Residents are scheduled for monthly rotations at a single institution. While some of these rotations are dedicated to a single radiologic subspecialty and occupy the entire month, others may involve rotating through various services in weekly blocks. For instance, residents will spend the entire month scheduled on pediatric radiology during their first year, while residents assigned to the UNM General Pool will rotate weekly through various services such as the main reading room (ICU/Chest/ER), GI/GU fluoroscopy, body CT, and interventional. VA General Pool rotations of one week duration include body CT/MRI, ultrasound, neuroradiology, and GI/GU fluoroscopy. Two week blocks are generally reserved for neuroradiology, diagnostic imaging (ultrasound/mammography), senior rotations in pediatrics, and nuclear medicine.
Assigned rotations through the subspecialties of radiology expose the resident to the typical routines found in private practice in addition to the academic setting. Residents receive extensive training in the following rotations:
| University of New Mexico | New Mexico VA Healthcare System |
|
Pediatric Radiology (Childrens Hospital of New Mexico) Pediatric Orthopedic Radiology (Carrie Tingley Hospital) |
|
| Musculoskeletal Radiology | Musculoskeletal Radiology & Neuroradiology |
| Neuroradiology | |
| Nuclear Medicine | Nuclear Medicine |
| Reading Room (ICU / Chest / ER) | |
| Body CT/MRI | Body CT/MRI |
| Gastrointestinal/Genitourinary Fluoroscopy | Gastrointestinal/Genitourinary Fluoroscopy |
| Cardiovascular & Interventional Radiology | Cardiovascular & Interventional Radiology |
|
Ultrasound / Mammography
(Diagnostic Imaging) |
Ultrasound |
Combined with the ultrasound rotation at the Outpatient Imaging and Surgical Center (OSIS), the mammography rotation gives residents experience in all aspects of breast imaging, including screening and diagnostic mammography, breast MRI, ultrasound, stereotactic biopsy, ultrasound-guided biopsy and aspirations, and wire localizations for surgical biopsy. Breast MRI is performed on the Siemens 3 Telsa MR and scanner located at the OSIS. Residents are invited to attend the weekly Cancer Center multidisciplinary conference with Dr. Eberhardt.
Working one-on-one with faculty and fellows, residents actively
participate in all types of angiography and interventional procedures.
Pre-procedure evaluation of patients, including obtaining informed consent for procedures,
review of pertinent studies, procedure
planning, patient monitoring, and short and long-term follow-up are completed with
supervision. Studies performed include arteriography, venography, angioplasty, stent
placement, biliary intervention, genitourinary procedures, liver and renal transplant
evaluation and treatment, TIPS (transjugular intrahepatic portosystemic
shunt) placement, thrombolysis, embolization, vertebroplasty, filter placement, central
venous access, and biopsies and drainages under fluoroscopic, CT, and US guidance.
Neurointerventional procedures include intracranial aneurysm coiling and embolization of
intracranial masses and vascular lesions. In addition to
performing procedures, residents round daily on hospitalized
interventional radiology patients.
Interpreting chest radiographs is a fundamental and demanding requirement for a radiologist. In the main reading room at UNMH, residents interpret chest radiographs on patients in the medical (MICU), trauma/surgical (TSI), and neurosciences (NSI) intensive care units. Other inpatient and outpatient chest radiographs from UNMH and outpatient clinics are also reviewed. The main reading room staff also read all radiographic exams performed in the UNM Emergency Department.
Residents
work with thoracic and body imaging attending radiologists to interpret all
abdominal and chest CT/MRI exams performed in the Department of Radiology at
UNMH and the BBRP imaging center features two 1.5 T Siemen I scanners and 2
16 slice Siemen CT scanners as well as a Siemens 64 slice dual source CT
scanner. The department will soon be acquiring a second 64 slice dual
source scanner. Residents with faculty supervision, read all the
studies including trauma evaluations, ER examinations, cancer center
evaluations as well as coronary CT angiographic, evaluations of cardiac MRI.
Residents also interpret all chest and abdominal CT/MRI examinations at
the VA medical center, which features Marconi PQ-6000 and Siemens Somatom
helical CT scanners.
This section covers the recognition and diagnosis of musculoskeletal diseases, including arthropathies, neoplasia, and assessment of trauma through the interpretation of conventional radiographs, CT, and MR studies. Residents learn techniques for intra-articular gadolinium injection for MR arthrography. A rotation through pediatric orthopedic radiology offers residents the opportunity to learn about musculoskeletal diseases in children.
During the neuroradiology rotation, residents learn anatomy, pathology, and differential diagnoses as
applied to the spine, brain, head, and neck. This
rotation also covers
technical aspects of CT and MR imaging, including occasional myelography exams. As residents gain experience, they assume greater
responsibilities for prescribing scan sequences and dictating reports.
Residents attend weekly combined neuroimaging conferences with the neurology and
neurosurgery departments. Neurovascular
procedures are performed as part of the Angiography & Interventional Radiology rotation.
This block provides residents with a sound understanding of the diagnostic and therapeutic uses of radiopharmaceuticals. The VA medical center was instrumental in the development of PET/CT fusim technology. PET/CT imaging is performed at both institutions with dedicated instrumentation. Emphasis is also placed upon radiopharmacy techniques including quality control. The new UNM cancer center facility with expected completion in February 2009 will contain a cyclotron used to manufacture radiopharmaceuticals. Both institutions have the ability to perform quantitative gated SPECT imaging for myocardial perfusion scans. Residents also learn techniques of nuclear medicine therapy using I-131 for hyperthyroidism and thyroid cancer, as well as Sr-89 for palliation of bone metastases.
The department
performs all radiographic imaging for Childrens Hospital of New
Mexico which is now contained within the newly completed Bill & Barbara
Richardson Pavillion as well as Carrie Tingley Hospital. Residents work with
two fellowship-trained pediatric
radiologists and referring pediatricians. Residents spend at least
three months on this rotation throughout their residency. Topics
covered include interpretation of conventional radiographs, fluoroscopy,
ultrasound, and CT/MRI. Intensive care unit staff, ward unit staff,
house staff, and medical students meet daily in the pediatric radiology
reading room to review in-house patient exams and to discuss imaging
strategies.
Residents become adept at performing all types of non-interventional fluoroscopic examinations at both UNMH and the VA medical center. Included in the fluoroscopy rotations are all aspects of the diagnosis of GI pathology using single contrast and biphasic examination of the entire alimentary tract. Additional exams include biliary studies, fistulography, and placement of enteric feeding tubes. Contrast studies of the GU tract (intravenous urography, voiding cystography, and retrograde urethrography) and the pharmacological actions of contrast materials are included in this section. The Department of Radiology collaborates with the Department of Speech Pathology for swallowing studies and the Department of OB/GYN for hysterosalpingograms. Residents become proficient in using digital fluoroscopy equipment, Siemens Sireskop digital fluoroscopy suite at the VA medical center, as well as a newly constructed fluoroscopy suite of UNMH.
Ultrasound rotations are provided at both UNMH OSIS and the VA medical center. Residents interpret ultrasound examinations of the neck, breast, abdomen, and pelvis, as well spend time with the ultrasonographers learning techniques of real-imaging. Residents are involved in ultrasound procedures, including biopsies and hysterosonography. State-of-the-art ultrasound equipment is available at the three facilities.
