Anatomy

The First Year radiology curriculum in anatomy includes a module in imaging anatomy delivered by clinical radiologists. This programme has been developed jointly with the Department of Anatomy and ensures integration of imaging into the curriculum in anatomy. Imaging anatomy teaching incorporates didactic lectures in a large lecture theatre setting and small group interactive sessions in a modern anatomy laboratory (UCC Flame lab). These sessions include a brief amount of background information regarding radiology in the form of dedicated introductory lectures and references to diagnostic imaging procedures in all other sessions, but the core information delivery is with regard to radiological anatomy and modality recognition. Radiologic anatomy is taught in parallel with traditional anatomy teaching. This imaging anatomy module represents the first exposure of medical students to radiology.

In recognition of the importance UCC places in integrating education in imaging anatomy into the undergraduate curriculum in anatomy, the Lecturer in Radiology post is funded 50% by the Department of Anatomy. The lecturer is based one day/week in the Department of Anatomy.

We have assessed the student perception of learning experiences in collaboration with our anatomy colleagues.

• Murphy KP, Crush L, O'Malley E, Daly FE, Twomey M, O'Tuathaigh CM, Maher MM, Cryan JF, O'Connor OJ. ‘Medical student perceptions of radiology use in anatomy teaching’. Anat Sci Educ. 2014 Dec. PMID 25516061
• Murphy KP, Crush L, O'Malley E, Daly FE, O'Tuathaigh CM, O'Connor OJ, Cryan JF, Maher MM. ‘Medical student knowledge regarding radiology before and after a radiological anatomy module: implications for vertical integration and self-directed learning’. Insights Imaging. 2014 Oct;5(5):629-34. PMID: 25107581

Introduction to modalities

Second Year and Third Year graduate entry students receive instruction on imaging modalities: the methods of image creation, appearances, indications and contraindications with reference to pathology for emphasis of salient aspects.

Clinical Radiology

During Fourth Year, three areas of radiological practice have been chosen for specific emphasis. Students are expected to learn the core aspects of these sub-disciplines and identify how they integrate with patient management strategies; familiarity with the radiological modalities that are used, indication, contraindications, complications, clinical factors which determine the optimal method of imaging, patient preparation, communication with referring physicians, what imaging information is required to be given by referring physicians and how imaging affects treatment decisions.  The three areas are:

1.   Interventional Radiology

The CIRSE Curriculum provides guidance. Students are expected to be familiar with the basis of interventional radiology, methods of image guidance, radiation protection principles and issues to address prior to a patient undergoing a procedure. Students should be familiar with vascular and non-vascular interventional radiology, specifically:

• Peripheral access Devices
• PE and DVT
• Percutaneous biopsy, abscess drainage, nephrostomy, and biliary drainage

2.   Radiological aspects of the multidisciplinary team meetings (MDT)

Students are expected to be familiar with the purpose, conduction and pertinent radiological aspects of MDT conferences. The context in which radiological exams are performed and imaging appearances observed for the diagnosis and staging of cancer, assessment of treatment response and detection of recurrence will be emphasised and students should be familiar with treatment pathways.

3.   Emergency Department Radiology

Students should be familiar with the role of radiology in the emergency department. Most radiologic modalities are used for assessment, triage, diagnosis and follow-up. Students should be familiar with the imaging findings encountered. Examples include:

• Trauma series radiographs
• Peripheral limb radiographs
• CT imaging (abdomen, chest, head,), ultrasound (abdomen)
• MRI (head and musculoskeletal system)
• Nuclear medicine (bone scan) and fluoroscopy (swallowing studies, IR)

Final Year

The aim of Final Year radiology instruction is to ensure that students are familiar with the core imaging modalities used in the diagnosis and treatment of diseases pertaining to the main anatomical systems of the body. The common modalities used are plain film imaging, fluoroscopy, ultrasound, CT, MRI and nuclear medicine. Students should be able to recognise and differentiate each imaging modality, be familiar with indications, risks, limitations and contraindications to each modality, be aware of how patients are triaged for a particular radiological examination, be comfortable interpreting radiological images depicting pathologies which are commonly encountered and easily recognized by clinicians, and to know how a patient’s treatment should progress based on the imaging findings.  Students receive four one-hour lectures during tutorial blocks. Thoracic, gastrointestinal and musculoskeletal/neurological radiology are emphasised. Students are expected to be familiar with interpretation of the following radiographic findings:

