Thoracic Fellowship


Fellowship Director:
Sandra A. A. Oldham, MD, FACR

Department Chair:
Susan John, MD

Address:
Department of Diagnostic and Interventional Imaging
6431 Fannin Street, Suite 2.026
Houston, TX 77030
Phone: 713-500-7640

Fellowship Information:
Number of positions: 1
Length of fellowship: 1 year
Established in 2005

Requirements:
• Applicants must be either certified by the American Board of Radiology in Diagnostic Radiology or be Board eligible.
• Applicants must be licensed in Texas prior to beginning the Fellowship.

Application:

What are the duties and responsibilities of the Fellow?

The Fellow will be responsible for the following activities: on a daily basis, interpreting chest radiographs on ICU and non-ICU patients, protocoling chest CT requests, interpreting chest CT scans, including CT angiograms and high resolution chest CT (HRCT).

It is expected that the Fellow will also interact with the faculty in Nuclear Medicine for the interpretation of thoracic PET/CT scans.

The Fellow will rotate for a total of two months through MHH Heart & Vascular Institute or other hospitals to gain experience in cardiac imaging.

The Fellow will be available for consultation in the reading room with medical students, residents and faculty of Memorial Hermann – Texas Medical Center (TMC). The Fellow will also be involved in teaching the Radiology residents on the Thoracic Radiology rotation.

The Fellow will be on call for Thoracic Radiology for one week approximately every five weeks. There will always be back-up for the Fellow from the Thoracic Radiology faculty if needed.

Applicants with a Texas medical license may qualify for additional clinical responsibilities and a commensurate raise in salary for work at the instructor level one day per week.

This Fellowship is approved by the Texas Medical Board. There is no subspecialty board for Thoracic Radiology. The Fellow will be assigned to the Memorial Hermann-Texas Medical Center (TMC) Department of Diagnostic and Interventional Imaging. Depending on the needs and interests of the Fellow, and availability of funds, the Fellow may rotate at other institutions.

What are the goals and objectives of the training program?

Goals: Demonstrate learning of the knowledge-based objectives, demonstrate knowledge of normal and abnormal anatomy and pathology as it pertains to the chest, accurately and concisely dictate a chest radiograph, chest CT or MR report, communicate effectively with referring clinicians and others, obtain pertinent patient information relative to radiologic examinations, demonstrate knowledge of the clinical indications for obtaining chest radiographs, special views, know when chest CT or MR may be indicated, develop skills in protocoling, monitoring and interpreting chest CT scans, demonstrate an ability to interpret multiplanar reformatted or 3-D images of CT or MR studies as appropriate, demonstrate a responsible work ethic, and participate in quality improvement/quality assurance activities.

Objectives: Demonstrate learning of the knowledge-based objectives; dictate accurate and concise chest radiograph, chest CT and chest MR reports; communicate with referring clinicians regarding significant or unexpected radiologic findings and document who was called, and the date and time of the call in the dictated report; obtain relevant patient history from electronic records, dictated reports or by communicating with referring physicians; assist referring clinicians with the results of imaging interpretation and the impact on patient management; appropriately protocol all requests for chest CT to include thin-section images, high-resolution images, expiratory images or prone images when appropriate and use of intravenous contrast, given the patient history; monitor chest CT exams and determine if additional imaging is needed before the CT exam is completed, when able; demonstrate the ability to manage an intravenous contrast reaction that occurs during a CT examination; act as a consultant for referring clinicians and recommend the appropriate use of imaging studies; assess diaphragmatic motion with fluoroscopic “sniff test”; decide when it is appropriate to obtain help from supervisory faculty; participate in discussions with faculty regarding operational challenges and potential systems solutions regarding all aspects of radiologic service and patient care.

Objectives: Demonstrate learning of the knowledge-based objectives; dictate accurate and concise chest radiograph, chest CT and chest MR reports; communicate with referring clinicians regarding significant or unexpected radiologic findings and document who was called, and the date and time of the call in the dictated report; obtain relevant patient history from electronic records, dictated reports or by communicating with referring physicians; assist referring clinicians with the results of imaging interpretation and the impact on patient management; appropriately protocol all requests for chest CT to include thin-section images, high-resolution images, expiratory images or prone images when appropriate and use of intravenous contrast, given the patient history; monitor chest CT exams and determine if additional imaging is needed before the CT exam is completed, when able; demonstrate the ability to manage an intravenous contrast reaction that occurs during a CT examination; act as a consultant for referring clinicians and recommend the appropriate use of imaging studies; assess diaphragmatic motion with fluoroscopic “sniff test”; decide when it is appropriate to obtain help from supervisory faculty; participate in discussions with faculty regarding operational challenges and potential systems solutions regarding all aspects of radiologic service and patient care.

How are the postgraduate residents selected for the training program?

Each Fellow is required to have completed residency training in Diagnostic Radiology and be, at least, Board eligible. We prefer the applicant be Board Certified. He or she must also have a current, valid State of Texas medical license.

Thoracic Imaging Fellows are selected by the Fellowship Program Director. Materials solicited for review include a letter stating your interest (a personal statement), an up-to-date curriculum vitae, medical school transcripts, a copy of the American Board of Radiology diploma, if available, a letter of recommendation from the applicant’s residency program director plus two other letters of recommendation, sent to the above address. Candidates selected for an interview come to UT Houston Medical School for a formal interview with the Fellowship Director as well as with other Thoracic Imaging Faculty members.

The University of Texas Medical School at Houston is an equal opportunity employer.

What are the formal educational experiences required? (i.e. grand rounds, seminars, journal club). What presentations are required and how often?

The Fellow will prepare the radiology portion of the following conferences as well as attend and participate in the monthly Pulmonary/ Pathology/ Radiology conferences as well as the monthly Pulmonary/Radiology interesting case conference. The Fellow will also attend the weekly Pulmonary Grand Rounds. To augment cardiac imaging, the Fellow will attend local Cardiac Imaging conferences given in the Texas Medical Center.

What are the research and teaching requirements of the Fellow?

Research: The Fellow will be required to engage in clinical research and submit at least one poster/exhibit or paper for presentation at either the Radiological Society of North America (RSNA), American Roentgen Ray Society (ARRS), Fleischner Society, Society of Thoracic Radiology (STR) or similar meeting during the Fellowship year.

Teaching: The Fellow will prepare and deliver at least one monthly conference to senior medical students on the Radiology 4.001 elective. The Fellow will prepare and deliver at least one Thoracic Imaging case conference for the Radiology residents at UTH. The Fellow is responsible for a monthly Radiology/Pulmonary Interesting Case conference and a Radiology/Pathology/Pulmonary conference given monthly. There is also one-on-one teaching of residents and medical students at the PACS workstations daily.

What type of supervision is provided for the fellow?

The Fellow will work side by side with Faculty in the chest room and will be supervised by that attending faculty. In turn, the Fellow will supervise Radiology residents in the Chest Room.

How is the fellow evaluated in the training program and what are the performance standards used?
There will be written evaluations twice a year by the Program Director. Every month, the Fellow’s work and progress will be discussed by the Fellow and the Program Director informally.