Duration of Residency Training in Singapore

The duration of residency training accredited by ACGME-I and that required for exit certification by the Specialists Accreditation Board is listed in the following table. Where the duration for accreditation exceeds that of ACGME-I, the remaining time will be accredited by the Joint Committee on Specialist Training (JCST).

Specialty

Duration of training accredited by ACGME-I for residency programme (mths)

Total duration of training in Singapore (mths)

Diagnostic Radiology

48

(48) + 12

Training Requirements Document

Specialty

Training Requirements             

Diagnostic Radiology

Diagnostic Radiology Residency Training Requirements & Programme Accreditation Submission
 

Singapore Country Addendum to the ACGME-I Advanced Specialty Requirements

The Singapore Country Addendum to the ACGME-I Advanced Specialty Requirements prescribes specialty-specific programme requirements applicable to residency programmes in Singapore as discussed with the ACGME-I and the Singapore Residency Advisory Committees (RAC).

Read together with the  ACGME-I Advanced Specialty Requirements, they represent the requirements of graduate medical education in the specialties listed.

Section

ACGME-I Specialty-Specific Program Requirements for Graduate Medical Education

Addition/Change

Clarification

I.B

The education in diagnostic radiology must be 48 months in length.

 

The total duration of training for exit certification as a Diagnostic Radiologist in Singapore is 60 months.

R5 Requirements

a. This can be a year spent in a single subspecialty similar to a fellowship year or consisting of several subspecialty rotations of minimum 3 months each. PDs should also utilize this year to address deficiencies in the Resident's experience.

b. There should be a mandatory 3 months elective performed in a Sponsoring Institution outside the Resident's programme.

c. Further electives can be performed in private practice only in the last 3 months at the end of R5 but these should be clinical 'hands-on' postings. These should be pre-approved by the RAC.

d. Research electives can be performed up to a maximum of 6 months but should be pre-approved by the RAC.

e. There should be 'on call' duty during R5.

f. At least 6 months of R5 should be within the parent Sponsoring Institution.

Exit Requirements

a. Completion of the 5 years programme with fulfillment of all requirements including passing of the required intermediate summative examination ie. FRCR or Masters in Medicine (Diagnostic Radiology).

b. Logbook entries to be completed as per requirements.

c. Performance certified by PDs.

d. First authorship publication as defined in Annex 1.

e. Ethics course participation.

f. Exit assessment / examination.

 

II.B

There must be at least one FTE physician faculty in each of the nine-subspecialty areas. The nine subspecialty areas are neuroradiology, musculo-skeletal radiology, vascular and interventional radiology, cardiothoracic radiology, breast radiology, abdominal radiology, pediatric radiology, ultrasonography and nuclear radiology.

1. This individual must practice at least 50% of his or her time in the subspecialty area, and must demonstrate a commitment to the subspecialty.

 

 

In Singapore, ultrasound is exempt from having a physician FTE who practices at least 50% of his or her time in the subspecialty.

Ultrasound is a modality of imaging that is covered by the other subspecialty areas eg. musculoskeletal, breast, abdominal and pediatric radiology etc.

VI.D.1

(foundational requirements)
Duty hours are defined as all clinical and academic activities related to the program; i.e., patient care (both inpatient and outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities, such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

1. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities.

a. Residents can spend a reasonable period of their time on service related activities so long as the 80 hours are not exceeded and the core educational activities are not impacted. This will be initially capped at 2 sessions per week and will be reviewed after 3 years.

Singapore RAC specification.

II.I.1.C

c. The program must systematically review the radiologic images evaluated only by residents to assure accuracy.

(1) This may occur by having all residents’ reports signed and reviewed by faculty within 24 hours; or,

(2) Routinely sampling the residents’ reports for faculty over-read to check its accuracy.

b. During the R1 year, prior to passing the National Plain Film Test, Residents will have all plain film interpretations checked and reports signed out by faculty i.e. 100% over read. During this period, a minimum of 600 studies must be logged. At the end of this intense plain film education period, the Resident’s plain film reading skills will be formally assessed by the National Plain Film Test held after 6 months of R1.

c. Residents, who pass the National Plain Film Test held after 6 months of R1 will be allowed to read and report plain films. The Resident should have ready access to specialist radiological consultation under such service arrangements. The volume of films read under the service arrangement cannot be more than more than 600 plain film studies per month during R1 to R3.

i) Residents who pass the National Plain Film Test held after 6 months of R1 will have their plain film reports under training over-read regularly with 50% of their reports over-read. Major discrepancies defined as those that could potentially adversely affect clinical outcomes, change clinical management, or incur disability or mortality, will be tracked in this way for every Resident.

ii) The program will track the individual major discrepancy rate for each Resident based on this over-read which will be reported to MOH and RAC quarterly. Any Resident that has an equal or greater than 5 percent major discrepancy rate will be required to receive further training and supervision that will include 100 percent over-reads and retesting. Each program’s Residents' interventions and outcomes should be included in the annual major discrepancy report to the ACGME-I.

d. Senior Residents R4 and above need not be subject to plain film over-read and may supervise residents from R1 to R3 as part of their progressive responsibilities.

Singapore RAC specification


Annex 1: First Authorship Publication Requirements

A first authorship paper is required as part of the requirement for exit. This paper should be a first authorship paper published in a peer reviewed journal currently indexed in MEDLINE. It must be an accepted paper.

A provisionally accepted paper DOES NOT meet the requirement. The paper published or accepted for publication should be within the Residency training period. A paper published prior to start of Residency is not acceptable.

The types of publications that are acceptable are as follows:

  1. Original research/paper
  2. Case report or case series
  3. Reviews (all types including pictorial review/essay)
  4. Technical innovation/notes

All other papers will be judged on a case to case basis. Residents are advised to seek the opinion of the RAC as to the suitability of the papers to be submitted for exit.

Requirements for Progression to Senior Resident

Specialty

Requirements

Diagnostic Radiology

  • Pass FRCR 2A
  • PD certification of successful completion of R3


Exit Criteria

Specialty

Current Exit Examinations / Assessments

Diagnostic Radiology

  • MCQs
  • Oral examination
  • Clinical assessment
  • Publication of first authorship paper