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Breast Imaging Ambulatory Clinic (HYS Centre)

GENERAL OBJECTIVES

 At the end of the rotation the resident will demonstrate the ability to supervise and perform breast imaging in an ambulatory setting, and advise referring physicians as to the appropriate investigations for their patient. 
 

SPECIFIC OBJECTIVES

At the completion of training in the office setting the resident will have acquired the following competencies and will function effectively as:
 
Medical expert/clinical decision-maker
Specific Requirements:
·         Be familiar with the technical and physical aspects of digital mammography and breast ultrasound.
·         Understand the quality control procedures that relate to breast imaging.
·         Understand the indications for breast imaging.
·         Know the typical mammographic and sonographic of the normal breast and axilla, benign breast change and malignant breast disease.
·         Be familiar with unusual appearances of benign and malignant breast disease.
·         Know how to tailor and correlate breast imaging to the clinical concern.
·         Understand the appropriate clinical-radiologic-pathologic correlation.
·         Understand the appropriate follow-up care of patients who have undergone investigational procedures.
·         Be familiar with the role, value and controversies of mammographic screening.
·         Develop competence in effective consultation.
·         Become well-versed with BIRADS lexicon to guide management
·         Know the risks of breast imaging e.g. radiation dose related to mammography, and false positive/negative imaging.
·         Demonstrate effective time management skills for the level of training.
 
Communicator
Specific Requirements:
·         Demonstrate an effective and concise reporting style, which includes recommendations for further management.
·         Demonstrate a sound and systematic reporting style.
·         Understand the importance of communication with referring physicians, and when verbal or urgent communication is needed.
·         Communicate effectively and compassionately with patients and their families.
 
Collaborator
Specific Requirements:
·         Able to function as member of multidisciplinary health care team in the optimal practice breast disease.
·         Consult effectively with other physicians and health care professionals.
 
Manager
Specific Requirements:
·         Understand the economic issues pertaining to breast imaging/screening
·         Able to supervise quality assurance activities.
 
Health Advocate
Specific Requirements:
·         Can explain benefits and risks of breast imaging/screening
·         Identify important risk factors for breast cancer.
·         Recognize when radiologic investigations or procedures would be detrimental to the health of the patient.
 
Scholar
Specific Requirements:
·         Demonstrate self-motivation and understand the unique learning acquired while actively directing workup of breast pathology.
·         Critically appraise medical literature as it relates to breast imaging and disease.
·         Able to educate clinical colleagues, medical students and technical staff on issues relating to breast imaging.
·         Attend designated rounds.
 
Professional
Specific Requirements:
·         Be able to accurately assess one’s own performance, strengths and weaknesses.
·         Be punctual and make him/her self available for teaching and review sessions.
·         Exhibit appropriate interpersonal relationships with clinicians and support staff
·         Uphold confidentiality of patients and their right to make informed decisions.
 
RESIDENT DUTIES:
  • As in most rotations, the resident is expected to take a graded increased responsibility during the mammography training
  • The resident will be first in line to supervise breast imaging.  The resident will check cases with the staff radiologist while the patient waits to determine what other/if any other imaging/procedures are needed.  Radiologists will always supervise.
  • The resident will have the most valuable experience by being immediately available/present for the technologists.  Arrive at 8:00 am the first day and proceed directly to the mammography area.  Check the procedure list in mammography and ultrasound.
  • Cases performed will be reviewed by the resident with the staff radiologist, then reported by the resident with the staff radiologist.
 
RESIDENT EVALUATION:
Ideally feedback should be provided on an on-going basis from the attending radiologist.  An ITER will be completed by the rotation supervisor and reviewed with the resident at the end of the rotation.
 
RECOMMENDED READING:
  • Breast Imaging – Kopans
  • Teaching Atlas of Mammography – Tabar & Bean
  • Breast Imaging Companion – Cardenosa
  • ACR BIRADS atlas
  • CAR Breast Imaging CD