Guidelines

for
Competency Based Training
Programme
in

DNB- RADIO DIAGNOSIS

NATIONAL BOARD OF EXAMINATIONS

Medical Enclave, Ansari Nagar, New Delhi-110029, INDIA
Email: [email protected] Phone: 011 45593000

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CONTENTS

I. OBJECTIVES OF THE PROGRAMME

a) Programme goal
b) Programme objective

II. ELIGIBILITY CRITERIA FOR ADMISSION

III. TEACHING AND TRAINING ACTIVITIES

IV. SYLLABUS

V. COMPETENCIES

VI. THESIS & THESIS PROTOCOL

VII. LOG BOOK

VIII. NBE LEAVE GUIDELINES

IX. EXAMINATION –

a) FORMATIVE ASSESSMENT
b) FINAL THEORY & PRACTICAL

X. RECOMMENDED TEXT BOOKS AND JOURNALS

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PROGRAMME GOAL

 To make them understand & implement the knowledge regarding the role
of various imaging modalities, helpful in the management of different
clinical conditions. At the end of his/her training, he/she should be capable
to take up a career in teaching institution or in diagnostic center or in
research..

 Aimed at imparting training in both conventional radiology and modern

imaging techniques so that the candidate is fully competent to practice,
teach and do research in the broad discipline of radiology including
ultrasound, Computed Tomography and Magnetic Resonance Imaging.
Candidate should be well versed with medical ethics and consumer
protection act and the Prenatal Diagnostic Technique (PNDT) Act.

 To orient and train student in different aspects of diagnosis with

interventional radiology

 Special emphasis will be on new imaging techniques like (USG, CT, MRI)
interventional radiology.

 Training will be oriented for technical aspects of clinical radiology and

applied radiology and post treatment follow up in cancer.

 Ultimate goal will be to provide quality education for the post graduates
and quality diagnostic care for different sections of the society

PROGRAMME OBJECTIVES
 Etiology, patho-physiology, and principles of diagnosis and management
of common problems including emergencies, in adults and children.

 Demonstrate understanding of basic sciences relevant to this specialty.

 Identify important determinants in a case (e.g. social, economic,

environmental and take them into account for planning therapeutic
measures.

 Recognize conditions that may be outside the area of

specialty/competence and to refer them to proper specialist or ask for
help.

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 Advise regarding the management (including interventional radiology) of
the case and to carry out the management effectively.

 Update oneself by self-study and by attending courses, seminars,

conferences and workshop which are relevant to the field of radio-
Diagnosis.

 Carry out guided research with the aim of publishing his/her work and
presenting work at various scientific fora.

 Take a proper clinical history, examine the patient, perform essential

diagnostic/interventional procedures and interpret the results to come to a
reasonable diagnosis or differential diagnosis in the condition.

 Provide basic life saving support service in emergency situations.

 Undertake complete patient monitoring including the care of the patient.

 Independently conduct and interpreted all routine and special radiological

and imaging investigations

 Interact with other specialists for the maximum patient benefit

 Undertake further specialization in field of Radiology

 To conduct teaching program for undergraduate and paramedical and

technical staff

 Adopt ethical principles in all aspects of his/her practice. Professional

honesty and integrity to be fostered.

 Develop communication skills in order to explain the various options

available in management and to obtain a true informed consent from the
patient.

 Be humble and accept the limitations of his knowledge and skills and to
ask for help from colleagues/ seniors when needed.

 Respect patient rights and privileges including patient’s right to information

and right to seek a second opinion.

 Organize CMES and workshops utilizing modern methods of teaching and

evaluation

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ELIGIBILITY CRITERIA FOR ADMISSIONS TO THE PROGRAMME

(A) DNB Radio Diagnosis Course:

1. Any medical graduate with MBBS qualification , who has qualified the
Entrance Examination conducted by NBE and fulfill the eligibility criteria
for admission to DNB Broad Specialty courses at various NBE accredited
Medical Colleges/ institutions/Hospitals in India is eligible to participate in
the Centralized counseling for allocation of DNB Radio Diagnosis seats
purely on merit cum choice basis.

2. Admission to 3 years post MBBS DNB Radio Diagnosis course is only

through Entrance Examination conducted by NBE and Centralized Merit
Based Counseling conducted by National Board of Examination as per
prescribed guidelines.

(B) DNB (Post diploma) Radio Diagnosis Course:

1. Any medical graduate with MBBS qualification who has successfully

completed DMRD (and fulfill the eligibility criteria for admission to DNB
(Post Diploma) Broad Specialty courses at various NBE accredited
Medical Colleges/ institutions/Hospitals in India is eligible to participate
in the Centralized counseling for allocation of DNB (Post Diploma)
Radio Diagnosis seats purely on merit cum choice basis.

2. Admission to 2 years post diploma DNB Radio Diagnosis course is

only through PDCET Centralized Merit Based Counseling conducted by
National Board of Examination as per prescribed guidelines.

Duration of Course:

For Primary candidates : 3 years

For Secondary Candidates : 2 years

Every candidate admitted to the training programme shall pursue a regular

course of study (on whole time basis) in the concerned recognized institution
under the guidance of recognized post graduate teacher for assigned period of
the course.

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TEACHING AND TRAINING ACTIVITIES

The fundamental components of the teaching programme should include:

1. Case presentations & discussion- once a week
2. Seminar – Once a week
3. Journal club- Once a week
4. Grand round presentation (by rotation departments and subspecialties)-
once a week
5. Faculty lecture teaching- once a month
6. Clinical Audit-Once a Month
7. A poster and have one oral presentation at least once during their training
period in a recognized conference.

The rounds should include bedside sessions, file rounds & documentation of case
history and examination, progress notes, round discussions, investigations and
management plan) interesting and difficult case unit discussions.

The training program would focus on knowledge, skills and attitudes (behavior), all
essential components of education. It is being divided into theoretical, clinical and
practical in all aspects of the delivery of the rehabilitative care, including methodology of
research and teaching.

Theoretical: The theoretical knowledge would be imparted to the candidates through

discussions, journal clubs, symposia and seminars. The students are exposed to recent
advances through discussions in journal clubs. These are considered necessary in view
of an inadequate exposure to the subject in the undergraduate curriculum.

Symposia: Trainees would be required to present a minimum of 20 topics based on the

curriculum in a period of three years to the combined class of teachers and students. A
free discussion would be encouraged in these symposia. The topics of the symposia
would be given to the trainees with the dates for presentation.

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Clinical: The trainee would be attached to a faculty member to be able to pick up
methods of history taking, examination, prescription writing and management in
rehabilitation practice.

Bedside: The trainee would work up cases, learn management of cases by discussion
with faculty of the department.

Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals
is given towards the end of this document. The candidate would summarize and discuss
the scientific article critically. A faculty member will suggest the article and moderate the
discussion, with participation by other faculty members and resident doctors. The
contributions made by the article in furtherance of the scientific knowledge and
limitations, if any, will be highlighted.

Research: The student would carry out the research project and write a thesis/
dissertation in accordance with NBE guidelines. He/ she would also be given exposure
to partake in the research projects going on in the departments to learn their planning,
methodology and execution so as to learn various aspects of research.

