The abdominal imaging fellowship program at UAB provides advanced training in body CT, ultrasound, and MRI. The program is a well-rounded and varied experience that can serve as a solid foundation for either academic or private practice careers.
Specific goals for our fellows include:
- Prescribing, performing, and interpreting body imaging studies using state-of-the-art equipment and techniques
- Learning and performing image-guided interventional procedures
- Developing communication and teaching skills
- Having opportunities and guidance for research
- Gaining experience in making decisions and managing personnel
- Acquiring role models and mentors for future endeavors
We meet these objectives with:
- Experienced, high quality faculty with varied interests
- Advanced equipment in all areas
- High volume of cases with many complex and unusual diseases
- Excellent clinical services
- A supportive and congenial working environment
What sets us apart:
- Dedicated teaching by world leaders in Radiology
- One month of protected electives
Our department's abdominal radiologists provide coverage for body CT, US, body MRI, and GI/GU exams. These faculty rotate between modalities on a daily basis. This staffing system necessitates familiarity with all areas of abdominal imaging, thus promoting more effective imaging strategies for diagnosing abdominal disease.
Our abdominal imaging faculty members have a wide range of experience, accomplishments, interests, and attributes. Several are widely known experts in abdominal imaging, with numerous scientific publications as well as prominent roles in national radiology organizations. Others are rapidly gaining stature in the academic radiology community, with growing reputations for high quality academic and clinical work.
Fellowship Program Organization
The abdominal imaging fellowship divides clinical time between body CT, US, and body MRI. We can arrange some additional time in specific areas, depending the fellow's individual interests. Though we do not require our fellows to spend time doing GI fluoroscopy, many of our fellows have sought additional training and experience in GI fluoroscopy. We encourage, but do not require, research activities; fellows who are actively pursuing research projects can receive up to one day per week in academic time.
During the fellowship, rotations average 1 - 2 weeks in length. The rotation schedule is generally flexible, and can accommodate personal and professional needs that may arise at different times of the year.
Faculty members always provide supervision and guidance for the fellows on clinical services. At the beginning of the year, the faculty work closely with the fellows to facilitate the transition from general radiologist to abdominal imaging specialist.
Intensity of supervision gradually decreases during the course of the year, as the relationship between faculty and fellow evolves to become more collegial and consultative. Late in the year, the fellows can assume full responsibility for running their assigned section, though faculty remain present on the assigned service for oversight, advice, and instruction on the finer points of abdominal imaging.
On many days, the fellows work with residents on their assigned service. Our residents are an enthusiastic, motivated, and talented group who consistently enjoy working with fellows. We expect our fellows to assist the faculty in supervising and teaching our residents, and hope that the fellows can act as role models for the residents. Many of our fellows have cited the quality of interaction with the residents as being a highlight of the fellowship.
Clinical Environment, Responsibilities and Rotations
UAB Radiology has moved toward a filmless environment, performing nearly all abdominal imaging interpretations on PACS workstations. All ER films, chest films, and abdominal films are also acquired, interpreted, and archived digitally. We also use voice-recognition computerized transcription which allows us to dictate, edit, and sign reports for most studies within minutes of the examination's completion. These reports then simultaneously and instantaneously are inserted into the patient's electronic medical record, available to any UAB clinician anywhere in the medical center.
Body Computed Tomography
When assigned to CT, the fellow provides coverage at either UAB Hospital or The Kirklin Clinic. The total CT experience is roughly evenly divided between the inpatient and outpatient facilities. Occasional days at the VA medical center include coverage of ultrasound at that facility. The fellow participates in scan setup and interpretation, and coordinates CT guided biopsies and fine needle aspirations. We train our fellows not only how to interpret images, but also how to get the most out of the available technology. Areas of special faculty expertise and interest in CT include imaging focal liver and pancreatic disease, GU tract imaging, multiphase techniques, and contrast issues.
The North Pavilion opened December 2004. This facility is a 900 bed, 900,000 square feet state-of-the-art hospital.
The main radiology department is found on the sixth floor of the North Pavilion, where there are two Philips Brilliance Power 64-channel CT scanners with a complete cardiac analysis package, one Phillips Brilliance Power 64-channel CT scanner, and one 16-channel CT scanner with CT fluoroscopy. There are four 3D reconstruction workstations. Two 40-slice Philips Brilliance Power CT scanners are located in the UAB emergency department.
An average of 10,000 CT scans are performed monthly between University Hospital and The Kirklin Clinic.
The Kirklin Clinic has one Philips Brilliance Power 40-channel CT scanner, and two GE HD750 64-slice CT Scanner with complete cardiac package, iterative reconstruction and dual energy.
Approximately 100 abdominal CT scans are performed per day between University Hospital, The Kirklin Clinic, and UAB Highlands with an additional 15-20 at the VA Hospital.
The abdominal imaging section actively participates in the performance of radiofrequency ablation procedures including percutaneous, laparoscopic, and open procedures involving tumors of the liver, retroperitoneum, and kidneys. Currently over one hundred procedures performed.
A fellow assigned to ultrasound provides coverage at either University Hospital or The Kirklin Clinic. Our broad variety of ultrasound examinations includes general abdominal, abdominal Doppler, carotid Doppler, peripheral venous, pelvic, and small parts. We also do a large number of examinations of liver and kidney transplants. Our department performs many emergency obstetrical studies, usually first trimester. We use ultrasound guidance for a majority of our biopsies and aspirations. These procedures include liver, kidney, thyroid and pancreatic biopsies, and aspiration/drainage of thoracic, abdominal, and pelvic fluid collections. Our faculty interests include vascular imaging, ob/gyn studies, and imaging focal liver and kidney lesions. We are one of the nation's leading centers for studying ultrasound contrast agents, with several contrast agent trials every year. We are also conducting several studies pertaining to dialysis access, one of which has NIH funding.
