Education

The Department of Vascular and Interventional Radiology (DVIR) at Singapore General Hospital (SGH) provides a comprehensive range of vascular and non-vascular interventional service. SGH is a 1600 -bed acute tertiary hospital, providing cutting edge medical treatment in all spheres.

The Department has access to 8 interventional radiology suites housed under the Division of Radiological Sciences, which are equipped with modern machines including the Siemens Artiz Zeego, Siemens and Toshiba DSA with cone beam CT systems, Toshiba hybrid angio-CT systems and Toshiba biplane systems. All IR suites are equipped with Ultrasound scanners for US guided/assisted interventions. DVIR is staffed by 22 Interventional Radiologists and performs about 10,000 vascular and non-vascular procedures a year.

The spectrum of VIR procedures performed include:

• Venous access (PICC, tunnelled and non-tunnelled central catheters, ports)
• 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, SAFARI technique), thrombolysis and debulking procedures
• Aortic stent grafts for aneurysmal disease and dissection
• DVT thrombolysis and venous stenting
• IVC filter insertion and removal
• Embolisation for trauma, tumour, bleeding GIT, PPH, haemoptysis
• Testicular vein embolisation
• Prostatic artery embolisation
• Fallopian tube recanalisation
• Uterine fibroid embolisation
• Transarterial Chemo-embolisation (conventional TACE, balloon TACE, drug eluting bead TACE) and radio-embolisation (Y90 spheres)
• Thermal ablation (RFA; MWA) of liver and lung tumours, as well as benign thyroid nodules
• Cryoablation of renal and bone tumours
• Vertebroplasty / cementoplasty for augmentation of musculoskeletal tumours
• Biliary drainages, dilatations and stenting
• Nephrostomies and ureteric stenting
• Radiological guided gastrostomy insertion, NJ tube insertion and GI stenting
• Fusion and contrast enhanced US guided procedures

Faculty
See Our Care Team.
 

Fellowships

IMPORTANT NOTICE 

Introduction
The Vascular and Interventional Radiology (VIR) Fellowship at the Department of Vascular and Interventional Radiology (DVIR) is specifically crafted to offer international radiologists a profound exposure to a diverse range of vascular and non-vascular interventional procedures within Singapore's largest tertiary hospital. 

This programme is strategically designed to serve as a distinctive developmental opportunity, empowering young radiologists to acquire novel procedural skills and expand their clinical knowledge, which can subsequently be applied and shared within their home institutions.

Training Setup
Singapore General Hospital is a 1600-bed acute tertiary hospital, providing cutting edge medical treatment in all specialty disciplines.

The Department has access to 8 interventional radiology suites housed under the Division of Radiological Sciences, which are equipped with state of the art machines including the Philips Azurion 7, two Siemens Artis Q, and two Toshiba hybrid angio-CT systems. All IR suites are equipped with Ultrasound scanners for US-guided/ assisted interventions. DVIR is staffed by 21 interventional radiologists and performs about 10,000 vascular and non-vascular procedures a year.

A wide range of VIR procedures are performed* including:

Oncological interventions:

• Transarterial Chemo-embolisation (cTACE, debTACE) and radio-embolisation (Y90 spheres) 
• Thermal ablation (RFA; MWA) and non thermal (IRE) of liver tumours 
• Ablation of renal and lung tumours 
• Biliary drainages, dilatations and stenting 
• Pre-operative lung tumour localisation

Musculoskeletal interventions:

• Vertebroplasty (including stenting) for benign and malignant spine disease 
• Nerve blocks and ablations (degenerative and malignant indications) 
• Thermal ablation of bone and soft tissue tumours 
• Palliative embolisation of MSK tumours
  

Vascular interventions:

• Dialysis access (AVF/AVG) angioplasty and thrombolysis 
• Lower limb angioplasty/stenting, thrombolysis and debulking procedures 
• IVC filter insertion and removal 
• Hepatic Venous-portal Pressure Gradient measurement (HPVG)

Emergency interventions:

• Embolisation for trauma, tumour, bleeding gastrointestinal tract, bronchial embolisation 
• Pulmonary Thrombectomy and catheter directed therapy 
• Transjugular portosystemic shunt (TIPS) and Retrograde Transvenous Obliteration

Genitourinary interventions:

