1. REPORT ON RSNA DEREK HARWOOD NASH INTERNATIONAL FELLOWSHIP DR CALLEN ONYAMBU MBChB,MMED UNIVERSITY OF NAIROBI

2. O BJECTIVES Learn the best imaging protocol for different clinical indications for musculoskeletal imaging Improve my knowledge in musculoskeletal imaging by learning from the experience of the MSK radiologists Learn how to do rotator cuff ultrasound Get more experience in teaching residents Observe different MR arthrography procedures Learn how to do image guided biopsies for tumors Develop collaboration for future research in MSK imaging

3. B ACKGROUND I was privileged to be one of the recipients of the RSNA Derek Harwood –Nash international fellowship 2014. I spent three months at the University of Maryland Medical center where I have gained a lot of insight into musculoskeletal imaging

4. P ROGRAM OUTLINE Under the guidance of my supervisor and mentor Dr C. Resnik I rotated through the musculoskeletal imaging department with a short rotation in shock trauma which also handles acute MSK cases. Dr Resnik is an excellent teacher and together with fellow attending radiologists they guided me through the various imaging cases with absolute dedication and depth of knowledge that was inspiring

5. P ROGRAM Emphasis on excellent anatomic knowledge as the back bone to proper diagnosis was made. Daily lectures and conferences with a multidisciplinary assortment of cases helped to enhance my knowledge in radiology

6. T EACHING OF RESIDENTS AND FELLOWS Excellent hands on supervision and teaching skills for residents and fellows The highlight of the daily sessions was the ‘read outs’ when we could get to through each case done by a resident or fellow. Learning points for various cases were always emphasized.

7. I MAGING PROTOCOLS I have been able to learn the best imaging protocols for various MSK clinical imaging indications. In particular I have improved knowledge of bone and soft tissue tumor imaging protocols. Better understanding if in-phase and out-of phase imaging for tumors Imaging in the diabetic foot for osteomyelitis versus neuropathic changes

8. C LINICAL MEETINGS WITH RHEUMATOLOGISTS Regular meetings with rheumatologists helped enhance the practice of radiology and foster team work Each session gave a better understanding of what the clinician wants and what is expected of the radiologist in order to plan management

9. C OLLABORATION FOR RESEARCH During journal club meetings and at noon conferences different research techniques were emphasized This will help my research agenda and doing research with our residents Use of research to improve practice Exploring plans for future collaboration in research

10. CONCLUSION This is has been a great privilege to me as an individual and a tremendous learning experience Knowledge learnt is definitely going to be a great resource for my home institution and the radiology community in Kenya I am optimistic we shall have great collaboration for future research

11. A CKNOWLEDGEMENT Thanks to the RSNA International Committee on Radiology Education (CIRE) for making this training possible.

12. T HANK YOU