The basic reference document is the Regulation of the Minister of Health of 6 August 2001 on the specialisation of doctors and dentists (Dziennik Ustaw /Official Journal of Laws/ No. 83 item 905 of 13.08.2001 as amended).

QUALIFICATION PROCEDURE

In order to enter into the qualification procedure the doctor submits the application for the initiation of the specialisation in radiology and imaging diagnostics to the Regional Centre for Public Health /Regional Centre/ in the region in which he intends to go into the specialisation training.
The number of specialisation places for each qualification procedure in a given region is established by the Minister of Health on the proposal of the relevant Regional Consultant for radiology and imaging diagnostics.
The submission of applications takes place twice a year: by April 30 and November 30, respectively, every year.
Every year the qualification procedure is carried out twice: in the period of May 1 to June 15 and December 1 to January 31, respectively.
The qualification procedure comprises the formal evaluation of the application and competition procedure that is composed, for both prospective residents and non-residents, after their completion of the postgraduate medical training, of two stages:
* a test exam (nation-wide) in general medical knowledge
* an interview by the committee appointed by the relevant province governor presided by the Regional Consultant

On the basis of the results of both stages of the qualification procedure ranking lists of the doctors qualified for the initiation of the specialisation are established.
The qualified doctors are referred to the vacant training places in the centres authorised for providing specialisation training in radiology and imaging diagnostics in a given province and entered in the list of approved centres of the Minister of Health.

THE REALISATION OF THE SPECIALISATION

The specialisation may be carried out:
* on a resident's job based on an employment contract of a limited duration concluded with the centre providing specialisation training (a resident's job is financed by the Ministry of Health)
* on a job based on an employment contract of an unlimited duration or of a limited duration equal to the duration of the specialisation training, concluded with the centre providing the specialisation training
* during the training leave granted by the employer for the period of specialisation training (the doctor's employer grants a training leave for the period of the specialisation training provided by the specialisation centre)
* within doctoral studies provided by a competent centre (the doctoral studies are extended by the specialisation programme)
* on a job based on an employment contract of an unlimited duration concluded with a centre not entered in the list of centres providing specialisation training and during the training leave granted by the employer for the realisation of part of the specialisation programme in a specialisation centre
* on the basis of a civil contract

In the application the doctor may select a centre that has a vacant training place and that would provide specialisation training for him and present a preliminary approval of the head of that centre.
Doctors qualified for specialisation training receive a referral to centres authorised to provide specialisation training in radiology and imaging diagnostics, a specialisation booklet and a list of medical procedures.
The doctor selects a specialisation supervisor from among specialists in radiology and imaging diagnostics proposed by the head of the centre to which he was referred.
The specialisation supervisor is responsible for a detailed plan of specialisation training that the doctor under specialisation training is supposed to submit in the regional centre within 6 months of the date of the initiation of the training.
The specialisation training should be carried out according to the specialisation programme and the detailed plan set out by the specialisation supervisor.

The duration of specialisation training is 5 years for doctors immediately after the postgraduate medical training and it may be prolonged by the specialisation supervisor. On the other hand, on the proposal of the specialisation supervisor the duration of specialisation training may by shortened by the Minister of Health.

During the five years' period it is necessary to complete the following practical training courses:
* a course in general radiology (including the min. of 6 months of CT and 8 months of US)
2.5 years
* a course in paediatric radiology 6 months
* a course in vascular and interventional radiology 5 moths
* a course in oncological radiology 1 month
* a course in MRI diagnostics 5 months
* a course in the breast diagnostics 3 months
* a course in nuclear medicine 1 month
* an additional period for the disposal of the specialisation supervisor

During the practical training courses the doctor under training is supposed to work a given number of duty hours:
12 in general radiology, 5 in paediatric radiology, 5 in ultrasonography, 5 in computed tomography.
The progress of specialisation training is supervised by the specialisation supervisor. He checks and evaluates the theoretical knowledge and practical skills of the specialisation trainee:
* tests in theoretical knowledge and practical tests of medical procedures set out in the training course programme
* tests in the material covered by theoretical training courses
* the evaluation of theoretical papers, a review work or an original work