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SYLLABUS

Physics related to Radio diagnosis

 Introduction to general properties of radiation and matter. Fundamental of

nuclear physics and radioactivity.
 Production of x-ray
 X-ray generating apparatus
 Interaction of x-rays and gamma rays with matter and their effects on
irradiated materials.
 Measurement of x and gamma rays
 Interaction of x-rays with the patients
 Radiographic image
 The image receptor
 Contrast media.
 Radiation protection & Radiation hazard
 Picture archiving and communication system (PACS) and Radiology
Information system
 Image quality and quality assurance
 Radionuclide imaging (gamma camera, spect. PET)
 Computed tomography
 Principles of diagnostic ultrasound and Doppler
 Magnetic resonance imaging

Radiography and Processing techniques

 Dark room technique

 Radiography of the extremities
 Radiography of the spine, abdomen, pelvic girdle and thorax
 Radiography of the skull
 Contrast techniques of GI tract, biliary tract, GU tract
 Contrast techniques of C.N. system
 Contrast techniques of the cardio vascular system including chest
 Miniature radiography, macro radiography & magnification techniques
 Pediatric Radiography
 Dental , portable and emergency radiography
 Contrast & contrast reactions
 Quality Assurance

Anatomy

 Gross and cross sectional anatomy of all the body systems.

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Pathology

 Gross morphology of pathologies condition of systemic disease.

RADIODIAGNOSIS –COURSE CONTENTS

Various diseases involving the following systems-

 Musculoskeletal System
 Respiratory System
 Cardio-vascular system
 Gastro-intestinal tract including Hepatobiliary system
 Urogenital tract.
 C.N.S. including spine
 Radiology of obstetric and Gynecology
 E.N.T, EYES, Teeth, soft tissue, Breast.
 Endocrinal Glands
 Clinical applied radionuclide imaging.
 PAC’S, digital radiography and other recent advances, molecular and
Functional imaging.
 Emergency radiology and trauma
 Interventional Radiology related to different system of the body.
 Radiation Physics.

Contrast Agents:-

Contrast media, their type, formulation, mechanisms of action, dose schedule,

routes of administration, adverse reactions and their management and recent
development.

THE RESPIRATORY SYSTEM

 The normal chest, methods of investigations, techniques, interpreting

chestradiograph and disease differential diagnosis. The mediastinum,
chest wall, pleura and diaphragm; Diseases of airways: collapse and
consolidation; pulmonary infections ; pulmonary neoplasm’s;

 Diffuse lung diseases; occupational lung disease; chest trauma,

pulmonary thromboembolism; chest in critical care patients, interventional
techniques ; chest in neonates, and pediatric chest radiology.

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THE CARDIOVASCULAR SYSTEM:

 Goal is to provide experience in the role of imaging in cardiovascular

diseases by different techniques including cardiac cathaterization and
cardiac angiography, Digital subtraction angiography (DSA) and
interventional procedures in non cardiac arterial and venous diseases

 Diseases and disorders of cardiovascular system including congenital

conditions and the role of imaging by conventional, ultrasound, Echo,
color-Doppler, CT, MRI, angiography (including DSA) and radionuclide
studies. It also includes interventional procedures e.g; balloon angioplaty,
embolization etc.

 Understand the anatomy and common pathology of congenital and

acquired cardiac conditions.

 Correlate plain film findings of common congenital abnormalities with

those shown by angiography and explain the pathophysiology including
abnormal pressure measurements.

 Correlate plain film findings and the echocardiographic studies of patients

with acquired valvular diseases and other common pathologic conditions
including pericardial pathology.

 Understand the role of newer modalities like CT/MRI, in aortic diseases

e.g., aorto- arteritis, aortic dissection and aortic aneurysm.

 Should be able to perform fluoroscopy on patients before and after valve

replacement and identify those with complications after valve replacement.

 Understand the principle and logic behind various interventional

procedures carried out in the cardiovascular labs e.g; PTCA, balloon
dilatation of valvular lesions, septostomy etc.

 The normal heart: anatomy and techniques of examination.

 Acquired heart disease

 Techniques: the chest radiograph, non-invasive imaging

echocardiography, nuclear imaging, CT, MRI. Invasive imaging and
interventional techniques

 Congenital heart disease, ischemic heart disease, radiology of pulmonary

circulation, cardio my apathies and tumors, pericardial disease cardiac
transplant surgery; role of Radiology in cardiac prostheses and

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pacemakers, Arteriography and interventional angiographic
techniques,Phlebography

THE ABDOMEN AND GASTROINTESTINAL TRACT

 Basic anatomy and physiology in clinical practice relevant to imaging

examinations of the gastrointestinal tract, hepatobiliary tract, pancreas

 Clinical significance of pathology associated with clinical presentation and

link with likely diagnoses

 Construction of appropriate imaging pathway and protocol considering

different pathologies and management options and according to available
resource and case complexities

 Common surgical procedures, expected post-operative imaging

appearances and common complications

 Understand indications, contraindications and limitations of relevant

specialized barium/contrast imaging examinations of the gastrointestinal
and hepatobiliary tract

 Role of plain films in modern era imaging of GIT

 Conventional examination of GIT using barium and water soluble contrast

media- esophagus, upper gastrointestinal study, follow through for small
bowel (including small bowel enteroclysis)and enema (both conventional
and double contrast) for colon.

 Other investigations done using fluoroscopic guidance - fistulogram,

sinogram, t-tube cholangiography, sialography etc.

 Examination of liver, biliary system and pancreas using all the imaging
modalities available to a radiologist including specialized investigations
like ERCP, PTC and interventional procedures like abscess drainage,
percutaneous trans hepatic biliary drainage (PTBD, internal and external),
tumor embolization, radiofrequency(RFA) ablation etc.

 Indications and limitations of ultrasound, CT and MR

 Understand indications, limitations and contraindications of various

interventional radiology techniques

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 Diseases and disorders of GIT, omentum, peritoneum and mesentery.
Diseases and disorders of hepato-biliary-pancreatic system. Conventional
and other imaging methods like US, CT, MRI, DSA and isotope studies
pertaining to these systems.

 The Abdomen : Normal appearance, abdominal calcification, acute

abdomen, pneumperitoneum, post operative abdomen, Intraperitoneal
fluid, inflammatory conditions, intraabdominal abscesses, intramural gas
and other conditions.

 The Esophagus-anatomy and normal appearances, radiological

investigation like barium, usg, including endovascular, CT, MRI. diseases-
hiatus hernia, oesophagitis, neoplasm, esophageal Varices, associated
dermatological conditions, trauma, esophageal web, motility
disorders,eosophageal diverticulum, extrinsic esophageal compression,
post operative changes, scintigraphy.

 The Stomach - anatomy and normal appearances, radiological and

imaging investigations, inflammatory diseases, tumors, structural and
functional abnormalities, extrinsic masses, post operative stomach- USG,
CT, MRI, examination, radionuclide studies.

 The Duodenum and small bowel-anatomy and normal appearances,

radiological investigations ( Barium meal follow through, enteroclysis,
CT,MRI, with CT/MRI enteroclysis, virtual endoscopy). diseases-
neoplasms, infections, and infestations, radiation enteritis, mechanical
small bowel intestinal obstruction, ischemia, intramural hemorrhage,
diverticulitis, and blind loop, neuromuscular disorders, malabsorption
syndromes, immunological disorders, radionuclide studies of small bowel.

