Diagnostic Radiology Residency Curriculum

First-year residents rotate through abdominal imaging (CT, fluoroscopy, and ultrasound), breast imaging, cardiothoracic imaging, musculoskeletal imaging, neuroradiology, nuclear medicine, pediatric imaging, and interventional radiology (including vascular and cross-sectional). These rotations are geared to introduce the junior residents to basic radiology concepts, prepare residents for junior call, and expose residents to all areas for future fellowship discernment.

Second-year residents rotate through abdominal imaging (CT, MRI, fluoroscopy, and ultrasound), breast imaging, cardiothoracic imaging, musculoskeletal imaging, neuroradiology, nuclear medicine, pediatric imaging, and interventional radiology (including vascular and cross-sectional). Additionally, residents begin to rotate at the Ann Arbor VA, where they complete cardiothoracic, nuclear medicine, and interventional radiology rotations. These rotations are more focused on advanced modalities in each subspecialty as second year residents are prepared to enter the senior call pool. There is also devoted clinical research time in which residents have time away from clinical duties to focus on their research.

Third-year residents continue to rotate through all of the subspecialties, spend time at the Ann Arbor VA, and continue working in the senior call pool. Most residents attend AIRP during this year. Our third-year residents receive excellent Core Exam preparation from our faculty in the months leading up to the exam.

Fourth-year residents gain significant autonomy in creating their schedule to best serve their career goals with nine months of elective time. Electives are diverse within any radiology subspecialty, and many residents pursue electives in non-radiology areas such as research, medical education, and informatics. Some residents spend time on other clinical services related to their areas of interest, such as urology or pathology, and others dedicate time to dissections in the anatomy lab. Residents can also elect to spend their fourth year of radiology training in our nuclear medicine division in the pathway to dual certification.

Residents taking junior call independently interpret radiographs and nuclear medicine scans for both adult and pediatric emergency room patients and inpatients. They also independently perform urgent fluoroscopy exams, including image-guided lumbar punctures. Preliminary reports are dictated into the electronic medical record prior to being finalized by the attending later in the shift or the next morning. Volume averages 80-120 radiographs, 0-2 nuclear medicine scans (predominantly HIDA and V/Q scans), and 0-2 fluoroscopic exams over the course of a full 11-hour shift.

Residents gain experience in the junior call system in the spring of their first year, when they shadow a senior "buddy resident" to learn the system. First-year residents also work with attending supervision on several short shifts in the evening hours. During the second year, residents are assigned to 4-5 weeks of independent, overnight junior call along with scattered daytime weekend shifts and short (5-hour) evening shifts. A week of overnight junior call is repeated in the final year of residency to help senior residents refresh their basic skills.

Residents taking senior call independently interpret cross-sectional studies (US, CT, or MRI) across every subspecialty for both adult and pediatric emergency room patients and inpatients. They dictate preliminary reports containing urgent findings into the electronic medical record. Senior on-call residents are also responsible for protocoling urgent cross-sectional exams, responding to contrast reactions and extravasations, and checking technologist-performed US exams and trauma CT scans for quality control. Reading room assistants are always present during call shifts to help answer the phone and to facilitate imaging-related requests. Volume averages approximately 70-100 cross-sectional exams over the course of a full 12 hour shift.

Residents are assigned to 2 weeks of senior call in the second half of their second year, 4 weeks during their third year, and 4-5 weeks during their final year. Residents also cover scattered daytime weekend shifts and short (5-hour) evening shifts. These weeks are a mix of evening and overnight shifts and are tiered so when junior residents are assigned to these call shifts they are paired with senior residents for support.

From 12:00 – 1:30 pm, there are two separate 45-minute conferences given by faculty from all radiology subspecialties. These conferences cover the organ system-based core curriculum through both case-based and didactic methods. There also are several weeks of noon conferences every year dedicated to the non-radiologic curriculum, such as treatment of contrast reactions, quality improvement, and the business of radiology.

Every morning starts with an hour-long conference starting at 7:30 am. These conferences are often given by residents or fellows. The majority of these conferences are cased-based presentations. Trainee conferences are supervised by faculty, allowing for the trainee to develop presentation and radiologic skills.

The department hosts monthly grand rounds given by a mix of invited lecturers, internal faculty, and our own senior residents presenting a capstone project. There are several named annual lectureships for visiting professors such as the Whitehouse Lecture, the DiPietro Lecture, the Beierwaltes Lecture, and the Berg Lecture.

After rotating through all core rotations and before starting both junior and senior call, selected faculty are invited to review high-yield call cases to the resident class preparing for the pool, during specially given afternoon conferences. These conferences are highly rated by residents as a way to consolidate their knowledge before taking call.

Residents attend an internal physics course given by our department’s world expert medical physicists. The lectures cover the physics of all modalities to prepare for the ABR Core Exam as well as satisfying the National Regulatory Committee requirements to become an authorized prescribers of radiopharmaceuticals.

Every spring, faculty participate in a series of lectures held daily at 7:30 am and 12:00 pm specifically designed to prepare third year residents for the Core Exam given by the American Board of Radiology. These lectures, which tend to be hot-seat conferences, are consistently rated as the best conferences given every year.

The department participates in a large number of weekly tumor boards. Residents have the opportunity to take part in these conferences and present cases along with fellows and faculty in order to participate more fully in the various interdisciplinary teams.