Crosshouse Hospital

crosshouse

 

 

General Information

Crosshouse is 25 miles from Glasgow and easily reached via the M77 in approximately 30 minutes, with ample free parking available within the hospital grounds.  There are comprehensive postgraduate training programmes in all the clinical specialities with an active CME Programme organised by the Postgraduate Tutor.  The hospital’s education centre has recently been refurbished.  It has a computer centre offering Internet access as well as seminar rooms and a well-stocked library.  Radiology (and many other) journals are also accessible on-line via the hospital Intranet.  There are numerous points of access to these facilities throughout the radiology department.  The Radiology Seminar room has recently been updated with data projection, internet access and interactive whiteboard.

The Department

Consultants and Specialist Interests

  • Dr E Lindsay – Breast, Nuclear Medicine
  • Dr D Rawlings – CT/ MRI, ENT
  • Dr S. Unnam – CT/ MRI Oncology, Gastroenterology
  • Dr S Rasul (Clinical Director) – Nuclear medicine, Respiratory, Musculoskeletal
  • Dr B Sarkar (Educational/Clinical Supervisor)- Gynaecology, Non-vascular intervention
  • Dr C Nicolson – Gastroenterology, Non-vascular intervention
  • Dr J Kelly – Breast
  • Dr C McArthur – ENT, Neurology
  • DR H Halbert – Gynaecology
  • Dr O Thomas (Wednesdays only) – Paediatrics
  • Dr R Shaw – Breast, Musculoskeletal

Crosshouse is a 550+ bed DGH.  The radiology department performed over 85000 examinations last year.

General Radiology

The hospital covers all areas of general medical, surgical and orthopaedic practice including ITU, surgical HDU and both CCU and the Ayrshire renal dialysis unit.  In-patient subspecialities include paediatrics, haemato-oncology, obstetrics and gynaecology.  There is also a busy ENT and maxillofacial surgery service which includes head and neck oncology and the National Centre for Cochlear Implant Surgery, offering a unique experience to those interested in this area.  Ophthalmology is provided as an out-patient service.  Our busy A&E department generates a significant amount of wide-ranging trauma imaging.

 

 

Intervention

With both urology and vascular services based at Ayr Hospital, interventional work is limited but includes frequent CT- and ultrasound-guided biopsy and drainage procedures.  There are numerous dedicated procedure (US & CT) appointments through the working week.  The trainee would have a competition-free opportunity to perform these under supervision. In addition, transvaginal ultrasound guided intervention (biopsy/aspiration) occurs on occasion.

 

Breast Radiology

Crosshouse Hospital is unique in the West of Scotland in that the Medical Imaging Department provides comprehensive support to the Symptomatic Breast Service and is also responsible for the delivery of the South West Scotland Breast Screening Programme.  Around 400 breast cancers in total are diagnosed each year.

Ultrasound and mammography reporting, with guided FNA and core biopsy as required, are provided to the 3 rapid access breast clinics per week.  All rapid access clinic mammograms are double-reported.  Digital mammography for new and review patients occurs daily and regular breast ultrasound is undertaken.  2 sessions per week are utilised to perform stereotactic- and ultrasound-guided localisations.  Dynamic contrast enhanced breast MRI is performed and reported on site, currently approx. 12 per month.  Such cases include family history screening, cancer evaluation and implant assessment.

Excellent multidisciplinary team (MDT) working exists within the ‘Breast Team’ and two MDT meetings are held each week: one to review radiology and pathology of breast screening cases and a full Ayrshire wide MDT with video linking to Ayr Hospital.

Breast Team review meetings are held quarterly.

The South West Scotland Breast Screening Unit, based at Ayrshire Central Hospital, Irvine, provides the breast screening service to a population of >80,000 women age 50-70 years in Ayrshire & Arran and Dumfries & Galloway.   All mammograms are double read with arbitration of non-concordant cases.  Three assessment clinics are held each week.  A mammography film library has been developed at the Breast Screening Centre.

