Neuroradiology Rotation Specific 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:
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.
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.
MEDICAL EXPERT/CLINICAL DECISION MAKER
- plain x-ray
- CT scan
- MRI scan
- SPECT scan
- MR spectroscopy
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
- Inflammatory (osteomyelitis)
- Trauma (fractures)
- Tumors (metastases, dermoid)
- absence or hypoplasia of the odontoid
- os odontoideum
- segmentation anomalies
- Klippel-Feil anomaly
- butterfly vertebrae
- spinal dysraphism
- tuberculosis spondylitis
- aneurysmal bone cyst
- osteoid osteoma
- Langerhans cell histiocytosis of bone
- atlanto-dens and atlanto-occipital injuries
- malformations of cortical development
- heterotopic gray matter
- focal cortical dysplasia
- anomalies of the corpus callosum
- Dandy-Walker malformations
- Chiari malformations
- neurocutaneous syndromes
- aqueductal stenosis
- bacterial infections ( including meningitis, cerebritis, and abscess)
- tuberculosis infections
- viral infections (encephalitis)
- Rasmussen's encephalitis
- Acute disseminated encephalomyelitis
- brainstem glioma
- pineal region tumors
- choroid plexus tumors
- cerebral injury (including shearing injuries and concussion)
- subdural hematoma
- epidural hematoma
- subarachnoid hemorrhage
Metabolic brain disorders
Mesial temporal sclerosis
- tethered cord
- dermal sinus
- intradural lipoma
- Leigh's disease
- Transverse myelitis
- Be able to explain findings to patients, families, and other consultants.
- Discuss appropriate information with patients/families and the health care team.
- 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.
- 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.
- 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 .
- Understand the indications and cost for various radiological procedures.
- Demonstrate good time management skills.
- 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.
- 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.
- 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.
- 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.
- Be able to critically assess the neurosurgical and radiologic literature.
- Participate in neuro-radiology academic activities.
- Demonstrate a personal learning strategy and effective reading.
- 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.
- 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.