Nuclear Radiology

The specific goals include objectives required for every level and focused area of training, with graduated levels of supervision and responsibility. All aspects of nuclear medicine imaging and therapy are incorporated into the fellowship, including cardiac nuclear medicine. During every training rotation, the fellow will read the required material and study the teaching files in nuclear medicine. Over time, the fellow will become progressively more knowledgeable about normal scintigraphic anatomy and physiology and about the scintigraphic appearance of disease processes. The structured training provides the base for Board preparation (ABR Special Competency in Nuclear Radiology) and the clinical and academic practice of Nuclear Radiology.

During the Nuclear Medicine Fellowship, the fellow is expected to:

• Gain competence in interpreting dynamic and static nuclear imaging (planar, SPECT, SPECT-CT and PET-CT) of physiologic and pathophysiologic processes
• Gain competence in the utilization and handling of radiopharmaceuticals, and quality control of nuclear imaging instruments and radiopharmaceuticals
• Increasingly understand disease entities, their clinical presentations, and current modes of treatment
• Develop the know how to supervise and perform radionuclide image-guided procedures
• Learn how to function as an NRC Authorized User of radioisotopes for diagnostic use and for therapies involving administered doses <33 mCi I-131, administered doses >33 mCi I-131, and for palliation of bone pain at the completion of the final rotation.
• Establish a firm foundation of clinical knowledge and technical expertise upon which to base further personal development in the field of Nuclear Radiology
• Develop familiarity with the signs and symptoms of disease entities amenable to the diagnosis with Nuclear Radiology, and complementary role of other imaging modalities
• During every rotation, read the required material and study the teaching file in nuclear medicine
• Develop an understanding of common research methods and study design as well as common pitfalls to clinical research, with emphasis on application to Nuclear Radiology
• Learn to perform and skillfully implement the clinical and technical aspects of Nuclear Radiology procedures to maximize their safe utilization
• Become progressively more knowledgeable about normal scintigraphic anatomy and physiology and about the scintigraphic appearance of disease process
• Gain competence in interpreting dynamic and static nuclear imaging (planar, SPECT, SPECT-CT and PET-CT) of physiologic and pathophysiologic processes
• Develop a complete understanding of the fundamentals of radiation physics, radiation biology, and radiation protection as they relate to Nuclear Radiology
• Serve as a learning resource for medical students, residents, and ancillary medical staff and become actively involved with teaching of residents
• Develop the habit of routinely surveying the medical literature and using this knowledge in patient care; this should be done before any type of procedure or with any clinical presentation with which the fellow is not completely familiar
• Develop a bedside and clinic manner that meets the needs of patients and provides a thorough patient assessment
• Demonstrate a knowledge of and attitude for ethical practice
• Have consistently professional behavior and good communication skills
• The fellow will know how to supervise and perform radionuclide image-guided procedures at the completion of their fellowship
• The fellow will know how to function as an NRC Authorized User of radioisotopes for diagnostic and therapeutic purposes

The above goals and objectives are communicated to the fellow through faculty and fellow meetings, email messages, and managerial meetings. Print and Web-based materials are provided to all faculty and staff, as well as the fellow. Fellowship supervision in Nuclear Radiology is a combination of consultative and direct supervision with graded increases in responsibility. Our general philosophy is that in order to provide high quality clinical service and excellent fellowship teaching, close fellowship supervision is important with progressively increased responsibility as the fellow gains experience. Fellow evaluations of performance are maintained by the Fellowship Coordinator.

Radiology residents who desire to begin a fellowship immediately following the completion of their residency should apply in the late fall/early winter of their 3rd year of radiology residency. Fellows are selected on the basis of their medical training, general and academic achievements, and personal qualities. No preference is given to any particular medical school or geographic area, nor is race, sex, or national origin a consideration. International medical graduates are welcome to apply. A personal interview is required unless there are exceptional circumstances.

Applicants will need to send the following, via email, to Sandy Kerns:

• Curriculum Vitae (CV)
• Personal statement or letter of interest summarizing your training background, areas of particular strength and interest, and describing how you would hope to utilize and apply your medical training
• Three current letters of recommendation, including one from your radiology residency program director; letters should come from those persons who are familiar with your recent training and current professional activities.  Letters of recommendation may be sent via email, however, this must come from the account of the author or his/her designee (program coordinator, administrative assistant).
• USMLE Steps I, II, and III
• ECFMG certification (if applicable)

Current Nuclear Medicine and Molecular Imaging faculty

The Division of Nuclear Medicine provides full diagnostic and therapeutic services with radioactive materials. Usual procedures include studies such as radionuclide imaging and functional studies of the kidney, lung, bone, liver, hepatobiliary system, thyroid and infection. Tumor imaging is provided with MIBG, Octreoscan, MIBI, radiolabeled antibodies, and I-131. Studies of the gastrointestinal tract include quantitative gastric and esophageal emptying studies, and scans for Meckel’s diverticulum or gastrointestinal bleeding. Brain imaging includes cisternograms, cerebrospinal fluid flow and shunt studies, and planar and SPECT scans of cerebral blood flow. SPECT/CT is also available.

Positron emission tomography (PET) is available using the latest technology, PET-CT. PET-CT combines PET and CT in a single machine, which is used to provide information about metabolism linked to CT anatomy in a single exam. PET/CT is available for all approved clinical indications, including oncologic, neurologic, and cardiac.

Therapeutic procedures include treatment of thyrotoxicosis and thyroid cancer with radioactive iodine, and radioimmunotherapy for Non-Hodgkin’s lymphoma, therapy for bone pain due to bone metastases, and radiosynovectomy.

Nuclear Medicine Fellowship Curriculum

Following a transitional period in which graded responsibility is transferred to the fellow, the fellow is assigned to call for weekends (Friday night through Monday morning) on a rotating basis with a frequency no greater than every 3rd weekend. The fellow serves as a back-up from home to Radiology residents working in the hospital that are available to cover all emergency or after hours cases, with final back-up by a Nuclear Radiology attending.

Fellows are provided with written evaluation of their performance four times during the program. The faculty performs evaluations of the fellows’ performance at 3, 6, 9, and 12 months.

Anonymous evaluations by the fellows of the program are completed annually, and faculty are anonymously evaluated quarterly. Faculty are evaluated using a numerical scoring system on a wide variety of clinical, teaching, and research skills.

Our fellows receive an annual salary that is competitive with compensation offered by other institutions. They receive medical and dental care benefits for themselves and their immediate family. Additionally, malpractice insurance is provided at no charge.

Our fellows receive an annual stipend. This stipend is to cover expenses related to attending meetings or buying books. Each fellow is encouraged to attend one educational meeting of his/her choice.

Vacation and Leave Policy

Fellows have 15 business days of vacation time. Additional time off is granted for fellows presenting at national Radiology meetings.

Office Space

Fellows have combined office space with several cubicles, separate computers, telephones, and PACS.

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