Emergency Radiology Fellowship

Overview:

The Emergency Radiology fellowship at University of Texas Health, San Antonio is a one-year, non-ACGME-accredited program during which the fellow works under six, multispecialty-trained radiologists who are committed to graduate medical education. Emergency radiology fellows are vital members of the division, participating in daily patient care and facilitating the oversight, interpretation, and timely reporting of emergency imaging studies. Though a highlight of the program, trauma is not the sole focus of the fellowship, the fellow will also be an essential member in the teaching of radiology residents and other trainees. Regular learning sessions are held with ED radiology faculty in the form of didactic lectures, subspecialty focused case conferences, journal clubs, and opportunities for research/publications. Dedicated time is given to fellows for elective rotations with other University of Texas Health radiology subspecialty divisions. Fellows also have opportunities to participate in teaching activities for the radiology residents. The faculty member assigned to ER provides coverage on/off-site and/or by telephone to whom the ER team directly reports.

General guidelines/expectations:

Primary responsibilities:

Best possible patient care is what we aim for. Everything practiced within the ER is focused on this primary principle. Being the upper most level in the room, the fellow must make sure that quality reports are produced with fast turnaround times (30 minutes for stat ER CT studies).
Approximately 90-95 percent of the fellow’s time is spent on the clinical services. Assume full responsibility in the reading room at any given time. This includes acting as a primary liaison to the referring providers, assuring efficient progress of the night’s work, triaging add-on and outside consultations, interpreting imaging studies, helping to solve protocol questions and issues brought by the technologists, and solve questions brought by clinicians and ordering providers.
Mandatory communication with the referring physician – in cases of life threatening critical, unexpected findings, or change in report/staff addendums.
During the morning week shifts or during the subspecialty rotations the ER fellow is expected to cover the EC CT or plain film list specifically between 12pm and 1pm – during which the subspecialties lack personnel as the resident noon lecture takes place at this hour.

Secondary responsibilities:

Assist in the supervision of radiology residents.
Support the academic mission of the Emergency Radiology section by teaching medical students, residents and other referring physicians—both formally and informally.
The fellow is  not just required to collect and assign interesting ER cases but also required to provide a cohesive learning environment for the residents rotating with him/her, in the manner of healthy case based discussions whenever possible.
The fellow is expected to become a member of ASER and submit at least one educational exhibit or poster during the year of  training. Though not mandatory, participation by the fellow in research is strongly encouraged.

Rotations, lectures/conference, leave of absence:

1.      Every ER fellow is subject to the following shifts,

1.1.    Night shift: Tuesday through Sunday (6 days) – 4pm to 12am. This would be the primary shift of the ER fellow where he/she (along with two other  residents) will be responsible in reading the EC list, inpatient CT list (with acute findings), ICU plain films, STAT in-patient plain films, and ultrasound list.

1.2.    Alternating week shift: Tuesday through Friday (4 days) – 8am to 4.30pm. During this shift the fellow is expected to rotate within any of our other subspecialties such as Neuro-radiology, Musculoskeletal radiology, Body CT/MRI Imaging (includes fluoroscopy and ultrasound), Cardio-thoracic imaging, and Pediatric radiology.

2.      Following conferences and didactic lectures will be held:

2.1.   Bi-weekly, fellow lecture/teaching session

2.2.    Monthly, subspecialty-focused interesting case conference

2.3.    Monthly, emergency radiology journal club

3.      Times of the major radiological meetings (RSNA, ARRS, AUR) and American Board of Radiology or in-service examination times are also not suitable for vacation.

4.      The fellow can attend one approved (as presenting author of poster/ educational exhibit or other research material) conference with the USA.

Mandatory obligations of an ER fellow:

1.      All verbal consultations need to be accompanied by a written preliminary note in the PACS. As with other preliminary reports, discrepancies with the final written report need to be communicated to a referring physician as a critical finding.

2.      Work in tandem with the ER residents manning the desk by understanding that the fellow is second in the chain of command after the attending faculty. Answer telephone and on-site consult requests and be the primary work force.

3.      Immediately evaluate patient with contrast reaction or extravasations. Makes necessary documentation and takes further actions.

4.      Develop and maintain a strong working relationship with the trauma team/emergency department via interpersonal communications and skills.

5.      Be in the expected work area from 4 pm through 12 am (night shift) and 8 am through 4.30 pm (morning shift).

6.      Become a counterpart of the attending radiologist and share his/her responsibilities.

 

Program Director: Sandhya Vinu-Nair, M.D.

Program Coordinator: Stephanie Navarro – email: NavarroSB@uthscsa.edu