Report of Outreach Professor Maria Cortes. MD

I would like to share my experience as a participant of the Outreach Professorship program organized by the ASNR and the Peruvian Society of Radiology.

My contact radiologist Dr. Jeremy Carpio organized my visit with the staff of the National Institute of Neoplastic Disease INEN. The coordinator of my visit locally is Dr. Raymundo Flores. They made sure that, my visit, presentations and stay were perfect.

I must start by giving you an idea of this hospital, which intimidated me due to its importance at a national level for being the referral center for any case of cancer. In 2014 the INEN reported 328 new CNS tumor cases. This does not include tumors from orbits, ENT or lymphoproliferative disease.

The institute has 382 active beds. The radiology department has its own residency program of three years of training (they are seeking to extend to 4 years). At present they have 25 residents. All of them live in a building next to the main hospital. The hospital provides housing and meals for the residents for the entire residency training.

Their program is very hierarchical and the chief of residents has a lot of responsibilities on teaching and supervision of the junior residents. Each junior resident has a defined role on rotation basis, like, for example, being in charge that every academic presentation has a confirmed venue, the audiovisuals are ready and the presenter finds all the connections and projector ready for the session. They have three sessions per day, a formal lecture at 8:00, cases review at noon and another review at 19:00.

My week of visit started on September 5th, with a formal presentation at 8:00am. Since this was the first time, and suspecting that the residents see mostly neoplastic cases, I prepared demyelinating disease and other white matter disease cases. We followed with a visit of the institute and then I had a session with all the residents where they literally challenged me with cases of tumors that were incredible! All of them had histopathology correlation. This went on until noon when I presented a lecture of leukodystrophy of adult presentation. Each presentation was made in Spanish for hour and 15 minutes approximately. By 2pm my day was finished and the staff kindly took me for lunch everyday.

On the following days, I presented twice daily, a formal lecture in the morning and rounds of cases at noon. I had the chance to present on Brain Vascular lesions, Common imaging findings on Brain tumours, etc. The latter was very direful, considering the amount of local pathology they have, however was very interesting to discuss with the residents and staff from the pathology department that kindly attended. During the morning, I reviewed every day cases with the residents who managed to everyday find cases that were amazing! These sessions were from 10am-12pm. At noon we went for my cases rounds presentations.

The radiology residents always participated on the cases rounds; the chief resident designated each participant. Usually the R2s were active on these sessions.

I had the opportunity to talk to all the senior residents one on one; they invited me once for a lunch. They had many questions about fellowship opportunities and subspecialty mentorship that, I found, was very gratifying and inspiring for me. I feel responsible now for helping more international graduates and collaborate with their staff in teaching.

The end of the week was short due to the Interamerican Radiology College Conference to which all the staff and residents were attending.

The residents attended the neuroradiology module where I presented on stroke and endovascular treatment, cases of stroke and also on spinal fluoroscopy guided procedures. Also during the week, I had the chance to participate on interdisciplinary meetings. They have cases for embolization that I reviewed and I believe the discussion was timely and useful, since unfortunately they do not have endovascular services available.

In summary, I had a very rewarding experience, I had the sense they appreciated it very much. They were very thankful and on our last day together they gave me a certificate of visiting professor and tokens of appreciation. I would appreciate any feedback on my visit. This was my first experience, and I followed instinctively the teaching format I use at our program of radiology. I wanted to thank you and the ASNR for this valuable opportunity, I certainly would apply for more opportunities like this.

Sincerely yours,

Maria Cortes. MD.