31,000 sonograms are performed per year between the University Hospital, The Kirklin Clinic, and UAB Highlands. There are six Sequoia's and 5 IU22's at the three locations. The three IU22s at University Hospital (one 2009, one 2008) have contrast and 3-D packages. We have the latest off-line Philips Q-lab and View Forum 3-D packages on separate dedicated workstations and a dedicated Bioengineer with focus on ultrasound contrast physic and elasticity. At University Hospital, the ultrasound department has participated in 13 ultrasound contrast national and international trials since 1994. Among the faculty, there are 5 Fellows of the Society of Radiologist in Ultrasound (second highest number of any institution in the world), 2 full time clinical coordinators to help recruit and facilitate research, along with additional grant personnel. There are 12 sonographers and two radiologist sonographer assistants with substantial ultrasound experience.
A wide variety of ultrasounds are performed, including general abdominal, renal, pelvis, small parts, first trimester OB, lower and upper extremity venous, pre and post hemodialysis mapping as well as pre and post liver and renal transplants. About 60% of the examinations are vascular. Ultrasound is used as the primary modality for biopsy and procedure guidance. A large volume of liver, renal, thyroid, and lymph node biopsies or aspirations performed, as well as many thoracentesis and paracentesis procedures. All three institutions are filmless and use Siemen's KinetDx system to review and archive images. A large teaching file is actively maintained and updated by the sonologists and staff.
Magnetic Resonance Imaging
Our outpatient units at the Kirklin Clinic, which are also equipped with Advantage Windows volume rendering, use two GE 1.5 T LX 15HDX scanners.
A Philips 1.5 T Achieva and a Philips 3T Achieva has each been installed. Our inpatient MR units at the University Hospital are a GE 1.5 Tesla Horizon LX Echospeed and a GE Signa 1.5 T magnet. These technologies are enhanced with a GE Advantage Windows workstation with volume rendering.
The imaging fellows participate in both clinical and research activities in body MRI. When assigned to MRI, the fellow covers both inpatient and outpatient cases. We perform 18-25 studies per week, with the case material consisting of a mixture of hepatobiliary, genitourinary, gynecologic, vascular, and thoracic disease. Though our department's musculoskeletal division has primary responsibility for musculoskeletal MR, we encourage our fellows to participate in their readout sessions. We have conducted research projects involving investigational MR contrast agents, pancreatic disease, preoperative staging of liver tumors, pelvic floor dysfunction, and polycystic kidney disease.
Time is available for research, and fellows are encouraged to become involved in projects during the fellowship year. UAB has a growing reputation for high quality research, among the top 20 in NIH funding of all U. S. universities in 2008. Faculty in the Abdominal Imaging Division have many ongoing projects, and fellows may participate in those projects if they so choose. Supervision and guidance are also available to help fellows initiate new projects. The fellows' research activities often lead to scientific articles and presentations at national meetings. Though most research conducted in the department is clinical, extensive resources exist for a broad variety of research endeavors. In addition to our clinical faculty, we have a large physics group which includes a section of Imaging Informatics. Extensive computer and statistical resources are also available.
Teaching And Clinical Conferences
We expect our fellows to conduct informal viewbox teaching when they work with residents; this is usually an extremely pleasant and rewarding experience.
Though we do not require that our fellows give formal lectures to the residents, the opportunity to prepare and give a lecture on virtually any topic is there if the fellow so desires. In fact, our residents have enjoyed past fellows' lectures so much, that they have frequently requested more fellow lectures on their didactic schedule. Fellows may also conduct board review sessions for senior residents.
After an initial orientation period, the imaging fellows will also attend and conduct any of several regularly scheduled interdepartmental clinical-radiologic case conferences. The conferences are held jointly with the divisions of gynecologic oncology, transplant surgery, gastroenterology, urology, general surgery, and GI surgery. These informative sessions are valuable opportunities for interacting with our referring clinicians
Call Responsibilities, In-house Moonlighting and Benefits
Routine clinical responsibilities are on weekdays only. The fellow will occasionally take general radiology call, which includes coverage for pre-operative, emergency room, and in-patient plain film studies. General call consists of 2-3 weekdays per month providing backup for on-call residents via pager, and about one weekend day every 2-3 months reading films in-house. Faculty and fellows share imaging call, with each person averaging about one week every 2-3 months.
Our fellows have the option of participating in our faculty pool for providing reimbursed evening attending coverage for the emergency room and for body imaging. Our evening attendings provide in-house backup for our residents covering emergency plain film, ultrasound, and body CT studies. Participating fellows will receive the same additional compensation that our participating attendings receive, at an hourly rate competitive with community moonlighting opportunities.
Salary, conference and vacation time, and fringe benefits are competitive with other fellowship programs. Fellows are on the same footing as faculty members in choosing vacation days, making vacation time generally flexible. Our book and travel allowance for fellows is the same as for junior faculty, a quantity which exceeds that offered by most other programs.
Thank you for your interest in the UAB Abdominal Imaging Fellowship program. If you are interested in applying for our body imaging fellowship, please submit an application along with three letters of recommendation, personal statement, and your current curriculum vitae. Also, three years of ACGME is required in the state of Alabama. Please call/ email if you have any questions. 1/4/16
John V. Thomas, M.D., Program Director | Heather Fisher, Program Coordinator
Department of Radiology - University of Alabama Hospital
619 19th Street South - Birmingham, Alabama 35249-6830
(Tel) 205.934.7133 - (Fax) 205.975.4413
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