• Nephrostomies and ureteric stenting 
• Hysterosalpingogram and Fallopian tube recanalisation 
• Angiomyolipoma embolisation 
• Prostate artery embolisation / Uterine fibroid embolisation

Others:

• Venous access (PICC, tunneled and non tunneled central catheters, ports) 
• Image guided biopsies (including transjugular liver biopsy) and drainages 
• Fusion and contrast enhanced US guided procedures 
• Radiological guided gastrostomy insertion and NJ tube insertion

*variable case mix and first operator experience for fellowship is expected*

Training Curriculum

Hands-on Procedural and Clinical training:

• BASIC IR TRAINING (2 – 3 months): familiarising with departmental protocol and workflow, evaluation of patients pre- and post- procedure and competent in basic procedures (tailored to individual fellows’ previous experience), basic skills in IR
  
  
• SUBSPECIALTY ROTATION (9 – 10 months): taking on more complex procedures performed under direct consultant supervision, in addition to rotation through HPB (hepato-pancreatico-biliary), MSK (Musculoskeletal), Vascular and GI-GU (Gastrointestinal- Genitourinary) subspecialties
  
  
• All clinical activities will be performed under the supervision of VIR consultants, initially as assistants and subsequently as primary operators.
• All fellows are rostered for weekday and Saturday extended hours duties. There are no overnight calls. 
• Fellows are tasked to participate in non-procedural clinical roles i.e. clerking in of patients, pre- and post-procedure management of patients, and ward rounds.
• Involvement in Departmental teaching and administrative events, including M&M meetings, biopsy audits, research meetings and MDT meetings are compulsory. 
• Additional opportunities to be rotated through to the IR service at Sengkang General Hospital and KK Women’s and Children’s Hospital can be discussed.
• No neuro-intervention training opportunities are available under this fellowship.

Example of fellow weekly roster:

Fellow responsibilities: 

• Maintain a logbook of VIR procedures performed/assisted
• Respectful behaviour towards other members of IR team (nurses, radiographers, clerical staff) 
• Maintaining patient confidentiality, professional, and ethical behaviour
• Attend outpatient clinics and perform inpatient consults 
• Ward rounds to review patients pre and post procedure
• Participate in weekly education (including teaching of junior residents), monthly mortality & morbidity, biopsy audit and research meetings 
• Fellows are expected to do a minimum of 4 teaching presentations
• Attend interdisciplinary rounds (e.g. Vascular surgery-DVIR, Urology-Radiology, Gastroenterology/hepatobiliary surgery-Radiology rounds) with emphasis on multi-disciplinary approach to patient management 
• Annual leave (entitled 21 days) application to be made in timely manner

Academia and Research:

• Research engagement is strongly encouraged. 
• Fellows will be required to do at least 4 journal readings and presentations in 1 year 
• Research time off (1 session per week) to conduct at least 1 research or audit project can be discussed. 
• Submission of an abstract to a conference is compulsory. Submission of a manuscript for publication is encouraged.
  
  

Admission Criteria

• Postgraduate medical qualification in Radiology e.g. FRCR, MMed or equivalent 
• 5 years radiology residency training or equivalent at expected start date of fellowship (e.g. for 3-year training programs, a further 2-year postgraduate experience required) 
• Proven competency in English per Singapore Medical Council’s requirements for clinical fellowship 
• Selection of interventional radiology fellows will be prioritised based on the following: 
• Regions with little interventional radiology expertise (priority for ASEAN and countries with MoU for training) 
• Candidates in a position to develop public service and train next generation of interventional radiologists over time 
• One year and self-funded fellowship applicants preferred 
• Candidates with no or early interventional radiology experience preferred

Application process for eligible applicants

• Once accepted for fellowship, the registration process facilitated by PGMI will take months to be processed. 
• It is in your interest to respond to PGMI emails promptly. Failure to adhere to timelines (PGMI queries, source document verification, English competency exams) following approval of application may result in withdrawal of fellowship offer.
• All current and future employment (please indicate if none) must be indicated on application form. Incomplete forms will be rejected in the first instance. 
• Limited sponsored fellowship positions are available (maximum 3 at any one time). All applicants will automatically be considered for sponsorship (SGD$2000-4500 per month) from Department of Vascular and Interventional Radiology (DVIR) / Division of Radiological Sciences and SGH/PGMI fellowship award. 
• There is high demand for fellowship position, with more applicants than positions available for both sponsored and self-sponsored positions 
• Email is the main line of communication; it is in your interest to respond to the emails promptly. 
• Failure to adhere to timelines (PGMI queries, source document verification, English competency exams) following approval of application may result in withdrawal of fellowship offer.

