We realize that your choice of a Neuroradiology Fellowship is difficult and that considerations include the academic program, faculty, work environment, geographical location, and various other personal reasons. We also recognize the substantial personal commitment it takes to extend your training and improve your skills. Please know that we take your commitment seriously and commit to train you to the best of our ability. Finally, it is our responsibility to help guide you in your job search and do our utmost to assist you in obtaining the position of your choice.
Overall Program Goals
- The overall goal of the Neuroradiology Fellowship Program is to fulfill the three-fold mission of the University of Virginia Health system: To provide excellence and innovation in the care of patients, the training of health professionals and the creation and sharing of health knowledge.
- To that end, the program is designed to enable the Diagnostic Neuroradiology Fellow to accumulate a broad base of medical knowledge, to develop progressively independent interpretive and technical skills under supervision, and to become proficient at accurate clinical decision making and consulting; the fellowship aims to provide teaching and research opportunities for fellows, adjusted to special interests and talents.
- At the conclusion of the fellowship, the graduate will have the foundation to build an academic career in radiology, advance subspecialty knowledge and skills as an advanced clinical fellow or instructor, or enter community practice as an expert diagnostic neuroradiologist.
As a result of our clinical training and didactic conferences, we expect each neuroradiology fellow who finishes training with us to be able to:
- Understand the functional neuroanatomy of the brain and spine
- Understand the physical principles underlying advanced neuroimaging modalities such as MRI, CT, and PET
- Have good general knowledge of related neuroimaging techniques, such as PET
- Perform and obtain competence in head, neck and spine biopsies
- Perform safely and interpret accurately myelograms, CT scans and MRI scans in the most complicated/difficult cases encountered in common clinical practice
- Be able to design and modify CT and MR protocols as new techniques are developed
- Have thorough imaging and clinical knowledge of diseases of the head and neck
- Develop skills and confidence in discussing neuroimaging cases with requesting physicians and teaching other physicians about neuroimaging
- Be familiar with scientific data and issues debated in current neuroradiology literature
- Design and complete a research project
Neuroimaging training includes all aspects of neuroradiology of the brain, head, neck, and spine including plain radiographs, computed tomography, and magnetic resonance imaging. The fellow is exposed to all facets of ENT and pediatric neuroradiology.
Training in advanced imaging techniques is the cornerstone of our fellowship and includes MR Spectroscopy, MR Perfusion, CT Perfusion, fMRI, DTI and CSF flow analysis. Non-invasive vascular imaging is critical to the expert neuroradiologist: at UVA, your experience will include training in a variety of techniques including high-resolution CT Angiography, 3D TOF MRA, contrast-enhanced MRA, time-resolved MRA, CT venography and 2D TOF MR venography.
Familiarity with various post-processing equipment is essential to be nimble, thorough, and accurate. The Department has vast 3D resources including a 3D Lab with experts in Syngo.via applications. The Carestream PACS 3D resources include built in platforms that allows for perfusion analysis, vessel analysis, and volume rendering applications. All platforms are maintained at a high level with regard to version/platform and in-hospital support maintains the systems. The fellows are encouraged to utilize the workstations and become independent of the technologists, even though the 3D techs routinely create the 3D and post-processed images.
The procedure experience can be subdivided into several distinct areas: head & neck biopsies, percutaneous spine procedures (including myelography, vertebroplasty, kyphoplasty, biopsies, etc), and optional participation in catheter angiography and neuroendovascular therapeutics.
Diagnostic neuroradiology fellows rotate on a weekly basis among the following rotations: early (7am-4pm), mid (8am-5pm), procedures (8am-5:30pm), late (3pm-9pm), Long Term Acute Care Hospital (LTACH) (8am-6pm), and academic rotation (8am-5pm). Fellows are on call approximately every fifth weekend (7am-5pm Sat/Sun).
During the early and late shifts, fellows share the plain films, CT and MRI studies with the 2-3 residents in the reading room. The number of studies is approximately the same for each fellow and resident, but the fellows are expected to read more complex cases (CTAs, advanced CT and MR imaging techniques, MRI of the head and neck, pediatric neuroradiology cases). This was introduced at the request of prior fellows so that they can develop their advanced neuroradiology knowledge while maintaining their skills in reading simpler studies, such as head CTs.
During academic time, the fellow:
- May attend any of the conferences indicated on the neuroradiology conference schedule and, once comfortable, present some of them
- Is in charge of the Interesting Case conference, and coordinates with another fellow and the residents to present at least four cases
- Is teamed with one attending to serve as a research mentor and works on at least one academic deliverable (peer-review article, review article, teaching conference, QA project)
- Is involved with review of literature, collaboration with technologists including 3D lab to become familiar with advanced imaging techniques and their processing, and preparation of teaching conferences
- Is responsible for leading a journal club with their peers
The five fellows split equally the weekday and the weekend calls, currently assigned on a weekly block schedule. During call, fellows have access to PACS from home using a VPN. The fellow covers home pager call from Monday through Sunday of the call week. Before a weekend of call, the fellow is on the Friday late shift. There is no in-house overnight call, but the fellow on call for the weekend reads in-house with staff on Saturdays and Sundays 7am-5pm. After a weekend of call, the fellow is on academic rotation.
Fellows are provided with written evaluations of their performance 4 times during the program year. The faculty performs evaluations of the fellows’ performance at 3, 6, 9, and 12 months. Anonymous evaluations by the fellows of the program are received twice per year and faculty evaluations are completed quarterly. Faculty are evaluated on a wide range of clinical, teaching, and research skills using a numerical scoring system and written comments through New Innovations.