 Thoracic Imaging:

• Cardiac enlargement
• Cardiac failure and pulmonary oedema
• Pleural effusion
• Pulmonary collapse and consolidation
• Misplaced “tubes and lines”
• Pneumothorax, including tension
• Pneumomediastinum and subcutaneous emphysema
• Hyperinflation of lungs
• Free gas beneath the diaphragm
• Detection of pulmonary and mediastinal masses
• Signs of acute vascular problems, including aortic dissection and trauma

 Abdominal Imaging:

• Small and large bowel obstruction
• Toxic megacolon
• Signs of intestinal perforation
• Aortic aneurysm
• Urinary calculi
• Gallstones
• Endoluminal foreign bodies

 Skeletal Imaging:

• Common fractures in the limbs
• Fracture of femoral neck
• Fractures of the wrist and scaphoid
• Fractures of the shoulder, including dislocation
• Pelvic fractures
• Signs of osteoarthritis
• Sclerotic and lytic metastases
• Skull fracture
• Cervical spine fracture and dislocation

Students are encouraged to discuss and question structured diagnostic regimens in different clinical settings. This includes the relationship of clinical radiology techniques to other investigations (for example endoscopy, conventional cardiac investigations). The disadvantages of over-investigation are highlighted.  The use of integrated small group discussion involving clinician colleagues and radiologists is encouraged as is the importance of Evidence Based Practise. Examples of conditions, for which appropriate diagnostic algorithms could be discussed would include:

 Chest and Cardiovascular Disease:

• Asthma
• Aneurysms and vascular dissection
• Pulmonary emboli
• Pulmonary neoplasms
• Haemoptysis

 Gastrointestinal Disease:

• Abdominal pain
• Abdominal masses
• Abdominal trauma
• Inflammatory bowel disease
• Jaundice
• Hepatic neoplasms
• Biliary disease

 Renal and Urological Disease:

• Renal failure and urinary obstruction
• Haematuria
• Urological neoplasms
• Renal and urinary infection

 Endocrine and Breast Disease:

• Thyroid dysfunction and thyroid masses
• Breast Masses

 Oncological and Marrow Disease:

• Principles of oncological staging by imaging and knowledge of common staging classifications
• Investigation of haematological disease including anaemia and leukaemia
• Basic knowledge of potential complications of oncological treatment and means of detection

 Musculoskeletal disease:

• Bone and soft tissue infection
• Bone and soft tissue trauma
• Bone and soft tissue tumours
• Diagnosis of undisplaced or stress fractures
• Investigation of spinal injury
• Investigation of low back pain
• Metabolic bone disease
• Arthritites

 Neurological Disease:

• Head injury
• Intracranial haemorrhage and infarction
• Spinal cord compression and radiculopathy
• Intracranial space occupying lesions

 Disease in Childhood:

• The principles of imaging in children, including protection of the patient and confidentiality.
• Disease of the chest and gastrointestinal tract in childhood, and certain paediatric neoplasms.

 Obstetric and Gynaecological Disease:

• Investigation of suspected pregnancy, including ectopic gestation.
• Post menopausal bleeding
• Gynaecological neoplasms

Students also receive small group tutorials from Consultant Clinical Radiologists in the Mercy University Hospital, the Bon Secours Hospital, The South Infirmary Hospital, South Tipperary General Hospital, University Hospital Kerry, University Hospital Waterford and Mallow General Hospital. The co-ordination of the schedules for these tutorials is the responsibility of the UCC Radiology Department, based at Cork University Hospital.

Students receive dedicated small group tutorials focusing on radiologic aspects of paediatric radiology delivered by two fellowship trained consultant radiologists and by the senior lecturer.

Students are invited to attend an interactive teaching session conducted by Dr. Michael Bennett on Wednesday evenings during the academic year from 5.30 pm – 7.00 pm. These consist of clinical vignettes, which a panel of final medical students discuss, and as part of this discussion, a radiological review of the relevant pathology is provided weekly by Professor Maher.

