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Rotation: Elective Thoracic Radiology  1 Block Supervisor: ______ Rotation Specific Goals and Objectives Thoracic Surgery Training Program Rotation: Elective Thoracic Radiology 1 block Supervisor: __________________ INTRODUCTION The competent practice of General Thoracic Surgery is highly linked to the ability of interpreting chest imaging and understanding the procedures and limitations related to image-guided diagnostic procedures. A condense rotation focusing on imaging will help the Thoracic Surgery trainee in developing a systematic approach to chest imaging, widened the differential diagnosis of abnormal findings and understand better the possibilities and challenges related to image- guided diagnostic procedures for chest diseases. CLINICAL AND EDUCATIONAL EXPECTATIONS • Participation in Chest Radiology activities (diagnostic and procedural) • Participation in Radiology/Respirology/Thoracic Surgery multidisciplinary rounds • Participation in Thoracic Surgery teaching rounds • Participation in Oncology/ Radiology multidisciplinary rounds • Participation in the Thoracic Surgery call schedule: Coverage of one week-end and 4 evenings (18h-8h) / block EVALUATION Assessment for this elective will be based on fulfillment of the basic expectations and achievement of the set objectives. The evaluation will be fill out by the supervisor of the rotation and forwarded to the Thoracic Surgery trainee and Program Director. Goals and Objectives of the Thoracic Surgery Resident/Fellow for the Research Elective SPECIFIC OBJECTIVES At the completion of the research elective the resident will: Medical expert General • Understand the proper utilization of the various chest imaging modalities used for diagnostic and interventional purposes • Develop a comprehensive approach to the interpretation of chest imaging • Learn and apply proper terminology in the description of findings on various chest imaging • Understand the utilization of appropriate radiological tests based on indications, cost- effectiveness and risks versus benefits • Understand the preparation of patients and patient positioning for various chest diagnostic or interventional procedures Revised 2017-10-17 Page 1 of 3 Rotation Specific Goals and Objectives -Thoracic Surgery Training Program Rotation: Thoracic Radiology • Understand the indications, sides effects and complications related to the use of contrast media • Understand the relative radiation exposure of various chest imaging modalities and their potential hazard • Demonstrate appropriate learning of the imaging anatomy by identifying the thoracic anatomic structures on various imaging modalities • Lungs, lobes, fissures and airway anatomy • Pleura and pericardium • Heart (ventricle, atrium, atrial appendage, valves, coronary artery) • Pulmonary vessels • Aorta, major arteries and veins • Bones • Esophagus, thymus, thyroid gland • Muscle and diaphragm • Understand and identify on imaging the presenting patterns of the following entities and propose a reasonable differential diagnosis based the findings and the history provided • Interstitial lung disease (nodular, reticular, reticulo-nodular, honeycombing, etc) • Alveolar lung disease • Atelectasis, airway pathology and obstructive lung disease • Mediastinal findings including masses or lymph nodes enlargement • Solitary or multiple pulmonary nodules or masses • Thoracic trauma • Chest wall and diaphragm pathologies • Congenital lung diseases • Pleural and pericardial pathologies Chest radiograph / Fluoroscopy • Develop a systematic approach to reading and interpreting CXR • Differentiate normal and abnormal findings • Identify and understand the significance of various Thoracic Radiology signs on a radiograph: air bronchogram, air crescent sign, deep sulcus sign, silhouette sign, etc. • Describe the principle of chest fluoroscopy, including the assessment of the diaphragm CT scan • Develop a systematic approach to reading and interpreting CT scan of the chest • Differentiate normal and abnormal findings • Recognize the differences in protocol for low dose CT, CT without contrast, CT with contrast, high resolution CT and CT pulmonary angiogram • Recognize the indications and limitations of these various protocol relating to the indication for performing the imaging MRI • Identify the indications and limitations of MRI in the investigation of chest diseases • Understand the physical property of MRI diagnostic testing, including the differentiation of contrast versus non contrast study Revised 2017-10-17 Page 2 of 3 Rotation Specific Goals and Objectives -Thoracic Surgery Training Program Rotation: Thoracic Radiology • Recognize the contraindications of MRI • Develop a basic approach to understanding MRI images and findings CT guided lung biopsy • Participate and perform with the assistance of the supervisor some image-guided procedures of the chest • Understand the planning, limitations, challenges and risks related to performing image guided diagnostic procedures Communicator • Listen effectively • Communicate effectively with supervisory staff • Communicate with ordering physicians about significant or unexpected radiologic findings • Able to obtain and informed consent (conduct and purpose of procedure, risks, benefits, alternatives, solicit patient questions) for interventional procedures • Dictate accurately and concisely an imaging report (or mock report) Collaborator • Participate and contribute in multidisciplinary rounds • Work harmoniously with all members of the Radiology team Manager • Arrive for the rotation activities on time and prepared / submit assignment on deadline • Utilize resources effectively, in a cost effective way and to balance patient care, learning needs and other activities Health Advocate • Identify the important determinants of health affecting patients • Understand and communicates the benefits and risks of radiological investigations for screening • Understand and learn about the use and misuse of radiological imaging Scholar • 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 Professional • Demonstrate a responsible work ethic, exhibit appropriate personal and interpersonal professional behavior respecting the needs for culture, race and gender • Deliver highest quality care with integrity, honesty, compassion • Assess accurately own performance, strengths and weaknesses and accept feedback Revised 2017-10-17 Page 3 of 3 .
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