How to Ace The Radiology Portfolio
The radiology portfolio is the only part of the application where you can (almost) guarantee your score so it's worth putting some effort into it.
The scoring criteria are available on the portfolio self-assessment checklist through the Oriel website. Create an account, log in and find the Clinical Radiology vacancy. The checklist is in the documents.
The 2023 portfolio consists of 7 categories:
1. Commitment to specialty
2. Leadership and Management
3. Teaching and Training
4. Teaching Qualifications
5. Audit and QIP
6. Academic Achievements
7. Prizes and awards
1. Commitment to Specialty
In this section, you need to get more than 1 “significant exposures” to radiology. They define a “significant exposure” as at least 3 days in a radiology department doing either:
A taster week
A research project
A medical elective
A student selected component or a similar type of thing during your degree.
A taster week is essentially a week in a radiology department, experiencing what life is like for a radiologist. In general, doing taster weeks is valuable not just for the points, but also because it’s the best way to see if you would actually want to do radiology. In addition, you will meet registrars who can help you with your application, such as by getting audits and publications.
To arrange one, simply go to the radiology department in your hospital and ask for the contact details of whoever organises the taster weeks. The radiology training programme director should at least know, so you can always email them.
During the taster week, write short reflections about each day and after the week, email the organiser to ask for a signed letter confirming your attendance at the taster week.
What if you’ve already done your taster week in your current hospital - can you do one at a hospital you’re not employed at? Yes, you can - ask to organise an honorary contract with the trust; this is what I did for my second taster week. I e-mailed the radiology training programme director saying that I was at a district general hospital and wanted experience in a tertiary centre.
If you are still in medical school, organise a radiology SSC and/or elective: by doing them earlier, you have less to stress about later. I would still do a taster week during your foundation years as the radiology trainees can help with application tips.
If you have done a research project related to radiology, then that's also good for points in this section.
The FAST way to get maximum points would be to do 2 taster weeks, one in a tertiary referral hospital and one in a DGH. Interestingly, they actually state that doing 2 taster weeks in different healthcare settings would give you full points for this section.
You might say you don’t have enough study leave days for 10 days of taster week. Well, according to the scoring criteria, you only need to do 3 days for it to count as a “significant exposure”, so 2 taster weeks could theoretically be done in 6 days total. I would, however, recommend a full 5 days if you can manage as you get to know the department and registrars better, potentially giving you access to more opportunities.
To evidence the above, include signed confirmation letters of your attendance, as well as reflections and timetables.
2. Leadership and Management
This is a new section where you get points for holding leadership or managerial roles in organisations either within Radiology, outside radiology but within healthcare or outside healthcare altogether.
You get more points if the role is within Radiology and at a national level.
You have to have been in the role for a minimum of six months at the time of applying. This means that if you’re in a rush, then you won’t score any points here unless you have already had a role for >6 months.
A key thing to remember about the portfolio is that you’ll be scored based on your highest level of leadership role, rather than how many leadership roles you have had. This means that it is better to put a lot of effort into getting a national Radiology leadership role, than to get multiple smaller roles.
The way to get these is to start in medical school by joining your medical school Radiology society committee and then working your way up from there to joining a national radiology committee, many of which have places for junior doctors. If your medical school doesn't have a radiology society, then that's a great opportunity to create one! You'll be the president automatically!
Alternative backup options would be to try and get a national role outside of Radiology such as on one of the BMA committees or to become a committee member for your local doctors mess or junior doctors forum, however these will earn you fewer points.
The evidence to include would be confirmation that you have had the role for at least six months, signed by the chair of the committee or a senior figure.
Ideally it should also mention your role and responsibilities.
Radiology societies that you can join are listed on the IR juniors website.
3. Teaching and Training
The section awards points for having a major contribution to a teaching programme, with more points assigned to national or international teaching programmes.
Looking at their criteria, fundamentally all you need to qualify as a teaching program is more than one session over at least three months. Then to qualify as a national or international course, you just need attendees to be from different parts of the country or from other countries. Finally, you need a senior figure, ideally a consultant, to sign off your role as organiser.
To organise a national/international teaching programme, it helps a lot to get a role on a radiology organisation's committee, which could even be during medical school. You can then organise a teaching course by inviting different registrars or consultants to speak and this can be done either online or in person.
If you don't have enough time to do that, you could teach locally by organising regular teaching sessions for foundation year doctors and medical students. Or if you’re really short on time, you could just organise one small group teaching session in your hospital and score fewer points.
