - Contrast media, their type, formulation,
mechanisms of action, dose schedule, routes of administration, adverse
reactions, their management and recent developments.
• Quality Assurance
• MRI principles and physics,

2. Radiography and Processing techniques

• Dark room technique
• Radiography of the Musculoskeletal system and extremities
• Radiography of the spine, abdomen, pelvic girdle and thorax
• Radiography of the skull, orbit and sinuses.
• Contrast techniques of GI tract, biliary tract.
• Contrast techniques and interpretation of the genito-urinary system including
Gynaecology.
• Paediatric Radiography including bone age
• Dental, portable and emergency radiography

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 3. Anatomy
• Gross and cross sectional anatomy of all the body systems.

4. Pathology
• Gross morphology of pathologies condition of systemic disease

5. Principle and Practice of Radio Diagnosis

Imaging of various diseases involving the following systems with conventional
radiology, Ultrasound, Computed Tomography and Magnetic Resonance Imaging.

• Musculoskeletal System
• Respiratory System
• Cardio-vascular system
• Gastro-intestinal tract including Hepatobiliary system
• Urogenital tract.
• C.N.S. including spine
• Radiology of obstetrics and Gynaecology
• E.N.T, EYES, Teeth, soft tissue, Breast.
• Endocrine Glands
• Emergency radiology and trauma
Recent advances as applicable to Radiology

Clinical Epidemiology

Ethics in Medical Practice

Medico legal aspects relevant to Radiology including PC-PNDT Act.

Health Policy issues as may be applicable to the discipline

6. Practicals
Physics

• Effectiveness of Lead Apron and other protective Devices

• Quality control of X-rays and Imaging equipments
• Evaluation of performance of a film processing unit

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IV. COMPETENCIES:

1. Interpretation of images
2. Skill in performing a procedure.

1. Interpretation of images:
The student should be able to interpret images on all imaging modalities of diseases of
following organs:

• Musculoskeletal System - Interpretation of diseases of muscles, soft tissue,

bones and joints including congenital, inflammatory, traumatic, endocrine
and metabolic, neoplastic and miscellaneous conditions.
• Respiratory System - Interpretation of diseases of the chest wall, diaphragm,
pleura and airway; pulmonary infections, pulmonary vasculature; pulmonary
neoplasm; diffuse lung disease; mediastinal disease, chest trauma; post-
operative lung and X-ray in intensive care.
• Cardiovascular System - Interpretation of diseases and disorders of
cardiovascular system (congenital and acquired conditions including
ischemic heart diseases).
• Gastro-intestinal tract and hepato-biliary pancreatic system - Interpretation of
diseases and disorders of mouth, pharynx, salivary glands, oesophagus,
stomach, small intestine, large intestine, diseases of omentum, peritoneum
and mesentery: acute abdomen, abdominal trauma. Diseases and disorders of
liver, biliary system and pancreas.
• Urogenital System - Interpretation of various diseases and disorders of
genitorurinary system. These include: congenital, inflammatory, traumatic,
neoplastic, calculus disease and miscellaneous conditions.
• Central Nervous System (C.N.S.) - Interpretation of diseases and disorders of
the head, neck and spine covering, congenital, infective, vascular, traumatic
neoplastic degeneration metabolic and miscellaneous condition.
• Imaging in Obstetrics and Gynaecology.
• Imaging of Breast
• ENT, EYE and Dental Imaging.
• Imaging of endocrine glands and those involved with metabolic diseases.
• Paediatric Radiology.
• Imaging in Emergency Medicine.

2. Skills in performing a procedure:

The student should be able to perform the following procedures:

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 • Radiography: should be able to independently perform radiography of
common and some important uncommon views of different body parts. This
includes positioning, centring of X ray beam, setting of exposure parameters,
exposing and developing the films. The student should be familiar with
conventional radiography and also with CR and DR systems.
• GIT contrast studies: Barium studies (swallow, upper GI, Follow through,
enema); fistulogram, sialogram, cologram/ileostogram,
• GU: Excretory urography, MCU, RGU, nephrostogram, genitogram
• Ultrasound: The student should be able to perform and interpret all
Ultrasound studies. These studies include: abdomen, pelvis, small parts,
neonatal head, breast, Colour Doppler imaging (arterial and venous studies),
obstetrics/gynaecology and intervention procedures using ultrasound
guidance.
• CT Scan:
i. Select CT protocol according to the clinical diagnosis.
ii. Do reconstruction of images, perform triple phase study, perform &
interpret advanced applications like CT enterography, CT
angiography etc.
iii. Demonstrate knowledge of the CT finding of the common pathological
conditions.
iv. Interpret conventional and modified body CT examinations.
v. Know limitations of CT in the diagnosis of certain diseases.
vi. Perform CT guided simple interventions (under supervision)
• Interventional Radiology: The student should be able to perform simple,
common non- vascular procedures under ultrasound and fluoroscopy
guidance e.g. FNAC, FNAB, abscess drainage, drainage catheter placement,
nephrostomy, biliary drainage etc.

