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Pediatric

Dr. Oscar Navarro
Pediatric Radiology Program Director

The Clinical Fellowship Program in the Department of Diagnostic Imaging at The Hospital for Sick Children provides training for those radiologists interested in pursuing a career in pediatric imaging. The candidates must have already completed a four-year training in a diagnostic radiology residency program or must be board-certified as radiologists in their country of origin. The program is within one of the largest and busiest pediatric radiology departments in the world, performing approximately 130,000 examinations per year, allowing exposure to practically the entire spectrum of normal and pathologic imaging findings one can encounter in pediatric practice. The Clinical Fellowship Program is open to both national and international applicants and in fact in January 2017 we had fellows from Canada, Mexico, Chile, Brazil, Ireland, Turkey, Egypt, D. R. Congo, Saudi Arabia, Qatar, India, South Korea, and New Zealand.

The Clinical Fellowship Program in our Department is part of the Fellowship Program of the Department of Medical Imaging of the University of Toronto. Our Department offers fellowships in Pediatric General Radiology, Pediatric Neuroradiology, Pediatric Interventional Radiology, Pediatric Cardiac Imaging and Pediatric Nuclear Medicine. We have a variable number of funded and self-funded positions available, starting in July and sometimes also in January of each year. The funded positions are paid for by our Department whereas the funding of the self-funded positions should be arranged by the candidate either through international grants or sponsoring institutions in their home countries.

There is flexibility in the duration of the fellowships. Interested candidates may apply to one-year, 18-month or two-year programs depending on the particular needs of the applicant or of the institution that is sponsoring the candidate. At the time of the application, the candidate can apply to more than one fellowship program, for example, one year of Pediatric General Radiology and one year of Pediatric Neuroradiology. However, each application is treated separately by the Fellowship Committee and, therefore, we cannot guarantee that the candidate will be accepted in all of the requested fellowships. In many occasions the decision regarding acceptance for a second year may be delayed until the subsequent application process.

The Pediatric General Radiology fellowship includes rotations in the following areas: plain radiographs (including in-patient studies from the pediatric and surgical wards and from the neonatal and pediatric intensive care units, as well as outpatient and emergency room examinations), fluoroscopy (gastrointestinal/ genitourinary), ultrasound (including neuro-sonography), body CT, body MR imaging (chest, abdomen and musculo-skeletal), neuroradiology (including CT and MR imaging), and nuclear medicine.

Our training program in Pediatric General Radiology is currently accredited by the Royal College of Physicians and Surgeons of Canada as a one-year Pediatric Radiology Residency Program. This means that those trainees that have completed a diagnostic radiology residency program in Canada and/or are certified by the Royal College of Physicians and Surgeons of Canada in Diagnostic Radiology and enter our program in Pediatric General Radiology will be recognized as PGY6 pediatric radiology residents. These trainees may be eligible for certification with examination in Pediatric Radiology by the Royal College of Physicians and Surgeons of Canada following successful completion of our program.

The clinical fellowship in Pediatric Neuroradiology provides training in diagnostic pediatric neuroradiology, including CT and MR imaging of the brain, neck and spine, and covers a wide range of congenital and acquired conditions. Fellows gain competence in protocoling, monitoring and reporting CT and MR imaging studies from the fetus through to the age of 18 years including premature infants. Fellows are actively involved in the presentation of clinical case rounds, in the preparation of lectures, scientific presentations and educational exhibits, and in clinical research. Fellows become part of the neuroradiology team with active interactions with many clinical services especially Neurosurgery, Neurology and Otolaryngology/Head & Neck Surgery.

The clinical fellowship in Pediatric Interventional Radiology provides training for those radiologists interested in pursuing a career in image-guided pediatric interventions. Our Division of Pediatric Interventional Radiology is one of the largest and busiest in the world, performing a wide variety of procedures, including but not limited to central venous access, biopsies, gastrointestinal access, management of post-surgical and post-transplant complications, angiography, and management of vascular anomalies. Fellows are exposed and actively take part in numerous procedures under the supervision of staff interventional radiologists and it is expected that at the end of the fellowship they will be the main operators in the majority of interventions. Fellows are also actively involved in morning huddles, clinical rounds, clinic consults and post-procedure patient management.

The clinical fellowship in Pediatric Cardiac Imaging provides training in MR, CT and plain chest radiography in children with congenital or acquired cardiovascular disease. The program is a combined program for radiology and cardiology fellows. Fellows gain competence in designing, protocoling, monitoring, post-processing and reporting MR and CT imaging studies as well as plain chest radiographs. Importantly, the program is set in such a way that fellows work closely together with technologists to acquire basic knowledge and skills on MR and CT scanning. In addition, radiology-based fellows learn basic cardiology concepts through daily interaction with colleague cardiology-based fellows. Fellows are also provided with ample opportunities to participate in clinical discussions and rounds, to attend a number of lectures organized by the Department of Diagnostic Imaging and the Division of Cardiology, Department of Pediatrics. Fellows are actively involved in research projects and presentations at scientific meetings.

