24th August, 2018

Clinical Radiology Trainee Welcome

Day

York

10th-12th

September, 2018

RCR 2018

ACC, Liverpool

14th-16th

November, 2018

BSIR 2018 Annual Meeting

Bournemouth, UK

30th-31st October, 2018

Clinical Leadership and Management

Course for Diagnostic Specialties (ST5+)

Keele University

Mersey School of Radiology

Summer Newsletter

Volume 2 Issue 3 July 2018

Events:

Dear All,

Welcome to the third issue of the Mersey School ofRadiology Newsletter 2017-18 and our final as LeadRegistrars.

We would like to take this opportunity to thank youall for letting us represent you this year, it’s been apleasure on our behalf! We know your new LeadRegistrars, Dr James Hare and Dr Elfadil Elmahdi,will do a fantastic job in the coming year!

If you have anything in future that you would like tobe included in the next edition of the newsletterthen email the new Lead Registrars atmerseyleadspr@gmail.com.

Thank you again and best wishes for the future!

Emma and Jehan

In this edition…

Dr Emma HallCo-editor & Lead SpR

Farewell to Joan Scott!………………….. 2-4

Spotlight on a Specialty.................... 5

RCR BSIR Travelling Professorship…. 6

BSER Annual Meeting 2018…………… 7

Contents…

Consultant Editor for Mersey Newsletter

Dr Sumita Chawla

Dr Jehan GhanyCo-editor & Lead SpR

!

Volume 2 Issue 3 Page 1

An Interview with Joan ScottBy Dr Roy Chaudhary

Volume 2 Issue 3 Page 2

Tell us a bit about yourself. Where does your family originally come from? Where did you growup? How did you come across the job and how did you get it?Born and bred on the Wirral. At the age of 10 my family (mum, dad and two sisters) moved toGermany with my Dad’s job. My sisters and I attended The International School in Hamburg for twoyears, before returning to the Wirral. I went to Oldershaw School in Wallasey before moving on toMillbank College of Commerce in Liverpool where I completed the Medical Secretarial Diploma. Myfirst job was as junior secretary in the University Department of Orthopaedic and Accident Surgeryin 1980 where I stayed for two years. I was appointed Personal Secretary to the Professor ofRadiodiagnosis (Graham Whitehouse) in 1982. The previous secretary had been in post for six yearsand I remember wondering at the time how anyone could stay in the same job for so long. 36 yearslater…………

How will you contrast the first half of your career of working with Prof Whitehouse and DrFewins to the second half of your career of working with Dr Curtis and Dr Chawla?When I joined the Department of Radiodiagnosis in 1982 we were based on the 4th floor of theUniversity Clinical Departments block in the Royal Liverpool Hospital. As well as the Professor, therewas a full-time Senior Lecturer (Consultant), a Lecturer (Senior Registrar), a librarian and a darkroom technician. We each had our separate offices and we also had the sole use of two tutorialrooms, a library and a large photographic suite on the same floor. Professor Whitehouse was anavid writer and I spent a lot of my time typing up research articles and papers for publication injournals. Prof Whitehouse also wrote and edited a number of text books. Deciphering his hand-writing was a bit of a challenge! I also typed all his x-ray and mammography reports. In the earlydays I used an electric typewriter (no computers!) and there was no CT or MR in the hospital.Technology had move on quite a bit by the time Dr Hilary Fewins became Head of Training. Hilarywas loved by all the trainees for her caring and gentle nature and fair and positive leadershipqualities. I have moved offices/buildings several times over the years. The training scheme hasgrown and flourished under the guidance of Dr John Curtis and Dr Sumita Chawla in recentyears. My job has become much busier, but just as enjoyable.