 Large Bowel-Anatomy, colonic function, investigations like (Barium, CT,

MRI, Colonography, virtual colonoscopy), diseases- tumors, diverticular
diseases, colitis, miscellaneous conditions, appendicitis, Scintigraphic
detection of bleeding,

Abdominal imaging-

 Liver: gross anatomy, plain film diagnosis, investigations like USG, CT,
MRI, MRCP, PTC, ERCP, T-tube cholangiography, vascular studies,
hepatobiliary interventions., portal hypertension, focal masses, diffuse liver
disease, inflammatory disease of liver, gall bladder and biliary diseases,
gall bladder masses, radiology in liver transplantation. Radiology of spleen
pancreas, peritoneum and mesentery, Pancreas; embryology, radiological

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anatomy, techniques of examination, radiological diagnosis and
interventional treatment.

 GI manifestation of AIDS; Radiological evaluation, techniques, lesions,

oesophagitis, lesions involving stomach, small bowel, colon, biliary tract,
 ymphadenopathy.

 GI angiography – general considerations, celiac and hepatic, pancreatic,

SMA & IMA angiography, GI bleeding, angiography in portal hypertension,
PTA and mesenteric ischemia.

 Newborn and young infant: lesions causing obstruction, atresia, gastric,

antral or pyloric atresia, small bowel atresia, anal atresia and imperforate
anus, anomalies of rotation and mid gut volvulus, enteric duplication,
hypertrophic pyloric stenosis, gastro esophageal reflux and hiatus hernia,
Hirschsprung’s disease, colonic immaturity, neonatal small left colon
syndrome, meconeum plug syndrome, meconium ileus, intussusceptions,
necrotizing enterocolits

 Role of Imaging in Fetal Medicine

 Acute abdomen - investigations and interpretations with abdominal trauma

imaging

 Radiology of Post-operative abdomen and organ transplantation (Liver,

Pancreas, etc.)

 Ischemic conditions of Bowel and Mesentery and role of

arteriography and Doppler study

 Upper and lower GI bleeding and GI radiological investigations including

scintigraphy

 GI manifestation of AIDS; Radiological evaluation, techniques, lesions,

esophagitis, lesions involving stomach, small bowel, colon, biliary tract,
lymphadenopathy

ENDOCRINE DISEASE

 Introduction, Pathophysiology, radiological techniques, hypothalamus,

pineal, pituitary, thyroid, para thyroid, thymus, pancreas, GI tumors,
adrenal, female reproductive system, male reproductive system

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GENITO-URINARY SYSTEM –

 Applied anatomy to interpret uro-gynaecological imaging

 Clinical significance of pathology associated with presentation and link

with likely diagnoses

 Knowledge of local/regional guidelines in relation to clinical presentation

 Various diseases and disorders of genito-urinary system including

congenital,inflammatory, infectious, traumatic, neoplastic, calculus
disease and miscellaneous conditions.

 Performance, direction and interpretation of the conventional radiological

examinations of the urinary tract including: intravenous urography;
cystograms, micturating cystourethrography (MCU),
hysterosalpingography (HSG) and retrograde urethrography (RGU).

 Diagnostic imaging modalities and procedures which are used to evaluate

urinary tract pathology i.e. Ultrasound, CT, MRI, angiography, as well
as various interventional procedures like percutaneous nephrostomy,
radio frequency ablation (RFA), kidney biopsy, stent placement, antegrade
pyelography, tumor embolization etc.

 Emergency conditions involving the urinary tract including trauma,

infection, vascular compromise and obstruction.

 Evaluation of renal mass lesions and the evaluation of other urinary tract
neoplasms, including the detection and staging of the tumor.

 Recognition of the difference between the pattern of diseases affecting the

genitourinary tract of adults and that of children and understand and
identify the common conditions affecting the pediatric genito-urinary
system on imaging.

 Evaluation of renal failure & post-transplant kidney.

 Miscellaneous including cystic disease of kidney, nephrocalcinosis, lower

urinary tract obstruction/infection and post-operative problems, male
infertility imaging and interventions and trauma of genito-urinary tract

 Interventional Uroradiology – Percutaneous nephrostomy, renal cyst

puncture, FNAC and ureteric stenting.

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 The female reproductive system: ultrasound in obstetrics and gynecology,
antenatal ultrasound including TIFFA, NT/NB , obstetric doppler evaluation
, imaging in gynecology, MRI of female pelvis, radiological techniques in
obstetrics and gynecology, congenital anomalies of female genital tract,
inflammatory diseases, tumors of pelvis.

 Imaging in infertility with detailed knowledge of HSG

 Methods of investigation – plain films, IVU, MCU, ultrasound, CT

scanning, MRI, MR-angiography, antegrade pyelography, retrograde
pyelography, cavernosography, radionuclide imaging. Nuclear medicine in
genitourinary tract, clearance techniques, dynamic renal scan, static renal
scan, V-U reflux, role of radionuclide scanning in renal infections,
Urodynamics, lower urinary tract studies, applications in bladder instability,
urinary incontinence, outflow obstruction, neurogenic bladder, & upper
urinary tract, disease.

 Renal parenchymal disease; anatomy, normal appearances, differential

diagnosis, renal infections. Renal masses: modalities available for
diagnosis, non-neoplastic renal masses, neoplastic renal masses - benign
and malignant, calculus disease and urothelial lesions, nephrocalcinosis,
other lesions, staging of upper urinary tract tumors, staging of balder
tumors.

 Urinary obstruction: Pathophysiology, diagnosis by different modalities,

non obstructive dilatation, causes of obstruction, urinary bladder; normal
anatomy, radiological evaluation, pathologies, prostate: Normal anatomy,
radiological investigations, congenital processes, infection, calculi, tumors,
BHP, carcinoma. Reno vascular hypertension, renal arteriogrpahy, Reno
vascular disorders, Reno vascular HT - etiology, management,
investigative strategy, identification of renal artery stenosis, significance of
renal artery stenosis, radiological treatment of Reno vascular
hypertension, PTA, embolization in Reno vascular HT. Injuries to urinary
tract-kidney, ureter, bladder and urethra classification of renal injuries,
principles of management, evaluation, imaging, modalities, radiological
findings, complications. Renal failure and transplantation; renal size and
collecting system dilatation, diagnosis of causes of failure, transplant -
investigation of donor, IVU, vascular studies, radionuclide imaging,
evaluation of recipient, surgical techniques, transplant kidney –
radionuclide imaging, ultrasound, angiography, CT, MRI and
complications of transplantation.

 Paediatic uroradiolgoy: introduction, techniques, embryology, congenital

anomalies, neonatal conditions, infections and V-U reflux, hypertension in
a child, renal tumors in childhood.

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MUSCULOSKELETAL SYSTEM

 Skeletal Trauma: General conditions, spine: cervical, thoracolumbar,

pelvis and acetabulum, appendicular skeleton. General classification of
bone lesions, benign tumors & cysts of bone, giant cell tumors, tumors of
fibrous origin, other tumors, tumor like conditions synovial tumors,
malignant bone tumors, metastatic lesions, primary malignant tumors,–
chondral origin, osteoid origin, fibrous origin, marrow origin, notochord
origin, synovial origin, other tumors.

