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Curriculum

  • Radiology, Diagnostic - Curriculum

    Rotations | Conferences | Research

    Rotations

    The curriculum has been revamped to accommodate to the new Boards and the re-structured 4th year.  Rotations continue to be four weeks in length, so that 52 such blocks occur during the four-year program.

    The first 36 months (39 rotations) of the Program have been redesigned to fully prepare the resident for all of the organ systems and modalities the resident will be required to know for the new Core Board Examination at the conclusion of that time period.

    The fourth year has been restructured to allow, after consultation with the Program Director, more advanced subspecialization while also providing time for further training in the more advanced areas of radiology.

    Assignments in a particular subspecialty, such as GI radiology, are spaced as evenly throughout the first three years of the training program as possible so as to provide the resident with an opportunity for graded responsibility from junior to more senior years.

    There are no fellows in the Program so residents achieve a high level of responsibility in each rotation and will easily find their niche in the more subspecialized portions of the senior year.

    First Year

    The primary objective of the first three years is for the resident to accumulate data and acquire facts; that is, these years are critical for the resident to read, listen, experience, and gather as much information as possible. The Program’s goal is to put the resident in the best position to successfully complete the new Core Board examination at the end of 36 months of training.

    The Orientation Program is integrated into the first six rotations. It is designed to introduce the residents to the fundamentals of radiology through didactic presentations, lectures and conferences given by the faculty who focus on the entities the resident is most likely to see. At the same time, the residents rotate through six fundamental areas of radiology: emergency radiology, body CT imaging, neuroradiology, critical care radiology, abdominal radiology (GI/GU) and ultrasound. Every first-year resident will have had four weeks experience in each of these areas by the end of the sixth month of training.

    The Department’s philosophy throughout the residency is that the resident learns best through supervised performance of a particular study. Besides introducing the fundamentals of radiology, one of the main objectives of these early months is to prepare the resident for trauma/critical care radiology.
    The remainder of the first year is occupied by repeat rotations through abdominal radiology, body CT, critical care radiology and ultrasound as well as rotations through MRI and nuclear medicine.

    First-year residents take no overnight, in-house call. They do have “buddy-call” with a more senior resident.

    Second Year

    During this year, the resident spends 12 weeks in angio/interventional radiology, and returns for an additional rotation in nuclear medicine.

    In nuclear medicine, the resident participates in all aspects of the clinical and laboratory aspects of the specialty.

    Daily review sessions of general nuclear imaging studies are augmented by combined review sessions with the cardiologists for nuclear cardiology, and with the diagnostic radiologists for bone scans. The resident also participates in the evaluation of all thyroid patients.

    The resident also receives additional training in abdominal radiology (GI/GU), body imaging, emergency radiology, ultrasound and MRI.

    Training in pediatric radiology usually takes place this year with 12-weeks of rotations at St. Christopher’s Hospital for Children. At St. Christopher’s, our residents function in the same capacity as they do at Einstein. That is, they are responsible for the performance and interpretation of the pediatric procedures under the guidance of the full-time, Board-certified pediatric radiologists there. Much of the dictation is done by the resident with staff supervision.

    Overnight, in-house call begins in the second year. We use a week-long, night-float system. The call frequency and duty hours comply with all ACGME duty-hourstandards.

    Third Year

    The resident spends most of this year returning to, and refining skills in, many of the earlier rotations, bringing to these rotations additional responsibility and increased experience. The resident rotates through abdominal radiology, ultrasound, musculoskeletal radiology, critical care, and continues with MRI (body and musculoskeletal).

    In addition, the resident spends three assigned rotations of concentrated training in mammography during this year and the fourth year. These three rotations supplement the 50-60 hours of clinical mammography conferences all residents receive throughout the Program and allow the graduating resident to be MQSA certified.

    The residents obtain their training in cardiac radiology from several different sources. The residents receive 52 hours of lectures and conference on congenital and adult cardiac disease during the course of the program at the Medical Center. These conferences include cardiac anatomy, physiology and pathology including cardiac MRI. These 52 hours of conference are augmented by additional conferences, which include pediatric angiographic studies, given by the staff at St. Christopher’s Hospital for Children. Further, the residents see congenital cardiac lesions on their three-month rotation at St. Christopher’s where they are also exposed to cardiac MRI. Adult nuclear cardiology is enhanced by the presence of a cardiologist who, along with the radiologist, helps the resident with the clinical aspects of nuclear interpretation.

