Radiodiagnostics (Eng)
Z Profiles
Adapted Radiology Learning Outcomes for Medical Students
1. Foundational Knowledge
- Explain imaging principles
- Describe the physics, indications, and limitations of X-ray, CT, MRI, ultrasound, and nuclear medicine.
- Understand safety and risk
- Outline radiation protection principles (ALARA), contrast media risks, and MRI contraindications.
- Demonstrate anatomical knowledge
- Recognize normal anatomy as visualized on standard imaging modalities.
2. Clinical Judgment & Appropriateness
- Select first-line imaging
- For common clinical presentations (e.g., trauma, acute abdomen, chest pain, suspected stroke), justify the appropriate modality using evidence-based guidelines.
- Apply appropriateness criteria
- Balance diagnostic yield with cost, availability, radiation exposure, and patient safety.
- Communicate effectively in requests
- Write imaging requests that clearly state the clinical question and relevant background.
3. Image Interpretation
- Recognize urgent findings
- Identify critical abnormalities (e.g., pneumothorax, fractures, intracranial hemorrhage, bowel obstruction).
- Apply systematic review methods
- Use structured approaches (e.g., ABCDE for chest X-ray, cross-sectional checklists for CT).
- Differentiate normal from abnormal
- Accurately identify common pathologies and avoid common pitfalls in interpretation.
4. Interventional & Procedural Awareness
- Outline common interventional radiology procedures
- Indications for biopsy, drainage, angiography, embolization.
- Understand image-guidance
- Principles of ultrasound- or CT-guided interventions.
- Recognize risks and consent needs
- Communicate benefits, risks, and alternatives of interventional procedures to patients.
5. Systems & Professionalism
- Navigate radiology workflow
- Understand how imaging is scheduled, prioritized, and reported within the healthcare system.
- Collaborate with radiologists and multidisciplinary teams
- Integrate imaging findings into patient management.
- Manage urgent communication
- Know when and how to escalate imaging findings that are life-threatening.
- Demonstrate ethical practice
- Respect confidentiality, incidental findings, and principles of informed consent.
6. Preparation for Practice
- Order imaging responsibly as a junior doctor
- Request investigations that are justified, cost-conscious, and patient-centered.
- Interpret common imaging in frontline practice
- Competently identify major abnormalities in chest X-rays, trauma films, and CT scans of the head.
- Handle adverse events
- Recognize and respond appropriately to contrast reactions and radiation risks.
- Manage urgent imaging pathways
- Understand processes for arranging out-of-hours CT, MRI, or urgent ultrasound.
7. Lifelong Learning & Innovation
- Critically appraise radiology research
- Understand sensitivity, specificity, predictive values, and how they affect diagnostic decisions.
- Stay current with innovation
- Describe advances such as AI in imaging, molecular imaging, PET/MRI, and low-dose CT.
- Reflect and self-assess
- Identify personal strengths and areas for improvement in radiology knowledge and practice.
Assessment Blueprint
- To make outcomes measurable
- Knowledge → MCQs/short-answer tests on imaging principles, risks, and appropriateness.
- Skills → OSCE stations (interpret chest X-ray, order appropriate imaging, explain findings).
- Clinical judgment → Case-based discussions (choosing imaging for clinical scenarios).
- Professionalism → Mini-CEX for communication in imaging requests, handling urgent results.
✅ Overall Goal: Graduates should be able to order appropriate imaging, recognize common and urgent findings, integrate radiology into patient care, and practice safely and ethically, while appreciating the evolving role of radiology in medicine.
