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ESGAR Junior Summer School 2017

What is the ESGAR Junior Summer School?

In 2017 the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) organised the 3rd Junior Summer School, a 5 day programme of focused teaching from 17th to 21st July for radiology trainees.  It was held at the Valata Minusa Country Resort approximately 15 minutes outside of the town of Modica in Sicily.  All of the teaching was delivered in English.  I hope that my account of the experience gives you a taste of the ESGAR Junior Summer School 2017 in Sicily!

ESGAR Junior Summer School 2017 summary

Background

The summer school is an initiative by ESGAR to promote abdominal imaging amongst new generations of radiologists.  Approximately 30 trainees are invited to participate each year.  The application process is simple and consists of sending a cover letter, CV and letter of proof of training.  Successful applicants are then invited to attend the summer school and asked to pay a course fee of €400 (all inclusive, excluding flights).  The teaching is delivered by senior consultants in the field of abdominal radiology and the content is primarily aimed at trainees in their 3rd-5th year of training, and radiology fellows.

Arriving in Sicily

Most participants flew into Catania Airport on the Monday morning.  Shuttle busses had been arranged to transport us from the airport to the venue.  Whilst waiting for the bus we had a chance to chat to some of the other attendees before we were whisked off into the Sicilian countryside on a 2-hour trip to the venue.

Courtyard of the Valata Minusa Country Resort
The Valata Minusa Country Resort was the venue for the ESGAR summer school 2017

The venue

The venue was the Valata Minusa Country Resort, a large villa in the countryside.  Originally a sighting tower until the late Middle Ages, it was later used as a centre for olive oil for farmers in the surrounding countryside. It had been recently renovated with air-conditioning, a swimming pool and large courtyard.  In a word, it was beautiful.  People were split into shared rooms with 2-4 people per room.  Each room had an en suite and air-conditioning.  The dress code was casual, with everyone wearing summer clothes (it was too hot for anything else!).

A specific programme of events had been arranged for the participants and tutors each evening.  This provided an opportunity to get to know others and do some informal networking.

The teaching programme

The whole week was very educational.  Teaching was split into morning and afternoon sessions, with the exception of the first (Monday) and last (Friday) days which were half-days of teaching.  Morning sessions usually ran from 9am to 12:30pm and afternoon sessions from 1:30pm to 3pm or 4pm.  Mid-morning there would be a break for coffee and snacks to keep us going!

Teaching at ESGAR Junior Summer School 2017
Teaching at ESGAR Junior Summer School 2017

The sessions consisted of an initial presentation by an expert, followed by interactive case based discussions with Q&As.

There were a whole range of topics covering…

  • MRI of the liver: how I do it
  • Imaging of the cirrhotic liver
  • Primary lesions in the non-cirrhotic liver
  • Vascular disorders of the liver
  • Liver metastases
  • Solid pancreatic neoplasms
  • Cystic pancreatic neoplasms
  • Imaging of the bile ducts
  • Imaging of IBDs
  • CT Colonoscopy
  • Imaging of the spleen
  • Non-traumatic abdominal emergencies
  • Contrast enhanced ultrasound (CEUS): technique and abdominal applications
  • Rectal cancer MRI
  • Follow up after colorectal surgery
  • Gastrointestinal stromal tumours (GISTs)
  • Whole body MRI imaging

Monday (Day 1)

On arrival, we were greeted by Simone and Giuseppe (Prof Giuseppe Brancatelli) from ESGAR, who helped us find our rooms and organised a late lunch and drinks.  We also met the other participants.  There were 30 of us in total coming from all over Europe and at different stages of training ranging from 1st year trainees up to newly appointed consultants.  Some trainees had come from even further afield (for example, Iran and Egypt).  The mix was great and it was interesting to learn how other training schemes in Europe were run.

After grabbing some lunch, we sat down to learn about MRI sequences used in liver imaging and the MRI features of liver cirrhosis.  The discussion about imaging-pathologic correlation and the limitations of histology was particularly good.

Meeting everyone prior to dinner on the first evening
Meeting everyone prior to dinner on the first evening

On the first evening a dinner was prepared for everyone at the venue.  We sat in a large courtyard around candlelit tables and were served delicious local Sicilian dishes including handmade ricotta cheese, arancini and ‘Lolli nte favi’.  It was very atmospheric and a good end to a long day!

Tuesday (Day 2)

I couldn’t write about the ESGAR summer school without mentioning the excellent buffet breakfast.  It consisted of a delicious mixture of croissants (some with copious amount of Nutella inside), cake, yogurt, cheese, cereal, fruit and bread.  An espresso with breakfast was a great way to start each day.

Breakfast
Breakfast

In the morning, we were treated to an excellent talk on vascular abnormalities within the liver covering many of the different kinds of perfusion defects and what they indicate.  This was followed by case based discussions centred around MRI of the liver.  There were some great case examples including examples of polysplenia and hereditary haemorrhagic telangiectasia (HHT).  It was also good to see lots of examples of focal fatty change and fat sparing surrounding different lesions within the liver.

After a mid-morning cappuccino, there was a session on liver metastases, and following lunch, a guide to solid pancreatic neoplasms.  The teaching focused on tips to help differentiate autoimmune pancreatitis from pancreatic adenocarcinoma.  I found this particularly useful, especially seeing numerous examples of both conditions back-to-back which helped me appreciate some of the subtle signs to distinguish the two conditions.

Socialising in the evening
Socialising in the evening

The teaching finished at 3pm and we were taken by coach to a local beach near the southern point of Sicily for swimming, finger food and dinner by the sea.  The weather was beautiful, but not too hot, and the sea was very shallow and warm.  We grabbed some beers and swam in the sea for hours.  It was a great opportunity for everyone to relax and reflect on the days teaching.

