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Neuroradiology Objectives

Neuroradiology Rotation Specific Objectives

GENERAL OBJECTIVES:

Neurosurgery residents at the University of Toronto can spend 3 months or more on a neuroradiology rotation as part of their training. Neurosurgery residents usually undertake their neuroradiology training as intermediate level residents (PGY3- and -4) and can rotate to one of three different teaching hospitals within the University: Sunnybrook Health Sciences Centre, Toronto Western Hospital, and St Michael's Hospital.The following is a description of the rotation-specific objectives for neurosurgery residents undertaking their neuroradiology rotations as intermediate level residents: 

GOAL 
This rotation is designed to give neurosurgery residents the skills to review routine X-rays, CT scans, MRI scans and other diagnostic imaging techniques by one-on-one teaching with the Radiologists/Neuroradiologists, attendance at teaching rounds and self-directed study. 

DESCRIPTION 
The residents will be expected to participate in all daily activities involving review and reporting of neuroimaging cases along with staff and rotating radiology trainees. Residents will also participate in all rounds and teaching sessions planned by the neuroradiologists during the rotation. 
 

SPECIFIC OBJECTIVES:

MEDICAL EXPERT/CLINICAL DECISION MAKER

SKILLS

plain x-ray
angiograms
CT scan
MRI scan
SPECT scan
MR spectroscopy

KNOWLEDGE

The resident will be able to demonstrate knowledge concerning the appropriate diagnostic imaging techniques and imaging findings for most of the following clinical conditions/problems 

Skull

Congenital
Inflammatory (osteomyelitis)
Trauma (fractures)
Tumors (metastases, dermoid)

Spine

Congenital

absence or hypoplasia of the odontoid
os odontoideum
segmentation anomalies
Klippel-Feil anomaly
butterfly vertebrae
spinal dysraphism
diastematomyelia

Inflammatory

discitis
tuberculosis spondylitis

Neoplasms

aneurysmal bone cyst
osteoblastoma
osteoid osteoma
Langerhans cell histiocytosis of bone
metastases

Trauma

fractures/dislocations
atlanto-dens and atlanto-occipital injuries
spondylolysis/spondylolisthesis

Brain

Congenital

malformations of cortical development
lissencephaly
pachygyria
schizencephaly
heterotopic gray matter
polymicrogyria
focal cortical dysplasia
holoprosencephaly
anomalies of the corpus callosum
Dandy-Walker malformations
Chiari malformations
neurocutaneous syndromes
aqueductal stenosis

Inflammatory

bacterial infections ( including meningitis, cerebritis, and abscess)
tuberculosis infections
viral infections (encephalitis)
AIDS
Rasmussen's encephalitis
Acute disseminated encephalomyelitis

Neoplasms

medulloblastoma
ependymoma
brainstem glioma
astrocytoma
pineal region tumors
craniopharyngioma
astrocytoma
oligodendroglioma
PNET
choroid plexus tumors

Cerebral infarction/ischemia

cerebral injury (including shearing injuries and concussion)
subdural hematoma
epidural hematoma
subarachnoid hemorrhage

Metabolic brain disorders 

Leukodystrophies 

Mesial temporal sclerosis

Spinal Cord 

Congenital

myelomeningocele/meningocele
lipomyelomeningocele
diastematomyelia
tethered cord
dermal sinus
intradural lipoma
hydrosyringomyelia

Tumours

neurofibroma
astrocytoma
ependymoma
metastases

Inflammatory

ADEM
Leigh's disease
Transverse myelitis

 

COMMUNICATOR:

General Requirements

  • Be able to explain findings to patients, families, and other consultants.
  • Discuss appropriate information with patients/families and the health care team.

Specific Requirements

  • Obtain and synthesize relevant history from the examination request and be willing to acquire more information as required from the referring physician.
  • Communicate examination results effectively and in a timely fashion.
  • Show an understanding of the radiological findings and be able to explain them to patients, families, and consultants.

COLLABORATOR:

General Requirements

  • Be able to consult effectively with radiologists and technical staff regarding indications for diagnostic imaging, including appropriate history, physical and diagnostic considerations.
  • Contribute effectively to other interdisciplinary team activities especially neurosurgery.

Specific Requirements

  • Provide instruction to medical students and more junior physicians at a level appropriate to their clinical education and professional competence.
  • Willingly share knowledge with others with whom they are associated, thus ensuring the most effective delivery of health care to patients .

MANAGER:

General Requirements

  • Understand the indications and cost for various radiological procedures.
  • Demonstrate good time management skills.

Specific Requirements

  • Recognize that effective use of time depends upon punctuality.
  • Recognize that effective use of time requires planning.
  • Develop speed as well as accuracy in diagnostic imaging skills.
  • Reserve time for reading and keeping current with the neurosurgical and neuroradiological literature.
  • Establish routines for carrying out regular activities and adhere to them.

HEALTH ADVOCATE:

General Requirements

  • Identify the important determinants of health affecting patients.
  • Contribute effectively to improved health of patients and communities.
  • Recognize and respond to those issues where advocacy is appropriate.

Specific Requirements

  • Learn about community resources (e.g. diagnostic imaging facilities)
  • Understand the role of national and international bodies in the promotion of neurosurgical health, and the prevention, detection, and treatment of neurosurgical disorders.

SCHOLAR:

General Requirements

  • Develop, implement and monitor a personal continuing education strategy.
  • Critically appraise sources of medical information.
  • Facilitate learning of patients, house staff/students and other health professionals.

Specific Requirements

  • Be able to critically assess the neurosurgical and radiologic literature.
  • Participate in neuro-radiology academic activities.
  • Demonstrate a personal learning strategy and effective reading.

PROFESSIONAL:

General Requirements

  • Deliver highest quality care with integrity, honesty and compassion.
  • Exhibit appropriate personal and interpersonal professional behaviors.
  • Practice medicine ethically consistent with obligations of a physician.

Specific Requirements

  • Be willing to participate in case discussions concerning appropriate diagnostic and management procedures.
  • Be willing and able to appraise accurately his/her own professional performances and show that he/she recognizes his/her own limitations with regard to skill and knowledge by appropriately consulting other physicians and paramedical personnel when caring for the patient.
  • Be willing and able to keep his/her practice current through reading and other modes of continuing medical education and develop a habit of maintaining current his/her clinical skill and knowledge base through continuing medical education.