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Guide for final year radiology residents and tips for the MD/DNB/DNB radiology exam!

Final year Radiology Residents
Final year Radiology Residents | Photo by John-Mark Kuznietsov

Guide for final year radiology residents and tips for the MD/DNB/DNB radiology exam!

Congratulations on surviving through three years of radiology!  The next task on hands is clearing the final radiology exam. The Indian examination system and the entire education system is far from perfect. You are expected to slog during the first year without time for reading and then during the final year, you read up without time to apply what you read. 

During the first year you work and have no time to read. In the final year, you read and have no time to put to work what your read!
. Anyways there is not much we can do about that and there is no point arguing. Here is my guide for final year radiology residents.

You can also refer to guides for first-year residents and the FRCR exam.

Radiology Thesis

  • Start working on your thesis as early as possible.
  • Finish your thesis well in advance before your exams so that you do not have that stress at the back of your mind.
  • There can be edits in your thesis so be prepared for that and allocate time accordingly.
  • Here is a detailed guide for preparing Radiology thesis: Radiology thesis topics

Radiology exam: Theory

  • Go through the question banks available here: Question Papers, here,  and this Compiled Question Bank.  (Compiled from DNB Rad, NBE and from various radiology groups). For the latest question papers its best to refer to the official DNB website. You can also search for a particular year question paper using the custom google link I created here: DNB Radiology Question papers. Just enter the particular year in the search box after “radiodiagnosis”
  • System-wise division of Theory exam: Courtesy Dr. Sanjay Yadav.
System-wise division of Theory exam
Division of Theory exam
  • Here is the indicative division of theory topics for each paper on the official DNB page.
  • Decide what books suit you and start reading for the theory radiology exam accordingly. Your seniors will tell you the pros and cons of different books but you should stick to one book that suits you. Diagnostic Radiology Berry series is a good book that covers most of the topics for the radiology exam. Here is the complete list of recommended books: Recommended Books for Radiology Residents.
  • One day prior to the exam you should have a single book to revise so keep one book for each system and whatever you feel is missing add on to that book. The simplest way to do that is to note down additional information on a piece of paper and stick it in that one book using glue. A crude method but works well :).
  • Make heading for each answer and note it down in the book you are reading so that one day before the exam you can revise quickly.
  • Try to read books in physical form and not from an electronic device like an iPad or tablet. Instead, collect all standard books in the digital form and add in material from that in the common book whenever you feel that there is some deficiency.
  • For recent advances go through recent articles of IJRI. I have observed that most of the questions are picked up from there. You do not have to read all the articles. You have to read only those articles which can be posted as a long question. For eg. In the Oct-Dec 2017 issue, there is an article titled: Spinal dysraphism illustrated; Embryology revisited. This can come as a question in the exams. So go through it and make notes in one book as discussed earlier.
  • Keep one book for answers which are not given well in any of the books and you have to refer to online content for that. For eg., MRCP is a commonly asked question but isn’t given in the standard books which we all read (at least at that time when I passed out). So you can refer this article MR Imaging and CT of the Biliary Tract and make notes for this question. On the last day of the exam, you do not have to go searching for the article.
  • Start practicing line diagrams and paste in the books you are going to refer one day before the exam. This book: Primer of Diagnostic Imaging gives a lot of good line diagrams which can be reproduced in the exams.
  • Read and revise physics as it is volatile.
  • Read and revise physics AGAIN as it is volatile!