Radiation Protection

In response to concerns over the risks associated with growing levels of exposure to ionizing radiation through medical imaging, the European Council Euratom directive of 1997 recommended that radiation protection should be integrated into the curriculum of medical schools. Final year medical students in UCC receive a radiation protection course during their first week of college. Professor Maher, Dr O’Connor, the UCC Lecturer,  and Ms. Niamh Moore, lecturer in Radiography, UCC, provide this. Students complete a multiple-choice questionnaire after the course to receive a certificate. The course emphasizes the principles of radiation protection: justification, optimisation and the use of doses as low as reasonably practicable. Instruction on which radiological modalities deliver a large absorbed radiation dose is provided. The value of alternative investigations which do not entail exposure to ionising radiation is highlighted. Recognition of increased risk in pregnancy and childhood is discussed and measures used to avoid inadvertent irradiation in early pregnancy are explained.

Students’ awareness of radiation protection and the benefit of instruction has been assessed and published by our group.

O’Sullivan J, O’Connor OJ, O’Regan K, Clarke B, Burgoyne LN, Ryan MF, Maher MM. ‘An assessment of medical students’ awareness of radiation exposures associated with diagnostic imaging investigations’. Insights into Imaging 2010 May;1(2):86-92. PMID: 22347909

During 2014, UCC Radiology Department in collaboration with Dr. Sabine Tabirca of the Computer Science Department at UCC, have developed a Radiation Protection App and online module in Radiation Protection. This is now available for download on the Apple App Store and Google Play.

Textbooks and Reference

• Royal College of Radiologists, Making the best use of a Department of Clinical Radiology: guidelines for doctors (5th edition). RCR, London 2004.
• Royal College of Radiologists: Radiology for Medical Students Paper 4. The Place of Clinical Radiology and Imaging in Medical Student Education: recommended framework for curriculum design. (www.rcr.org)
• Lecture notes on radiology 3^rd Ed -Patel, PR (Blackwell)
• Crash Course in Imaging 1^st Ed-Kelly B, Nickle IC (Elsevier)
• Radiology MRI cases; www.radsource.us/‎

• Radiology knee iPad app
• Radiology head iPad app
• http://www.meddean.luc.edu/lumen/meded/medicine/pulmonar/cxr/atlas/cxratlas_f.htm
• http://www.radiologyeducation.com/
• http://www.learningradiology.com/medstudents/medstudtoc.htm
• http://www.bubbasoft.org/
• http://student.bmj.com/student/get-articles-for-topic.html?id=488&name=Radiology
• http://radiopaedia.org/articles/
• http://www.radiologyassistant.nl/en/

Elective Students

Elective students

Each year the Department of Radiology mentors summer elective students; third year students completing mini-electives and fourth year students completing elective experience prior to entering their final year of medical school. A structured program is provided. Students receive tutorials during this time, attend departmental teaching meetings, multi-disciplinary meetings and spend time observing CT, interventional radiology and fluoroscopy in practice. Students also observe radiologists reporting clinical examinations. Students are encouraged to contribute to research and if possible work on their final medicine research project during this time period.

Elective Students

2014: Luke O’Donnell, Jessica Stack, Daniel O’Connor, Eibhlin Ni Mheachair

2015: Eight elective students were hosted by the department. Ms Ailbhe McGoldrick, Ms Holly Acton

2017: Zsolt Kocsis, Aoife Feeley, Philip Mulryan, Jamie O’Braonain, Dara O’Brien, Yi Jia Teo Mykyta Kachanov,  Quentin Staniek (France, Lilles)

2018: John Cosgrave, Haleeda Hilmi, Orlaith Desmond, Ivan Simonson, Robin Mannessier (France, Lilles)

2019: Elizabeth Jackson, Henry McGee, Mohmmad Amin Mirbalouchzehi, Avril Compton, Zhang Yong Tai, Niamh Mooney, Maria Coleman 

2020: Aoife Jones Thachuthara, Kenneth Jun Chuen Low, Sudharrshan Nair, Niamh McCarthy, John P. Kelleher, Aileen O'Mahony, Shearer Alan Jihill