    NEW IN 2014: We have incorporated a Cardiac Imaging rotation into our curriculum.  During each block, one senior resident will be assigned to Cardiac Imaging and will participate in all duties associated with any Cardiac CT or MRI study performed during the day.  Resident responsibilities will include: protocoling studies, being present during image acquisition, learning about post processing for these types of advanced studies, image interpretation and report rendering.

    Residents attend the four-week Radiologic-Pathology Course at the American Institute for Radiologic Pathology (AIRP) during this year, subsidized by the Department.

    Call will be adjusted in the third year to allow the resident ample opportunity to study for the Core Examination at the conclusion of this year.

    Fourth Year

    The fourth-year curriculum has been re-structured to reflect the changes instituted by the American Board of Radiology.

    The fourth year allows for greater individual freedom and increased time for subspecialization while providing some time to refine diagnostic skills. Senior residents serve as true consultants and active educators. We are committed, as always, to see that our residents continue to receive superb training in a way that prepares them best for their fellowship, Boards and a future staff position.

    We expect that residents will be able to obtain up to six months of subspecialty training during this year, arranged by them and the Program, to supplement and enhance their previous training. At the discretion of the Program Director, assignments may be made to certain areas in which the resident may benefit from enhancement of their clinical proficiency.

    During the 4th year, residents may also receive additional focused training in ultrasound, interventional procedures, nuclear medicine, body CT and mammography.

    Fourth-year residents are able to participate in the call schedule either from home, as back-up to one of the more junior residents in-house on-call, or in the hospital.

    Rotations | Conferences | Research | Top

    Conferences

    There are two, hour-long diagnostic radiologic teaching conferences each day, one at 8 a.m. and another at noon.

    It has always been the philosophy of the Department that residents’ conferences reign supreme and take precedence over any service obligations so that, with very few exceptions, all of the residents are expected to and do attend each and every conference, regardless of their subspecialty assignment.

    Every conference is monitored by at least one faculty member who is assigned to be the leader of that conference. Additional faculty attend conferences as staffing permits.

    Regular conferences continue when the residents rotate through St. Christopher's Hospital for Children for their major pediatric radiology experience staffed by an outstanding group of pediatric radiologists at that hospital.

    Morning Conferences

    These include a didactic lecture course in radiologic physics offered by an in-house physics lecturer. This course is supplemented by the faculty to highlight areas that involve patient safety and practical applications of physics principles.

    Every other Friday morning, there is a Resident Case Presentation Conference with the Program Director in which a resident prepares interesting cases in advance and shows them as unknowns to the other residents. These conferences frequently focus on the more esoteric and unusual diagnoses and draw heavily upon both the Department’s cases and outside teaching files. Observation, description and the differential diagnosis of findings are stressed. Within the past few years, residents have used this forum to develop and enhance their teaching and presentation skills.

    Once a month, all residents review the appropriate, recent radiologic literature with emphasis on developing a critical analysis of the articles chosen. This Journal Club, monitored by Dr. Cheryl Kirby, is attended by all of the residents and appropriate faculty.

    On most Wednesday mornings, a special Combined Faculty-Resident Case Conference is held. The emphasis during these conferences is on radiologic diagnosis, patient management and the proper use of the multiple imaging modalities available to radiologists.

    On some mornings, the pathologically-proven missed or misinterpreted studies are shown during Morbidity/Mortality Conference with the goal of making appropriate teaching points to avoid such occurrences in the future.

    The other morning conferences are clinically-oriented, resident film-reading sessions. These include conferences in Angio/Interventional, mammography,  and a monthly Cardiac Radiology Conference.

    Noon Conferences

    Each day at noon there is a faculty-monitored, resident film-reading session for one hour. These conferences take the form of didactic lectures and/or case-based conferences.

    During most of these noon conferences, residents discuss cases which are unknown to them and their discussion is guided by the assigned faculty in attendance with active participation by the other residents. During each four-week cycle of conferences, all of the major subspecialty areas of diagnostic radiology are covered at least once, some more often.