V. POSTING
The postgraduate student should be posted in all sections (Conventional radiology, U/S,
CT, etc.) so that there is adequate exposure to all modalities. The proposed duration of
postings is as under.

• Conventional Radiology 6months

• Ultrasound, Colour Doppler &
• US guided interventions 6months
• CT & CT guided interventions 6months
• Special. Investigations & contrast studies 2 months
• Emergency Radiology 2 months
• Elective posting 2 months

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 Institutions where MRI is available, candidate will work in MRI for two months elective
posting.

Institutions where MRI is not available, it is desired that candidate may be sent other
institute for MRI, mammography and Interventional radiology training in place of 2
months elective posting.

1. SCHEDULE FOR ROTATION OF RESIDENTS

Conventional
Conventional Contrast studies
Contrast
skull, spine, US and GIT and other US and
Chest and studies -
Doppler fluoroscopicinve Doppler
abdomen musculo- [Link]
stigations
1st skeletaletc

Year US and Conventional

skull, spine , CT US and Emergency CT
interventions musculoskel interventions
etaletc.
Conventional: CT and
Chest and Elective CT US and Doppler Emergency Intervent
abdomen ions
2nd

Year Conventional: Conventional CT & US and

Musculo- CT &
Chest and elective Interventio Intervent
skeletal, Interventions
abdomen ns ions
mammography

2. Radiological Procedure which the candidates must know

S As As first Independently under
Name of Procedure
No. Observer assistant supervision

1 Dark room(each step) 10 10 20

CXR, PA, AP & Lateral

2 view Apicogram, 20 20 50
Decubitus

3 Extremities & spine 30 30 50

4 Skull& PNS 30 30 50

5 Fluroscopy 20 20 20

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 Barium Studies – Swallow,
6 10 10 50
UGI BMFT &B enema

7 IVP, MCU, RGU, HSG 10 10 50

8 Drainage procedures 10 10 50

9 Biopsy / FNAC 10 10 50

Doppler Examinations
10 (obstetric and non 50 100 100
obstretic)

11 TRUS, TVS 50 50 100

12 Obstetric Ultrasound 50 50 200

13 Non obstetric ultrasound 50 50 400

14 Neonatal cranial USG 10 20 20

15 CT SCAN 20 20 200

16 CT guided procedures 20 20 -

3. Radiological procedures which the candidates may know/desirable

CT enterocyclysis

Barium Enteroclysis

CT Angiography

Sonourethrography

Bowel Ultrasound, Musculoskeletal ultrasound

USG contrast

Tube based procedures- Nephrostogram, T tube Cholangiogram, Sinogram,

Fistulogram

ERCP, PTC, Arterigraphy/Venography, CT cistenography, CT Mylography,

Myelogram, CT Angiogram/ Venogram

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VI. LOG BOOK
A candidate shall maintain a log book of operations (assisted / performed) during the
training period, certified by the concerned post graduate teacher / Head of the
department / senior consultant.

This log book shall be made available to the board of examiners for their perusalat the
time of the final examination.

The log book should show evidence that the before mentioned subjects were covered
(with dates and the name of teacher(s) The candidate will maintain there cord of all
academic activities undertaken by him/her in log book.

• Personal profile of the candidate

• Educational qualification/Professional data
• Record of case histories
• Procedures learnt
• Record of case Demonstration/Presentations
• Every candidate, at the time of practical examination, will be required to
produce performance record (log book) containing details of the work done
by him/her during the entire period of training as per requirements of the
logbook. It should be duly certified by the supervisor as work done by the
candidate and countersigned by the administrative Head of the Institution.
• In the absence of production of log book, the result will not be declared.

VII. RECOMMENDED TEXTBOOKS AND JOURNALS

1. Must Read
• Text Book of Radiology and imaging - David sutton
• Grainger & Allison's Text book of Diagnostic Radiology (Churchill
Livingstone)
• AIIMS-MAMC-PGI’s Comprehensive Textbook of Diagnostic Radiology,
Volumes 1, 2, 3
• Diagnostic ultrasound - Carol C. Rumack
• Callen: Ultrasonography in obstetrics and gynaecology
• CT and MRI of the whole body- John R. Haaga

2. Reference Books
• Textbook of Gastrointestinal Radiology- Gore and Levine (Saunders)
• Caffey's Paediatric Radiology
• Diagnosis of Diseases of the Chest -Fraser

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 • Diagnostic Imaging Series: (Amirsys, Elsevier)
• Margulis: Alimentary tract radiology volume I & II
• Davidson’s: Radiology of the kidney and Genito-urinary tract
• Clark: Positioning in radiology Dahnert: Radiology Review Manual
• Webb: High Resolution CT of the lung
• Som and Curtin: Head and neck imaging

3. Journals
• Indian Journal of Radiology and Imaging
• Radiological Clinics of North America
• Seminars in U/S, CT and MRI
• American Journal of Neuro-Radiology
• Clinical Radiology
• Radiology
• Radiographics
• Neuro Radiology
• American Journal of Roentagenology
• Seminars in Roentgenology

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