Education

THE PROGRAM STRUCTURE

The Diagnostic Radiology Residency Program at Albany Medical Center is designed to provide a balance of supervised case interpretation, independent learning, didactic lectures, research opportunities, and patient care.  All this is done in the context of the six competencies mandated by the ACGME: patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Ultimately, these competencies insure that we produce radiologists who are knowledgeable and compassionate care givers, who have developed the tools to continue learning and growing throughout their careers, and who are enthusiastic participants in the health care system.  Upon completion of our program, residents will have acquired substantial medical and radiologic knowledge and the skills to apply this knowledge to all aspects of the daily practice of radiology.

ROTATIONS

The program consists of a series of rotations through the clinical subspecialties of radiology.  Rotations are usually four weeks in duration.  Some rotations, in the Emergency Department (ED) and on senior night float, are typically two weeks in duration.  Residents are required to have 16 weeks in nuclear medicine and 12 weeks in mammography to comply with regulations of the ACGME and the American Board of Radiology.  Elective rotations are available to our third and fourth year residents.

On most rotations, residents preview cases at PACS viewing stations and then review findings and impressions with a radiology staff member in a personal teaching exchange.  All work done by the residents is supervised by attending radiologists, with an emphasis on giving the resident the opportunity to make independent decisions, which are then reviewed by a faculty member.  As residents progress through the program, they have increased responsibilities and independence commensurate with their knowledge.

 

First Year

Subspecialty	# Rotations in Year 1
Musculoskeletal	1.0
Neuroradiology-CT	1.5
Fluoroscopy (GI, GU)	2.0
Chest Radiology	2.0
Pediatric Radiology	1.0
Body Imaging (CT)	1.0
Body Imaging (US)	1.0
Nuclear Medicine	1.0
Emergency Radiology	2.5

Residents have core rotations in which they are exposed to all modalities, and are able to develop the learning skills needed to succeed in subsequent years, without the burden of on call responsibilities. In addition, first year residents are expected to acquire facility with the hospital information and radiology PACS systems, dictating radiology reports, and communicating results to referring physicians.  In accordance with the ACGME program requirements, no first year resident is allowed to enter preliminary reports into the PACS system or communicate preliminary reports to clinical staff without the study being reviewed with attending staff or a senior resident.

 

Second Year

Subspecialty	# Rotations in Year 2
Neuroradiology-MRI	1.0
Interventional Radiology	2.0
Nuclear Medicine	1.0
Chest Radiology	1.0
Breast Imaging	1.0
Pediatric Radiology	1.0
Body Imaging (CT)	1.0
Body Imaging (US)	1.0
Body Imaging (VA)	1.5
Emergency Radiology	1.0
Senior Night Float	0.5

Residents receive increased exposure to cross-sectional imaging, and return to many of the plain film rotations with new and increased responsibilities.  Second year residents also rotate through interventional radiology and breast imaging.  All procedures are performed under direct supervision of an attending interventionalist.  The program is structured so that residents have been exposed to all major subspecialty areas by the end of their second year of training.

 

On-Call Schedule

Call is an extremely important part of the resident’s learning and maturation.  Residents begin a supervised exposure during working hours in the Emergency Department under attending supervision in their first year.  During this early experience, all films are reviewed with the resident and cleared by the attending before preliminary reading.  In the second year, the resident is given further responsibility in interpreting the studies commensurate with experience and knowledge.  Readout sessions are scheduled frequently during the call period, and a final readout session occurs before the resident goes off duty.

Weekend call is scheduled on a rotating basis, dividing the time into two or three shifts.  The senior resident on call is responsible for interpreting body imaging studies and pediatric procedures.  Faculty support of call residents is extensive.  In-house residents rely upon attendings from each division who are scheduled to be available for consultation and for image review.  

Third and Fourth Year

The last two years of residency training are designed to suit the needs of the individual residents as they complete their training and prepare for board examinations.  Residents complete at least three rotations on each radiologic subspecialty, yet have the flexibility to spend time electively exploring individual areas of interest or receiving additional training.  The resident is given the opportunity to make independent decisions, and increased responsibility in image analysis, reporting of results, and performing procedures, all with the careful review and supervision of faculty members.  Additional rotations during the last two years of residency include Body MRI, Cardiac Radiology, Obstetrical Ultrasound, and the Armed Forces Institute of Pathology (AFIP). 

CONFERENCES

• Two conferences are scheduled daily, Monday-Friday, at noon and 1:00 p.m.
  Subspecialty faculty present noon conferences in both didactic and case presentation format.  Resident presentations are usually scheduled at 1:00 p.m. with attending supervision.  Vascular-Interventional conferences are scheduled at 7:15 a.m. on either Tuesday or Wednesday each week. 
• First year residents are given six months of intense orientation lectures, concentrating on plain film interpretation.  These sessions include both lectures and review of teaching file cases.  This experience helps the junior resident gain confidence in plain film interpretation.
• Residents actively participate in the preparation and delivery of case conferences, discussing the findings in unknown cases, and therefore reviewing the approach to image interpretation, pattern recognition, and formulation of appropriate differential diagnoses.
• Residents are responsible for accumulating interesting cases, for reading about the disease entities they are presenting, and for communicating their knowledge to all those in attendance.
• Conference preparation involves learning clinical radiology, pathology, literature review and requires familiarization with the hospital information system.  By preparing and presenting these conferences, all residents master the use of electronic media, and become comfortable with public speaking.
• In 2007 we initiated a series of lectures entitled Beyond Imaging, which include the elements of research, journal club, HIPAA, quality improvement, business of radiology, financial planning, and ethics.
• Speakers from prestigious institutions have been invited to present Grand Rounds at various times during the past few years.  Grand Rounds teaching days include an hour-long presentation followed by two to three hours of case presentations by the guest lecturer and the residents.  These lectures provide residents with an opportunity to interact with respected faculty members from other institutions and to learn from them in an informal setting.

RESIDENT ASSESSMENT

Albany Medical Center utilizes the New Innovations system for resident evaluations by faculty after each rotation.  These are reviewed by the resident with the program director at six month intervals.   Examinations to assess interpretive skills are taken by each resident before beginning their Emergency Radiology rotation and call responsibilities.  

Residents are required to take the American College of Radiology In-Training Examination each year. The results are viewed as important feedback for independent study in preparation for written boards, and for both the residents and the department regarding performance when compared nationally to their peers.

 BENEFITS

• Tuition for the Armed Forces Institute of Pathology (AFIP) radiologic pathology course in Washington DC, and a $2500 housing allowance.
• Board review courses will be financially supported.
• Additional funding for resident travel to conferences to present findings of their original research.
• 20 days vacation/sick time each year, not including time for presentation of research, or the above mentioned review courses. 
• Internal moonlighting opportunities may be available for qualified residents at the appropriate academic levels.
• Meal allowance for on call service.
• Dedicated Radiology Library and learning resource center accessible to residents 24 hours per day.  Funds are allocated yearly for acquisition of new textbooks and materials for the Radiology Education Center.
• Albany Medical College Schaeffer Library with on-line full text access to most major medical journals accessible from computers throughout the medical center.