 Bone and joint infections: periostetis and osteomyelitis, chronic

osteomyelitis, bone and joint infections, in neonates, infections arthritis,
granulomatous arthritis, parasitic and fungal infections, viral disorders,
sarcoidosis, diabetic osteopathy, infected prostheses.

 Metabolic and endocrine diseases of the skeleton, anatomy, and

physiology; increase and decrease in the bone density, generalized or
localized; quantitative bone mineral analysis. Skeletal dysplasia’s; normal
bone growth, disorders affecting growth plate, disorders affecting
epiphysis and apophyses metaphyses, diaphyses,
mucopolysacchariodoses, mucolipidoses, miscellaneous conditions
including neurofibromatosis and Paget’s disease, chromosomal disorders;
Cranio – vertebral instability, joint disorders, Patho physiological concept
and diagnostic approach Inflammatory (synovial) arthropathies, connective
tissue disorders, crystal deposition arthropathies, degenerative joint
arthropaties, degenerative disease of spine, arthography, radiology of soft
tissues; imaging techniques, focal lesions, calcification and ossification.
Gas in soft tissue, soft tissues tumors; musculo skeletal system in
children-development and nutrition; Congenital anomalies and bone
Dysplasia, inflammatory neoplastic, traumatic, endocrine, metabolic and
systemic skeletal disorders in children; radiology of child abuse;

 Musculo Skeletal CT (computed tomography), techniques aspects of

clinical applications; in trauma; musculo skeletal infections neoplasm’s
and low-back pain syndromes, quantitative bone mineral analysis, uses in
joint diseases, CT-based interventional techniques

 Musculo skeletal MR (Magnetic Resonance Imaging), normal signals,

bone marrow-reconversion, infiltration or, replacement, bone marrow
edema, myeloid depletion, bone ischemia, bone tumor imaging, joint
imaging; Radio-nuclide bone imaging: Technique, normal bone scan,
specific applications.

 Ultrasound in Musculoskeletal system for assessment of muscular,

tendinous and ligamentous pathologies and joint.

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CENTRAL NERVOUS SYSTEM:

 Methods of examination and diagnostic approach; cranial and intracranial

pathologies, intracranial tumors- supra and infratentorial, pituitary tumors,
intracranial infections, degenerative disorders, demyelinating disorders,
cerebro-vascular ischemia, intracranial vascular abnormalities, HIV
infections- cerebral complications.
 Spine: methods and diagnostic approach. Plain Radiography, CT, MRI,
Myelography, spinal angiography. Radionuclide imaging of CNS-
Radiopharmaceutical and bloodbrain barrier(BBB), scintigraphy,
radinuclide arteriography, positron emission tomography(PET), receptor
imaging, monoclonal body imaging, ultrasound of infant brain.

OPHTHALMOLOGY, ENT and FACE; maxillofacial and dental radiology

 Orbits: anatomy and techniques, intraocular abnormalities, orbital

pathology, orbital trauma, inflammatory disease, space occupying lesions;

 Nose and Para nasal sinuses, Ear-Anomalies or development, methods of

investigation, HRCT temporal, anatomy and diseases, MRI for inner ear,
mouth, pharynx and larynx, Para pharyngeal spaces.

 Ocular ultrasound and its applicationsin detection of posterior segment

diseases

 Neck anatomy on various modalities and diseases and application of

various imaging modalities like CT, MRI, and Isotope studies, PET,
SPECT etc

 Neck spaces anatomy in relevance to spread of various diseases across

different spaces and compartments.

 Diseases Involving larynx- congenital, infectious, inflammatory and

neoplastic

 Malignant & benign neoplastic diseases of head and neck region

 MRI for inner ear, mouth, pharynx and larynx, Para pharyngeal spaces.

 Maxillofacial pathology, fracture, benign lesions, malignant lesions,

differential diagnosis of radiolucent and radio opaque lesions,

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abnormalities of growth and development, tempomandibular joint, salivary
glands, soft tissue calcification, dental radiology, anatomy of teeth and
supporting structure

 Dental radiology, anatomy of teeth and supporting structure

,Developmental anomalies, eruption of teeth, dental carries, pulpuitis and
periapical infection, periodontal disease, fracture of teeth and alveolar
bone, resorption of teeth, Neck anatomy on various modalities and
diseases.

Reticuloendothelial Disorders

 Lymphoma-pathology and imaging, spleen- Imaging, interventional

techniques

 Imaging in oncology-General methods in oncological diagnosis, staging

and follow-up, ovarian tumors, nonseminomatous germ cell tumor,
colorectal cancers, lung cancer and others

 Radiotherapy, treatment planning, interventional radiology-complication

and treatment, radionuclide imaging in oncology, HIV infection and
AIDS(Acquired immunodeficiency syndrome), background, epidemiology,
treatment pathogenesis, natural history diagnosis complication and
treatment

 Myeloproliferative disorders: red blood cell disorders, chronic hemolytic

anemia’s, other anemia’s and bone marrow dyscrasias, white cell
disorders, lymphoma, plasma cell disorders, reticulo- endothelial
disorders, hemophilia and other bleeding disorders

Angiography –intervention and other techniques

 Embolization, Percutaneous Trans luminal angioplasty, regional

arteriography, head and neck, thorax, abdomen, upper and lower
extremity angiography, angiography for endocrinal glands.

Venography

 Technique and complications ,regional venography of head and neck,

thorax and abdomen-SVC venography,IVC venography, Azygos and
ascending lumbar venography, Mesenteric and portal venography,

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gonadal venography, pelvic venography, venous sampling, interventional
technique in venous system.

Vascular Imaging

 Doppler Ultrasound, clinical applications, volumetric flow measurements,

color- flow imaging, artifacts, error and pitfalls, power Doppler and
endovascular ultrasound
 Interventional radiology: informed consent, biopsy procedures
 Percutaneous decompression, extraction and drainage
 Image guided therapy
 Interventional vascular techniques
 Percutaneous techniques for vascular extractions impact on medicine and
radiology

The Breast:

 Understand anatomy and physiology of breast, changes with age and

patterns of disease spread and principles of differentiation between
normal breast, benign and malignant disease

 Physics of image production and how it affects image quality with respect
to mammography, ultrasound & breast MRI with indications for and
determining optimal imaging examination

 Clinical presentation, pathogenesis and basic principles of treatment of

breast disease

 Role of conventional and digital mammography in screening of breast

cancer, benign and malignant lesions of the breast

 Interpretation of mammograms

 Understand basic principles underlying population screening and

assessment of screen detected abnormalities

 Breast ultrasound - discriminate cystic v solid mass; recognize typical

features of benign and malignant masses; identify and discriminate
between normal and abnormal axillary lymph nodes.

 Image guided cyst aspiration, abscess drainage, fine needle aspiration

and core biopsy under supervision, Vacuum assisted biopsy (VAB),
stereotactic FNAC and biopsy, ductography.

