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RSNA Global Learning Centers: Host Center Application
Application must be completed in English for consideration
1. Host Institution Information:
Host Institution
*
Address 1
*
Address 2
City
*
State/Province
*
(required for United States and Canada)
ZIP/Postal Code
*
Country
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Curacao
Cyprus
Czechia
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
EAST TIMOR
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji
Finland
France
France - Metropolitan
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
KOREA, REPUBLIC OF
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Reunion
Romania
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts And Nevis
Saint Lucia
Saint Martin
Saint Pierre And Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Serbia
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkiye
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Telephone
*
2. Identify a Program Director for this institution. This person must be the main point of contact for RSNA throughout the three-year program period (English speaking). The Program Director will help to assess the needs of their radiology department, assist the RSNA team in developing a customized educational plan and will determine who participates in the program from the host center.
Program Director Name:
*
Position held at institution
*
Telephone
*
Email
*
3. Briefly Describe the Radiology Department
Length of Training
*
Content of Training
*
Number of Trainees/Residents
*
Number of Faculty in Radiology Department
*
Number of faculty who work to teach the Trainees/Residents
*
Type of Degree or Diploma Granted
*
Organization that Grants Degrees
*
Name of Radiology Department Chairman
*
Official Language
*
Please note that this program will be conducted in English
4. Radiology Department Information:
Approximate number of radiologic examinations/procedures per year
*
Type of procedures performed (check all that apply)
*
Chest
Intravenous Pyelogram (IVP)
Barium Enema
Mammography
Upper GI
Bone
Pediatrics
Ultrasound
Number of Ultrasound Units
Type of Ultrasound Units
Computed Tomography (CT)
Number of CT Units
Type of CT Units
Magnetic Resonance (MR)
Number of MR Units
Type of MR Units
Angiography
Number of Angiography Units
Type of Angiography Units
Nuclear Medicine
Number of Nuclear Medicine Units
Type of Nuclear Medicine Units
Other
5. Availability of Learning Resources/Equipment Checklist (check all that apply)
*
Internet Access
Technology Support
Dedicated space for the creation of a virtual classroom onsite
Basic Classroom accommodations (furniture, ect...)
Other
6. How would this institution benefit from partnering with RSNA to create a Global Learning Center?
Describe the needs of the institution (education and resources/equipment).
What are the current goals of the center?
Are there certain diseases/conditions this center would like to address?
List 2-3 subspecialties in which you would require more training
What format of learning would be preferred?
7. Qualifications and Expectations of the RSNA team:
Provide specific needs, including subspecialties and expectations for the RSNA team.
*
8. Technology/ Artificial Intelligence
Explain how your radiology department is using advanced technology (i.e. PACS system, informatics, artificial intelligence).
9. Other Information:
Please provide any other information that would be of assistance to the Committee on International Radiology and Education (CIRE) in evaluating your application
Submit