2021: Kevin Crishan, John Bradley, Samantha Hayes, Diana Stephanie Grunbert, Mohammad Hemi

2022: Joe Brown, Rebecca Mortesen, Sean Blackburn, Bogomil Lazaryev, Arsani Yousef, Aoife Dempsey, Ghazal Aljarad, Ana Maria Toader (Madrid, Spain)

Final Year Project

Final Year Projects

Many final year radiology students are mentored for their final year radiology project in the Department of Radiology, UCC. Many of these projects have led to peer-reviewed paper publications for the students involved.

2009

Jennifer O’Sullivan

O’Sullivan J, O’Connor OJ, O’Regan K, Clarke B, Burgoyne LN, Ryan MF, Maher MM. ‘An assessment of medical students’ awareness of radiation exposures associated with diagnostic imaging investigations’. Insights into Imaging 2010 May;1(2):86-92. PMID: 22347909

David Sawbridge

Sawbridge D, O’Connor OJ, MacEneaney P, Maher MM, Fitzgerald E. ‘Successful endovascular treatment of an infected external iliac pseudoaneurysm presenting with hemorrhage total hip arthroplasty’. Journal of Vascular and Interventional Radiology 2010 Jul; 21(7):1135-6. PMID: 20570177

2010

Sebastian McWilliams

McWilliams S, O’Connor OJ, McGarrigle AM, Quigley E, Shanahan F, Maher MM. ‘CT-based estimation of intracavitary gas volumes using threshold-based segmentation: in vitro study to determine the optimal threshold range’. Journal of Medical Imaging and Radiation Oncology 2012; 56(3): 289-94 2012 Jun;56(3):289-94. PMID: 22697325

2011/12

Kate Carey

McLaughlin PD, Murphy KP, Hayes SA, Carey K, Sammon J, Crush L, O'Neill F, Normoyle B, McGarrigle AM, Barry JE, Maher MM. ‘Non-contrast CT at comparable dose to an abdominal radiograph in patients with acute renal colic; impact of iterative reconstruction on image quality and diagnostic performance’. Insights Imaging. 2014 Apr;5(2):217-30. PMID: 24500656

Shane Parfrey

Coyle JP, Brennan CR, Parfrey SF, O'Connor OJ, Mc Laughlin PD, Mc Williams SR, Maher MM. ‘Is serum C-reactive protein a reliable predictor of abdomino-pelvic CT findings in the clinical setting of the non-traumatic acute abdomen?’ . Emerg Radiol. 2012 Oct;19(5):455-62. PMID: 22532154

McWilliams SR, Murphy KP, Golestaneh S, O'Regan KN, Arellano RS, Maher MM, O'Connor OJ. Reduction of guide needle streak artifact in CT-guided biopsy. J Vasc Interv Radiol. 2014 Dec;25(12):1929-35. doi: 10.1016/j.jvir.2014.08.028. Epub 2014 Oct 11. PMID: 25311968

2012/13

Eoin O’Malley

Murphy KP, Crush L, O'Malley E, Daly FE, Twomey M, O'Tuathaigh CM, Maher MM, Cryan JF, O'Connor OJ. ‘Medical student perceptions of radiology use in anatomy teaching’. Anat Sci Educ. 2014 Dec. PMID 25516061

Murphy KP, Crush L, O'Malley E, Daly FE, O'Tuathaigh CM, O'Connor OJ, Cryan JF, Maher MM. ‘Medical student knowledge regarding radiology before and after a radiological anatomy module: implications for vertical integration and self-directed learning’. Insights Imaging. 2014 Oct;5(5):629-34. PMID: 25107581

Charlie Sullivan

Sullivan, C, Murphy KP, Power D, Maher MM, O’Connor OJ. ‘Radiation exposure from diagnostic imaging in young patients with testicular cancer’. Eur Rad 2015 Apr;25(4): 1005-13. PMID: 25500962

Hiliary O’Sullivan

Murphy KP, Crush L, McLaughlin PD, O'Sullivan HS, Twomey M, Lynch S, Bye J, McSweeney SE, O'Connor OJ, Shanahan F, Maher MM. “The role of pure iterative reconstruction in conventional dose CT enterography”. Abdom Imaging. 2015 Feb;40(2):251-7. PMID 25139642

2014/15

Karanvir Singh Dhatt

Role of iterative reconstruction in reducing radiation dose in Cystic Fibrosis (CF) patients receiving treatment with Kalydeco

David Glynn

The Quality of Internet Information on CT Radiation Dose.