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 BIRADS and New BIRADS system for lesion characterization and quality
assurance

 MRI breast with emphasis on use of volume MR with newer sequences in

breast imaging like DWI & PWI

 Breast tomosynthesis

 Role of breast cancer screening and guidelines

 The mammographic technique, equipment and quality control, indications

for mammography, normal anatomy, benign conditions, carcinoma,
calcifications, breast screening, lesion localization, breast ultrasound. Role
of MRI, PET, thermography, Elastography, CT, Image guided
interventions for diagnosis and therapy of breast lesions

Diagnostic Techniques and General Conditions-

 Picture archiving and communication systems and digital radiology,

intravascular iodinated contrast media, general principles of ultrasound,
vascular ultrasound, recent developments in whole body Computed
tomography, Basic principles of Magnetic Resonance Imaging, General
Principles of Radionuclide imaging, dual energy X-ray absorptionetry,
functional imaging, medico legal issues in diagnostic and interventional
radiology, patient dosage and radiation protection in diagnostic imaging
,cost benefit.
Radiology Emergency Medicine

 The student should be able to evaluate emergency radiographic

examinations with reasonable accuracy and have clear understanding of
the protocol of imaging in emergency situations of different organ systems.

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Diagnostic Techniques

General Radiology

The student should be able to evaluate conventional radiographs including

radiographs on chest abdomen, pelvis, skull (including PNS+Orbit), spine,
musculoskeleton and soft tissues. Student should be able to perform radiography
of different body parts.

Ultrasound

The student should be able to perform and interpret all ultrasound studies. These
studies include: abdomen, pelvis, small parts, neonatal head, breast, color
duplex imaging (arterial and venous studies), obstetric/gynecology and
intervention procedures using ultrasound guidance.

CT

 Select CT protocol according to the clinical diagnosis.

 Demonstrate knowledge of the CT finding of the common pathological
conditions.
 Interpret conventional and modified body CT examinations like HRCT,
dual/triple phase, Vertical CT etc.
 Know limitations of CT in the diagnosis of certain diseases.
 Perform CT guided simple interventions (under supervision)

Angiography

Should be able to perform (under supervision) and interpret routine angiographic

procedures and vascular interventions.

MRI

 Select MRI protocol according to the clinical diagnosis

 Knowledge of conventional and modified MRI examinations, including
MRA, MRV, MRCP, MRS.
 Demonstrate knowledge of the MRI of the common pathological
conditions.
 Mammography and Breast Intervention
Interventional Radiology

The student should be able to perform (under supervision) simple interventional

procedures of all the organ systems.

21
 Vascular interventional radiologic procedures such as Percutaneous
transluminal angioplasty, stenting, embolization using various embolic
material and arterial & venous thrombolysis.

 Various non-vascular interventional procedures such as percutaneous

nephrostomy, stenting, abscess drainage, PTC/PTBD, biliary stenting
percutaneous US/CT guided biopsy, balloon dilatation of the esophagus
etc

 Regional arteriography of head and neck, thorax, abdomen, upper and

lower extremities.

 Venography; technique and complications , regional venography of head

and neck, thorax and abdomen-SVC venography, IVC venography, Portal
venography, gonadal venography, pelvic venography, venous sampling,
interventional technique in venous system

 Trans arterial chemoembolization & Trans arterial radio embolization –

indications, technique and complications

 Doppler evaluation and endovascular management of varicose veins

 Neurointerventions in stroke. Aneurysm , AVM, fistula

 Bone biopsy

 Radiofrequency ablation : indications, techniques and contraindications

 Digital subtraction angiography: equipment, applications ,

 Radiation protection during interventional procedures

22
RECENT ADVANCES IN RADIOLOGY

ONCOLOGIC RADIOLOGY

 At the end of the rotation the resident should be able to interpret

radiological investigations in patients with neoplastic diseases (both
benign and malignant)
 Understand pathology and patho-physiology of common neoplasms.
 Learn the algorithmic approach to image these patients based on the
suspected disease, its biological behavior and potential and limitations of
various imaging modalities.
 Perform appropriate investigation (both conventional and newer methods),
interpret the results and reach at a reasonable diagnosis/ differential
diagnosis based on the clinical and biochemical results.
 Learn to communicate the results in a precise way in a written report to
the concerned unit.

NUCLEAR MEDICINE

 At the completion of this rotation the resident should be able to interpret

common nuclear medicine examinations (including cardiac cases).
 Student should be able to evaluate the examinations for completion and
determine what further images (including non nuclear medicine) need to
be done.
 Student should have a good understanding of the physical and biological
properties of the commonly used radiopharmceuticals and become
familiar with safe handling of isotopes and basic radiation safety measures
while dealing with isotopes.

Biostatistics, Research Methodology and Clinical Epidemiology

Ethics
Medico legal aspects relevant to the discipline
Health Policy issues as may be applicable to the discipline

23
PRACTICALS
Physics

 Film characteristics
 Effectiveness of Lead Apron and other protective Devices
 Beam parameters check
 Optical Radiation field alignment
 Assessment of Scatter radiation
 Quality control of X-rays and Imaging equipments
 Evaluation of performance of a film processing unit

Practical radiography

 Dark room techniques

 Radiography of the extremities
 Radiography of the spine, abdomen, pelvic girdle and thorax
 Radiography of the skull
 Contrast techniques and interpretation of GI tract, biliary tract, etc.
 Contrast techniques and interpretation of the Genito-urinary system
 Contrast techniques and interpretation of the central nervous and
cardiovascular system
 Miniature radiography, Macro-radiography and magnification techniques
 Dental and portable radiography

Anatomy

Gross and cross sectional Anatomy of all the body systems

Pathology

Gross morphology of pathological condition of various systems

Contrast Media

Their types, formulations, mechanism of action, dose schedule, routes of

administration, adverse reactions and their management.

24
Competencies

General Principles

Acquisition of practical competencies being the keystone of postgraduate

medical education, postgraduate training is skill oriented. Learning in
postgraduate program is essentially self directed and primarily emanating from
clinical and academic work. The formal sessions are merely meant to
supplement this core effort.

Teaching Sessions

In addition to conducting and reporting of routine and special investigation in the

area of posting under direct supervision, formal teaching session to be held on
working days. These include seminars in physics and general radiology, journal
clubs, case presentations; Interdepartmental meets, Film reading session.

Teaching Schedule

The suggested departmental teaching schedule is as follows:

1. Seminar
2. Film Reading
3. Case presentation
4. Inter department meet
5. Journal club
6. Statistical meetings: Weekly./ monthly
7. Mortality meetings
8. Interdepartmental Meetings
9. Film Reading / Physics Seminar

Note

 All sessions will be co-ordinate by the faculty members.

 All the teaching sessions to be assessed by the consultants at the end of
session and graded
 Attendance of the Residents at various sessions should be at least 75%

25
Posting
The postgraduate student should be posted in all sections (Conventional
radiology, U/S, CT, MRI etc.) so that there is adequate exposure to all modalities.
The proposed duration of postings is as under.

