Neuroradiology Fellowship

ACGME Accreditation Faculty Hospital Application  • Match  • Visa Fellowship Evaluation   Forms (MS Word format) Fellow Elective Request (MS Word) INR Fellowship Requirements Clinical Exams/Year Fellows' Working Hours  • Call  • Health Insurance  • Housing Information      - Whipple Park  • Living in Rochester  • Vacation & Benefits       - Professional Allowance Maximize Your Fellowship   (MS Word format) Conferences  • AFIP  • Curriculum  • Lectures Neuro Fellowship Manual Office Suite  • Fellows' Office Procedures: Diagnostic  Contact Info Procedures: Interventional  Equipment  • Angio  • PACS  •PET Scanner  • Scanners  • 3D Fellow Nationality Background Research  • Research Publications  • Visiting Researchers  General Radiology Faculty Teaching File Vision  Goal Why Rochester? ACGME Accreditation: Our neuroradiology program has been approved for five neuroradiology fellows. We have elected to have 3 ACGME accredited first year neuroradiology fellows since this matches our clinical volume of cases considering that our fellows stay for two years and the second year allows for additional training and sub-specialization. We currently have six fellows in training (3 first and 3 second year). Most of our second year fellows have used this additional year for sub-specialty training in interventional neuroradiology, but we also offer sub-specialty training in pediatric neuroradiology or advance MR imaging.       Our associated Diagnostic Radiology Residency Program is currently fully accredited for a total of 36 residents. Application: Application is done through the match and instructions are provided on the web at http://www.nrmp.org/fellow/match_name/radiology/about.html. Applications can be sent at any time. For a Neuroradiology Fellowship application we would like to see the following documents: Application Form Curriculum Vitae Personal Statements Three letters of recommendation USMLE transcripts ECFMG certificate (when applicable) Any other document that the candidate would like to draw our attention to. Send the entire application either by e-mail to: Holly_Stiner@urmc.rochester.edu or by mail to: Holly Stiner Fellowship Coordinator Department of Imaging Sciences PO Box 648, 601 Elmwood Avenue Rochester, NY 14642-8648. PL Westesson, MD, PhD Program Director We look forward to receiving your application and we will carefully review all applications. We offer interviews to many candidates. We select the best possible candidates based on academic and clinical competence. We are also looking for people who will fit into our group. If you have any questions please feel free to give us a call 585-275-1983.     We currently have 3 first year ACGME approved neuroradiology positions. In addition, we have 3 second year positions. In total there are 6 fellows in neuroradiology.   Match Dates: Schedule of dates for the 2011 Radiology Fellowship match: Interviews begin: February 15, 2010 Match Opens: March 3, 2010 Rank Order List Open: May 12, 2010 Interviews end: May 15, 2010 Quota Change Deadline: May 26, 2010 Rank Order List Close: June 9, 2010 Match Day: June 23, 2010 For Match updates visit: http://www.nrmp.org/fellow/match_name/radiology/dates.html Match Results 2004: For fellows starting 7/1/05 our neuroradiology fellowship matched all 3 first year slots with 3 strong candidates. The statistics nationwide was not that good - 57% of all fellowship programs were not filled. Specifically 76% of breast imaging, 78% of interventional and 49% of the neuroradiology programs did not fill. The most popular was musculoskeletal were 94% of the programs were filled. J1 VISA: The University supports J1 visas for qualified candidates. Successful passage of USMLE 1 and 2 are required. It is not necessary to pass the USMLE 3 for a J1 visa. The University of Rochester supports J1 visas for all trainees. The normal visa for a trainee in our fellowship program is a J1 visa.   back to top Clinical Exams/Year Hospital Bed Capacity 720 Film reading    Hospital Admissions (total) 38,749 Adult 32,049 Pediatric 6,700 No. of Neurosurgery Admissions 1,423 No. of Neurology Admissions 1,130 Diagnostic Radiology Examinations (all areas) 312,642 Neuroradiology Examinations (total) 55,234 Neuroradiology Examinations-Noninvasive Plain films: Skull 143   MRI: Brain 5,512 Facial bones 1,237   Extracranial head and neck 3,670 Cervical spine 6,047   TMJ 25 Thoracic spine 2,993   Cervical spine 1,010 Lumbar spine 6,761   Thoracic spine 550 CT: Brain 10,406   Lumbar spine 1,124 Extracranial head and neck inc. 2D/3D 4,239   MR Spectroscopy 178 TMJ 2   Noninvasive Doppler of carotid 248 Cervical spine inc. 2D/3D 2,694   PET 1,237 Thoracic spine inc. 2D/3D 512   SPECT 182 Lumbar spine inc. 2D/3D 1,896   Transcranial neurosonography 701 Neuroradiology Procedures - Invasive Myelography: Cervical 199 Cerebral angiography: Intracranial (1,752 vessels = 584 cases) 584 Thoracic 13 Extracranial (39 vessels = 13 cases) 13 Lumbosacral 560 Spinal angiography 1 2 Level 46 Embolization procedures: Complete 114 CT Myelograms 932 External carotid, internal carotid/ vertebral or complex 26 Discograms: Cervical 37 Thrombolysis 3 Lumbar 186 WADA with injection 35 Vertebroplasty/Kyphoplasty 12 Cervical and Lumbar Punctures 989 Dacrocystograms 1 Consultations 7 Biopsies (all) 92 Nerve Blocks 17 Reporting Period: July 1, 2003 - June 30, 2004 back to top