Radiology Exam: Practical

  • Read and revise physics as it is volatile!
  • Go through all the physics instruments in your department. If not available google about basic radiology types of equipment like the grid, cassettes and how they look.
  • Go through a list of commonly asked spotters, cases and practical questions in DNB exams here Radiology Practical Exam Questions.
  • Here are a few commonly asked Viva questions in the practical radiology exam: Courtesy Dr. Sanjay Yadav sir:
Commonly asked Viva questions in Radiology Practicals.
  • Every examiner is asking PC & PNDT act in viva. In IJRI there are two articles. Please go through it. Form A to Form G you must know.
  • Next, suppose you want to start your own setup. What are the procedure and fees?
  • What is the dose of nonionic contrast in pediatric patients
  • You should know in detail about mitral stenosis. It appears simple but major grilling will be there Barium swallow findings in mitral stenosis Type of mitral valve used in transplant
  • Next tuberculosis findings in long bones and joints You should know Antitubercular drugs
  • Division of mediastinum Anterior and posterior mediastinal masses
  • Contrast you should know, low osmolar, iso-osmolar, high osmolar differences
  • Few examiners are fond of asking how much grams of iodine is present in ionic and non-ionic contrast
  • What is single contrast and double contrast barium study
  • HSG procedure and instruments used in it, medication is given before HSG, contraindications of HSG
  • Posterior urethral valve
  • Umbilical vein and artery catheter, position
  • CR and DR differences
  • Single emulsion and double emulsion film
  • Chemical composition of films
  • Image intensifier
  • Screen
  • Cones and grids
  • Contents of developer and fixer
  • Safe light wavelength
  • Distance between two xray machines and CT scan
  • Atomic number of barium, iodine, gadolinium
  • Signs of pneumoperitoneum
  • Division of liver and lung segments
  • Arnold Chiari malformation
  • Ultrasound contrast available in India,
  • Embolic agents,
  • Heparin dosage
  • Constituents of Ultrasound gel.
  • Coiling, gel, foam, a little about catheters,
  • Spinal arteries anatomy
  • Osteogenesis imperfecta types,
  • Bronchogenic Ca staging
  • Ovarian carcinoma staging,
  • Role of the radiologist in AV malformation,
  • Bronchial artery embolization,
  • PTC procedure
  • Contrast used in myelogram.
  • Absolute contraindication of IVU
  • You make a mistake in differentiating features between Wilm’s and neuroblastoma the examiner will not pardon
  • Role of PET-CT in lymphoma,
  • Pressure injector
  • TLD badge
  • Go through the spotters’ collection in your department.
  • Read the latest ACR Contrast Manual: ACR contrast Manual. You can quote this for contrast related questions that the examiners ask you.
  • Do read about the proper use of TLD.
  • Design for MRI machine
  • There are loads of resources, however, we cannot post all of them owing to size constraints. Browse the collection of radiology exam resources here: Radiology Exam Resources
  • Good books for practical exams
  • Another good book for commonly asked practical questions is Known Unknowns Of Everyday Radiology Practice.
  • For spotters you can go through the following :
  • Here are a few suggestions from someone who has recently cleared DNB practicals in the first attempt:
    • Try memorizing Chapman & Nakielny's Aids to Radiological Differential Diagnosis as much as possible especially the differentials for chest and bone cases.
    • Try presenting as many cases to the department faculty and amongst yourself. Present cases as you would do in the exam.
    • For instruments, viva and interventional radiology go through the following YouTube playlist:

     

    • Revise theory related to radiation protection well. It is commonly asked in exams.
    • On the day of the practical radiology exam : 
      • Get proper sleep the previous night.
      • Reach at least half an hour early to the examination center.
      • Carry all essentials to the center including hall ticket and a copy of your thesis. 
      • Read and revise your thesis well. You will be asked questions on that.
      • During spotters write COMPLETE answers. For eg. “Sessile osteochondroma involving the distal end of the radius.” rather than just sessile osteochondroma.
      • Follow instructions given at the examination center. Do not get in the bad books of the examiners.
      • Respect the examiner’s opinion and try not to argue with them. 
      • Handle films carefully. Examiners have collected cases over their entire career and hence they value them a lot which is obvious. They would not like you handling films in a shabby manner.  You can use this pointer to point findings in the films: Extendable Fescue Ball Pen with LED Flashlight and Laser Pointer.
    Extendable Fescue Ball Pen with LED Flashlight and Laser Pointer

    Smart Pro 4-in-1 Extendable Fescue Ball Pen with LED Flashlight and Laser Pointer

    Smart Pro 4-in-1 Extendable Fescue Ball Pen with LED Flashlight and Laser Pointer

    • Do not cheat. Your colleague is as clueless as you about the spotter as you are!

    Best of luck and hopefully all of you do well in the exam!

    More Radiology resources

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