When we arrived back at the accommodation, the party didn’t stop and many of us swam in the pool until late!

Wednesday (Day 3)

Breakfast was again delicious and the first morning session was on cystic pancreatic neoplasms with many examples of different lesions.  The second morning session covered a range of different biliary system pathologies.  There was a lot to take in, however copies of the slides were uploaded to the ESGAR website after the event so we could download them and learn in our own time.

Learning about the imaging features of fibrosis in inflammatory bowel disease from Dr A Laghi (Rome, Italy)
Learning about the imaging features of fibrosis in inflammatory bowel disease from Dr A Laghi (Rome, Italy)

Lunch was again a mixture of local Sicilian dishes (pasta, tomatoes etc) and many of the faculty joined us which made it easy to chat, ask questions and get to know everyone.  The afternoon started with tips on CT colonography interpretation and the last session of the day was very interesting, focusing on imaging of the spleen and discussion of the assessment and follow-up of splenic lesions.

Teaching on colon polyps by Dr A Laghi (Rome, Italy)
Teaching on colon polyps by Dr A Laghi (Rome, Italy)

The teaching finished at 4pm and many of us spent time swimming and cooling off.  Giuseppe kindly arranged for lots of ice-creams to be delivered and we ate these by the pool before getting ready to visit Modica in the evening.

In the evening we had an informal tour of Modica, a UNESCO-listed picturesque Baroque town.  We were dropped off at the Via S. Benedetto da Norcia viewpoint and after taking some snaps, we walked down the thin winding streets to the Church of San Pietro, then to the Duomo of San Giorgio before finishing at a chocolate tasting shop and having dinner at ‘Osteria dei Sapori Perduti’.

View of the Duomo of San Giorgio during our walking tour of Modica
View of the Duomo of San Giorgio during our walking tour of Modica
Everyone on the steps of the Church of San Pietro in Modica
Everyone on the steps of the Church of San Pietro in Modica

We were told that the restaurant tended to serve very large amount of food so the organisers ordered for half the number of people.  Even so, the delicious food kept coming and coming!  There were a mixture of local Sicilian dishes and red wine.  As we ate, many of us popped next door to buy some local chocolate to take home at the end of the week.

Thursday (Day 4)

After breakfast there was teaching on non-traumatic abdominal emergencies and contrast enhanced ultrasound.  Dr T Bartolotta (Palermo, Italy) showed many interactive cases where contrast ultrasound was used to characterise liver lesions.  Giving examples of real life use gave me an appreciation of how this was used in day-to-day practice.

We were treated to an amazing lunch of Sicilian scaccia, which the cook had started preparing early in the morning the same day.  There were a whole range of flavours, meats and vegetables and something for everyone.

Eating saccia at lunchtime
Eating saccia at lunchtime
Teaching on rectal cancer imaging by Dr R Beets-Tan (Amsterdam, Netherlands)
Teaching on rectal cancer imaging by Dr R Beets-Tan (Amsterdam, Netherlands)

The afternoon presentations on rectal cancer imaging and follow-up of colorectal cancer were excellent.  I now have a much better appreciation of the value of diffusion imaging in the follow up of rectal cancer.

In the late afternoon we set off to the beach again to swim in the sea and cool off.  A few of us swam out and around a small fishing boat anchored in the bay, whilst others floated closer to the shore.  Someone brought along an inflatable pink flamingo which proved to be a big hit, especially for drifting along with a beer in hand!

The resident cat
The resident cat

Friday (Day 5)

It was coming to the end of an educational and fun packed week.  After packing our bags, we were treated to teaching on gastrointestinal stromal tumours and whole body MRI imaging, a topic that many of us had little or no experience in and therefore found useful as an introduction.

Teaching on whole body MRI by Dr M Galia (Palermo, Italy)
Teaching on whole body MRI by Dr M Galia (Palermo, Italy)

The coach came to take us all to the airport at 11:30am.  It was sad to leave, however the hosts kindly packed us each a lunch bag for the journey and gave us a bar of ‘Cioccolato di Modica’ to take back with us.  It was a nice send off from the organisers who had done a fantastic job, particularly Simone Semler-Fierro and Giuseppe Brancatelli who did much of the work to make the course enjoyable.

'Ciccio', the resident mule at Valata Minusa
'Ciccio', the resident mule at Valata Minusa

Summary

The ESGAR Summer School was delivered by experts at the top of their field with a non-threatening mix of lectures and interactive cases.  I was able to pick up some invaluable pieces of knowledge.  Copies of the lectures were uploaded to the ESGAR website and made available to download afterwards so participants could access them after the course.  The level of the teaching was pitched at 4th-5th year trainees and fellows, however much of the content will also be useful for 3rd year trainees and new consultants.  The venue was stunning, I made friends with trainees from all over Europe and there was a brilliant social programme.  A special mention must go to the local organiser, Dr. Giuseppe Brancatelli, who kept everything running smoothly and the feedback for the event was brilliant.

I would thoroughly recommend the ESGAR Junior Summer School to any radiology trainee interested in abdominal radiology and I have no doubt that this excellent course will continue to run in the years to come.  I look forward to seeing everyone again at a forthcoming ESGAR meeting!

   ESGAR links

If you would like to ask me more about my experience of the ESGAR Junior Summer School or have any questions, please feel free to contact me via the contact us page.

Participants of the ESGAR Junior Summer School 2017
Participants of the ESGAR Junior Summer School 2017

This post was written by Dr Christopher Clarke, Radiology Fellow, Leeds (UK) at the time of publishing.

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