Yourself and Dr Curtis formed a great team for the Mersey School of Radiology, which in a wayset a benchmark for Radiology training. What do you have to say about him?What can I say about the legend that is Dr John Curtis? I knew him first as a wet-behind-the-earsradiology registrar in 1992 and worked more closely with him between 1996-1997 when he heldthe post of Lecturer in the Department of Medical Imaging. John is one of the world’s greatesthuman beings and it has been a pleasure and a privilege to work with him as Head of Training forthe last ten years. I will miss all his jokes and anecdotes - even though I’ve heard them all severaltimes over!

Joan, first of all many congratulations on a fantastic career withMersey School of Radiology, and after 36 years of dedication,your retirement is well-earned. On behalf of everyone, I justwant to say a big thank you! To begin with the burning question,what did you think of some of the dance moves (including thoseon Bollywood songs) from the Consultants at the Black Tie ballheld recently?I was very impressed by the standard and variety of dancing thatwe experienced at the ball. The Bollywood dancing was enjoyed byall with great energy and enthusiasm! I think Dr Gerhard Bockelermust take the prize for the most ‘expressive dancing’ and also forthe person who spent the most time on the dance floor. Dr AndyHealey, with his ‘interpretative dance’ moves came a close second.The sighting of Dr John Curtis making some shapes was also a raretreat.

An Interview with Joan Scott continued…By Dr Roy Chaudhary

Volume 2 Issue 3 Page 3

What do you have to say about the Registrars that you have seen grow up from being babyRadiologists to Consultants? Also, what has been your experience with the lecturers with whomyou worked closely?This has definitely been one of the highlights of the job. Some trainees have come bursting in tothe world of radiology with great vim and vigour – passing all exams at first attempt andvolunteering for the important roles and responsibilities. Others have quietly and steadilyprogressed, some with less confidence or minor set-backs along the way. Most get there in the endwith the great support that is provided by MSR. The Lecturers are a special breed. They have beensuch a great help and support to me over the years. Again, there have been big personalities andthose who simply like to get the job done. I’ve loved them all! Best of luck to Radhika and Ros fornext year – they will need lots of help and support from all.

You were very popular as we could see from the fact that so many people turned up for ball, tocelebrate your career. What is the secret?I think the fact that I have been in the job for 36 years might have something to do with thenumber of people attending the ball. It has been an honour to have worked with such a fantasticbunch of people.

All of us at Mersey School of Radiology feel that you are so kind, humble and loyal. Do you thinkyour husband and your daughters will have the same to say about you?Now that I have relinquished the responsibility for organising 50+ radiology trainees, my family area bit concerned that all my attention (and bossing around!) with be focused on them. I think Stevewill be spending plenty of time on the golf course!

Now that you are retiring, you could be a bit sensational and tell us about some of the intriguingradiology characters you have met over the years or perhaps some amusing stories fromradiology parties?I could……….. but I won’t. What happens in MSR stays in MSR!

What is it that you are most looking forward to in your retirement?The older I get, the more I realize that what matters most is having time to spend with family andfriends. Time is moving on. We will be moving house over the summer so that will keep me busyfor a while. I also hope to play more golf, get fit and lie in on Monday mornings. I’m a rubbish cook– so that’s another challenge for me to look forward to!

Joan, its been a pleasure being a Registrar with you in-charge. Last question, when are youcoming back to Mersey School of Radiology?How could I possibly return after I have been given such a fantastic send-off?! Please invite me tothe Christmas do though!

Joan Scott’s Black Tie BallA few photos from the night!

Volume 2 Issue 3 Page 4

An interview with Dr Sheetal Sharma, Consultant BreastRadiologist with an interest in Non-Vascular Intervention.

Spotlight on a SpecialtyBreast Radiology

By Dr Bilal Warraich

Volume 2 Issue 3 Page 5

Thanks a lot for taking part in spotlight on a specialty. I am sure your input will be very helpful inhighlighting breast radiology to all our trainees in the region. Firstly, why did you choose to dobreast radiology as a subspecialty interest?