1. Chest
- X-ray (CXR) basics
- Pneumonia / consolidation
- Pleural effusion
- Pneumothorax (tension and simple)
- Pulmonary edema (e.g., “bat wing” pattern in heart failure)
- Lung mass or nodule (recognition, not characterization)
- Atelectasis / collapse
- Rib fractures
- Mediastinal widening (aortic dissection, trauma)
- Emergency CT recognition
- Pulmonary embolism (filling defect in pulmonary arteries)
- Aortic aneurysm / dissection
2. Musculoskeletal & Trauma
- Fractures: long bones, ribs, pelvis, skull vault/base
- Dislocations: shoulder, hip, elbow
- Spinal trauma: vertebral body compression fracture, subluxation
- Osteoarthritis: joint space narrowing, osteophytes
- Bone tumor basics: lytic vs sclerotic lesions (awareness level)
3. Neurology / Head
- CT Brain
- Intracranial hemorrhage: extradural, subdural, subarachnoid, intraparenchymal
- Acute ischemic stroke (loss of grey–white differentiation, hyperdense vessel sign)
- Mass effect / midline shift
- Hydrocephalus (enlarged ventricles)
- Skull fracture
- MRI Brain (basic exposure)
- Demyelination plaques (awareness only)
- Space-occupying lesions (recognition of abnormal mass)
4. Abdomen & Pelvis
- Plain abdominal film
- Bowel obstruction (dilated loops, air-fluid levels)
- Free air under diaphragm (perforation)
- Renal/ureteric calculi (if radio-opaque)
- Ultrasound
- Gallstones and cholecystitis
- Hydronephrosis
- Abdominal aortic aneurysm
- Ascites
- CT Abdomen
- Appendicitis (awareness, common signs)
- Diverticulitis (wall thickening, fat stranding)
- Solid organ injury (liver, spleen trauma)
- Tumors (recognize mass lesions, not detailed staging)
5. Oncological Awareness
- Recognition of common malignancies: lung mass, breast mass, colorectal mass on CT, lymphoma (mediastinal mass, lymphadenopathy).
- Understanding of staging scans (awareness, not detailed TNM).
6. Oncologic & Medical Emergencies
- Spinal cord compression (MRI spine awareness)
- Tumor lysis syndrome imaging (rare, awareness)
- Neutropenic enterocolitis (CT awareness)
7. Interventional Radiology (Awareness Level)
- Lines/tubes placement (NG tube, central venous line, endotracheal tube)
- Drains and stents in situ (recognition, basic function)
📌 Key Principle
Students don’t need subspecialist-level interpretation. By graduation, they should:
- Identify common, life-threatening, and frequently encountered abnormalities
- Differentiate normal vs abnormal
- Know when to escalate to a radiologist
Radiology Syllabus for Medical Students (2 weeks, 5h/day)
Week 1 – Fundamentals and Modalities
- Day 1 – Introduction & Imaging Principles
- 1h: Introduction to radiology, its role in medicine
- 2h: Physics of X-ray, CT, MRI, ultrasound, nuclear medicine
- 1h: Radiation safety and contrast agent risks (ALARA principle)
- 1h: Introduction to PACS, systematic image interpretation
- Day 2 – Chest Imaging
- 2h: Normal anatomy on chest X-ray and CT
- 2h: Core pathologies (“must know”): pneumonia, pneumothorax, pleural effusion, pulmonary edema, atelectasis
- 1h: Practical session – CXR interpretation (ABCDE method)
- Day 3 – Brain and Neuroimaging
- 2h: CT brain – normal anatomy and basic principles
- 2h: Emergencies: hemorrhage, ischemia, mass effect, hydrocephalus, skull fractures
- 1h: Mini-OSCE practice – acute CT cases
- Day 4 – Abdomen & Pelvis
- 2h: Abdominal X-ray and ultrasound – normal anatomy, indications
- 2h: Pathologies: bowel obstruction, free air, cholelithiasis, hydronephrosis, abdominal aortic aneurysm
- 1h: Practical interpretation + ultrasound video cases
- Day 5 – Musculoskeletal & Trauma
- 2h: Skeletal radiographs – normal appearances and standard projections
- 2h: Fractures, dislocations, spinal compression injuries
- 1h: Practical seminar – trauma cases (OSCE style)
Week 2 – Applications, Oncology, Intervention
- Day 6 – Oncologic Radiology
- 2h: Principles of staging, overview of common cancers (lung, breast, GI)
- 2h: “Should know” findings: masses, lymphoma, colorectal cancer, ascites
- 1h: Case-based discussion – when to suspect malignancy
- Day 7 – Acute & Emergency Radiology
- 2h: Emergencies (pulmonary embolism, aortic dissection, spinal cord compression)
- 2h: Practical case-based learning – radiology in emergencies
- 1h: Mini-OSCE – urgent decision-making
- Day 8 – Interventional Radiology (awareness)
- 2h: Basics of biopsy, drainage, angiography, embolization
- 2h: Medical devices in imaging (tubes, catheters, stents, drains)
- 1h: Video demonstrations + practical case discussions
- Day 9 – Integrated Clinical Radiology
- 2h: Radiology in multidisciplinary teams (oncology board, trauma team)
- 2h: Complex case interpretation (chest CT, abdominal CT, brain CT)
- 1h: Group work – student presentations of cases
- Day 10 – Review & Assessment
- 2h: Consolidation of “must know” findings – checklist review
- 2h: OSCE/practical test (interpretation of 10 cases)
- 1h: Reflection, feedback, discussion about lifelong learning in radiology
🎯 Key Points
- Daily balance
- theory (2–3h) + practical case-based work (2–3h).
