Vascular and Interventional Radiology (VIR) Fellowship

Training program and objectives:

The VIR Fellowship at SGH is a hands-on clinical fellowship (6 or 12 months) which provides the full range of vascular and non vascular interventional procedural as well as clinical experience. There is also exposure to vascular imaging, neurointervention and research.

Training Setup

The VIR Fellowship programme is conducted at the Interventional Radiology Centre (IRC) within the Department of Diagnostic Radiology (DDR) of the Singapore General Hospital which is a 1600 bed tertiary acute hospital.

IRC has 5 interventional suites equipped with state of the art machines including the Siemens Zeego and Toshiba hybrid angio-CT systems. All IR suites are equipped for Ultrasound scanners for US guided/assisted interventions. The VIR section is staffed by 8 Interventional Radiologists and 1 Neuro Interventional Radiologist and performs about 7000 procedures a year. The procedures performed include the full spectrum of vascular and non vascular as well as neuro interventional procedures.

The spectrum of VIR procedures performed include:

• Venous access (PICC, tunneled and non tunneled central catheters)
• Image guided biopsies (including transjugular liver biopsy) and drainages
• Dialysis access / central venous angioplasty, stenting, thrombolysis
• Lower limb angioplasty/stenting (including subintimal and infrapopliteal angioplasty)
• Biliary drainages and stenting
• Nephrostomies and ureteric stenting
• Transarterial Chemoembolisation (TACE) and radioembolisation (Y90 spheres)
• Uterine fibroid embolisation
• Other embolisation (eg trauma, tumour, bleeding GIT, PPH, bronchial etc)
• Fallopian tube recanalisation
• Aortic stent grafts
• Radiofrequency ablation of liver tumours
• Endovenous laser treatment of varicose veins
• Neuro interventions (including Coiling of cerebral aneurysms, AVM/CCF embolisation)

Scope and Content

1. Hands-on training

   • Fellows will spent most of their time in the Interventional suites performing procedures under the supervision of VIR consultants, initially as assistants and subsequently as primary operators for basic VIR procedures once the Fellow is proficient in basic IR techniques.
   • Fellows will be rostered to tag on to on call VIR consultants to assist in emergency IR procedures.
   • Fellows are expected to maintain a log book of VIR procedures performed/assisted.
   • At the end of 6 months, Fellows are expected to be able to perform independently diagnostic angiography, tunneled and non tunneled central venous catheters, simple biopsies and drainages, TACE, IVC filter insertion as well as uncomplicated femoral and dialysis access angioplasty procedures.

2. Non invasive imaging

   • Fellows will have opportunities to report CTA/MRA examinations (pre and post aortic stent graft evaluation and lower extremity CTA/MRA) together with VIR consultants.

3. Clinical patient management

   • Fellows will be involved in the pre-, intra- and post- procedure assessment and management of patients.
   • Fellows are expected to go on daily ward rounds to review patients post (and sometimes pre) procedure.
   • Fellows will be given opportunities to sit in the VIR Outpatient Clinic together with the VIR Consultants.
   • Fellows will be required to attend and participate in the weekly VIR breakfast meetings and monthly M&M (mortality and morbidity) rounds. Journal readings, case discussion, didactic teaching, will be conducted in these meetings.
   • Fellows are expected to attend interdisciplinary rounds (eg Vascular surgery-VIR rounds, Urology-Radiology rounds, Gastroenterology/hepatobiliary surgery-Radiology rounds, etc) to better appreciate the multi disciplinary approach to patient management.

4. Academia and Research

   • Fellows will be required to do at least 2 journal readings within the 6 month fellowship.
   • Fellows will to given research time off (1 session per week) to conduct at least 1 research or audit project.
   • Fellows are encouraged to present abstracts/posters at local/regional Conferences and submit manuscripts for publications.

Faculty

Admission Criteria

Minimum requirements for all Fellows :

• Postgraduate medical qualification in Radiology e.g. FRCR, MMed or equivalent
• 2 years of postgraduate training experience in relevant specialty
• Proven competency in English language (to fulfill Singapore Medical Council’s criteria for medical registration for clinical fellowship)

Fellowship Application

Please submit application electronically or download application form at www.pgmi.com.sg

Sponsorship for Fellowship

Sponsorship from the Dept of Diagnostic Radiology is available. To apply, please indicate on the fellowship application form that funding is required. Upon successful application, each fellow will be awarded a stipend of S$2000 per month.

For more information on VIR Fellowship

Please contact A/Prof. Tan Bien Soo, Director Vascular and Interventional Radiology at tan.bien.soo@sgh.com.sg