Course Review

Leeds surgical neuroradiology course

Authors: Hugh Sims-Williams, James Sutcliffe 

Publication date:  24 Nov 2012

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The past 10 years have seen a rapid increase in the application of diagnostic imaging techniques and image guided treatments, and as a direct result the Royal College of Radiologists is seeking an increase of 60 trainees a year for the next five years.[1] [2] Neuroradiology in particular is a growing specialty, and there has been a considerable increase in the number of endovascular procedures performed, especially in acute stroke management and the treatment of intracranial aneurysms. This increase is in part owing to the results of the international subarachnoid aneurysm trial (ISAT),[3] which initiated a move to multidisciplinary team treatment of aneurysms; endovascular management is becoming increasingly common in the United Kingdom and the United States.

The Leeds surgical neuroradiology course reflects this move to multidisciplinary team management of neurosurgical pathology, and the faculty reflects this change, with teaching being provided by radiologists, physicists, interventionalists, and neurosurgeons.

Who is it for?

Despite its niche name, this course is not just for radiologists or surgeons and has relevance for anyone interested in the radiological investigation and diagnosis of neurological presentations. The course is run annually at Leeds Radiology Academy and should be considered by neurosurgeons, radiologists, and neurology trainees—both aspiring and at fellowship level.

When did you do it?

I attended this course in its second year, which was at the start of my neurosurgery specialist trainee year 1. There were several junior doctors looking to gain experience for forthcoming interviews and a considerable number of senior trainees preparing for fellowship exams.

Why did you do it?

The world of imaging can be daunting, especially to someone straight out of foundation training. I wanted to learn which scans to request, to recognise which scan had been performed, and to learn how to communicate the findings with clarity. This will allow me not only to participate fully in multidisciplinary team meetings but also to communicate effectively with fellow clinicians and ultimately to initiate appropriate management plans for acutely unwell patients.

How is the course structured?

The course takes place over one and a half days and begins with a basic review of the physics behind magnetic resonance imaging and computed tomography. This leads into a detailed discussion over which sequences should be used to differentiate specific pathologies.

The teaching then moves into core topics, which are covered in depth with a large number of images. The topics include cranial and spinal infection; congenital and developmental malformations; cranial and spinal trauma; intracranial haemorrhage; adult and paediatric cranial and spinal tumours; and neurovascular spinal disease. Each topic area concludes with a small group viva where delegates are put in the hot seat to discuss and interpret scans. The course is limited to 30 applicants to ensure groups of six or fewer during the vivas.

My favourite part of the course was a final review of on-call images, where “not to be missed” scans were reviewed (fig ). Tips were shared on how to recognise the subtleties of these scans.

How much effort did it entail?

The course was very intense, probably because it is aimed at such a wide range of abilities. I understood most of what was taught, but the pace was fast and the vivas were challenging. It was a long weekend, but was broken up by a good meal out on Saturday night.

Was there an exam?

No. The course organisers have applied for continuing professional development accreditation.

How much did it cost?

The course cost £225, including lunch, refreshments, and a meal out.

Was it worth it?

This course was definitely worth attending. It was incredibly useful, and it has given me the confidence to participate in neuroradiology meetings. It is held at a leading radiology educational centre, and so the level of enthusiasm and ability of the faculty is excellent. I subsequently attended run-through neuroradiology interviews, where my understanding of magnetic resonance imaging and positron emission tomography scanning and interpretation of computed tomography scans resulted in an offer of training. I met lots of fellow trainees, and I enjoyed socialising after the intense first day.

I would recommend this course to junior doctors preparing for radiology, neurology, or neurosurgery interviews, but I would also recommend it, as part of continuing education, to more senior doctors who are preparing for exams or who want to increase their understanding of neurosurgical pathology.

Top tips

• Read as much about neuroradiology as you can before the course: get a book from the library on computed tomography head scans or use online tutorials (for example, www.headneckbrainspine.com).

• Ask a friendly radiologist to go over cranial computed tomography and magnetic resonance imaging scans before you attend.

• Don’t be disheartened by the amount of information covered on the course; doctors from the foundation years to consultant level attend the course and so different aspects will be more relevant to your level of experience.

Competing interests: None declared.

Hugh Sims-Williams neurosurgical research fellow  School of Medical Sciences, University of Bristol, UK
James Sutcliffe radiology specialist trainee  Oxford University Hospitals, Oxford, UK

 hugh.sims-williams@bristol.ac.uk