Dr. Oscar Navarro
Paediatric 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 paediatric 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 and need to meet the minimum eligibility requirements for licensure with the College of Physicians and Surgeons of Ontario. The program is within one of the largest and busiest paediatric 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 paediatric practice. The Clinical Fellowship Program is open to both Canadian and international applicants and in fact as of April 2020 we have fellows from Canada, Argentina, Andorra, United Kingdom, Germany, Switzerland, Nigeria, Israel, Saudi Arabia, Iran and India.
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 Program offers fellowships in Paediatric General Radiology, Paediatric Neuroradiology, Paediatric Interventional Radiology, Paediatric Cardiac Imaging, and Paediatric 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.
Most of our fellowships are of one-year duration although in Paediatric General Radiology there is some flexibility and 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 Paediatric General Radiology and one year of Paediatric 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 clinical fellowship in Paediatric General Radiology includes rotations in the following areas: plain radiographs (including in-patient studies from the pediatric and surgical wards and from the neonatal and paediatric intensive care units, as well as outpatient and emergency room examinations), fluoroscopy (gastrointestinal and genitourinary), ultrasound (including neuro-sonography), body CT, body MRI (chest, abdomen and musculoskeletal), neuroradiology (including CT and MRI), and nuclear medicine. Fellows have protected time to attend multiple one-hour teaching sessions every week and periodically participate at clinical case rounds in general surgery, oncology, chest, emergency, non-accidental injury and gastroenterology.
Our training program in Paediatric General Radiology is currently accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC) as a one-year Paediatric Radiology Residency Program. This means that those trainees that have completed a diagnostic radiology residency program in Canada and/or are certified by the RCPSC in Diagnostic Radiology and enter our program in Paediatric General Radiology will be recognized as PGY6 paediatric radiology residents. These trainees may be eligible for certification with examination in Pediatric Radiology by the RCPSC following successful completion of our program. Trainees that are not part of the RCPSC track may also take the RCPSC examination in paediatric radiology through the Subspecialty Examination Affiliate Program (SEAP) and become a subspecialist affiliate with the RCPSC.
The clinical fellowship in Paediatric Neuroradiology provides training in diagnostic pediatric neuroradiology, including CT and MRI of the brain, head and neck, and spine, and covers a wide range of congenital and acquired conditions. Fellows gain competence in protocoling, monitoring and reporting CT and MRI studies from the fetus through to the age of 18 years including premature infants. Two one-hour teaching sessions dedicated to paediatric neuroradiology are held every week. Fellows are actively involved in the presentation of clinical case rounds and in the preparation of lectures and presentations for meetings. 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 Paediatric 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 Paediatric Cardiac Imaging provides training in MRI, 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 MRI and CT 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 MRI 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 Paediatrics. Fellows are actively involved in research projects and presentations at scientific meetings.
The clinical fellowship in Paediatric Nuclear Medicine provides training for board-certified nuclear medicine physicians or radiologists that are interested in paediatric 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 paediatric nuclear medicine examinations. Fellows are actively involved in teaching and participation in clinical rounds.
Fellows are trained and evaluated in all aspects of the CanMEDS competency framework (medical expert, communicator, collaborator, leader, health advocate, 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 paediatric imaging, participation in clinical rounds, and presentation at quality assurance rounds and journal club. Fellows are also expected to cover MRI evening shifts and to take night and weekend call on a rotating basis with the other fellows. As the fellows gain more familiarity with paediatric 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 paediatric 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 paediatric 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.
Goals and Objectives
- Paediatric General Radiology
- Paediatric Neuroradiology
- Paediatric Cardiac Imaging
- Paediatric Interventional
- Paediatric Nuclear Medicine
The application process starts about two years before the start date of the fellowship. For fellowships starting in July 2022, the application process will open on May 15, 2020 and will close on July 31, 2020. The application process to all of the fellowship programs (Paediatric General Radiology, Paediatric Interventional Radiology, Paediatric Neuroradiology, Paediatric Cardiac Imaging and Paediatric 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 by email before the deadline. All reference letters should be dated in 2020 and addressed to Dr. Oscar Navarro, Paediatric Radiology Program Director. In the preparation of the curriculum vitae, the candidate should clearly identify publications (peer-reviewed and non-peer-reviewed), oral presentations, posters and research work still in progress. All published work should be listed following standard format:
Becker A, Henderson J, Lovren D. Effect of high intensity sport activities in the metaphyses of long bones in prepubescent children. J Pediatr Sports Med 2019; 65:731-738.
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. Paediatric General Radiology and Paediatric 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.
It is expected that all fellowship candidates have advanced English language proficiency, both oral and written. Although we do not require that the applicant pass an English language exam, the candidate’s fluency in English will be evaluated at the time of the interview.
Orientation Handbook for New Residents and Fellow
The 2019 Orientation Handbook for New Residents and Fellows at the University of Toronto is currently available and we expect the 2020 version will become available in July 2020. 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 Paediatric 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, Ontario M5G 1X8
Fellowship Program, Applications Process
Department of Diagnostic Imaging
The Hospital for Sick Children
555 University Avenue
Toronto, Ontario M5G 1X8