DIR Education & Research

General information 

The Clinical Fellowship Program in the Department of Diagnostic Radiology and Interventional Radiology 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 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 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 May 2024 we have fellows from Chile, Panama, Costa Rica, Spain, France, United Kingdom, Nigeria, South Africa, 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 sponsored and self-funded positions should be arranged by the candidate either through scholarships or sponsoring institutions in their home countries.

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. Fellows are expected to cover daytime and afterhours work, including evening and night shifts as well covering weekends and holidays, on a rotating basis with other fellows. The clinical exposure is supplemented by regular teaching sessions, participation in clinical rounds, and presentation at quality assurance rounds and journal club. Fellows are expected to reach the level of junior staff radiologists 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 and general radiology meetings as well as to the publication of many papers and book chapters. Fellows are expected to be productive, and the Department of Medical Imaging of the University of Toronto requires production of at least one original research article per year of fellowship to issue a certificate of completion of fellowship.

Paid vacation is 20 working days 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 (PDF)
• Paediatric Neuroradiology (PDF)
• Paediatric Cardiac Imaging (PDF)
• Paediatric Interventional (PDF)
• Paediatric Nuclear Medicine (PDF)

Paediatric General Radiology Fellowship 

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 during the week and periodically participate in clinical case rounds in general surgery, oncology, emergency, non-accidental injury, and urology.

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. Fellows 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.

Starting July 1, 2024, our program will start the implementation of Competence by Design (CBD), which is the RCPSC model for competency-based medical education. The goal is to improve curriculum, training experiences, assessments, documentation of training progress, and provide larger number of opportunities for feedback and coaching.

Read about the goals and objectives for the General Radiology Fellowship (PDF)

Paediatric Neuroradiology Fellowship 

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.

Read about the goals and objectives for the Neuroradiology Fellowship (PDF)

Paediatric Interventional Radiology Fellowship 

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.

Read about the goals and objectives for the Interventional Radiology Fellowship (PDF)

Paediatric Cardiac Imaging Fellowship 

The clinical fellowship in Paediatric Cardiac Imaging provides training in MRI of congenital and acquired cardiovascular disease in children. With the recent acquisition of new CT equipment in our department, we expect that the training will also extend into cardiac CT. The program is a combined program for radiology and cardiology fellows. Fellows gain competence in designing, protocoling, monitoring, post-processing and reporting MRI. Importantly, the program is set in such a way that fellows work closely together with technologists to acquire basic knowledge and skills on MRI. 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 Intervenional Radiology and the Division of Cardiology, Department of Paediatrics. Fellows are actively involved in research projects and presentations at scientific meetings.

Read more about the goals and objectives for the Cardiac Imaging Fellowship (PDF)

Paediatric Nuclear Medicine Fellowship 

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.

Read more about the goals and objectives for the Nuclear Medicine Fellowship (PDF)

 

The application process to all fellowship programs (Paediatric General Radiology, Paediatric Interventional Radiology, Paediatric Neuroradiology, Paediatric Cardiac Imaging and Paediatric Nuclear Medicine) will open on September 1, 2024 and includes funded and self-funded positions. The deadline to submit all documents is October 17, 2024.

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 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, usually, the applicant will only be accepted into one fellowship at a time.  

How to apply

1. Submit the following items through the Application Portal:
   1. Completed application form (PDF)
   2. Curriculum vitae
   3. Letter of intent
2. In addition to the above, three recent reference letters, all dated 2024 and addressed to Dr. Oscar Navarro, Paediatric Radiology Program Director, should be submitted separately by each of the referees in PDF format to dir.fellowship@sickkids.ca

In preparing the curriculum vitae, the candidate should list their publications (peer-reviewed and non-peer-reviewed), oral presentations, posters and research work still in progress, and the authorship contribution (Principal author, collaborator, senior responsible author). All published work should be listed following standard format: 

• Foden P, Doku J, De Bruyne K. Effect of high intensity sport activities in the metaphyses of long bones on MRI in prepubescent children. J Pediatr Sports Med 2023; 65:731-738 (Principal author). 

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).