There are two breast MDTs – one for breast screening and another Ayrshire-wide meeting for all cases from the screening and symptomatic service and post-operative reviews.  Opportunities to prepare and chair the meetings are available to trainees with supervision as required.

The mix of symptomatic and screening work within the one directorate provides the ideal opportunity to expand the radiology trainee knowledge of the reporting aspects and the practical skills required in Breast Imaging.  Practical skills training offered include:
–      Stereotactic breast wire localisations and core biopsies

  • Large volume vacuum assisted biopsies
  • Ultrasound-guided wire localisations and core biopsies

 

Skill mix

A team of ultrasonographers provide the majority of the outpatient ultrasound work in Ayrshire.  In addition, a team of reporting radiographers contribute to the traumatic appendicular plain film reporting.

 

Equipment

  • 1.5T Siemens Avanto MRI scanner
  • 2x Philips Ingenuity 128 slice CT scanners
  • 2x Philips Affiniti 70G ultrasound
  • 2x Toshiba Aplio ultrasound
  • Philips Affiniti 50G portable ultrasound machine
  • Digital fluoroscopy suite
  • General reporting
  • Breast Screening Unit
  • Radiologist-led Nuclear Medicine (dual-headed Siemens gamma camera)
  • Kodak PACS was installed in 2007 as part of the National PACS project.

 

Academic Programme

MDT meetings

  • Weekly – Colorectal, upper GI, gynaecology, ENT, lymphoma, paediatric, breast and respiratory

Educational meetings

  • Weekly – Medical
  • Monthly – Haematology, geriatrics, stroke and surgery

 

 

 

 

Audit

Registrars are offered the opportunity to undertake an Audit Project whilst at Crosshouse and will have the opportunity to present the work at our local Audit Meeting.  Library/ internet facilities and audit support are available.  An active participation in the Departmental Audit is encouraged and all clinical-radiological meetings.

 

 

The Registrar

The registrar’s rota can provide a wide-ranging experience in all branches of DGH radiology.  This can be modified to suit individual requirements and interests which will be established prior to the attachment.  A consultant will support all sessions with the level of direct supervision being determined by the trainee’s level of experience.  The trainee will be encouraged to attend all regular CPCs and academic meetings.  There will be continuing appraisal of registrar with regular feedback to them and to the Tutor of the next module.  There is a regular undergraduate teaching programme during term time, which allows the registrar to teach under Consultant supervision if so desired.  If the registrar is approaching the 2B examination, regular viva practice sessions can be incorporated into the weekly rota.

 

The weekly timetable is tailored to the specific needs of the registrar but examples include:

General Radiology with interventional interest

  • 2 sessions CT – general list with mix of biopsies/drainages
  • 2 sessions MR – a mix of general and special interest cases
  • 1 session plain film reporting
  • 2 sessions ultrasound – including dedicated biopsy/drainage cases
  • 0.5 session fluoroscopy – can include enemas, HSGs, swallows, etc if desired
  • 0.5 session case review – Teaching appropriate to trainee’s needs
  • 2 study sessions

 

 

 

General radiology with ENT interest

  • 2 session CT – general list
  • 2 session MR – general list
  • 1 session cochlear CT/MR reporting
  • 1 session plain film reporting – including cochlear implant assessment
  • 1 session ENT ultrasound
  • 1 session general ultrasound
  • 2 study sessions

 

Breast radiology

  • 2 sessions breast screening
  • 1 sessions symptomatic breast US clinic
  • 1 session breast ultrasound list
  • 1 session breast MDT
  • 1 session MRI – including breast cases
  • 1 session mammogram reading
  • 1 session plain film reporting/stereotactic breast localisations & biopsies
  • 2 study sessions

 

Contacts

Please contact Dr Bappa Sarkar for more information                                                                                                       bappa.sarkar@aapct.scot.nhs.uk   (01563-826-142)

 

 

 

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