 Conventional 10 to 14 months
 U/S 10 to 12 months
 CT / MRI 10 to 12months

SCHEDULE FOR ROTATION OF RESIDENTS

1st Musculosk Emergency US US Chest Chest

Year eletal
GU GU GIT GIT CT CT
2nd US US Chest Musculoskele Emergenc Emergenc
Year tal y y
CT CT Intervent US MRI MRI
ion US /
CT
3rd GIT GIT US US/CT CT CT
Year Intervention
MRI MRI US Chest Elective Elective

Radiological Procedure which the candidates must know

S Name of Procedure As As first Independently under

No. Observer assistant supervision
RADIODIAGNOSIS
1 Dark room(each step) 20 20 100
2 CYR & apicogram & H-virus, 20 20 50
decabities
3 Other X-rays(extremities & spine) 20 20 20
4 Skull 100 50 100
5 Fluroscopy 50 50 50
6 Barium Swallow BMUGI BMFT (& 10 10 50
Enteroclysis) B enema
7 IVP, MCU, RGU 10 10 30
8 Tube based procedures 20 20 20

26
 nephrostmy-T tube
 sinogram, fistulogram
9 Drainage procedures 10 10 50
10 Biopsy / FNAC 10 10 50
11 Doppler 50 100 100
12 TRUS, TVS 50 50 100
13 Neonatal cranial USG 10 20 20

Radiological procedures which the candidates may know/desirable

Name of procedure
RADIO DIAGNOSIS
CT enterocyclysis Dark
MR enterocyclysis
Diffusion & perfusion & MRS
Angiography
 CT
 MR
 DSA
Sonourethrography
Bowel Ultrasound
USG contrast
Transcmial
Interventional Radiology
Nuclear Imaging
 Echocardiography
 Angicardiography

Investigations/ tests which the candidates must know to interpret

Name of Investigations
ERCP
PTC
Arterigraphy/Venography
CT cistenography
CT Mylography, Myelogram
MRCT
MRCP
CT/MR Angiogram/ Venogram

27
THESIS PROTOCOL & THESIS
The candidates are required to submit a thesis at the end of three years of
training as per the rules and regulations of NBE.

Guidelines for Submission of Thesis Protocol & Thesis by candidates

Research shall form an integral part of the education programme of all

candidates registered for DNB degrees of NBE. The Basic aim of requiring the
candidates to write a thesi protocol & thesis/dissertation is to familiarize him/her
with research methodology. The members of the faculty guiding the
thesis/dissertation work for the candidate shall ensure that the subject matter
selected for the thesis/dissertation is feasible, economical and original.

Guidelines for Thesis Protocol

The protocol for a research proposal (including thesis) is a study plan, designed
to describe the background, research question, aim and objectives, and detailed
methodology of the study. In other words, the protocol is the ‘operating manual’
to refer to while conducting a particular study.

The candidate should refer to the NBE Guidelines for preparation and
submission of Thesis Protocol before the writing phase commences. The
minimum writing requirements are that the language should be clear, concise,
precise and consistent without excessive adjectives or adverbs and long
sentences. There should not be any redundancy in the presentation.

The development or preparation of the Thesis Protocol by the candidate will help
her/him in understanding the ongoing activities in the proposed area of research.
Further it helps in creating practical exposure to research and hence it bridges
the connectivity between clinical practice and biomedical research. Such
research exposure will be helpful in improving problem solving capacity, getting
updated with ongoing research and implementing these findings in clinical
practice.

Research Ethics: Ethical conduct during the conduct and publication of research
is an essential requirement for all candidates and guides, with the primary
responsibility of ensuring such conduct being on the thesis guide. Issues like
Plagiarism, not maintaining the confidentiality of data, or any other distortion of
the research process will be viewed seriously. The readers may refer to standard
documents for the purpose.

The NBE reserves the right to check the submitted protocol for plagiarism, and
will reject those having substantial duplication with published literature.

28
PROTOCOL REQUIREMENTS

1. All of the following will have to be entered in the online template. The
thesis protocol should be restricted to the following word limits.

 Title : 120 characters (with spacing) page

 Synopsis [structured] : 250-300
 Introduction : 300-500
 Review of literature : 800-1000
 Aim and Objectives : Up to 200
 Material and Methods : 1200-1600
 10-25 References [ICMJE style]

2. It is mandatory to have ethics committee approval before initiation of the

research work. The researcher should submit an appropriate application to
the ethics committee in the prescribed format of the ethics committee
concerned.

Guidelines for Thesis

1. The proposed study must be approved by the institutional ethics

committee and the protocol of thesis should have been approved by NBE.

2. The thesis should be restricted to the size of 80 pages (maximum). This

includes the text, figures, references, annexures, and certificates etc. It
should be printed on both sides of the paper; and every page has to be
numbered. Do not leave any page blank. To achieve this, following points
may be kept in view:

a. The thesis should be typed in 1.5 space using Times New

Roman/Arial/ Garamond size 12 font, 1” margins should be left on
all four sides. Major sections viz., Introduction, Review of Literature,
Aim & Objectives, Material and Methods, Results, Discussion,
References, and Appendices should start from a new page. Study
proforma (Case record form), informed consent form, and patient
information sheet may be printed in single space.
b. Only contemporary and relevant literature may be reviewed.
Restrict the introduction to 2 pages, Review of literature to 10-12
pages, and Discussion to 8-10 pages.
c. The techniques may not be described in detail unless any
modification/innovations of the standard techniques are used and
reference(s) may be given.
d. Illustrative material may be restricted. It should be printed on paper
only. There is no need to paste photographs separately.

29
3. Since most of the difficulties faced by the residents relate to the work in
clinical subject or clinically-oriented laboratory subjects, the following
steps are suggested:
a. The number of cases should be such that adequate material,
judged from the hospital attendance/records, will be available and
the candidate will be able to collect case material within the period
of data collection, i.e., around 6-12 months so that he/she is in a
position to complete the work within the stipulated time.
b. The aim and objectives of the study should be well defined.
c. As far as possible, only clinical/laboratory data of investigations of
patients or such other material easily accessible in the existing
facilities should be used for the study.
d. Technical assistance, wherever necessary, may be provided by the
department concerned. The resident of one specialty taking up
some problem related to some other specialty should have some
basic knowledge about the subject and he/she should be able to
perform the investigations independently, wherever some
specialized laboratory investigations are required a co-guide may
be co-opted from the concerned investigative department, the
quantum of laboratory work to be carried out by the candidate
should be decided by the guide & co-guide by mutual consultation.

4. The clinical residents are not ordinarily expected to undertake

experimental work or clinical work involving new techniques, not hitherto
perfected OR the use of chemicals or radioisotopes not readily available.
They should; however, be free to enlarge the scope of their studies or
undertake experimental work on their own initiative but all such studies
should be feasible within the existing facilities.

5. The DNB residents should be able to freely use the surgical

pathology/autopsy data if it is restricted to diagnosis only, if however,
detailed historic data are required the resident will have to study the cases
himself with the help of the guide/co-guide. The same will apply in case of
clinical data.

6. Statistical methods used for analysis should be described specifically for

each objective, and name of the statistical program used mentioned.

General Layout of a DNB Thesis:

 Title- A good title should be brief, clear, and focus on the central theme of
the topic; it should avoid abbreviations. The Title should effectively
summarize the proposed research and should contain the PICO elements.

30
 Introduction- It should be focused on the research question and should
be directly relevant to the objectives of your study.

 Review of Literature - The Review should include a description of the

most relevant and recent studies published on the subject.

 Aim and Objectives - The ‘Aim’ refers to what would be broadly achieved
by this study or how this study would address a bigger question / issue.
The ‘Objectives’ of the research stem from the research question
formulated and should at least include participants, intervention,
evaluation, design.

 Material and Methods- This section should include the following 10

elements: Study setting (area), Study duration; Study design (descriptive,
case-control, cohort, diagnostic accuracy, experimental (randomized/non-
randomized)); Study sample (inclusion/exclusion criteria, method of
selection), Intervention, if any, Data collection, Outcome measures
(primary and secondary), Sample size, Data management and Statistical
analysis, and Ethical issues (Ethical clearance, Informed consent, trial
registration).