The Fellowship Committee will review all applications within a few weeks after the deadline and select a few candidates for an interview. All interviews will be held remotely using a videoconference platform, all interviews for each specific program occurring on a single day. The final decision about acceptance will be made within a few weeks after the interview. 

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 assessed at the time of the interview. 

Contact

For more information regarding Paediatric Radiology Fellowships or the application process, please contact  dir.fellowship@sickkids.ca or Oscar Navarro, MD  Fellowship Program Director at oscar.navarro@sickkids.ca

Paediatric Imaging Rotation for Diagnostic Radiology Residents 

Radiology Residents are an integral part of the Department. Residents from the University of Toronto and Queen's University rotate in Diagnostic Imaging for 2–4 months, as part of their overall residency program in radiology. The purpose of this policy is to ensure optimum supervision, instruction and evaluation for Radiology Residents in the performance and reporting of radiological procedures. 

Application procedure 

To complete a rotation in the Department of Diagnostic Imaging at The Hospital for Sick Children, students must be accepted to a residency program at the University of Toronto or Queen's University.  Please contact your university for more information on rotations.  

• University of Toronto Radiology Residency Program 
• Queen's University Diagnostic Radiology Residency Program

Paediatric Radiology Medical Electives Program 

The Medical Electives program run by the Department of Diagnostic Imaging allows 4th year medical students to shadow either a resident, fellow or staff radiologist on a daily basis for the duration of his/her elective. The medical student also attends the daily teaching rounds presented by the Diagnostic Imaging staff.  

Application process 

University of Toronto Medical Students (Year 4): Submit the "University of Toronto Clerkship Elective Proposal Form" to the Supervisor of Diagnostic Imaging Electives for approval of a DI elective. The form is faxed back to the Electives Officer, Undergraduate Medical Education at U of T. Immunization is processed through U of T. At the conclusion of the elective (2 weeks to 1 month), a U of T evaluation form is completed by a staff radiologist and signed by both the staff radiologist and Supervisor of DI Electives and faxed to the Electives Officer, Undergraduate Medical Education at U of T.  

Medical Students from outside the University of Toronto umbrella (Year 4): Students are processed through the University of Toronto Undergraduate Medical Education Office, Visiting Electives Program Administrator (including immunization). An electronic request for an international student DI elective is emailed from the U of T Undergraduate Medical Education Office, Visiting Electives Program Administrator, to the Supervisor of DI Electives, for approval or rejection of a DI elective. Request is electronically returned to the Electives Program Administrator at U of T. Upon completion of an international elective, an evaluation form from the home university is completed by one of the staff radiologists, and signed by the Supervisor of DI Electives. 

Approved students: Once a student has been approved for a DI elective, they must submit an HSC Appointment Form to Human Resources for approval by an HR rep. On the first day of the DI elective, the medical student has a brief orientation by the Coordinator of the DI Electives and the student obtains an HSC ID badge from HR (which is returned to the Coordinator of DI Electives at the end of the elective.)  

As a leading academic and research facility, it is the practice of The Hospital for Sick Children (SickKids) to disseminate knowledge throughout the world and to encourage, support and develop educational opportunities for health and other professionals. Observer education initiatives and exchange of information with our colleagues and community partners significantly enrich research, patient care activities and community service. Observers are health professionals who have been granted permission to observe specific procedures and/or processes on-site in Diagnostic Imaging in order to gain knowledge. 

General information 

The Department of Diagnostic Imaging offers Observerships in General Radiology, Neuroradiology, Interventional Radiology and Nuclear Medicine. The program is within one of the largest and busiest paediatric radiology departments in the world.  

SickKids is located in Toronto, Canada - the hub of the nation's commercial, intellectual and cultural life. Toronto is a vibrant city with one of the most diverse and multicultural populations in the world. Please visit the City of Toronto website for information on popular attractions and places to visit during your time in the city.  

For more information and to apply for Observership, please visit the application page for International Medical Observers.

More information about learner supports, living in Toronto, including cost of living, health care for trainees and other interesting topics for prospective fellows can be found in the Learner Resources page on the University of Toronto PGME website.