Within the radiology specialty, the training programme is structured in accordance with the standards dictated by the Royal College of Physicians and Surgeons of Canada (RCPSC). The programme consists of one year of general training in the various medical areas (surgery, paediatric, OB-GYN, etc.), followed by four years of training in imaging. Mandatory radiology training spans a number of radiology subspecialties including pulmonary, cardiac, neurological, abdominal, musculoskeletal, breast pathology, vascular and non-vascular interventional radiology and angioradiology, including conventional imaging, CT scanning, MRI and nuclear medicine. The applicable standards are available on the RCPSC website (www.rcpsc.medical.org). At the end of the training each candidate is invited to apply to the RCPSC certifying exam that consists of a written part, an objective structured clinical examination (OSCE), and an oral part.
There are 17 faculties of medicine in Canada, 16 of which offer a residency programme in diagnostic radiology (some of these offer specialty programmes in paediatric radiology and neuroradiology as well). Each programme has to be accredited by the RCPSC in order to have the permission to train radiology residents. 13 of these are offered in English and three are in French. Although residents are encouraged to be bilingual, only programmes within francophone universities in Québec require that its candidates be fluent in French. Thereafter, candidates wishing to practice in Québec must pass a fluency examination in basic French to obtain a license to practice in the province.
Radiology programmes easily fill their residency positions. This specialty is often much sought-after by medical school graduates. Those graduates wishing to apply for a position in a residency programme must register with the Canadian Residency Matching Service (CARMS) (www.carms.ca), which organises this process for all Canadian residency programs. From the outset of their training, residents are involved in clinical radiological work as well as interventions, and are supervised according to their level of autonomy.
All practicing radiologists should participate in maintenance of certification programmes, or in continuing professional development (CPD) initiatives. This requirement is linked to the license to practice in certain provinces. Radiologists who are fellows of the RCPSC can follow its programme, accumulating a minimum of 400 credits over a five-year period. Certain provinces offer similar programmes. Within this context, national organisations, universities and scientific associations regularly organise CPD activities in accordance with the standards developed by the RCPSC.
Employers do not have access to the specific results achieved by certified radiologists applying to work in hospitals, as these are confidential. However, candidate radiologists who apply must have passed the examination in order to obtain a license to practice. The "board eligible" notion as seen in the United States does not exist. However, there are specific requirements for foreign candidates who may, occasionally, obtain a restricted license to practice. These requirements are specified by the various provincial professional colleges. Hospitals and professional bodies may, however, require a physician's participation in a recognised CPD programme.
Can MEDS Training
All training programmes in Canada include a CanMEDS training component. CanMEDS refers to a description of the requirements for specialist physician roles which are specific to each specialty, including radiology. ese roles include medical expertise, communication, collaboration, professionalism, management, health advocacy, and scholarship. The Can- MEDS competencies specific to radiology are available for consultation on the RCPSC website (rcpsc.medical.org).
Radiology training requirements are also evolving in order to better address social needs. Not only is CanMEDS mandatory, but residents are encouraged more and more to train and collaborate with all healthcare professionals. In some provinces there is a mandatory 360 degree assessment of the radiologist in practice, and residents have to develop skills in practice audits and in the design of such assessments since this will be the norm in their practice.