 Results- Results should be organized in readily identifiable sections

having correct analysis of data and presented in appropriate charts,
tables, graphs and diagram etc.

 Discussion–It should start by summarizing the results for primary and

secondary objectives in text form (without giving data). This should be
followed by a comparison of your results on the outcome variables (both
primary and secondary) with those of earlier research studies.

 Summary and Conclusion- This should be a précis of the findings of the

thesis, arranged in four paragraphs: (a) background and objectives; (b)
methods; (c) results; and (d) conclusions. The conclusions should strictly
pertain to the findings of the thesis and not outside its domain.

 References- Relevant References should be cited in the text of the

protocol (in superscripts).

 Appendices -The tools used for data collection such as questionnaire,

interview schedules, observation checklists, informed consent form (ICF),
and participant information sheet (PIS) should be attached as appendices.
Do not attach the master chart.

31
Thesis Protocol Submission to NBE

1. DNB candidates are required to submit their thesis protocol within 90 days
of their joining DNB training.

2. Enclosures to be submitted along with protocol submission form:

a) Form for Thesis Protocol Submission properly filled.
b) Thesis Protocol duly signed.
c) Approval letter of institutional Ethical committee. (Mandatory, non
receivable of any one is liable for rejection)

Thesis Submission to NBE

1. As per NBE norms, writing a thesis is essential for all DNB candidates
towards partial fulfillment of eligibility for award of DNB degree.
2. DNB candidates are required to submit the thesis before the cut-off date
which shall be 30th June of the same year for candidates appearing for
their scheduled December final theory examination. Similarly, candidates
who are appearing in their scheduled June DNB final examination shall be
required to submit their thesis by 31st December of preceding year.
3. Candidates who fail to submit their thesis by the prescribed cutoff date
shall NOT be allowed to appear in DNB final examination.
4. Fee to be submitted for assessment (In INR): 3500/-
5. Fee can be deposited ONLY through pay-in-slip/challan at any of the
Indian bank branch across India. The challan can be downloaded from
NBE website www.natboard.edu.in
6. Thesis should be bound and the front cover page should be printed in the
standard format. A bound thesis should be accompanied with:
a. A Synopsis of thesis.
b. Form for submission of thesis, duly completed
c. NBE copy of challan (in original) towards payment of fee as may be
applicable.
d. Soft copy of thesis in a CD duly labeled.
e. Copy of letter of registration with NBE.

7. A declaration of thesis work being bonafide in nature and done by the

candidate himself/herself at the institute of DNB training need to be
submitted bound with thesis. It must be signed by the candidate
himself/herself, the thesis guide and head of the institution, failing which
thesis shall not be considered.

The detailed guidelines and forms for submission of Thesis

Protocol & Thesis are available at
www.natboard.edu.in.thesis.php.

32
LOG BOOK

A candidate shall maintain a log book of operations (assisted / performed) during

the training period, certified by the concerned post graduate teacher / Head of
the department / senior consultant.

This log book shall be made available to the board of examiners for their perusal
at the time of the final examination.

The log book should show evidence that the before mentioned subjects were
covered (with dates and the name of teacher(s) The candidate will maintain the
record of all academic activities undertaken by him/her in log book .

1. Personal profile of the candidate

2. Educational qualification/Professional data
3. Record of case histories
4. Procedures learnt
5. Record of case Demonstration/Presentations
6. Every candidate, at the time of practical examination, will be required to
produce performance record (log book) containing details of the work done by
him/her during the entire period of training as per requirements of the log
book. It should be duly certified by the supervisor as work done by the
candidate and countersigned by the administrative Head of the Institution.
7. In the absence of production of log book, the result will not be declared.

33
Leave Rules
1. DNB Trainees are entitled to leave during the course of DNB training as per the
Leave Rules prescribed by NBE.
2. A DNB candidate can avail a maximum of 20 days of leave in a year excluding
regular duty off/ Gazetted holidays as per hospital/institute calendar/policy.
3. MATERNITYLEAVE:
a. Afemale candidate is permitted a maternity leave of 90 days once during
the entire duration of DNB course.
b. The expected date of delivery (EDD) should fall within the duration of
maternity leave.
c. Extension of maternity leave is permissible only for genuine medical
reasons and after prior approval of NBE. The supporting medical
documents have to be certified by the Head of the Institute/hospital where
the candidate is undergoing DNB training. NBE reserves its rights to take
a final decision in such matters.
d. The training of the candidate shall be extended accordingly in case of any
extension of maternity leave being granted to the candidate.
e. Candidate shall be paid stipend during the period of maternity leave. No
stipend shall be paid for the period of extension of leave.
4. Male DNB candidates are entitled for paternity leave of maximum of one week
during the entire period of DNB training.
5. No kind of study leave is permissible to DNB candidates. However, candidates
may be allowed an academic leave as under across the entire duration of training
program to attend the conferences/CMEs/Academic programs/Examination
purposes.
DNB COURSE NO. OF ACADEMIC LEAVE
DNB 3 years Course (Broad & Super Specialty) 14 Days
DNB 2 years Course (Post Diploma) 10 Days
DNB Direct 6 years Course 28 days

34
6. Under normal circumstances leave of one year should not be carried
forward to the next year. However, in exceptional cases such as
prolonged illness the leave across the DNB training program may be
clubbed together with prior approval of NBE.
7. Any other leave which is beyond the above stated leave is not permissible
and shall lead to extension/cancellation of DNB course.
8. Any extension of DNB training for more than 2 months beyond the
scheduled completion date of training is permissible only under extra-
ordinary circumstances with prior approval of NBE. Such extension is
neither automatic nor shall be granted as a matter of routine. NBE shall
consider such requests on merit provided the seat is not carried over and
compromise with training of existing trainees in the Department.
9. Unauthorized absence from DNB training for more than 7 days may lead
to cancellation of registration and discontinuation of the DNB training and
rejoining shall not be permitted.
10. Medical Leave
a. Leave on medical grounds is permissible only for genuine medical
reasons and NBE should be informed by the concerned
institute/hospital about the same immediately after the candidate
proceeds on leave on medical grounds.
b. The supporting medical documents have to be certified by the Head
of the Institute/hospital where the candidate is undergoing DNB
training and have to be sent to NBE.
c. The medical treatment should be taken from the institute/ hospital
where the candidate is undergoing DNB training. Any deviation
from this shall be supported with valid grounds and documentation.
d. In case of medical treatment being sought from some other
institute/hospital, the medical documents have to be certified by the
Head of the institute/hospital where the candidate is undergoing
DNB training.

35
e. NBE reserves its rights to verify the authenticity of the documents
furnished by the candidate and the institute/hospital regarding
Medical illness of the candidate and to take a final decision in such
matters.
11.
a. Total leave period which can be availed by DNB candidates is
120+28 = 148 days for 6 years course, 60+14=74 days for 3 years
course and 40+10 = 50 days for 2 years course. This includes all
kinds of eligible leave including academic leave. Maternity /
Paternity leave can be availed separately by eligible candidates.
Any kind of leave including medical leave exceeding the
aforementioned limit shall lead to extension of DNB training. It is
clarified that prior approval of NBE is necessary for availing any
such leave.
b. The eligibility for DNB Final Examination shall be determined strictly
in accordance with the criteria prescribed in the respective
information bulletin.