    Most conferences feature case material generated by the faculty, although at least six conferences each month have cases selected by the resident. Two of these resident-generated conferences are held with the Program Director. The residents are expected to select cases, abstract the pertinent clinical information, guide the discussion and introduce outside reading they have done about the cases.

    Conference topics and selection of cases is guided by the written curriculum for that subspecialty. We attempt to cover almost all of the written curriculum every two years so that every resident is exposed to the full curriculum at least twice during the Program.

    Following noon conference, our residents enjoy a short, dedicated break from clinical and educational activities to eat lunch, most often as a group.

    Guest Lecturer Series

    The Department sponsors a series of guest lecturers during the academic year from all subspecialty areas to challenge our residents and expand their scope of learning.

    Other Conferences

    Residents receive considerable experience while accompanying a faculty radiologist to one of many inter-departmental conferences held each month. These combined clinician-radiologist conferences include Neuroradiology, Pediatric, Radiologic/Pathology, Pulmonary, Lung Cancer, Breast Cancer, Tumor Board, Urology, Orthopedics, Rheumatology, and GI Oncology conferences. During these conferences, the resident learns how to serve as the imaging consultant in a multi-specialty setting.

    All of our residents attend the four-week course at the American Institute for Radiologic Pathology (AIRP). In addition, all residents participate in about 50, one-hour radiologic-pathology conferences offered jointly by the Departments of Radiology and Pathology. In this monthly conference, the most interesting and educational gross pathologic specimens removed by our surgical staff in the previous month are brought to the conference where a staff pathologist goes over the pathology while a faculty radiologist and our residents review the accompanying imaging study.

    Our residents also receive extensive training in critical thinking through on-going lectures and workshops that focus on research fundamentals, statistics, research design, ethics in medicine and critical appraisal of the literature.

    Outside Conferences

    There are numerous city-wide conferences, lectures, meetings and seminars in radiology in the City of Philadelphia which the residents are encouraged to attend.

    Monthly society meetings in the City focus on interventional radiology, orthopedic radiology with pathologic correlation and a meeting of the Philadelphia Roentgen Ray Society, the oldest such society in the country, which brings prominent local and national radiologists to the City to speak about cutting-edge issues of the day.

    In addition, residents may be subsidized if they present an original scientific work at a national meeting and both our incoming and outgoing Chief Residents are fully subsidized to attend the annual national meeting of the American Association of Academic Chief Residents in Radiology.

    Rotations | Conferences | Research | Top

    Research

    Every resident in our Program develops a scholarly project which can be executed sometime during the residency. Such projects may take the form of research leading to a publishable paper, but may also include preparation of a scientific exhibit, an oral presentation (such as at a local society meeting), synthesis of clinical material into an intramural presentation or report, preparing cases for submission to web-based teaching files, or the like.

    Residents in this Program have a unique opportunity, if they so desire, to become involved in the electronic delivery of educational material through our Department's widely-acclaimed and nationally-known educational website, LearningRadiology.

    Over the last several years, radiology residents have participated in the presentation of over thirty scientific exhibits outside of the Department and have authored or co-authored over a dozen papers or abstracts.

    In each of the last five years, one of our senior residents has been selected for the RSNA/ARRS/AUR "Introduction to Academic Radiology Award," given to only one of 80 3rd-year residents throughout the Nation. In addition, our radiology residents have won awards from the Association of Women Radiologists, the RSNA, and the Society of Radiologists in Ultrasound.

    Commitment to Education:

    All of our residents now receive an Ipad to be used during their four years of residency at Einstein.  The Ipad comes loaded with 24 Radiologic textbooks and has become an invaluable tool for resident learning whether it be at the workstation, during conferences with audience response questions or at home studying.  Because the Ipad comes already loaded with 24 textbooks there should be no need to purchase any more textbooks.

    All of our residents also receive a subscription to Radprimer which is a website with thousands of multiple choice questions to help residents prepare for the new board exam. This site also has a tremendous amount of teaching material for residents to use on rotations to supplement the education they receive at the workstation and in lectures. There are hundreds of educational modules and pre and post quizzes to test knowledge and progress.

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