Our objective is to provide the Fellow with a comprehensive and highly supervised educational experience in the practice of neuroradiology. This includes training in the performance and interpretation of various neurologic examinations, including:

• diagnostic and Interventional angiography
• carotid ultrasonography
• myelography, CT scanning
• MR imaging, spectroscopy
• fluoro and CT-guided biopsies
• vertebroplasty
• some plain film interpretation.

Opportunities for research in neuroradiology are provided, and the Fellow is encouraged to participate in research projects and prepare at least one publication and/or presentation at a national meeting

We currently have 3 (1.5T) scanners and a 3T scanner, a 4 slice MDCT and are installing a 16 slice MDCT.

This program is affiliated with an ACGME-accredited training program in diagnostic radiology and is also associated with training programs in neurology, neurosurgery, neuropathology, vascular surgery, and neuroanatomy. The Fellow will participate in numerous radiology and interdisciplinary conferences, including a citywide neuroradiology conference, tumor board conference, cerebrovascular conference, neuropathology conference and a neurology/neuroradiology imaging conference.

The Neuroradiology program offers a minimum of one year and a maximum of two years of graduate medical education in neuroradiology. The first year emphasizes the development of neuroradiologic procedures; the development of knowledge in neuroanatomy, neuropathology, and neurophysiology through attending conferences and the laboratory; and the progressive development of teaching skills. The second year fellow functions at a staff level: supervising junior fellow and residents, serving as a consultant, and also becoming more productive academically.

Educational Curriculum

A. Clinical

1. University Medical Center

Clinical responsibilities are shared by the neuroradiology fellow and the residents on the neuroradiology rotation. The neuroradiology workday begins at 7:30 a.m. CT scans and MRI scans are protocoled by the resident and/or fellow the evening before. All unread CT and MRI scans are then previewed by the resident and/or fellow between 8:30-9:30 a.m., following the morning resident conferences. The scans are reviewed with the neuroradiology attending staff from 9:30 until 11:30 a.m. and are subsequently read out by the fellow and/or resident.

Cerebral angiograms are usually performed in the morning, generally at 8:00 a.m. and/or 10:00 a.m. Myelograms are usually scheduled at 1:00 p.m. These procedures are generally shared between the fellow and residents as will be subsequently discussed. Diagnostic radiology resident conferences are held between 7-8:30 a.m. and fellow attendance is optional.

1:30 p.m. the unread CT and MRI scans are again previewed by the fellow and/or residents. At approximately 2:30 p.m. there is another teaching round with the staff, at which time the CT scans, MRI scans, myelograms and angiograms are reviewed.

At 4:00 p.m. the fellow or resident checks the VA and UMC angiography and myelography schedules for the following day and consults with the referring clinicians when necessary. At 5:30 p.m., the evening and early morning CT and MRI scans are protocoled by the resident and/or fellow. Any residual unread CT or MRI scans are reviewed by the fellow or resident for possible call-reports.

2. Veterans Hospital

The neuroradiology service provides daily coverage at the Veteran's Hospital. Cerebral angiograms are usually performed in the early morning and myelograms in the late morning. The CT and MRI scans are interpreted daily by the neuroradiology staff in association with the fellow or resident when they are available.

B. Didactic

a. Cerebrovascular Conference, Monday, 5:00-6:00 p.m. Interdisciplinary conference involving neurology, neuroradiology, neurosurgery, and vascular surgery. The fellow frequently attends this conference and presents the appropriate imaging studies.

b. Neuroradiology conference for radiology residents, Tuesday, 7-7:45 a.m., every other week. The fellow shares with the neuroradiology staff the teaching of the radiology residents.

c. ENT Conference, Wednesday 4-5 p.m.: An interdisciplinary conference involving ENT, radiation oncology and diagnostic radiology, The fellow occasionally presents films.

d. Citywide Neuroradiology Conference (CME approved), 5-6 p.m., Thursdays. The community and university neuroradiologists present interesting cases as unknowns, calling on the resident and fellow for discussion.

e. Neurology/Neurosurgery Grand Rounds, Friday, 8-9 a.m. This conference is divided between lectures on clinically relevant topics and case presentations. The fellow attends selected conferences deemed to be of value in his training.

f. Neurology, Neurosurgery, Neuroradiology work conference, Friday 9-10 a.m. An interdisciplinary clinical management conference with particular emphasis on imaging studies. The neuroradiology fellow shares with the staff presenting the studies at this conference.

g. Neuropathology "brain cutting" conference. Friday, 10-11 a.m. Held every other Friday in the morgue.

h. Radiology research conference, Wednesday, 12-1 p.m. This conference involves all of diagnostic radiology and nuclear medicine and in the form of a journal club or research presentation.

C. Clinical Responsibilities

The Neuroradiology fellow shares the angiograms and myelograms with other senior residents on the neuroradiology rotation. They also share in consenting patients, making post procedural rounds and discharging patients. After the 2nd or 3rd month, the fellow is responsible for assisting the new residents on the service in the conduct of angiographies and myelographies. The fellow has priority over residents on all Interventional procedures and on infrequently performed studies, such as C1-2 punctures, discographies and percutaneous needle biopsies. There currently are more than enough procedures to be shared by the fellow and residents.

D. Teaching Responsibilities of Fellow

As previously noted, the neuroradiology fellow is given progressively more experience teaching residents and medical students and participating in interdisciplinary conferences. During the year, he will be expected to conduct at least five 1 hour conferences with the residents, five 1 hour conferences with medical students, and 12 interdisciplinary conferences. He will also assist in the training of residents on the neuroradiology service, both in the conduct of the examinations and in interpretations.

E. Evaluation of Fellow

The fellow is evaluated quarterly by the neuroradiology staff. Documented evaluation of performance and progress is made available to the trainee after each of these evaluations. Any problems which may occur with interpersonal relations, conduct of examinations, and procedural complications are immediately addressed.

F. Research Opportunities

The fellow is encouraged to participate in research projects and to prepare at least one publication or presentation for a national meeting during the year. Ample opportunities exist for both clinical and basic research.

G. Teaching Staff

The teaching staff includes five senior members of the American Society of Neuroradiology. The teaching staff provides extensive didactic teaching and direct to supervision of the trainee's performance and interpretations of neurologic procedures.

Caseload

Our weekly caseload at the University and VA Hospitals includes approximately 150 CT scans, 100 MRI scans , 4-5 cerebral angiograms, and 2-3 myelograms. We have recently added vertebroplasty procedures to our compliment of intervention procedures.

Application Process

The Department of Radiology, Section of Neuroradiology, participates in the newly formed ASNR match for neuroradiology fellowship placement through NRMP.

This program has elected to take internal candidates through July 1, 2008. We will, however, interview candidates in the fall of 2008 for neuroradiology fellowship training from July 1, 2009 – June 30, 2010. Please submit a universal application form, photo, C.V., 3 letters of recommendation, Medical School Dean’s letter, transcripts and USMLE scores to the address below.

Universal Fellowship Application Download

For Information, Contact:
Norma Varela, Coordinator, Administrative Services
Tel: (520) 626-7402; Fax (520) 626-1945

Joachim F. Seeger, M.D., F.A.C.R.

Director of Neuroradiology Fellowship Program
Professor of Radiology
Section of Neuroradiology
Arizona Health Sciences Center
P.O. Box 245067
Tucson, AZ 85724-50657