Structure of the Training Program
This is a two-year (104 week) fellowship program that will conform to the following structure:
The fellow will start by performing eight-week blocks in each of the following modalities (in his/her base institution):
Ultrasound: Apart from standard imaging procedures of the adult abdomen and pelvis, this rotation shall also include imaging of small parts such as the thyroid and scrotum. Fellows will be expected to personally scan patients, particularly when significant or ambiguous findings are observed by the technologists. Transvaginal female pelvic sonography as well as transrectal sonography of the prostate may also be performed with an appropriate chaperone where necessary. Doppler techniques including those of the carotid, organ transplant and peripheral vasculature should also be covered. In addition, contrast-enhanced sonographic techniques should be learned.
CT scanning: Routine abdominal and pelvic examinations should be prescribed, supervised, interpreted and reported by the fellow. Emphasis will be placed on learning multidetector CT techniques for a wide variety of applications. Specialized examinations such as CT colonography, CT angiography, and CT urography should all be learned. Since many examinations also include imaging of the chest, there will be significant exposure to chest diseases that may be associated with abdominal pathological processes. Opportunity might also be available to perform CT coronary and pulmonary angiography. The fellow should become comfortable after this period manipulating the imaging data at dedicated 3D workstations for both interpretation and illustration.
MR imaging: Emphasis must be placed on learning practical physical principles as they relate to abdominopelvic and chest imaging including MR angiography. Fellows should be heavily involved in direct supervision of examinations; working with technologists to make necessary adjustments to parameters and protocols as the studies are being performed. Indications and precautions for the use of a variety of MR contrast agents should also be learned. Proper post-processing of imaging data is a central part of the rotation.
The remaining 18 months shall be spent as follows:
Adult fluoroscopy (four weeks): The fellow will consolidate his/her fluoroscopic skills; including being exposed to a variety of less traditional examinations of the GI/GU systems; such as post-operative evaluation of bypass surgery patients. The fellow should also learn recent trends in the appropriateness of various fluoroscopic studies; many of which have been superseded by other cross-sectional techniques. Conventional abdominal radiography reporting should also be included in this rotation. Leaves will not be permitted during this period.
Cross-sectional interventional procedures (continuous eight week block): This rotation should be performed during the second year, during which the fellow should learn the necessary skills to safely and effectively perform sonographically and CT guided interventional body procedures such as drainages, biopsies, and aspirations. Appropriate indications, safety measures and follow-up should be emphasized.
Additional time in each of US (8 wks), CT (20 wks), and MR (24 wks): This will be performed in blocks of no less than four weeks at a time and will allow the fellow to apply the skills acquired during the first six months in a more independent fashion; functioning as a junior consultant with staff supervision available where necessary. These should be performed at various institutions, based on the fellow's clinical needs and the supervising staff's determination of required additional exposure.
Elective rotation (16 wks): Allows flexibility to enhance exposure to certain facets of the program or to work in areas of particular interest to the fellow such as in PET-CT, chest imaging, or high-risk obstetrical sonography for example. At least eight weeks of this period should have some relevance to the field of body imaging.
Research activities: The fellow will be given an average of one half day per week of protected academic time during his/her second year to complete a research project, supervised by a staff member.
The fellow shall perform a minimum of 16 weeks in each of CT and MRI during the first year, as well as a minimum of 12 weeks of US and 4 weeks’ elective. Rotations through the enrolled institutions should be in a minimum of three month blocks with a minimum of three months performed at all participating institutions.
During the entire period, fellows will be expected to demonstrate scholarly activity; such as review of specialized texts and recent literature, teaching of residents and junior staff, as well as involvement in relevant clinical-radiological conferences. Conducting an appropriate research project is strongly encouraged.