O'Neill S, Glynn D, Murphy KP, James K, Twomey M, Kavanagh R, O'Connor OJ, Maher MM. An Assessment of the Quality of CT Radiation Dose Information on the Internet. J Am Coll Radiol. 2018 Jan;15(1 Pt A):11-18. doi: 10.1016/j.jacr.2017.08.014. Epub 2017 Oct 24. PMID: 29079250

Safeih Galestaneh

McWilliams SR, Murphy KP, Golestaneh S, O’Regan KN, Arellano RS, Maher MM, O’Connor OJ. “Reduction of guide needle streak artifact in CT-guided biopsy”. J Vasc Interv Radiol. 2014 Oct;25(12): 1229-35. PMID: 25311968

2015/16

Barbara Ann Duffy

Analysis of High Dose Alert Flagged CT Procedures on the Dosewatch System.

Stephen O’Brien (Not directly supervised but contributed to project)

An investigation of the association between sarcopenia and post-operative morbidity and mortality in patients with gastric cancer.

Ross Caplice

Highs and lows in CT dose: Analysis of 12 months experience with a novel web based radiation dose tracking software program

2016/2017

Holly Acton

Acton H, James K, Kavanagh RG, O'Tuathaigh C, Moloney D, Wyse G, Fanning N, Maher M, O'Connor OJ. Monitoring neurointerventional radiation doses using dose-tracking software: implications for the establishment of local diagnostic reference levels. Eur Radiol. 2018 Sep;28(9):3669-3675. doi: 10.1007/s00330-018-5405-3. Epub 2018 Apr 12. PMID: 29651772

Award 2017 Fielding medal by the faculty of radiologists for best radiology research project performed by a medical student. Presented by the student at the Annual meeting of the Faculty of Radiologists 2017.

James Duffy

Radiation exposure and complications in CT guided interventions

Ailbhe Mcgoldrick 2016/2017

Retrospective review of the incidence of abnormal findings on abdominal imaging in patients undergoing appendicectomy remote from the time of appendicectomy

Amber Downes

Sub millisievert scanning of the abdomen and pelvis using model based iterative reconstruction in patients with acute abdominal symptoms: prospective randomized evaluation of diagnostic efficacy safety and patient outcome. Project presented at ECR 2016 and Annual meeting of the Faculty of Radiologists 2017.

2017/2018

Tyler Grey

The Impact of Radiographer Feedback on the Occurrence of Red Flag Dose Alerts in CT Studies

Matthew Curtin

CT Assessment of Tibial Fracture Healing Using Plain Film Doses

Ruth Kelleher

An Audit of CUH CT Protocol for Suspected Traumatic Injury.

2018/2019

Aoife Feeley

Fast acquisition abdominal MRI study for the investigation of suspected acute appendicitis in paediatric patients: Prospective assessment of diagnostic accuracy and clinical efficacy

Award 2019 Fielding medal by the faculty of radiologists for best radiology research project performed by a medical student. Presented by the student at the Annual meeting of the Faculty of Radiologists 2019

2018/2020

Mika O’Callaghan Maher

Use of ultra low dose CT scanning of the neck, thorax and abdomen with Model based Iterative reconstruction (MBIR) for assessment of ventriculoperitoneal shunt tubing in patients with suspected shunt malfunction: A prospective study

Dane Gunter

Safety, efficacy and tolerability of Orkambi (Ivacaftor/Lumacaftor) in a real-world setting.

Aislinn O'Connell

Low-dose CT in Crohn's disease

Emma O'Shea

Low-dose CT in lung nodule assessmen

Jiaying Lim

Assessment of body composition in breast cancer (Collaboration with department of surgery)

2021/2022