Subspeciality fellowships in Clinical Radiology

 What is a fellowship?

Fellowships are often seen as an opportunity to undertake training focused on an area of subspecialist interest such as neuroradiology or breast radiology. There are two types of fellowship:

Pre-CCT fellowships

Pre-CCT fellowships are usually undertaken in the final year or two years of speciality radiology training, ideally after completion of FRCR exams. The length and scope of these fellowships are subspecialty dependent with interventional fellowships typically lasting 2-3 years and breast fellowships 1 year. Whilst most trainees will undertake these fellowships within their base deanery, fellowships in other UK deaneries can count towards your training but will require deanery and RCR approval. Trainees may have to undertake fellowships at other deaneries in order to gain additional exposure to imaging/interventional techniques not routinely performed within their deanery. It is relatively uncommon to do pre-CCT fellowships abroad, although it is now recognised by new GMC guidance that ‘outside UK’ experience may form a part of subspecialty training, when approved by your deanery and RCR. The European Society of Radiology has a range of 3 months exchange programmes for fellowships (https://esociety.netkey.at/esr/myesor/).

Post-CCT fellowships

These are potentially valuable and recognised additions for your CV and a further chance for focused training within a chosen subspecialty. You can choose from UK based fellowships advertised by large specialist centres across UK. There is competitive entry and limited spaces which fill up quickly and in advance. If you are considering abroad experience, then Canada, North America, Australia and New Zealand are common destinations for UK radiologists

Are fellowships compulsory?

The RCR official position statement on fellowships:

‘We believe all training schemes should strive to provide excellent higher training in all specialty areas in ST4-ST5 (and to ST6 for IR specialism). Therefore we believe the concept of “fellowships” in these years of training is outdated and should be abandoned. Fellowships in these training years seem often to be more about enhancing the kudos of the institution, rather than any educational benefits to trainees. Higher training opportunities should by default be available to local trainees and should only be advertised nationally in exceptional circumstances when no suitable local applicant has shown interest.’

‘Post CCT fellowship training in specialist areas is welcomed as UK should be able to compete with overseas centres and stop some of the brain-drain that occurs, particularly to N America. However, this type of fellowship should only be offered when it is absolutely clear that there will be no impact upon core and higher training at the locality.

The College’s Training Department and I are unanimous in this view. I realise it will not be popular amongst those who wish to maintain status (quo), but I think it is important that we make an unambiguous statement on this issue.’

(Dr Richard Fowler, Warden Clinical Radiology, 2012)

Not every radiologist has to undertake a subspecialty fellowship to be appointable. Whether you need to do a fellowship or not depends on the type of radiology job you will be aiming to undertake in the future. If you plan to work as a general radiologist with specialist interest or in a district general hospital a post-CCT fellowship is certainly not essential. For those of you considering a career in a tertiary teaching hospitals and/or in a narrow specialist field such as neuroradiology, MSK radiology, paediatric radiology or interventional radiology, then having a fellowship under your belt may increase your chances of getting a competitive job. Fellowship is an opportunity for focused, intense training in a chosen subspeciality field, allowing exposure to level 2 RCR curriculum competencies (https://www.rcr.ac.uk/sites/default/files/cr_curriculum-2016_final_15_november_2016_0.pdf), which may not be available in your centre.

 How to get information about available fellowships?

If you think you may benefit from a fellowship, speak to your senior SpR colleagues, senior consultants within your area of subspecialist interest and your educational supervisor. Junior forums of subspecialty British radiological societies and websites of the specialty centres in UK and abroad are good source of information.

Abdominal and GI radiology fellowships: https://www.bsgar.org/juniors/fellowships/uk-fellowships/

Neuroradiology fellowships: http://bsnr.org.uk/

Interventional fellowships: http://www.bsir.org/bsirt/ir-fellowships/

Paediatric radiology fellowships: http://www.mybspr.org/fellowshipintro.htm

RCR research fellowships: https://www.rcr.ac.uk/clinical-radiology/academic-radiology-and-research/research-fellowships

When to apply for a fellowship?

Regardless of which type of fellowship you are planning, the general rule is to apply early. The timescale is at the discretion of the recruiting institution. Some of the fellowships, especially in North America or Canada advertise and fill up to 2 years in advance.

What are the potential advantages of undertaking a post-CCT fellowship?

  • Opportunity for further focused exposure to RCR curriculum level 2 subspecialty competencies
  • Opportunity to gain experience in imaging modalities/interventional techniques not available within own deanery
  • Opportunity to undertake research within area of subspecialist interest
  • Opportunity to experience the workings of a different radiology department and potentially different health care system
  • Opportunity to travel and explore new corners of the globe

What are the potential disadvantages of undertaking a post-CCT fellowship?

  • Financial implications (see below)
  • Delay in uptake of consultant post
  • Lots of paperwork and organisation needed to set up fellowship
  • Challenges of moving to new location and settling into new radiology department

Financial implications of undertaking a fellowship?

Pre-CCT UK-based fellowships and post-CCT UK and international fellowships come with a salary. It is worth checking in advance whether you can be a part of a local on-call rota, which will enhance your earnings. Competitive fellowship grants and various scholarships are provided for European pre-CCT exchange programmes by European radiological societies and imaging companies.

If considering an overseas fellowship initial expenses to consider include overseas medical registration fees, overseas royal college assessment fee, immigration and visa charges, legal certification of documents and private health assessments. Expenses to consider when undertaking fellowship include relocation costs such as flights, accommodation, car, health insurance, children’s school fees and medical indemnity whilst maintaining UK expenses such as mortgage and professional registration fees.

Do you have a fellowship you would like to advertise?

If you have a fellowship you would like to advertise on our website please contact us