Conferences: Weekly interesting case conference, clinical neuroscience conference, head and neck conference, oncology conference, tumor board, pediatric neuroradiology conference, didactic neuroradiology lecture, neuropathology/ neurosurgery conference, and weekly luncheon with the faculty. Dr. Yuji Numaguchi lectures on MR tractography at the Friday didactic conference. Dr. Almast presents a conference. Conferences in Diagnostic and Interventional Neuroradiology Dr. Loris Cedeno gives Neuroradiology Clinical Neuroscience Conference Policy for Neuroradiology Fellow Attending Armed Forces Institute of Pathology (AFIP) Background: Every year there is a Neuroradiology week at the Armed Forces Institute of Pathology in Bethesda/Washington. The same lectures will be given as during the regular six weeks AFIP for the Neuroradiology week, but for the neuroradiology week these lectures will be concentrated to one week. For those fellows who have no prior experience of AFIP, it is a worthwhile experience to participate in the Neuroradiology week. I do not think it makes much sense for fellows who already have attended a full six weeks of the AFIP course to spend another week listening to the same lectures. The week starts Monday morning and ends Friday evening. Support: The Section of Diagnostic and Interventional Neuroradiology will support the Neuroradiology fellow with $1000 allowance and five days of time off to attend the Neuroradiology week at the AFIP. The $1000 should be used for registration, hotel and/or transportation. If additional funds are needed the fellow is allowed to use money from his $1,800 professional account. The Neuroradiology week usually takes place in the beginning or middle of August.

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Equipment Angiography Equipment: A dedicated biplanar neuroangiography room was installed in 2002, and we have a separate myelography suite.   Biplanar neuroangiography room PACS: The entire radiology department is linked throughout by a PACS system. Images are distributed on the web and authorized clinicians have access to images on any internet computer. We are currently installing our second generation PACS which is a Kodak system PACS system PET Scanner: The University is served by a General Electric PET scanner. At present it is available two days per week. The neuroradiology cases are reviewed by neuroradiology together with the nuclear medicine specialists. A permanent PET Center is under construction and will be operational with a PET CT hybrid in the Spring of 2005. Scanners: We have three MR 1.5T scanners and and five CT scanners. The third MR scanner is a GE twin-speed magnet with strong gradients.     The MR scanners are located in the MR Center which is directly adjacent to the main Radiology Department and the neuroradiology center.     We have three CT scanners in the department and two in the Emergency Department. All but one of our scanners are multidetector scanners with the most advanced having 40 slices. MR Scanner CT Scanner 3D Rotational Angiography with a Vitrea 3D system is connected to Angiography, CT, and MR. 3D rotational angio (Flash movie full screen view)