In particular:
on the completion of each practical training course the doctor under training is supposed to obtain a passing grade for a test in the material covered by the course:
* a test in general radiology
* a test in CT diagnostics
* a test in ultrasonographic diagnostics
* a test in paediatric radiology
* a test in vascular and interventional radiology
* a test in oncological radiology
* a test in MRI diagnostics
* a test in the breast diagnostics
* a test in nuclear medicine
and also
* a test in medicolegal aspects
* a test in health promotion
During each practical training course the specialisation supervisor (or the supervisor of a given practical training course) evaluates the trainee's qualifications for his independent performance and assessment of diagnostic investigations. The trainee must show the skill of performing or setting the parameters of an investigation carried out by an electroradiology technician) and assessing the basic investigations covered by the training course.

After the completion of the specialisation training course in radiology and imaging diagnostics the doctor is expected to have the skills of:
* independent evaluation of conventional, CT, MRI and angiographic investigations
* planning investigations and the determination of a necessary investigation protocol and the appropriate sequences for each diagnostic problem in conventional, CT and MRI investigations
* performing and interpreting US investigations (including Doppler US)
* performing and interpreting contrast-enhanced investigation of the gastrointestinal tract
* selecting a diagnostic method allowing the obtaining of clinical data with the least possible exposition of the patient to ionising radiation and cost-effectiveness
The activity of the specialisation trainee is evaluated by means of preferential point system for his active and passive participation in congresses, symposiums, internal training courses, academic meetings according to the following scale (active / passive participation)
* international congresses 5/3
* national congresses 4/2
* national symposiums 3/1
* courses and workshops 3/1
* local and internal training courses 2/1

The candidate for the examination should obtain at least 5 points.
The specialisation programme also includes the participation in obligatory ("Physical and technical essentials of radiological imaging methods" and "Selected problems of imaging diagnostics") and recommended courses.

EXAM

Prior to his sitting for the exam the doctor submits his specialisation documents to the competent centre by July 31 or December 31, respectively, within the period not longer than 12 moths of the date of the recognition of the completion of the specialisation training by the specialisation supervisor.
The admittance of the doctor to the specialisation exam results from the proposal of the committee appointed by the Minister of Health on the basis of the following specialisation documents.
The documents:
1. (detailed) individual specialisation programme approved by the specialisation supervisor worked out on the basis of the framework programme
2. the doctor's application for the permission to take the state exam,
3. the qualification for the state specialisation exam after the verification of the formal aspects of the documentation, issued by the Regional Centre,
4. a professional opinion of the specialisation supervisor concerning the doctor,
5. specialisation training booklet including:
* the decision of the specialisation supervisor to recognise the specialisation training according to the programme,
* the required endorsements of the practical courses, tests, duty hours etc.,
6. the list of medical procedures performed (confirmed),
7. certificates of completed courses
8. a review paper, published or in a typescript, concerning the problems covered by the specialisation programme approved by the specialisation supervisor (persons with academic degrees: a list of publications approved by the specialisation supervisor, the certificate of an academic degree and title),
9. the certificate of the knowledge of a foreign language (English, French, German or Spanish),
10. the certificate issued by the Polish Medical Society of Radiology confirming the participation in its meetings during the specialisation training,
11. photocopies of the diplomas of specialisation degrees,
12. photocopies of the certificate of the academic degree.
If a specialisation programme includes any additional requirements - they must be fulfilled.

The specialisation exam takes place twice a year: in the spring session from March 1 to April 30 and in the autumn session from October 1 to November 30.
It is composed of two stages:

STAGE I

It is a test composed of 120 questions. There are 5 answers to each question to select from- only one of them is correct.
The exam takes place in a selected place in Poland for all the persons taking it in a given session. The test questions are aimed at checking the knowledge and the way of reasoning. The sentences are built on the basis of Bloom taxonomy that requires the application of complex mental operations. A three-grade evaluation scale is applied: grade I is for the power of memorisation, grade II is for the power of association, grade III is for the way of the application of the knowledge possessed to a new simple situation.
The number of points required to pass the exam is established separately for every examination session.
A passing grade for the test exam is a condition of taking the stage II of the specialisation exam.