The following estimated administrative fees are required prior to start of fellowship (as of December 2023):

• SGH-PGMI Administrative Fee: SGD 500 per application 
• Temporary Medical Registration with Singapore Medical Council Application fee: SGD 300
• Temporary Medical Registration with Singapore Medical Council Practicing Certificate Fee: SGD 450
• Training Employment pass from Ministry of Manpower
  • Application Fee: SGD 105
  • Issuance Fee: SGD 225
  • Multiple Journey Visa (if applicable): SGD 30
  • Malpractice Insurance Coverage: SGD 455 - 910
  • Work Injury Insurance: SGD 100
  • Basic Cardiac Life Support (ACLS) Course: SGD 204
  • Advanced Cardiac Life Support (ACLS) Course: SGD 327
  • Pre-attachment Medical Examination in SGH : SGD 300 - 400 

The above fees are subject to changes without prior notice and are on top of other expenses like accommodation in Singapore, transport (MRT / bus), communications (cell phone), basic meals, groceries and personal hospital and surgical insurance.

If you are interested, please contact Dr Alfred Tan, DVIR Fellowship Director at alfred.tan.b.c@singhealth.com.sg with a copy of your CV to arrange an interview.

Past Fellows:

• 2023: Dr Alfhmy Amal Khalil M (Saudi Arabia), Dr Dorothea Akosua Amoh (Ghana), Dr Whilmore Anak Johin (Malaysia)
• 2022: Dr M Imran Kham (Pakistan), Dr Francisco Joemel Dy (Philippines), Dr Lee Chung Yuen (Malaysia)
• 2021: Dr Ashton Anand Ramsundar (Trinidad and Tobago)
• 2020: Dr Faisal Al Balushi (Oman)
• 2019: Dhayal Balakrishnan (Malaysia), Md Abu Saleh Esha (Bangladesh), Kurt Gabriel (Jamaica), Duraisamy Sharmila (India)
• 2018: Mohammed Ali Jaafar Noori Alalsaidiessa (Iraq)
• 2017: Madhan Kumar Murugan (India)
• 2016: Latha Kandamaran (India)
• 2015: Kumar Kempegowda Shashi (India)
• 2014: Raza Sayani (Pakistan)
• 2013: Bishwajit Bhowmik (Bangladesh), Ali Abdullah Alomari (Saudi Arabia), Benjamin Dabo Sarkodie (Ghana)
• 2012: Muhammad Fiaz (Pakistan), Fidel Shilendra Rampersad (Trinidad), Sriram Jaganathan (India), Sidi Harouna Rashid (United Kingdom), Pankaj Sharma (India)
• 2011: Md Tariqul Islam (Bangladesh), Jolly Jason Catibog (Philippines), Ammar A H Aljumah (Kuwait)
• 2010: Dr Archana Dwivedee, Dr Irfan Amjad Lufti, Dr Md Sadrul Amin, Dr Said Khalfan Shabat Al Aghbari, Dr Sattar Amjad

DVIR Medical Student Electives

Description:

DVIR invites all medical students to embark on a discovery journey of minimally invasive interventional procedures #MIIP as part of the refreshed DVIR Medical Student Elective.

This updated 2023 curriculum is a kaleidoscope that aims to maximise the experience of the student through 6 exciting themes fashioned in a resource and time efficient manner to allow you to see the best of Interventional Radiology #IRAD in Singapore. Depending on the duration of your time with us, a specially curated program will be tailored by your supervising tutor to your educational needs. 

Goals and objectives of elective: 

1. To expose the students to the wide range of imaging guided minimally invasive procedures performed by Interventional Radiologists.
2. To help the student understand the basis, principles and techniques of the various types of interventions.
3. To familiarise the student with the workflow of a multidisciplinary team in interventional radiology and how it supports the needs of the hospital.
4. To participate in a short research or audit project to be completed by the end of the posting.

Types of medical student electives at DVIR

• Clinical elective 
• Clinical plus research elective
• Research elective 

Electives can either be standalone (i.e. DVIR alone) or in combination with concurrent electives in the Department of Diagnostic Radiology (DDR) and/or Department of Nuclear Medicine and Molecular imaging (DNMMI).

