Interview with Dr Baljeet Dhillon

This is a transcript of an interview with Dr Baljeet Dhillon. We edited the transcript for clarity. Dr Dhillon is an examiner on the Norwich FRCR 2B Course. In this interview, he explains how, and why the courses are helpful for FRCR 2B registrars.

Q. Could you tell us a bit about yourself and your career to date?

I'm currently a Consultant Interventional Radiologist at Norfolk and Norwich University Hospital. I've been there for two years, now. I got my medical degree in the United Kingdom. After that, I completed the foundation program and core surgical training. That's when I decided to come into radiology. I was part of the Norwich training scheme. I trained in general diagnostic radiology as well as interventional radiology.

Q. What are your specialisations and interests and why did you choose them?

In the interventional radiology side, we practice general vascular and body IR. So, we cover vascular, hepatobiliary, genital, and urinary. Everything except for cardiology or neuro intervention. I don't have a specific subspecialty interest in intervention itself. I do a lot of general work, including the endovascular repair of aneurysms. Also, uterine fibroid embolization, any emergency embolization, lines, and fistula work for dialysis access. On the diagnostic side, I do general radiology. I also have a subspecialty interest in head and neck radiology and I am a part of the head and neck MDT.

I always enjoyed doing procedures, so intervention was going to be a natural fit for me in that regard. I'm not the sort of person who can sit down and report all day. I need a certain amount of variety. So that's why I chose intervention. From the head and neck side, I did ENT as part of my surgical training, so I thought that would be a natural progression. Plus, I quite enjoy doing ultrasounds and biopsies, so all that fits in with my job. The stars aligned in Norwich in that they needed somebody for intervention, as well as head and neck. So it worked out quite well from my point of view regarding the job.

Q. How can an FRCR 2B registrar be better prepared to sit the exam?

Practice, practice, practice is the motto. The FRCR 2A exam is very information-driven, whereas the FRCR 2B exam is a bit more real-to-life in a lot of ways. You feel more like a radiologist when you're preparing and sitting the FRCR 2B exam. It's more about what you do day-to-day. Looking at scans, looking at X-ray images, and formulating diagnoses. Rather than relying on whether you can remember 20 facts about a certain pathology. Practising is very important.

The one thing I do tell a lot of people is that their style of answering the question or dealing with the scan is very important for the FRCR 2B vivas. That is why practicing by yourself or with other people helps. Also, doing the work.

It's a bit of a volume game. The more you see, the more you remember, and the more it will help you in your exam. It's not a situation where you lock yourself in a room and study. What helped me was actually being at work, reporting scans and checking with people. It was learning how things look on imaging and how to describe things in a certain way. Some examiners expect specific key phrases or keywords when you're describing a pathology. If you don't have experience with time spent in the department, you will struggle with that. So the important thing is to practice and spend time and do the work.

Q. Any particular advice to Radiologists from abroad trying to sit the FRCR?

Foreign-trained radiologists often have excellent educational or theoretical knowledge. They're also very good at giving out diagnoses. Where they may lack is presenting themselves well. Language is an issue, especially when they're not native English speakers.

So my advice to them would be to keep the language simple and try and be as clear as possible when speaking. Often, speaking slower helps the examiner to listen and understand what you're trying to say.

They know the pathology so well that they forget the ancillary things around it. They often forget to mention things like an onward referral, discussion with MDT, and offering options for biopsy. And that's where they can gain extra points.

Q. How does joining an FRCR course help a registrar?

Joining an FRCR 2B viva course will give you an outside perspective. If all your preparation and training is in-house within your hospital, you have the opinions of only a certain set of people who you work with. Going for a viva course gives you an external opinion of somebody else from a different place or setting. They may also have a different experience of the exam. Going through a course allows you to be more in the mind frame of sitting for the exam. It adds a time and stress element that a candidate needs to experience in a protective setting of a course. You don't want to experience that for the first time during the exam. It helps from an exam perspective to get all those fears and ticks out of the way.

Q. What has your involvement been with Norwich FRCR and Revise Radiology Courses?

With Norwich FRCR, I've seen it from both sides of the table. Being a trainee at Norwich, I was a delegate on the course when I sat the exam. Then as I became a consultant, I got involved with organizing the exam and being an examiner. My involvement as a faculty member began after we collaborated with Revise Radiology. One of my predecessors, Dr Ali, wanted a different way of setting the course during the pandemic. The collaboration with Revise Radiology is the best fit to get our course on an online platform and to a much wider audience. At the moment, I work with Revise Radiology to set up later courses and organize the examiners from our end. We're getting a lot more delegates coming in from places like Hong Kong, Singapore, and so on. That enriches the whole experience and the whole course.

The feedback from both the faculty members and the delegates sitting the exam has been positive. People quite like the fact that the course is online. Plus, it's quite nice that we can extend to a wider audience.

Q. Do you have any advice for how Revise Radiology could better serve the Registrars' needs?

Revise Radiology does a great job. You have a variety of courses for different settings. Norwich is quite happy to be part of the Revise Radiology family of courses. You provide a good platform for the exam PACS system and it seems to work most of the time with very little or no glitches. That's a very useful, stable platform for us to have.

With regards to improvement, there's very little to improve, as we cover most aspects of the exam. The vivas are more important from a practice point of view. The trainees go through the rapids and the long case sections themselves on their own time. I've seen that done on other courses, so it may not need to be very heavy-handed from an examiner's perspective. I quite like that we also have observers on the course now. Some people may not be sitting the exam but want to get a flavour of the exam as part of their preparation. That's another useful thing that some trainees will find quite helpful.