How to Apply: Fellowships in Diagnostic and Interventional Neuroradiology
Please note: Positions for the 2013 Diagnostic Neuroradiology Fellowship program have been filled. We are currently accepting applications for 2014 through April 30th, 2013.
How to Apply
We participate in the Neuroradiology
Radiology Fellowship Match administered by the National Residency Match Program
(NRMP), and use the universal fellowship application designed by
the Association of Program Directors in Radiology. Applicants should
register with NRMP. Completion of an accredited
four-year radiology residency program is a prerequisite for
International medical graduates are welcome to apply to our fellowships. Fellows are selected on the basis of their medical training, general and academic achievements, and personal qualities. No preference is given to any particular medical school or geographic area, nor is race, sex, or national origin a consideration. International medical graduates need to have a permanently validated ECFMG certificate and have passed USMLE Step 3. They will be offered a Visa for the duration of their fellowship.
The following documents should be sent to our fellowship coordinator:
- The Universal Fellowship Application designed by the Association of Program Directors in Radiology
- Curriculum Vitae (CV)
- Personal statement or letter of interest summarizing your training background, areas of particular strength and interest, and describing how you would hope to utilize and apply your medical training
- Three current letters of recommendation, including one from your radiology residency program director; letters should come from those persons who are familiar with your recent training and current professional activities. Please instruct reference individuals to mail their letters of recommendation directly to Terry Johnson (contact information below)
- Dean's letter from medical school (optional)
- 2 X 2 photograph for identification (recommended)
- USMLE and/or LMCC scores (photocopies will suffice)
- ECFMG certification (if applicable)
Please send your completed application and supporting documents listed above to:
[For US Postal service delivery]
Radiology Fellowship Coordinator
University of Virginia
Department of Radiology and Medical Imaging
Charlottesville, VA 22908
[Physical address (for all other forms of delivery)]
Radiology Fellowship Coordinator
University of Virginia
Department of Radiology and Medical Imaging
1215 Lee Street
Charlottesville, VA 22908
Program Overview and Goals
We realize that your choice of a Neuroradiology Fellowship is difficult and that considerations include the academic program, faculty, work environment, geographical location, and various other personal reasons. We also recognize the substantial personal commitment it takes to extend your training and improve your skills. Please know that we take your commitment seriously and commit to train you to the best of our ability. Finally, it is our responsibility to help guide you in your job search and do our utmost to assist you in obtaining the position of your choice.
Overall Program Goals
- The overall goal of the Neuroradiology Fellowship Program is to fulfill the three-fold mission of the University of Virginia Health system: To provide excellence and innovation in the care of patients, the training of health professionals and the creation and sharing of health knowledge
- To that end, the program is designed to enable the Diagnostic Neuroradiology Fellow to accumulate a broad base of medical knowledge, to develop progressively independent interpretive and technical skills under supervision, and to become proficient at accurate clinical decision making and consulting; the fellowship aims to provide teaching and research opportunities for fellows, adjusted to special interests and talents
- At the conclusion of the fellowship, the graduate will have the foundation to build an academic career in radiology, advance subspecialty knowledge and skills as an advanced clinical fellow or instructor, or enter community practice as an expert diagnostic neuroradiologist
As a result of our clinical training and didactic conferences, we expect each neuroradiology fellow who finishes training with us to be able to:
- Understand the functional neuroanatomy of the brain and spine
- Understand the physical principles underlying advanced neuroimaging modalities such as MRI, CT, and PET
- Have good general knowledge of related neuroimaging techniques, such as PET
- Perform and obtain competence in head, neck and spine biopsies
- Perform safely and interpret accurately angiograms, myelograms, CT scans and MRI scans in the most complicated/difficult cases encountered in common clinical practice
- Be able to design and modify CT and MR protocols as new techniques are developed
- Have thorough imaging and clinical knowledge of diseases of the head and neck
- Develop skills and confidence in discussing neuroimaging cases with requesting physicians and teaching other physicians about neuroimaging
- Be familiar with scientific data and issues debated in current neuroradiology literature
- Design and complete a research project
Neuroimaging training includes all aspects of neuroradiology of the head, neck and spine including plain radiographs, computed tomography, and magnetic resonance imaging. The fellow is exposed to all facets of ENT and pediatric neuroradiology. The procedure experience can be subdivided into four distinct areas: diagnostic catheter angiography, neuroendovascular therapeutics, head & neck biopsies, and percutaneous spine procedures (including myelography, vertebroplasty, kyphoplasty, biopsies, etc).
