| There are two (2) Emergency Radiology Fellowship positions per academic year. The fellowship is one year in duration. Clinical work within Emergency Radiology focuses on the imaging of acutely ill and traumatized patients presenting to the Brigham and Women's Hospital Emergency Department, a level 1 trauma center within the City of Boston. This fellowship is designed for the radiologists seeking advanced training for a career in academic Emergency or Musculoskeletal Radiology or for private practice with an emphasis in musculoskeletal radiology.
The ER fellowship consists of 4 clinical shifts per week in Emergency Radiology and 1 day per week interpreting Musculoskeletal MR/CT. In addition to the training above, the fellow will spend a minimum of one month up to a maximum of three months of the academic year in Sydney, Australia observing and working in the clinical practice of NightHawk Radiology Services (NRS), a sponsor of the Emergency Radiology Fellowships. This externship will provide the trainee a valuable opportunity to gain the perspective of a “nighthawk” radiology service while also furthering his or her training in emergency radiology. The Fellow will be formally introduced to the concept of "nighthawk" coverage of U.S. hospital emergency departments during normal daytime and evening hours in Sydney. The fellow will have a stipend to cover their expenses (i.e. travel, room and board) while in Sydney in addition to their normal salary. For fellows involved in gainful research and interested in an academic career, up to one academic day a week is granted in lieu of a clinical day in Emergency Radiology. Those fellows granted an academic day must meet a minimum requirement of one publication of their research in a peer-reviewed journal during the academic year.
Educational Goals and Objectives
The primary general educational objective of the Division of Emergency Radiology is to educate diagnostic radiology residents and emergency radiology fellows on the radiological evaluation of the traumatized and acutely ill patient. Though many protocols used for routine outpatient exams are similar to those employed in Emergency Radiology, there are variations on protocols that prove useful in the Emergency Department patient population. Additionally, there are unique referral patterns and triage concerns that deserve special consideration when coordinating the imaging of these patients. Specific objectives include:
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Learn and/or refine ultrasound skills in the assessment for ectopic pregnancy, biophysical profile, placental and cervical evaluation, ovarian cystic disease, cholecystitis and biliary disease, testicular torsion and epididymo-orchitis, lower and upper extremity vascular ultrasound for clot evaluation, assessment for fluid in the setting of trauma, paracentesis, thoracentesis and ruptured AAA.
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Learn basic and tailored CT protocols for the most common pathologic entities seen in emergency radiology (e.g. appendicitis, diverticulitis). Learned advanced CT imaging protocols unique to emergency radiology (e.g. CT cystography for traumatic bladder rupture).
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Learn advanced Musculoskeletal imaging (CT, MRI) by rotating one day a week on the Musculoskeletal service with primary fellow responsibilities. Participates in Musculoskeletal call coverage.
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Acquire advanced skills in the imaging and management of acutely ill and traumatized patients.
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Develop skills for critically reviewing and providing instruction to residents. Participate in the education of residents and medical students.
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Improve skills for advising Emergency Medicine physicians and other referring physicians on the most effective and appropriate method(s) of imaging patients in the Emergency Department. Emphasis is placed on the fellow’s development as an imaging consultant versed on the most effective and appropriate method of imaging patients including an understanding of the efficacy and predictive value of commonly employed diagnostic methods.
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Initiate, develop and execute a research project of their choice in the Division of Emergency Radiology that results in at least one submission of their written work to a peer-reviewed journal for publication.
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Participate in the BWH Emergency Radiology mini-course for residents as well as routine sectional case conferences and morbidity and mortality conferences.
The Australia Curriculum
NightHawk Radiology Services, L.L.C.
Background:
NightHawk Radiology Services, L.L.C. is based in Sydney, Australia and is the premier provider of teleradiology services to hospitals and radiology groups in the U.S. They principally provide radiology coverage to emergency departments during the evening and overnight, hours in the U.S. that correspond to daytime and evening work hours in Australia (noon to midnight during daylight savings time, 10 a.m. to 10 p.m. during non-daylight savings time). This time zone difference creates an ideal setting for recruiting and retaining highly qualified radiologists to provide these greatly needed services. NightHawk Radiology Services is committed to the highest quality professional service. They provide rapid preliminary radiologic interpretations at the time of the patient visit to the emergency department. Official (primary) interpretations are provided by the radiologist(s) at the hospital the following day. A key to their success is the staffing of outstanding radiologists committed to providing subspecialty expertise in emergency radiology. All their radiologists are certified by the American Board of Radiology and many have fellowship subspecialty training to further enhance their skills. Their radiologists are fully licensed in all U.S. states and fully credentialed in all hospitals for which they provide their radiology services. NightHawk Radiology Services is a limited liability company (L.L.C.) and is managed by the President and CEO, Dr. Paul Berger. Between Dr. Berger and Vice Presidents Chris Huber and Jon Berger, they bring a combined experience of over 35 years in Radiology and Teleradiology services to their clients.
Time Commitment:
A minimum requirement of 1 month for each fellow with the option of up to 3 consecutive months at the section head's discretion. Scheduling details and duration are arranged at the start of each academic year. Second and third quarters of the academic year are strongly favored for these external rotations.
Educational Material and Merits:
• Access to greater than 400 new live cases/day
• Access to sophisticated network for connecting U.S. Hospitals to the central reading site in Australia
• Access to a well-developed, active and thriving Nighthawk radiology practice
Staff Resources:
• 2-4 staff radiologists on at all times for teaching, review and instruction
• 1-2 networking staff (resource to learn basic networking ideas and strategies)
Potential Learning Strategies (can be individually tailored per day, per week, etc.):
• Select cases by modality
• Evaluate only known positive cases
• Evaluate unknown cases Practice certain types of cases (i.e. CT pulmonary angiograms)
• Review of internal Q/A files of known missed cases
• Preview and then review cases with staff for authentication
• Learn the details of a sophisticated, fully functional active Nighthawk service
Advanced Studies:
• Provide back-up and/or fellow coverage for BWH Emergency Radiology from Sydney, Australia
• Design and implement prospective and/or retrospective research projects based on Sydney cases
• Study network design/strategies for better solutions to 24-hour coverage of emergency department imaging
• Applications programming opportunities (SQL, Visual Basic, i.e. fax solutions, reporting solutions,
voice recognition applications).
For More Information:
Dr. Stephen Ledbetter - Director, Emergency Radiology
Dr. Salvatore Viscomi - ER Fellowship Director
Applying to the Emergency Radiology Fellowship Program
Please submit the following items for your application:
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Recent photograph of yourself
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Curriculum Vitae, including your email address
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Personal statement detailing your choice of an Emergency Radiology Fellowship
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Three (3) letters of recommendation from faculty members who you know well
(may be sent under separate cover)
Mail application materials to:
Dr. Salvatore Viscomi
ER Fellowship Director
Department of Radiology
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Address inquiries to:
Tracey E. Martin
Tel: 617-732-6506
Email: temartin@partners.org
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