The University of Toronto’s (UofT) Temerty Faculty of Medicine is one of the most renowned medical training universities in Canada, with residencies and fellowships like the ones offered by the Department of Medical Imaging (MI) continuing to be incredibly sought after programs. Most notably, the Diagnostic Radiology (DR) Residency Program, a five-year residency that’s been shaped by dedicated faculty, up-to-date industry practices and input from residents.
MI’s DR Residency program is not only one of the most sought after both domestically and internationally, but it’s also the biggest residency of its kind in Canada, averaging an entry class of 11 new PGY1 residents every year, as opposed to the national average of five to seven. As of this year, the DR residency program has 62 residents from PGY1 through PGY5.
“The main objective of DR residency is of course to make sure that our residents are competent diagnostic radiologists who can provide high-quality care to patients,” says Dr. Rachel Fleming, Assistant Professor and Diagnostic Radiology Residency Program Director. “There are unique aspects of our residency program that makes it stand out.”
The first year of the program is predominantly off-service so the residents are exposed to different aspects of clinical medicine including: Internal Medicine, Emergency Medicine, General Surgery, Obstetrics and Gynecology and Pediatrics, among other disciplines. In this year, residents rotate through all the main academic centres as well as UofT-affiliated hospital sites across the Greater Toronto Area (GTA).
“The main goal of the clinical year is for residents to immerse themselves in clinical medicine, be able to recognize and identify illness in patients and to understand when to ask for help,” says Dr. Fleming. “It’s also an important year for residents to begin understanding their clinical colleagues and what they’re looking for in MRI or CT scans.”
In the second year of residency, DR residents are based out of one of three core academic sites, including Sunnybrook Health Sciences Centre, St. Michael’s Hospital or the Joint Department of Medical Imaging (JDMI), which spans several hospital sites including Women’s College Hospital, Sinai Health System and the University Health Network (UHN).
During their time at their site, residents rotate through different divisions like Neuroradiology, Musculoskeletal (MSK) imaging, Abdominal imaging and Cardiothoracic Imaging. Emphasizing the importance of early procedural experience, most residents also rotate through Interventional Radiology. A few will have the opportunity to experience Pediatric imaging at the Hospital for Sick Children in their second year as well. Rotating through the subspecialties helps residents as they think about which area of radiology they want to specialize and which fellowships they may want to apply to, says Dr. Fleming.
In the second half of residency, residents get the opportunity to rotate through the other core sites as well as all diagnostic radiology subspecialties, including community hospital blocks in PGY4 and PGY5 as well as a rotation at American College of Radiology Institute for Radiologic Pathology (AIRP). Unique to UofT’s DR residency program is the forensic radiology block in PGY5, which offers residents hands-on experience in the coroner’s office.
“Something really unique to our residency and often very interesting to residents is the forensic radiology block,” says Dr. Fleming. “During this block, residents get to work in the coroner’s office as the sole radiologist, getting the opportunity to assist the coroner with investigations and diagnosing a cause of death.”
Aside from the numerous clinical blocks and rotations, residents in MI’s DR residency program have the opportunity to conduct their own research and quality improvement (QI) projects, contribute or author studies and papers and be involved in department committees like the Clinical Practice Improvement committee. On top of that, residents receive hands-on renowned training through different academic and leadership courses, weekly academic half days, and two resident retreats.
“Acting as a resident voice and advocate or representative for the resident body has been a uniquely rewarding experience, and it’s very gratifying to be able to take issues residents face help create solutions that are actually put into effect,” says Deputy Chief Resident Dr. Taryn Rohringer, a PGY3 DR resident. “This program is very responsive to resident feedback, which I think is a huge asset.”
Some of that feedback has led to the development and implementation of the department’s Equity, Diversity and Inclusion Committee and a resident-designed and led 12-week comprehensive summer lecture series for PGY2s to help prepare them for on-call shifts.
“Several years ago, some of our residents expressed that they didn’t feel knowledgeable enough or prepared enough to begin their on-call shifts at hospitals. The residents responded to that gap with a course designed by residents for residents,” says Dr. Fleming.
With so much academic and clinical learning entrenched in the program, it’s no wonder why MI’s DR residency program is so sought after, both in Canada and abroad.
“In my opinion, radiology is the best specialty in medicine, and I wouldn’t choose to do any other residency, which is what I tell many of the elective students who rotate through UofT,” says. Dr. Rohringer. “It’s challenging and intellectually stimulating work in an amazing, collegial environment that has a massive impact on patient care.”