The combination of patient contact, plenty of ultrasound and practical procedures were what mostappealed to me. The one thing I have always missed since starting radiology was the relationshipbuilt up between a doctor and a patient. Although breast radiology doesn’t necessarily fulfil that tothe same extent as clinical medicine, it goes some way towards it.

Would you say there are any negatives or aspects of the specialty which can be improved upon?

Not particularly. As with any job, it is what you make of it. There are challenges to all subspecialtiesbut there are plenty of opportunities within breast radiology to make a satisfying and enjoyablejob.

What would be a typical working day in the life of a breast radiologist?

As a screening and symptomatic radiologist, my time is divided between reporting screeningmammograms, seeing patients in screening assessment or symptomatic clinics or as part of anultrasound list. MDT preparation and attendance also takes up a significant amount of time. Thereare also the usual tasks which we all have to do such as emails and responding to clinicians’queries.

There is an impression that it is difficult to maintain a dual subspecialty interest including breastradiology due to the high yearly reporting requirements and a busy schedule with the nationalscreening programme. What are your thoughts on this?

I do feel that pursuing a subspecialty in addition to breast could be challenging but it would dependon how many sessions someone was planning to work. If a trainee were considering it I wouldadvise them to discuss it with the department they hoped to work in. I think a minimum of 5sessions are needed to fulfil the minimum requirements to be a screening breast radiologist butmost of us do more than that.

What are some of the big developments on the horizon for breast radiology?

There are plenty of exciting things on the horizon, including tomosynthesis and contrast enhancedmammography. Management of the axilla, particularly in patients undergoing neoadjuvantchemotherapy, is a current hot topic and there are interesting discussions going on at national levelat the moment.

What would be your advice to trainees considering breast radiology as a subspecialty interest?

I would absolutely encourage it. It’s an interesting specialty which provides great opportunities fordeveloping biopsy skills and allows plenty of patient contact. It is always worth speaking to breastradiologists to express your interest and find out more about the job.

Are there any courses, conferences or fellowships which you would recommend?

There are several national breast meetings – BSBR takes place in early November each year,Symposium Mammographicum is biennial - alternating with the International CambridgeConference on Breast Cancer Imaging – these take place in June/July. All subspecialty breasttrainees are expected to attend an approved national breast course, such as the one in Nottingham(Radiologists’ Specialist Course).

RCR BSIR Graham Plant Travelling ProfessorshipBy Dr David Garbera & Dr Mohamed Chunara

Volume 2 Issue 3 Page 6

Would you be surprised to learn that the number of paediatric interventional radiologists in the UKis the same as people who have ever walked on the moon? Dr Alex Barnacle is a ConsultantPaediatric Radiologist at Great Ormond Street Hospital in London, and delivered a fascinating seriesof lectures at The Christie Hospital in Manchester. She discussed important techniques, pathologyand advances in the field of paediatric IR. Topics during the afternoon session included basics ofvascular access, angiography and the management of renal stone disease. A key part of DrBarnacle’s talk also covered training routes in to paediatric interventional radiology. It wasinteresting to hear that a number of her GOSH colleagues became interventionalists after alreadyspecialising in diagnostic paediatric radiology, and in some cases with no significant priorexperience in adult interventional work.

We would like to extend our thanks once again to Dr Barnacle, and perhaps, after such an excellentprogramme, the number of paediatric interventionalists in the UK will finally start to outnumberastronauts who have walked on the lunar surface! By Dr Dave Garbera.

Dr Sam Byott is a Consultant Interventional Radiologist from the North West and from the get go,one thing that was crystal clear was just how good he was at capturing the audience’s attention. Histalk entitled “Paediatric IR: are they just small adults?” was insightful and very well-delivered to saythe least. What was really captivating was how he used his own personal encounters, both goodand bad, to convey key messages about paediatric intervention. I remember the deafening silenceamongst the attendees as he very eloquently relived his reaction to the first complication he dealtwith in a young patient following attempted vascular access. Having a clinician who conveys suchencounters with openness and brutal honesty, helps to remind us of a clear message that is usefulfor us all; we all make mistakes or at times encounter difficulties – whether it be a missed findingon imaging or a complication during image-guided intervention – what is important, is how wereflect on the situation, learn from any errors and educate others so that the chance of ithappening again is minimised as far as possible.