Training in advanced imaging techniques is the cornerstone of our fellowship and includes MR Spectroscopy, MR Perfusion, CT Perfusion, fMRI, DTI and CSF flow analysis. Non-invasive vascular imaging is critical to the expert neuroradiologist: at UVA, your experience will include training in a variety of techniques including high-resolution CT Angiography, 3D TOF MRA, contrast-enhanced MRA, time-resolved MRA, CT venography and 2D TOF MR venography.
Familiarity with various post-processing equipment is essential to be nimble, thorough, and accurate. The Department has vast 3D resources including a 3D Lab with Tera Recon, Vitrea, Leonardo and Advantage Windows workstations. The Tera Recon resources include a thin-client platform that allows for access to all PACS remotely. All platforms are maintained at a high level with regard to version/platform and in-hospital support maintains the systems. The fellows are encouraged to utilize the workstations and become independent of the technologists, even though the 3D techs routinely create the 3D and post-processed images.
Diagnostic neuroradiology fellows rotate on a weekly basis among 5 rotations: early (7am-5pm), procedures (8am-6pm), late (10am-7pm), Long Term Acute Care Hospital (LTACH) (8am-6pm) and academic rotation (8am-5pm). Fellows are on call approximately every fifth weekend.
During the early and late shifts, fellows share the plain films, CT and MRI studies with the 3-4 residents in the reading room. The number of studies is approximately the same for each fellow and resident, but the fellows are expected to read more complex cases (CTAs, advanced CT and MR imaging techniques, MRI of the head and neck, pediatric neuroradiology cases). This was introduced at the request of our present fellows so that they can develop their advanced neuroradiology knowledge while maintaining their skills in reading simpler studies, such as head CTs.
The procedure fellow works with the interventional neuroradiology team, performs diagnostic angiography studies and participates in endovascular treatments, percuatenous vertebroplasties and kyphoplasties. He/she is responsible for all aspects of patient care including the work-up, plan, and performance of the angiogram, post-operative care, and follow-up. Graduated responsibility results in independence in the angio suite while under the direct supervision of attending staff. There is an emphasis on the technical and interpretive aspects of catheter angiography with correlation to non-invasive exams Our fellows meet, and often surpass, the RRC requirement of 50 angio procedures per fellow. The diagnostic fellows actively participate in therapeutic endovascular cases along with the interventional fellow. The diagnostic portion of an angio case, along with initial elements of the therapeutic component, are frequently performed by the diagnostic fellow (i.e. more than just holding and flushing wires!). The procedure fellow also performs the CT-guided procedures with the diagnostic neuroradiology attending. Finally, the procedure fellow also helps the myelography resident with myelograms.
During the "academic" week, the fellow:
- Attends all of the conferences indicated on the neuroradiology conference schedule and, once comfortable, presents some of them
- Is in charge of the Interesting Case conference, and coordinates with another fellow and the residents to present at least four cases
- Is teamed with one attending to serve as a research mentor and works on at least one academic deliverable (peer-review article, review article, teaching conference, QA project)
- Is involved with review of literature, collaboration with technologists including 3D lab to become familiar with advanced imaging techniques and their processing, and preparation of teaching conferences
- Meets at least once during this week with his/her mentor and the division director to discuss research directions and/or review progress
- Is responsible for leading a journal club with their peers
The five fellows split equally the weekday and the weekend calls. During call, fellows have access to PACS from home using VPN. The fellow on call on Monday is also on call Friday, Saturday, and Sunday. The remaining four fellows are on call Tuesday, Wednesday, and Thursday. Before a weekend of call, the fellow is on the Friday late shift. After a weekend of call, the fellow is on academic rotation.
There is no in-house call, but the fellow on call for the weekend reads in-house with staff on Saturdays and Sundays.
Fellows are provided with written evaluations of their performance 4 times during the program year. The faculty performs evaluations of the fellows' performance at 3, 6, 9, and 12 months.
Anonymous evaluations by the fellows of the program are received twice per year and faculty evaluations are completed quarterly. Faculty are evaluated on a wide range of clinical, teaching, and research skills using a numerical scoring system and written comments through New Innovations.
Salary, Benefits, and Academic Stipend
Our fellows receive an annual salary that is competitive with compensation offered by other institutions, and receive medical and dental care benefits for themselves and their immediate family. Malpractice insurance is provided at no charge.
Fellows receive an annual stipend. This stipend is to be used for expenses related to attending meetings or buying books. Each fellow is encouraged to attend one educational meeting of his/her choice.
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Vacation and Leave Policy
Fellows have 20 days of vacation time and 5 days of meeting time to be spent at national radiology meetings. The program in neuroradiology follows the guidelines of the American Board of Radiology for Neuroradiology training programs with regard to leave time.
Fellows have combined office space with several cubicles, separate computers, and an up-to-date "fellow library" of books.
