Radiological Society of North America

1. Host Institution Information:

State/Province *
(required for United States and Canada)

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 *

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 *

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) *

Intravenous Pyelogram (IVP)

Number of Ultrasound Units

Type of Ultrasound Units

Computed Tomography (CT)

Magnetic Resonance (MR)

Number of Angiography Units

Type of Angiography Units

Number of Nuclear Medicine Units

Type of Nuclear Medicine Units

5. Availability of Learning Resources/Equipment Checklist (check all that apply) *

Dedicated space for the creation of a virtual classroom onsite

Basic Classroom accommodations (furniture, ect...)

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

RSNA Global Learning Centers: Host Center Application