Examples of teaching topics include:
How to interpret Chest X-rays
Ultrasound-guided cannula insertion
Ultrasound-guided ascitic drain insertion
Ultrasound-guided chest drain insertion
How to request the correct imaging modality for common emergencies (e.g. acute abdomen vs. renal stones)
How to suture
How to manage surgical emergencies
Which ever time a teaching program you organise, just need a senior figure a consultant to sign you off and ideally you should collect feedback from everyone to put in your portfolio as well as a timetable of your teaching course.
Teaching programme ideas
4. Formal Teaching Qualifications
For the section, you can only score for qualifications to be completed at the time of application. This means if you’re currently halfway through something (e.g. a PG Cert) then you wouldn't score ANY points.
To get maximum points for this section, you need to have a masters level teaching qualification and I don’t think it’s worth doing one purely for Radiology applications because they are expensive and you don’t really get that many extra points for it.
If you are very keen, you could do a part-time, online PGCert in medical education, such as the one run by The University of Edinburgh, which my colleague Yakup did in his FY1 year. Remember, you need to have completed it BEFORE the application deadline.
The best way to get points FAST would be to sign up to a 2-day train the trainers course and these tend to run throughout the year with different companies offering them. If you do one, try to get it on your study leave budget so you get reimbursed for the costs.
For evidence, include your certificate from the course or qualification.
5. Audit and Quality Improvement
The section has changed since last year because you now can only get maximum points with 2 Radiology-themed audit or quality improvement projects, and they have to have demonstrated a change.This means that realistically they need to be closed loop audits.
A great way to get involved in these is through your radiology taster week by getting some registrars to give you audits and QIPs to do. I have personally helped 2 taster week doctors get involved in radiology-themed audits.
The key thing is to pick FAST audits where you can complete 2 cycles of data collection quickly. Radiology is generally good for this as most data is electronic. Avoid paper form-filling or anything involving looking through paper medical notes.
The Royal College of Radiologists has a large database of audit templates ready for you to use in your department. Make sure you discuss with the audit lead before starting an audit so you don't end up repeating work. Also, make sure to pick a registrar to supervise who you think will make sure the audit is completed. Registrars usually need to complete 1 audit per year, so there will be someone with an audit happening and they're usually grateful for help.
If you’re short on time, then the most that you could do is to try and lead an audit or quality improvement project as a single cycle. This is worth fewer points.
To evidence this, get a signed letter from the consultant supervising the audit and include the PowerPoint presentation for your audit or a summary of the audit.
6. Academic Achievements
In this section, you get the most points for a postgraduate degree like a PhD or an MD. Unless you already have one of these qualifications, there’s no point at all even trying to get one of these, because of how long it takes to complete them.
They also only give you 1 more point than being first author on a radiology-themed publication, which is what you should aim to do.
Again, the best way to do this is by getting to know radiologists through taster weeks, student-selected components and electives who can supervise yo. It’s important here that you pick a project that will get published in a reasonably short time-frame, like a case report and there are lots of interesting cases in radiology.
Publications take time. The quickest I have published is in about 6 months from starting to acceptance in a journal for a case report. The longest is a systematic review that took 2 years.
Another important factor is the supervisor that you pick. You want someone who publishes a lot, so before you go to the supervisor, do a quick search on Google and PubMed to see how many publications they have.
You don't want to be stuck on a publication that drags on or where there are a lot of delays to getting data or waiting for ethics committee approval.
The other way to score points is through oral and poster presentations, with more points for Radiology-themed and national or international level presentations as the first author.
A lot of conferences accept submissions and to be honest most conference will accept poster presentations, partly because it helps to sell tickets. So, just submit your audits, QIPs and publications to any upcoming conferences (with your co-authors' permission, of course).
Evidence is in the form of an acceptance letter for a publication and ideally a copy of the manuscript. For presentations, a letter or certificate confirming the presentation or a timetable from the conference should be included.
7. Prizes and Awards
For full points, you can either get a distinction in your final year of medical school or get a prize. There are numerous radiology-related prizes and the key is to apply for ALL of them. For example, many are essay prizes so you need to keep submitting essays until you win a prize. The more you write, the better your essay-writing gets.
Here's a big list of prizes:
Society of Radiologists in Training Essay Prize (1 for medical students and 1 for junior doctors)
RadCast Roentgen Competition - Radiological Anatomy Competition