The Interventional Radiology Fellowship is a one-year ACGME accredited program with an option for two years depending on eligibility. Full training is accomplished in one year by rotating the fellows through all the different areas of interventional radiology in the participating institutions. The second year is provided to enhance the training received in the first year and to encourage more in-depth research efforts. Five fellowship training positions have been approved. Interventional Radiology encompasses a variety of invasive diagnostic and image-guided therapeutic techniques, including all aspects of radiological diagnosis and treatment of a wide array or organs, including blood vessels, biliary ducts, urinary tract, gastrointestinal tract, as well as magnetic resonance and computed tomographic studies of blood vessels excluding the cerebral vessels. Our fellowship program offers a quality graduate medical educational experience of adequate scope and depth in all of these associated diagnostic disciplines. We offer an environment that encourages the interchange of knowledge and experience among fellows and faculty within the program and with residents, fellows and faculty in other major clinical specialties throughout the hospital.
Our Interventional Radiology Fellowship Program is preceded by a mandatory ACGME or equivalent accredited diagnostic radiology residency. During the training, the fellow is exposed to patients with diseases of the above-mentioned structures. Besides performance of image guided invasive procedures, time is also set to interpret the MR and CT vascular examinations.
The minimum curriculum requirements will be met by the first year, by rotating the fellows through the different areas predefined as required, by regular evaluation sessions with the fellows, daily monitoring of the fellows by the staff, and by completion of competencies predetermined and set by the program.
The majority of the fellowship is spent working in invasive procedures. All fellows learn how to prepare for each individual procedure.
A three-month rotation through the non-invasive vascular lab provides training and background in the hemodynamics of the peripheral vascular systems. During this rotation, the fellows are exposed to vascular ultrasound, magnetic resonance angiography, and computed tomographic angiography. A multispecialty approach to vascular disease is taught to the fellows during this rotation. At this time, the fellow also collects and presents to the staff radiologists specific cases in which the interventional radiology department has been or will be involved. Follow-up cases are also specifically presented to the staff members, including fellows and residents, to further understand the disease processes that are involved with and continue in some cases following interventional procedures.
During the non-invasive vascular rotation months, fellows also participate weekly in a peripheral vascular clinic. Many of the patients seen will have noninvasive testing prior to their procedure, allowing patients to be evaluated in a clinical setting. Discussion with the clinical staff at this time is done and further follow-up and therapy are discussed and formulated. Also in clinic, the fellows see patients pre-procedurally for evaluation to ensure continuity of care from the stage before the procedure, during the procedure, and then following the procedure in clinical follow-up.
Interventional Radiology Program Goals and Objectives
The interventional radiology curriculum allows for progressive scholarship and experience. Upon completion of the program, fellows will have knowledge in 1) basic imaging principles and physics including: radiation biology and safety; knowledge in radiographic techniques and their indications including, computed tomography of blood vessels, fluoroscopy, sonographic-guided needle access, and MR imaging of blood vessels; 2) understanding of radiographic, and cross-sectional imaging (sonographic, CT and MR) applied to the diagnosis and performance of interventional procedures; 3) ability to perform invasive procedures such as diagnostic angiography (arterial and venous, excluding the heart), diagnostic cholangiography, diagnostic pyelography; needle-placement under image guidance; arterial and venous percutaneous transluminal angioplasty, stent placement, catheter-directed thrombolysis, mechanical thrombectomy, embolization, foreign body retrieval; biliary, GU, GI, peritoneal, extraperitoneal and thoracic drainage and sclerotherapy procedures; ureteral embolization procedures; biliary, GI and GU stricture dilation and stent placement; biliary and GU stone removal/manipulation; caval filter placement; central venous access placement; tradeobronchial intervention and 4)an understanding of emergency procedures, their indications and impact. Some limited training in MR-guided interventions is also provided.
Our principal philosophy is to educate, train, and supervise fellows during their fellowship with an emphasis that each fellow obtains the necessary attributes during their training. The expectations differ as each fellow progress through his/her fellowship and in most subspecialty divisions, teaching is scaled in a pyramid, building upon a base of information and adding to it with subsequent exposure.