A great line from Sam’s lecture was the following remark: “it still freaks me out in children just howclose to the skin the vessels are”. Whilst humouring, this reminds us of the fact that paediatricradiology isn’t just about the same procedures on ‘smaller adults’. Children come hand-in-handwith their parents and this in itself presents a whole new challenge. Not only are you required toengage the children so that they trust you with their life, but it also requires you to sensitively relaykey information to a parent about a procedure their child is to have. And if that isn’t enough,children have different physiological reserves, responses to illness and their own unique andmaturing anatomy. Keeping all of this in mind when you next see a smiling (or more likely sobbing)child on your list will serve you well in a career in general radiology/paediatrics/paediatric IR.

Overall, Sam was a really personable and engaging speaker. Thanks Sam, on behalf of all thetrainees in the North West, we appreciate your time and wise words! By Dr Mohamed Chunara.

In April 2018, the North West School of Radiology was selected to host a visit from the2018 RCR BSIR Graham Plant Travelling Professor. This year’s Professor was Dr AlexBarnacle from Great Ormond Street Hospital with a guest talk by Dr Sam Byott fromManchester Foundation Trust Hospitals.

Dr Alex Barnacle, Paediatric Interventional Radiologist

Dr Barnacle has a particular interest inpaediatric vascular malformations, and theevening session was devoted to anoverview of this topic. Often thought of asa difficult topic, Dr Barnacle successfullydelivered an extremely interestingdiscussion, and provide attendees with asystem with which they can assess avascular malformation and categorise it forfurther management. The use of a largenumber of ultrasound images helped tomake this a very valuable session for allattendees. Dr Barnacle’s delivery wasengaging, and echoed the very pertinentthemes discussed by Dr Byott - children arenot just small adults!

British Society of Emergency Radiology Annual Meeting 2018By Dr Radhika Prasad

Volume 2 Issue 3 Page 7

In June, Liverpool hosted the 4th annual British Society of Emergency Radiology (BSER) conference.The meeting, titled ‘top to toe emergency radiology’, was well attended by radiology consultantsand registrars from across the country. The interactive lectures, iMAC-based learning and quiz casesat the end of each session were well appreciated by delegates. The highlights of the conferenceincluded a fascinating talk on AI in radiology by Dr Declan O’Regan and an inspiring and insightfultalk from Miss Georgia Addy, a 16 year old girl who survived a major trauma incident 2 years ago.

The British Society of Emergency Radiology was set up in 2014 with the aim of pursuing excellencein Emergency Imaging in the UK by continually improving everyday practice through education andresearch. Dr John Curtis and Dr Caren Landes have taken up the new positions of President andVice-President, respectively, of this flourishing society.

Going forward, the BSER committee would like to encourage involvement of radiology trainees,who after all are the future of emergency radiology. The BSER is excited to announce BSER 2019conference will be held in Durham for the first time. Watch this space for more information on nextyear’s conference.

And finally…

And finally…

Thank you so much to Dr James Hare and Dr Rosalind Joseph on establishing and runningour regional Registrar Discrepancy Meeting. I think everyone would agree that this has had,and will continue to have, great educational benefit for us all. Dr Christopher McLeavy andDr Lizzie O’Mahony shall be taking over as the new leads for this educational forum in thecoming academic year.

Good luck to all the other trainees who are finishing this summer including JamesChambers, Dina Hikmat, Jen Jou Wong, Azadeh Taheri, Kim Lam and Neena Kalsy, as well asto Lilia Khafizova who is transferring to London to complete her training. We wish you allmuch success in your future endeavours!