6 themes of DVIR elective posting:

Introduction to IR
Description: Wholesome introduction to the department, the program outline and expectations

• Pre-posting and post-posting survey
• DVIR Welcome and walkabout
• "Introduction to IR" presentation
• DVIR quiz with feedback
• Self-directed learning through our notion portal

IR Daily
Description: The IR experience outside of the procedure rooms. Beyond being a skilled technician and understanding our clinical role in the management of our patients.

• DVIR Clinic sit In
• ADR Clerk-In with MO, Resident and Fellow
• Ward MO shadow with MO, Resident and Fellow
• Diagnostic Vascular Radiology Reporting
• Attendance at Inter-Professional Educational Sessions, M&M, Audits and MDT sessions

Scrub up 

Description: The highlight of the posting has to be getting scrubbed up for the heat of IR action in procedure suite

• General IR: Biopsy, Line insertion (PICC, CVC), Drainages
• Vascular: Peripheral Angioplasty, Dialysis Access Interventions, Venous Intervention
• Interventional Oncology: TACE, SIRT, Ablation, Malignant Stenting
• Pain: vertebroplasty / cementoplasty, nerve root block
• Emergency: Haemorrhage Embolisation, Stroke
• How to gown up and down
• Handling of basic IR kit
• Understanding Radiation protection
• Role of the IR nurse and radiographer

DVIR tutorial 

Description: A short focused 15 – 20 min one to one tutorial complimenting the “Scrub UP” case. 

• To reinforce the practical experience with theoretical knowledge
• Shared resources on Notion
• More tuition style than plenary

Special sessions

Description: Unique sessions working collaboratively with other specialties

• NeuroIR: A chance to see stroke thrombectomy, management of aneurysms
• Heart Centre / OT5: See the teamwork between cardiothoracic surgeons and Vascular surgeons in the deployment of TEVARs and EVARs 

Research & Audit

Description: For the budding researchers, an option to participate in a DVIR led research project or audit

• Data collection
• Spearhead a small project
• Review article write up 

Sample 2-week elective roster:

How to apply & contact information

Led by a dynamic educational team of young consultants and supported by senior consultant colleagues, our 22-member strong consultant body hope to share with you our passion in what we do day to day. Drop an email to Dr Leong Sum (leong.sum@singhealth.com.sg) or Dr Alfred Tan (alfred.tan.b.c@singhealth.com.sg) for more information.

Local medical school students (e.g. Yong Loo Lin School of Medicine, Duke-NUS medical school and Lee Kong Chian School of Medicine) should apply via their respective internal medical school application process for electives. 

Overseas medical students can find more information on how to apply at the SGH Associate Dean’s Office website. 
 

DVIR Trainee Positions available:

Medical Officer (3-6 MOs at any one time)

• 3 months of VIR combined with 3 months of Diagnostic Radiology
• Application via MOHH

Further information can be obtained from MOHH.

MOPEX MO DVIR contact: Dr Mark Wang (mark.wang.q.w@singhealth.com.sg)

Singhealth Residents 

• 4 months VIR posting (combined with Changi General Hospital) for R1-R4
• 3 – 12 months VIR posting for R5 applied via Residency Advisory Committee 

Further information can be obtained from: Diagnostic Radiology Residency

SingHealth Radiology Residency IR Core faculty contact: Dr Jasmine Chua (jasmine.chua.m.e@singhealth.com.sg)

MO / Singhealth Residents Posting Scope and Content

• Broad exposure to Vascular and Interventional Radiology (as well as diagnostic radiology)
• Involvement in pre-procedure rounds (including imaging review, consent and preparation), post-procedure rounds, management of complications and clinic follow up
• Opportunity to develop basic skills in image guided intervention, assist and observe in more complex advanced procedures
• Opportunity to learn normal radiological anatomy, develop basic skills in vascular cross-sectional imaging (CT and MRI)
• Opportunity to participate in research project leading to presentation and publication
• Weekly basic lectures in Interventional Radiology for trainees
• Weekly DVIR Interprofessional Continuing Medical Education 
• Weekly multidisciplinary meetings (Hepatobiliary, Vascular, Urology meetings, tumour boards)
• More focused individualised training program for residents who aspire to a career in interventional radiology
• Extended duties (i.e. out of office hours and Saturday) will be rostered 
• Trainees are expected to maintain a training logbook