36
EXAMINATION

FORMATIVE ASSESSMENT

Formative assessment includes various formal and informal assessment

procedures by which evaluation of student’s learning, comprehension, and
academic progress is done by the teachers/ faculty to improve student
attainment. Formative assessment test (FAT) is called as “Formative “as it
informs the in process teaching and learning modifications. FAT is an integral
part of the effective teaching .The goal of the FAT is to collect information which
can be used to improve the student learning process.

Formative assessment is essentially positive in intent, directed towards

promoting learning; it is therefore part of teaching. Validity and usefulness are
paramount in formative assessment and should take precedence over concerns
for reliability. The assessment scheme consists of Three Parts which has to be
essentially completed by the candidates.

The scheme includes:-

Part I:- Conduction of theory examination

Part-II :- Feedback session on the theory performance
Part-III :- Work place based clinical assessment

Scheme of Formative assessment

Candidate has to appear for
CONDUCT OF THEORY
PART – I Theory Exam and it will be
EXAMINATION
held for One day.
FEEDBACK SESSION ON Candidate has to appear for
PART – II THE THEORY his/her Theory Exam
PERFORMANCE Assessment Workshop.
After Theory Examination,
WORK PLACE BASED
PART – III Candidate has to appear for
CLINICAL ASSESSMENT
Clinical Assessment.

The performance of the resident during the training period should be monitored
throughout the course and duly recorded in the log books as evidence of the
ability and daily work of the student

1. Personal attributes:
 Behavior and Emotional Stability: Dependable, disciplined, dedicated,
stable in emergency situations, shows positive approach.
 Motivation and Initiative: Takes on responsibility, innovative,
enterprising, does not shirk duties or leave any work pending.

37
 Honesty and Integrity: Truthful, admits mistakes, does not cook up
information, has ethical conduct, exhibits good moral values, loyal to the
institution.
 Interpersonal Skills and Leadership Quality: Has compassionate
attitude towards patients and attendants, gets on well with colleagues and
paramedical staff, is respectful to seniors, has good communication skills.

2. Clinical Work:

 Availability: Punctual, available continuously on duty, responds promptly

on calls and takes proper permission for leave.
 Diligence: Dedicated, hardworking, does not shirk duties, leaves no work
pending, does not sit idle, competent in clinical case work up and
management.
 Academic ability: Intelligent, shows sound knowledge and skills,
participates adequately in academic activities, and performs well in oral
presentation and departmental tests.
 Clinical Performance: Proficient in clinical presentations and case
discussion during rounds and OPD work up. Preparing Documents of the
case history/examination and progress notes in the file (daily notes, round
discussion, investigations and management) Skill of performing bed side
procedures and handling emergencies.

3. Academic Activity: Performance during presentation at Journal club/

Seminar/ Case discussion/Stat meeting and other academic sessions.
Proficiency in skills as mentioned in job responsibilities.

FINAL EXAMINATION
The summative assessment of competence will be done in the form of DNB Final
Examination leading to the award of the degree of Diplomate of National Board in
Radio Diagnosis. The DNB final is a two-stage examination comprising the
theory and practical part. An eligible candidate who has qualified the theory exam
is permitted to appear in the practical examination.

Theory Examination
1. The theory examination comprises of Three/ Four papers, maximum
marks 100 each.
2. There are 10 short notes of 10 marks each, in each of the papers. The
number of short notes and their respective marks weightage may vary in
some subjects/some papers.
3. Maximum time permitted is 3 hours.
4. Candidate must score at least 50% in the aggregate of Three/ Four
papers to qualify the theory examination.

38
5. Candidates who have qualified the theory examination are permitted to
take up the practical examination.
6. The paper wise distribution of the Theory Examination shall be as follows:

Paper I

 Principles and practice of Radio diagnosis pertinent to Central Nervous System,

Head and neck, Endocrine system, Musculo skeletal system and soft tissues

Paper II

 Principles and practice of Radio diagnosis pertinent to chest with a focus on

Pulmonary and Cardiovascular Radiology
 Arterial and venous Doppler and Emergency Radiology including Trauma
Radiology.

Paper III

 Principles and practice of Radio diagnosis pertinent to Gastroenterology,

Hepatopancreatobiliary system, Genitourinary system, Obstetric imaging and
Gynecological Radiology

Paper IV

 Basic sciences as applied to Radio diagnosis

 Radiation physics and Radiation biology
 Physics of imaging
 Radiological procedures
 Contrast agents in radiation
 Forensic Radiology
 Research Methodology
 Nuclear Medicine
 Interventional Radiology
 Recent advances

39
a) Practical Examination:
1. Maximum Marks: 300.
2. Comprises of Clinical Examination and Viva.
3. Candidate must obtain a minimum of 50% marks in the Clinical
Examination (including Viva) to qualify for the Practical Examination.
4. There are a maximum of three attempts that can be availed by a
candidate for Practical Examination.
5. First attempt is the practical examination following immediately after the
declaration of theory results.
6. Second and Third attempt in practical examination shall be permitted out
of the next three sessions of practical examinations placed alongwith the
next three successive theory examination sessions; after payment of full
examination fees as may be prescribed by NBE.
7. Absentation from Practical Examination is counted as an attempt.
8. Appearance in first practical examination is compulsory;
9. Requests for Change in center of examination are not entertained, as the
same is not permissible.
10. Candidates are required not to canvass with NBE for above.

Declaration of DNB Final Results

1. DNB final is a qualifying examination.

2. Results of DNB final examinations (theory & practical) are declared as
PASS/FAIL.
3. DNB degree is awarded to a DNB trainee in the convocation of NBE.

40
RECOMMENDED TEXT BOOKS AND JOURNALS

MUST READ

 Sutton: Text book of Radiology and Imaging volume-I-II.

 Grainger and Allison’s Diagnostic Radiology: Text book of Medical
Imaging
 Haaga J.R.: Computed Tomography and MRI volume-I and II. PG
 Rumack: Diagnostic ultrasound volume I & II

REFERENCE BOOKS

 Lee: Computed body tomography with MRI volume-I & II

 Osborn A.G.: Diagnostic neuro-radiology
 Jacobson’s: Radiology of skeletal disorders
 Gore Levine: Text book of Gastrointestinal Radiology
 Margulis: Alimentary tract radiology volume I & II
 Davidson’s: Radiology of the kidney and Genito-urinary tract
 Clark: Positioning in radiology Dahnert: Radiology Review Manual
 Webb: High Resolution CT of the lung
 Som and Curtin: Head and neck imaging
 Stark and Bradley: Magnetic resonance imaging Volume I & II
 Scott W. Atlas: MR imaging of the brain and spine
 Mittelstaedt CA : General ultrasound
 Callen: Ultrasonography in obstetrics and gynaecology
 David Sutlon . Text book of Radiology & Imaging
 Lee Stanley
 Hagea
 Osborn
 Manju Pandey - Biostatistics

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JOURNALS

 Indian Journal of Radiology

 Radiology
 Radiological Clinics of North America
 Seminars in U/S, CT and MRI
 American Journal of Neuro-Radiology
 Clinical Radiology
 Radiology
 Neuro Radiology
 Journal of USG, CT, MRI
 AJR
 Seminars in Roentgenology
 RCNA

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