Radiology for RadOnc

[goodluck888]

I am doing a radiology elective right before entering RadOnc in July. I am wondering how much you could learn from radiology rotation? Any improtant anatomic site needs to learn most? Do you majorly focus on CT for contour purpose?

I am wondering how RadOnc resident gain their radiology experience besides daily work? Is there any way to get a better preparation for radiology part of the RadOnc work?

Any input is highly appreciated!

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[goodluck888]

I am doing a radiology elective right before entering RadOnc in July. I am wondering how much you could learn from radiology rotation? Any improtant anatomic site needs to learn most? Do you majorly focus on CT for contour purpose?

I am wondering how RadOnc resident gain their radiology experience besides daily work? Is there any way to get a better preparation for radiology part of the RadOnc work?

Any input is highly appreciated!

Sorry for sending the 2nd message. Any PGY 2-5 RadOnc resident wants to help out here? I am sure many other PGY-1 entering RadOnc in July and medical students are eager to see some suggestions too.

SimulD, Gfunk6, and many other active senior members here, can you take some time to give some suggestions? Thanks a lot in advance!

 

[Gfunk6]

I also did a radiology rotation during my internship but I did not find it particularly useful. The problem is, unlike other clinical services during internship, you cannot contribute meaningfully during a diagnostic radiology rotation. The attending that you work with is going to dictate what he sees while you sit their passively watching. If you are lucky, you may get an attending that talks you through his thought process. However, once you look at dozens of CTs/CXRs it is hard to stay awake since you are only observing.

You really learn radiology in Rad Onc by carefully reviewing the relevant imaging for your consults. One helpful suggestion I recieved is to study the relevant imaging anatomy in your case. For instance, if you have a lung case try to study the various nodal groups (e.g. what constitutes a N1/N2/N3 disease as well as anatomic divisions of lung lobes). However, there is not a lot you can do to prepare yourself before the Rad Onc portion of your residency. If you went to a decent intern program, chances are you've seen quite a bit of imaging anyway.

Overall head and neck imaging anatomy is probably the most difficult as this is not heavily emphasized during the 3rd and 4th years of medical school nor during internship.

 

[deleted4401]

Agreed.

Radiology elective rotations during intern year very quickly deteriorate into paid vacation. The residents can be very busy and may not take the time to teach you anything, and the attendings are very busy, as well. I'd say relax ...

Once you start residency, when looking at CT/MRI scans, you should in your head point out the different vessels/structures (here is the SVC, here is esophagus, etc., etc.) It is pretty hard, but with repetition, you get better at it. I'm sure you've heard it before, but when you are about to assess a scan - look at it first yourself and try to find the abnormalities, then read the report, and go back and see what else you missed.

-S

 

[goodluck888]

I also did a radiology rotation during my internship but I did not find it particularly useful. The problem is, unlike other clinical services during internship, you cannot contribute meaningfully during a diagnostic radiology rotation. The attending that you work with is going to dictate what he sees while you sit their passively watching. If you are lucky, you may get an attending that talks you through his thought process. However, once you look at dozens of CTs/CXRs it is hard to stay awake since you are only observing.

First of all, a million thanks to both Gfunk6 and SimulD for posting here!

I have the exact same feeling now that I feel like I am an outsider if not a "burden" to the "busy" radiologists who are dictating their radiology diagnosis case after case and want to go home early...

Since I don't feel that I am learning too much from my daily observing and at the mean time I feel the pressure I need to learn sth., I posted the above questions twice.

The bottom line that I want to know is that whether you guys will recommend some good websites or books that one can learn imaging anatomy by him/herself or frequently refer to during initial RadOnc months. I assume one of the ways to relieve some stress when work as a RadOnc intern (even though PGY-2) is that one has some good resources to refer to or backup when dealing w/ uncertainties. Any recs on that? Thanks a lot in advance!

 

[OTN]

Depending on the exposure you may have had to axial imaging in your training, I think doing a radiology rotation in either CT or MRI would be helpful.

It will, naturally, depend on the quality of the radiology department at your institution, but being familiar with axial imaging prior to starting a radonc residency would definitely be a plus.

 

[Gfunk6]

The bottom line that I want to know is that whether you guys will recommend some good websites or books that one can learn imaging anatomy by him/herself or frequently refer to during initial RadOnc months. I assume one of the ways to relieve some stress when work as a RadOnc intern (even though PGY-2) is that one has some good resources to refer to or backup when dealing w/ uncertainties. Any recs on that? Thanks a lot in advance!

Books and websites are of limited use IMO. I would get a nice imaging atlas -- surely your department would have one lying around, they are rather pricey to buy. For each patient that you have, review relevant normal anatomy. This is the best way to make information stick.