CIRSE Fellowship report: Marawan El Farargy
I completed my CIRSE Fellowship at the end of 2025 at Centro Hospitalar Universitário de Lisboa Central (CHULC) in Lisbon, Portugal. As a consultant interventional radiologist in vascular and non-vascular intervention in the UK, this fellowship provided valuable exposure to high-volume, complex interventional radiology practice within a leading European centre.
CHULC is internationally recognised for excellence in interventional radiology, particularly in embolization, hepatobiliary interventions and oncological procedures. The department functions within a highly structured clinical framework, characterised by strong multidisciplinary collaboration and effective integration of elective and emergency services. From the outset, the learning environment was welcoming, supportive and focused on meaningful clinical engagement.
A key strength of the fellowship was working under the supervision of Prof Tiago Bilhim. His approach emphasised technical excellence alongside sound clinical judgement, appropriate patient selection and evidence-based decision-making. I also had the opportunity to attend SAMS Hospital with Prof. Bilhim, gaining valuable exposure to his extensive experience in embolization practice. Case discussions were consistently detailed and outcome-focused, while maintaining patient safety and procedural efficiency.
During the fellowship, I gained extensive hands-on exposure to a broad range of advanced interventional radiology procedures. This included complex elective and emergency embolization, management of acute haemorrhage, hepatobiliary interventions involving challenging access and anatomy and oncological procedures delivered within a multidisciplinary cancer care framework. The high procedural volume allowed repeated exposure to complex cases, reinforcing technical proficiency and confidence in independent clinical decision-making.
Among the highlights of the fellowship was the opportunity to work within a consistently high-volume service managing complex embolization cases on a daily basis. The breadth of pathology, technical variety and efficiency of case execution provided exposure to approaches that are less frequently encountered in routine practice. The department’s structured preparation, pragmatic intra-procedural decision-making and confident use of advanced embolization strategies across both elective and emergency settings were particularly notable.
The experience also allowed comparison between my practice in the UK and the hosting institution in terms of service setup and workflow. CHULC operates dedicated interventional radiology lists with close coordination between operators, radiographers and nursing staff, enabling efficient case turnover while maintaining patient safety. Observing these processes provided practical insights into workflow optimisation, team dynamics and procedural organisation that can be adapted to improve efficiency and service delivery within my own centre.
Overall, the fellowship exceeded my expectations. In addition to refining technical skills, it reinforced the importance of continued professional development and international collaboration at consultant level. I return with greater confidence in complex embolization techniques and with practical ideas that will directly inform my clinical practice and contribute to ongoing service improvement.
Completing the fellowship during the Christmas period also allowed me to experience Lisbon at a particularly memorable time of year. The festive atmosphere and the warmth of the host team contributed positively to the overall experience and reinforced the strong sense of collegiality within the department.
The skills and perspectives gained during this fellowship will be directly applied to my consultant practice within the NHS, supporting high-quality patient care and continued professional development. The experience further highlighted the value of focused international fellowships in maintaining clinical excellence and supporting ongoing growth at consultant level.
I am sincerely grateful to CIRSE for awarding this fellowship and for their continued commitment to supporting excellence in interventional radiology. I would also like to express my deepest thanks to Prof. Tiago Bilhim and the entire interventional radiology team at CHULC and SAMS, including Dr. Elia, Dr. Alfonso, Dr. Rafaela, Dr. Teresa, Dr. Eduardo, Dr. Martin, Dr. Nuno and Dr. Daniel, as well as the radiography and nursing teams, for their outstanding support and hospitality throughout my stay.