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Faculty: Jeevak Almast, MD, Assistant Professor John Deveikis, MD, Professor Sven Ekholm, MD, PhD, Professor and Director of Neuroradiology Research Henry Wang, MD, PhD, Associate Professor, Director of MR Center, and Director of Interventional Neuroradiology Per-Lennart Westesson, MD, PhD, DDS, Professor and Director Jeevak Almast, MD Assistant Professor John Deveikis, MD Professor Sven Ekholm, MD, PhD Professor & Director, Neuroradiology Research Henry Wang, MD, PhD Associate Professor Director, Interventional Neuroradiology Director, MR Center P-L Westesson, MD, PhD, DDS Professor & Director back to top Fellows' Working Hours: 7:30 am – 5:00 pm, Monday through Friday. The on-call person reads with an attending and a resident for weekend cases from 8:00 am to about 12:00 noon on Saturday and Sundays. In spite of long working hours we have fun together. Call: Fellows are on-call every third to fourth week. There is no overnight call in the hospital but the fellows are on-call by beeper for neuroradiology cases. The fellow covers the neuroradiology service from 5:00 pm to 9:00 pm once per week. Fellows work with residents for mutual benefit. During regular working hours preliminary reports are given by the neuroradiology fellow for all emergency neuro cases. These reports are sent electronically via the PACS to the referring clinician. The study is later formally interpreted with the attending. A similar system is in place for off hours but these are covered with the residents with the fellows and attendings as back up. Health Insurance: visit http://www.rochester.edu/working/employment/benefits/medical.html for information on health insurance. Housing Information: Graduate Living Center Whipple Park Goler House The University offers safe and economic housing for fellows. Pictured above are the Graduate Living Center, Whipple Park and the Goler House. Many of our fellows elect to live in one of these places. Visit http://www.reslife.rochester.edu/graduate/topics.php for information on graduate housing, also see http://www.rochester.edu/pr/News/NewsReleases/general/housing03.html for information on University sponsored city home-buying incentives for faculty, staff, and fellows. Whipple Park: University housing for fellows and residents is available at Whipple Park. This area is close to the hospital and provides a good quality, inexpensive housing opportunity for fellows with children. This housing area is located in a beautiful forest setting with plenty of open space. Also, there is free bus transportation between Whipple Park and the hospital. Living in Rochester: Rochester is a medium size city with four seasons. Summers are beautiful and allow for a lot of outdoor activities such as hiking, sailing and golfing. There are plenty of public and private golf courses in the area. Nearby Lake Ontario is a great place for water activities.    Winter gives you the opportunity for skiing and snow boarding.White Face Mountain at Lake Placid is only 4 hrs away. Niagara Falls is one hour north of Rochester and Toronto is 3 hours away.    There will be no lack of leisure activities. Rochester and upstate NY is recognized for the beauty of the fall season. Here is fall sailing at the Irondequoit Bay. Vacation and Benefits:  Every fellows receives 22 days of vacation. An additional 5 days for a neuroradiology related conference is available. Professional allowance: Each fellow is given a professional allowance of $1,800 per year to cover professional expenses. These funds can be used for travel to professional meetings related to neuroradiology, for books, computer equipment or other professional expenses approved by the university. back to top

Fellow Nationality Background: We have enjoyed training fellows in Neuroradiology from many different countries at the University of Rochester.  Below is a listing of these countries: Australia 2 Ghana 1 Mexico  1 Colombia 1 India 6 Philippines  1 Egypt 1 Japan 2 Sweden  1 Finland 1 Mauritius 1 USA 32

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General Radiology Faculty: At present there are 32 faculty members in the radiology department (see http://www.urmc.rochester.edu/smd/rad/faculty.htm).

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Goal: To train outstanding neuroradiologists who will lead the field in the future. Program director teaches fellows and residents at the viewbox.

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Hospital: The Department of Radiology operates in Strong Memorial Hospital and Highland Hospital, and has an out-patient imaging center (University Medical Imaging). The fellows in Neuroradiology practice at the 750 bed hospital. Main SMH Entrance SMH with view of River Campus Main SMH Entrance Main SMH Entrance UMI entrance UMI registration desk

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Neuroradiology Fellowship Manual: About a 100 page neuroradiology fellowship manual has been developed and describes the content of the fellowship in great detail. This is available on the web in Acrobat PDF format.     The ACGME causes a little confusion because in their terminology the Neuroradiology Fellows are called Residents in Neuroradiology. This is probably for governmental financial issues, but this is a fellowship program open to those who have completed their radiology residency.

