Roughly one month is spent on each rotation, including fluoroscopy, ultrasound, plain radiography, CT/MR, neuroradiology, ER (call) and interventional radiology. Fellows with specific subspecialty interests, such as cardiac imaging, fetal imaging, nuclear medicine and musculoskeletal radiology, may choose to spend more time in these areas and less time in the other elective rotations.
All of the fellows will rotate through the same introductory rotations in the first two months, followed by their first overnight call shifts. We then blend elective rotations with the basic rotations, rotating on a weekly basis unless consecutive weeks on a rotation are desired. The program director meets with the fellows on a quarterly basis to review their progress and identify any areas that need correction or further work.
As the fellows begin identifying areas of specific interest, and/or interviewing for jobs and identifying areas that need further study, we can increase the number of subspecialty rotations.
During the typical work day, the fellow is responsible for dictating all studies assigned to their rotation. All studies are reviewed with the faculty member. All rotations have a 1:1 trainee-to-faculty ratio (i.e. residents and fellows are not doubled up on rotations).
The fellows are also responsible for preparing and presenting interdepartmental conferences. The fellows are expected to deliver two noon conferences during the year, one hot seat conference and one didactic conference, on a topic of their own choosing.
Fellows take call on a night float system, shared with the senior rotating residents. Night float shifts are from 11pm to 7am, Sunday through Thursday, followed by a post-call day off. There are no clinical duties during the day while the fellow is on the night float system. Fellows will do between 3 and 4 weeks (15 and 20 shifts) of night float during the fellowship year.
In addition, fellows do 5-6 weeks (5 consecutive days) of evening shift rotations, from 5 to 11pm, on call with a faculty member.
The fellows also cover a Saturday shift from 9am to 6pm, working with a faculty member. Saturday shifts do not take place on holiday weekends.
While on call, the fellow is responsible for providing preliminary interpretations on emergency and stat inpatient studies, including plain films, ultrasounds and CT/MR studies, as well as occasional fluoroscopy procedures (upper GI series for malrotation, air enema for intussusception reduction). Overnight the fellows also provide preliminary interpretations on neuroradiology studies. A faculty member checks out all studies at 7am the following morning. There is an ultrasound technologist in-house 24 hours a day, but the fellows are expected to scan each ultrasound patient to arrive at their own impression.
Moonlighting opportunities are available at TCH, once the fellow has completed their first week of night float.