The clinical fellowship in Pediatric Nuclear Medicine provides training for board-certified nuclear medicine physicians or radiologists that are interested in pediatric nuclear medicine. The program enables fellows to learn a wide variety of nuclear medicine imaging techniques and procedures in children including PET/CT and SPECT imaging as well as radionuclide therapy such as radioiodine therapy for thyroid cancer. Upon completion of training, the fellow is expected to be competent in performing and interpreting common pediatric nuclear medicine examinations. Fellows are actively involved in teaching and clinical rounds and must pursue at least one research project during their fellowship training.

Fellows are trained and evaluated in all aspects of the CanMEDS competency framework (medical expert, communication, collaboration, health advocacy, leader, scholar and professional roles). Fellows gain competence through a process of graded responsibility by which they take on increased responsibility as they acquire greater experience under ongoing supervision of staff radiologists. This is supplemented by daily teaching sessions in all areas of pediatric imaging, participation in clinical rounds, and presentation at quality assurance rounds and journal club. Fellows are also expected to cover MR imaging evening shifts and to take night and weekend call on a rotating basis with the other fellows. As the fellows gain more familiarity with pediatric imaging and with the department, they are put in a more supervisory role over diagnostic radiology residents who are performing “in house” call during their pediatric imaging rotation in our hospital. Fellows are expected to reach the level of junior staff colleagues before they leave the department.

Protected academic time is provided to the fellows so they can work in research projects and prepare presentations during the year. The fellows are supported in all academic activities and in the past this has led to numerous presentations at national and international pediatric imaging meetings as well as to the publication of many papers, chapters, and even books. Fellows are expected to be productive and in fact the Department of Medical Imaging of the University of Toronto requires production of at least one original research article per year of fellowship in order to issue a certificate of completion of fellowship.

Paid vacation is 20 working days per fellow, per year. Additional time is provided to all fellows to attend conferences and/or courses. Some funding is available for travel and accommodation to one conference for each year of fellowship dependent on the evaluation of the progress of research of each fellow.

Applications

The application process starts about two years before the start date of the fellowship. For fellowships starting in July 2019, the application process will be opened on May 15, 2017 and will close on July 31, 2017. The application process to all of the fellowship programs (Pediatric General Radiology, Pediatric Interventional Radiology, Pediatric Neuroradiology, Pediatric Cardiac Imaging and Pediatric Nuclear Medicine) is similar, including funded and self-funded positions.

In the application form there is updated information regarding available funded and self-funded fellowship positions at the time of the application. A completed application form, curriculum vitae, statement letter and three recent reference letters should be submitted before the deadline. All reference letters should be dated and addressed to Dr. Oscar Navarro, Pediatric Radiology Program Director. In the preparation of the curriculum vitae, the candidate should list all published abstracts and publications following standard format:

Costa D, Hazard E, Courtois T. Effect of high intensity sport activities in the metaphyses of long bones in prepubescent children. J Pediatr Sports Med 2016; 115:731-738.

The candidate’s name should be in bold font. Always use the standard abbreviation of a journal’s name according to the ISSN List of Title Word Abbreviations (see ISSN.org LTWA).

Candidates can apply to two different fellowships (i.e. Pediatric General Radiology and Pediatric Neuroradiology, etc) using one single form. The Fellowship Committee will review all applications within a few weeks after the deadline and will select a small number of candidates that will be called for an interview. An interview in person at our hospital is preferable as allows a better interaction between the candidate and the members of the Fellowship Committee. This visit is also extremely useful for the candidates as they can meet with other staff members and fellows within the department as well as to gain a better appreciation of the resources available for the program. The final decision about acceptance will be made approximately eighteen months before the start date of the fellowship.

Fellowship Application Form  (doc.)

Orientation Handbook for New Residents and Fellow

The 2016 Orientation Handbook for New Residents and Fellows at the University of Toronto is now available.  This downloadable booklet offers up-to-date information about topics such as registration, health care coverage, cost of living, accommodation, and child care and schooling, to help new learners, especially those from outside Canada, achieve a successful transition to residency and fellowship training at the University of Toronto.

For more information regarding Pediatric Radiology Fellowships or the application process, please contact: 

Oscar Navarro, MD                                              
Fellowship Program Director
Department of Diagnostic Imaging
The Hospital for Sick Children
555 University Avenue
Toronto, ON  M5G 1X8
Fax:  416.813.8389
email: oscar.navarro@sickkids.ca

Katherine McLaren
Fellowship Program Administrative Assistant
Department of Diagnostic Imaging
The Hospital for Sick Children
555 University Avenue
Toronto, ON  M5G 1X8
Fax:  416.813.8389
email: katherine.mclaren@sickkids.ca