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Office Suite: Neuroradiology is located in a separate office suite with seven offices and a conference room, and dedicated neuroradiology secretaries. Fellows' Office: A dedicated Neuroradiology fellows' office and Neuroradiology library are available for the fellows. This is located immediately adjacent to the Neuroradiology reading room. back to top

Procedures: Diagnostic Neuroradiology Brain Angiogram Cervical Spine Biopsy Cisternogram CT Angiogram CT Guided Biopsy CT Dacrocystogram Dentascan Discogram Functional MRI Intraoperative Angiography MR Angiogram MR Diffusion MR Imaging MR Imaging of the Fetus MR Perfusion MR Spectroscopy Myelogram and CT Myelogram Sacral Biopsy Sialogram Skull Biopsy Spine Angiogram Spine Biopsy TMJ Imaging 3D Reconstruction Procedures: Interventional Neuroradiology Acute Stroke Treatment, Thrombolysis Balloon Occlusion of CC Fistula Celiac Ganglion Block Cervical Epidural Steroid Injection Coil Embolization of Aneurysm CT, Ultrasound, and Fluoroscopically Guided Biopsies Disc Aspiration and Abscess Drainage Embolization of Nosebleed Epidural Blood Patch for Spinal Headache Glue Embolization Intraarterial Chemotherapy of Tumors Intrathecal Chemotherapy Intracranial Angioplasty for Stenosis or Vasospasm Intra- and Extra-cranial Stent Placement (in collaboration with general angiography) Lumbar Drain Lumbar Epidural Injection Kyphoplasty Nerve Root Blocks Petrosal Sinus Sampling Preoperative Embolization of Head, Neck, and Cranial Tumors Pudendal Nerve Block Sacroplasty Salivary Gland: Removal of Stone and Duct Dilatation SI and Facet Joint Injection Superior Hypogastric Block Temporary Test Occlusion Thrombectomy for Acute Stroke Vertebroplasty WADA Test for Brain Function Interventional cases are done with the second year fellows using a team approach. First year fellows also participate in interventional cases.

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Research: Fellows are encouraged to participate in research. Research time is available and we currently have our fellows scheduled for one full day per week for research. The Division of Diagnostic and Interventional Neuroradiology usually has one or two visiting researchers. The researchers are located in a dedicated Neuroradiology research office. Research Presentations: The fellows are encouraged to present material at the RSNA and ASNR. ASNR 2000 2001 2002 2003 2004 2005 2006 2007 2008 ASHNR 2005 2006 2007 ASSR 2003 2004 2007 ISMRM 2004 2005 2006 2007 2008 RSNA 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 ACOMF 2004 ARRS 2007 2008 AUR 2006 2008 EADMFR 2004 IADR 2005 Visiting Researchers: The Division of Neuroradiology usually has two to three full-time visiting researchers. Some of the visiting researchers may stay on as clinical fellows. back to top

Teaching File: The Division of Diagnostic and Interventional Neuroradiology has a large and active teaching file. It consists of three parts. Part one is our web-based interesting cases which is publicly available and consists of about 140 cases with extensive workups associated. We add one case per week or about 50 cases per year.       The second part is our traditional teaching file which is film-based and consists of about 4,000 cases in a traditional film archive. This is also recorded in a FileMaker Pro database and spans over a 20-year collection period.      The third part is a PowerPoint teaching file with is housed on a university server. There are currently about 100 cases organized according to disease condition in this database. We add 5-6 cases every week for about 300 cases per year. These cases are formatted in MS PowerPoint and ready to be used for presentation. Parts two and three are available to the neuroradiology attendings and fellows. Program Director tells about the penalty for not returning films to the division teaching file or books to neuroradiology library! back to top

Vision: Create an environment for clinical and academic neuroradiology that will stimulate faculty and fellows to achieve their goals, provide optimal patient care and excel clinically and academically. back to top Why Rochester? A recruitment video is now on the GME web site. Click on this link - http://www.urmc.rochester.edu/smd/gme/ and then "see videos here." We have a fellowship focus program where the fellows have a strong say You will benefit from the resources of a top-ranked university hospital with a top-ranked Neuroradiology faculty A wide-range of pathology gives you an unparallel learning opportunity Many weekly conferences with the faculty There is no overnight in-hospital call for fellows Active interdisciplinary conferences with neurosurgery, neurology, ENT, and neuropathology Outstanding benefits such as: healthcare (residents, spouses, & dependents), athletic center located inside medical center, and 4 ½ weeks vacation One academic day per week $1,800 professional allowance for books and other professional expenses Separate neuroradiology library with computers, refrigerator, and privacy for the neuroradiology fellows Large group of neuroradiology fellow creates a critical mass back to top For more information about the Neuroradiology Fellowship Program send your correspondence to: Per-Lennart Westesson, M.D., Ph.D., D.D.S. Department of Radiology, Box 648 University of Rochester Medical Center 601 Elmwood Avenue Rochester, New York 14642-8648 or email: Holly_Stiner@urmc.rochester.edu back to top