Research and Academic Activities
Participation in research and attendance at annual scientific meetings is encouraged. Consistent academic time is provided throughout the year (see fellowship organization section and description of "academic weeks"). Each fellow will be mentored by a different faculty member. The fellow, his/her faculty mentor, and the division director meet regularly throughout the year. Each fellow is expected to produce at least one academic deliverable (peer-review article, review article, teaching conference, QA project).
Fellows are encouraged to prepare material for presentation at a national meeting.
Fellows will be expected to assist in teaching of medical students and residents rotating on the Neuroradiology Service.
A full medical and neuroradiology library is available for fellows, as is a complete spectrum of teaching files and electronic media covering all aspects of neuroimaging and intervention.
The fellows' office maintains the Neuroradiology library, ancillary educational material, and desktop computers with internet and hospital systems access. The fellows may utilize any other department resources including the Section's administrative assistant, graphic artists, webmasters, and IRB support personnel, to name a few.
Clinical and Research Work Environment
The University of Virginia Medical Center is an integrated network of primary and specialty care services ranging from wellness programs and routine checkups to the most technologically advanced care. The hub of the Medical Center is a hospital with over 500 beds in operation and a state-designated Level 1 trauma center. In addition, primary and specialty care is provided at convenient clinic locations throughout Central Virginia communities.
The Neuroradiology Division at UVA provides clinical service at three facilities: the UVA Health Center, the Outpatient Imaging Center, and the Imaging Center at the UVA Transitional Care Hospital. The Imaging Centers are within a 7 minute drive from the main Health Center campus. Clinical imaging at UVA is performed on 5 clinical MR scanners (one 3T and four 1.5T Siemens scanners) and 5 CT scanners (one 64, one 32, two 16 GE scanners, and one dual-source Siemens scanner). One of the CT scanners has CT fluoroscopy capability. There is one dedicated myelography suite and two dedicated neurovascular angiography units at UVA, including one with state-of-the-art biplane fluoroscopy capability. UVA has three research MRI scanners (one 3T and two 1.5T Siemens scanners). Two of the research MR scanners are located at the Fontaine Research Park, 5 minutes away from the Health Center.
We have an integrated Carestream Picture Archiving and Communication System (PACS) permitting full filmless practice. Voice recognition (Powerscribe 5.0) is in place in addition to the electronic medical record. Home access to these systems allows for flexibility. StatDx is available on all work stations.
Our division is composed of 10 fellowship trained neuroradiologists, all members of the American Society of Neuroradiology, and 6-7 fellows (including interventional neuroradiology fellows). In addition to the neuroradiology fellows, 3 to 5 radiology residents rotate with us each month, as do 1-2 medical students.
We work closely with our MR physicists, including John P. Mugler III and James R. Brookeman, professors of radiology and biomedical engineering at UVA, well known for their groundbreaking work in magnetic resonance imaging techniques over the past two decades—notably for the development of 3-D pulse sequencing technique referred to as MP-RAGE (Magnetization-Prepared Rapid Gradient Echo).
We are very fortunate to work and be associated with nationally ranked departments and many outstanding referring physicians in the following departments (including a number named to the list of "Best Doctors in America”):
Our faculty is dedicated to excellence in clinical neuroradiology, as well as education and research. Members of the division serve on the editorial board of the American Journal of Neuroradiology, and have produced an extensive list of peer-reviewed publications in diagnostic and interventional neuroradiology and head and neck imaging.
Case and Procedure Volume
In 2009, approximately 450,000 radiologic/imaging examinations were performed at UVA, of which approximately 60,000 were Neuroradiology examinations.
The neuroradiology case load comprises a well-balanced mixture of congenital, traumatic, degenerative, infectious, and neoplastic diseases:
- Neuro CT: 17,400
- Neuro MRI: 9,400
- Diagnostic angiography: 1,560 (adult), 347 (pediatric)
- Endovascular procedures: 4,950
- Spine procedures: 1165 (adult), 7 (pediatric)
Interested radiology residents can contact Dr. Max Wintermark or Terry Johnson for further information regarding diagnostic neuroradiology fellowships, or Dr. Lee Jensen or Terry Johnson for information regarding interventional neuroradiology fellowships.
Max Wintermark, M.D.
Neuroradiology Fellowship Program Director
Chief of Neuroradiology
Lee Jensen, M.D.
Interventional Neuroradiology Fellowship Program Director
The Diagnostic Neuroradiology Fellowship Program at the University of Virginia is accredited by the Accreditation Council for Graduate Medical Education (ACGME).
The University of Virginia School of Medicine is accredited by The Liaison Committee on Medical Education (LCME). The University of Virginia is an Equal Opportunity/Affirmative Action employer; women, minorities, veterans and persons with disabilities are encouraged to apply.