- Core skills
- focus on “must know” abnormalities; checklist filled progressively.
- Assessment
- mini-OSCEs during the course + final OSCE on Day 10.
- Methods
- lectures, small-group seminars, PACS case reviews, OSCE-style practice.
Radiology Checklist
| Finding | Seen (yes/no) | Tried to interpret | Confident in recognition |
|---|---|---|---|
| Chest | |||
| Pneumonia / consolidation | ☐ | ☐ | ☐ |
| Pleural effusion | ☐ | ☐ | ☐ |
| Pneumothorax (incl. tension) | ☐ | ☐ | ☐ |
| Pulmonary edema | ☐ | ☐ | ☐ |
| Atelectasis / collapse | ☐ | ☐ | ☐ |
| Mediastinal widening | ☐ | ☐ | ☐ |
| Brain – CT | |||
| Intracranial hemorrhage (EDH, SDH, SAH, ICH) | ☐ | ☐ | ☐ |
| Acute ischemia | ☐ | ☐ | ☐ |
| Mass effect / midline shift | ☐ | ☐ | ☐ |
| Hydrocephalus | ☐ | ☐ | ☐ |
| Skull fracture | ☐ | ☐ | ☐ |
| Trauma / Skeletal | |||
| Long bone fractures | ☐ | ☐ | ☐ |
| Pelvic fractures | ☐ | ☐ | ☐ |
| Shoulder / hip dislocation | ☐ | ☐ | ☐ |
| Abdomen | |||
| Bowel obstruction (dilated loops, air-fluid levels) | ☐ | ☐ | ☐ |
| Free air under diaphragm | ☐ | ☐ | ☐ |
| Gallstones (US) | ☐ | ☐ | ☐ |
| Hydronephrosis (US) | ☐ | ☐ | ☐ |
| Abdominal aortic aneurysm (US) | ☐ | ☐ | ☐ |
| Oncology & Emergencies | |||
| Pulmonary embolism (CT) | ☐ | ☐ | ☐ |
| Aortic dissection (CT) | ☐ | ☐ | ☐ |
| Interventions / Devices | |||
| Position of tubes and catheters (NG, CVC, ET) | ☐ | ☐ | ☐ |
This version includes everything above plus additional findings.
| Finding | Seen (yes/no) | Tried to interpret | Confident in recognition |
|---|---|---|---|
| Chest (extra) | |||
| Lung mass / nodule | ☐ | ☐ | ☐ |
| Trauma / Skeletal (extra) | |||
| Vertebral compression fracture | ☐ | ☐ | ☐ |
| Osteoarthritis | ☐ | ☐ | ☐ |
| Bone tumors (lytic/sclerotic) | ☐ | ☐ | ☐ |
| Abdomen (extra) | |||
| Appendicitis (CT) | ☐ | ☐ | ☐ |
| Diverticulitis (CT) | ☐ | ☐ | ☐ |
| Tumors (mass on CT, US, X-ray) | ☐ | ☐ | ☐ |
| Ascites (US) | ☐ | ☐ | ☐ |
| Oncology (extra) | |||
| Lymphoma (mediastinal mass, lymphadenopathy) | ☐ | ☐ | ☐ |
| Colorectal cancer (CT) | ☐ | ☐ | ☐ |
| Breast cancer (mammography/US) | ☐ | ☐ | ☐ |
| Neuro (extra) | |||
| Demyelinating lesions (MRI) | ☐ | ☐ | ☐ |
| Brain tumor (MRI) | ☐ | ☐ | ☐ |
| Oncologic & Special Emergencies (extra) | |||
| Spinal cord compression (MRI) | ☐ | ☐ | ☐ |
| Tumor lysis syndrome (CT awareness) | ☐ | ☐ | ☐ |
| Neutropenic enterocolitis (CT awareness) | ☐ | ☐ | ☐ |
| Interventions (extra) | |||
| Drains and stents (recognition, function) | ☐ | ☐ | ☐ |
- 📌 How to use
- Seen → student has been exposed to the case (lecture, PACS, bedside).
- Tried to interpret → student actively described the image.
- Confident in recognition → student feels competent to identify it independently.