STAGE II

It takes place in selected radiological centres at the same time. It is composed of 3 parts (passing one stage is the condition of taking the subsequent one)

Part I
The practical exam in ultrasonography - the doctor should show the ability to perform an US examination.

Part II
The evaluation of clinical cases. Each doctor evaluates 40 cases presented on a computer monitor (the exam is worked out in PowerPoint). The sets of examination cases are composed of a clinical description and 1-3 radiological pictures (the information about the number of pictures for each case is given separately).
In all the centres there are the same sets of examination cases.

EXAMPLE - a file in PowerPoint

Part III
An oral exam during which 3 problem questions must be answered (the same set of questions in each of the centres)
Details concerning the exam are given in notifications sent to the doctors by CEM Łodź.

OBTAINING THE ACCREDITATION BY THE CENTRES for providing specialisation courses

The centres that intend to provide specialisation training in radiology have to obtain the accreditation (entry in the list of the Minister of Health).
For that purpose they submit to Centrum Medycznego Kształcenia Podyplomowego - Studium Medyczno-Organizacyjne /Centre for Medical Postgraduate Training - Medical Organisation Section/ (Warszawa) an application form filled in according to the appropriate sample that has to contain the accreditation of the Regional Consultant.

Having been checked for its formal aspects the application is evaluated by the Expert Committee for radiology and imaging diagnostics (the committee is convened twice a year) appointed by the Minister of Health. The obtaining of the accreditation is the condition of the centre being entered in the list of the Minister of Health, which authorises it to provide specialisation training. The entry is accompanied by the statement of the number of specialisation training places in this centre.

The centres providing specialisation training have to fulfil the following requirements:
1) they are centres whose activity is related to the specialisation training
2) they provide professional and organisational conditions that allow the realisation of the specialisation programme for a given number of doctors,
3) they have appointed committees supervising or they ensure the supervision of the quality of didactic and therapeutic activity, in particular of
a) postgraduate medical training
b) the analysis of the efficacy of treatment
c) the analysis of the causes of deaths and hospital infections,
4) they employ in hospital departments at least two doctors - specialists in radiology and imaging diagnostics
5) the tasks of a specialisation supervisor are carried out by specialists
6) they have the ward of anaesthesiology and intensive therapy if they are hospitals that are to provide specialisation training associated with operations and other medical procedures performed under general anaesthesia
7) they have medical equipment and devices necessary for the realisation of tasks set out in the specialisation programme
8) they provide the appropriate health services in the scope allowing the realisation of the specialisation training by a given number of doctors
9) they have the appropriate didactic equipment and they offer didactic facilities necessary for the realisation of the specialisation programme
10) they provide round-the-clock health services to in- and outpatients in life- and health-threatening conditions and in other emergency cases if they are health centres that are to provide specialisation training in a medical branch that requires working duty hours,
11) they provide the possibility to work duty hours by the doctors under the specialisation training in the quantity set out in the specialisation programme
12) they have concluded an agreement with centres entered in the list of the Minister of Health concerning the practical training courses set out in the specialisation programme which they cannot realise in their own facilities 13) they have obtained the accreditation of the Regional Consultant in radiology and imaging diagnostics

Some centres may provide only selected practical training courses set out in the specialisation programme (e.g. in paediatric radiology). In such event they should obtain the accreditation for providing practical training courses. The procedure of obtaining it is the same as in the case of specialisation training.

The specialisation programme comprises a number of theoretical specialisation courses. Such courses have to have the accreditation of the National Consultant as well as the entry in the list maintained by the Centrum Medycznego Kształcenia Podyplomowego CMKP /Centre for Postgraduate Medical Training/. Only the participation in such courses is recognised.