Vascular and Interventional Radiology (VIR) Fellowship

IMPORTANT NOTICE
Next available funded positions:

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 advanced 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 hepato-pancreatico-biliary (HPB), Musculoskeletal (MSK), Vascular and Gastrointestinal- Genitourinary(GI-GU) 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. 

Fellow responsibilities: 

• Maintain a logbook of VIR procedures performed/assisted performed 
• 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.
  
  

Faculty

• Dr Ankur Patel (Senior Consultant and Head of Department) 
• Prof Tay Kiang Hiong (Senior Consultant) 
• Prof Tan Bien Soo (Senior Consultant) 
• A/Prof Dr Richard Lo Hoau Gong (Senior Consultant) 
• A/Prof Farah Gillan Irani (Senior Consultant and Deputy Head of Department) 
• Dr Sivanathan Chandramohan (Senior Consultant) 
• Dr Luke Toh Han Wei (Senior Consultant) 
• A/Prof Apoorva Gogna (Senior Consultant) 
• A/Prof Too Chow Wei (Senior Consultant) 
• A/Prof Nanda Kumar (Senior Consultant) 
• A/Prof Leong Sum (Senior Consultant) 
• Dr Zhuang Kun Da (Senior Consultant) 
• Dr Sonam Tashi (Senior Consultant) 
• Dr Jasmine Chua (Senior Consultant) 
• Dr Kristen Alexa Lee (Senior Consultant) 
• Dr Alfred Tan (Consultant) 
• Dr Mark Wang (Consultant) 
• Dr Alexander Tan (Consultant) 
• Dr Heng Tseng Hui (Consultant)
• Dr Lee Weiyong (Consultant)

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