Cross-Sectional Imaging Fellowships

Three types of Fellowships are offered in Cross-Sectional Imaging:

  • Body (Cross-Sectional) Imaging (2 positions):
    - 3 four week blocks each of Body CT, US, Body MR; 1 block elective in other areas (including Mammography, Breast MRI, PET-CT, Chest and IR) (note: MSK not available as elective)
  • MRI (2 positions):
    - 10 four week blocks Body MR; 2 blocks elective (note: MSK is available as elective)
  • Cardiovascular Imaging (1 position)
    - 6 four week blocks of Cardiovascular MR and CT
    - 6 four week blocks of Body Imaging (Body MR, CT, US)
    - 1 Block elective

Elective time is flexible depending on service coverage requirements. Fellows are not sent to outpatient sites to monitor scanners.

Clinical Services

MRI

With a new hospital (Smilow Cancer Center) and new department of Radiology that opened in 2009, the clinical MRI service includes four 3.0T (Siemens Verio) and three 1.5T (Siemens Avanto, Espree, and Aera) scanners within Yale-New Haven Hospital, one off-site 1.5T (GE HD) scanner in a nearby facility, and one 3T (Siemens Skyra) scanner at a separate off-site facility.

The Body MRI service typically reads between 20-25 cases per day and provides the perfect balance between clinical workload and teaching. We do a high volume of Liver MRI for hepatoma screening as well as transplant evaluations and monitoring of disease following loco-regional therapies such as TACE, RFA, and Y-90 ablation. Other busy clinical programs include MR enterography, imaging of the female pelvis, MRI abdomen/pelvis for cancer staging and surveillance, and MRI prostate for targeted biopsy and tumor surveillance.

Dedicated MR Fellows spend 9-10 four-week blocks in Body MRI and are responsible for running the clinical service with primary responsibility for protocols and initial interpretations and are expected to ensure that the service runs smoothly on a daily basis. The goal of the fellowship is to provide fellows with the skills necessary to be the “go to” person for MRI issues in their future practices. In addition to clinical knowledge, relevant physics, MR safety, protocol design, and image optimization are included in the curriculum. Rotating Body Imaging Fellows, who spend 3-4 four-week blocks on the service, will gain the skills necessary to interpret almost any Body MRI case they are likely to see in their future practices.

CT and PET/CT

The CT service presently utilizes six 64 slice scanners and one 16 slice scanner, as well as one 64 slice and one 16 slice PET/CT scanners. Another 64 slice scanner is present in a nearby facility. Fellows supervise and interpret all Body CT exams including CT colonography, some types of CT angiograms, and living donor kidney and liver exams. They will learn and become proficient in performing advance 3D post-processing techniques (Vital Images Vitrea). Radiation dose reduction tools include adaptive statistical interactive reconstruction and prospective cardiac gating.

US

The US service provides comprehensive training in all areas of ultrasound. Attendings and trainees are physically stationed in the inpatient/outpatient clinic where they provide direct support for 9 ultrasound rooms including checking scans and interacting with patients. Support is also provided for scans performed in the Emergency Department, Transplant Clinic, Vascular Lab and Thyroid Clinic, which are also located within the hospital. Fellows have the opportunity to spend time in these clinics as well.

In addition to the standard fare (US of the right upper quadrant, kidneys, gynecology, early OB, carotid arteries, and leg veins), fellows will gain experience in performing more subspecialized exams such as pre and post transplant renal and liver Doppler, thyroid/parathyroid US, hemodialysis access evaluations, and upper/lower extremity arterial Doppler.

The US rotation includes experience in image-guided biopsy FNA of thyroid nodules and lymph nodes as well as paracentesis and thoracentesis.

Cardiovascular

The cardiovascular fellow is responsible for supervising and monitoring all cardiac MRI, cardiovascular MRA (thoracic and peripheral), and coronary CTA examinations; post processing the images on a dedicated cardiac imaging workstation; and generating reports. The fellow will also be responsible for interpreting aortic and certain lower extremity CTAs. Fellows have the opportunity to rotate through nuclear cardiology (SPECT and PET). Post processing software/hardware includes a GE ADW, Vital Images Vitrea, and CMR42 cardiac MR workstations. We perform between 500-600 Cardiac MRI / Thoracic MRA cases per year including assessment of adult and pediatric congenital heart disease; evaluation of cardiomyopathy and arrhythmia (including hypertrophic cardiomyopathy, ARVC, and atrial fibrillation); and evaluation for viability.

ED

A service component is required in the Emergency Radiology Department. For the 2013-2014 year the requirement is 9 daytime (8am-5pm) or evening (5pm–10 pm) weekend shifts over the course of the year-long fellowship. There is opportunity to work additional shifts for compensation. This will enable fellows to maintain and enhance clinical skills in all areas of radiology. Yale-New Haven Hospital has a busy emergency department and is a Level 1 Trauma Center.

Research

Fellows are encouraged to, but are not required to, participate in clinical research projects. For those interested in basic research, there is an array of whole body and animal research magnets in a dedicated research MR facility in the Yale University School of Medicine. These include 10 research scanners (with 1.5T, 3T, 4T, and 7T human scanners and 4.7T, 9.4T, and 11.7T small bore animal scanners). There are active research programs in cardiovascular MRI, MR spectroscopy, oncologic imaging, radiation safety, image processing, and contrast agents.

Conferences

There is a bi-weekly departmental Interesting Case Conference, two weekly Fellows Conferences (which includes didactic sessions on MR physics), and a weekly Body Club where fellows present challenging cases for discussion. Prominent guest speakers present Diagnostic Radiology Grand Rounds every other week from September to May. There are also a variety of interdisciplinary conferences (GI cancer, lymphoma, melanoma, liver tumor board, liver transplant, new GI cancer patient) that fellows participate in as well as many other interesting lectures at the medical school and on the Yale University campus.


Fellow Conference Schedule (2013-2014 academic year):
• Tuesday, 12 noon: Fellows Didactic Conference
• Every 2nd Wed., 1pm: Interesting Case Conference
• Thursday 12:30pm: Grand Rounds (every other week Sept.-May)
• Thursday 12 noon: Fellows Didactic Conference
• Friday, 11am: Body Club

Call

Fellows take approximately four weekends of call per year. Weekend call involves reading inpatient and outpatient CT and MR cases with staff Saturday and Sunday mornings from 8am-2pm. When combined with the required ED service component this results in approximately 13 weekends of call per year. While there is no in-house overnight call for fellows, an MRI beeper call is shared with the senior residents. The “on call” MRI fellow is responsible for interpreting emergency afterhours Body MRI exams (a laptop with PACS access is provided on a rotating basis). Most of these exams are to evaluate for appendicitis in pregnant patients. Over the past several years there have been, on average, two emergency cases per week. All cases are co-interpreted with staff in real time so fellows are not left alone in the middle of the night.

Faculty

Fellowship Director: Daniel Cornfeld, MD

Body Section
Daniel Cornfeld, MD
Steffen Huber, MD
Gary Israel, MD
Mahan Mathur, MD
Shirley McCarthy, MD, PhD
Bruce McClennan, MD
Jay Pahade, MD
Michael Spektor, MD
Jeffrey Weinreb, MD

Cardiovascular Section
Daniel Cornfeld, MD
Steffen Huber, MD
Hamid Mojibian, MD
Albert Sinusas, MD


Environment

Yale University School of Medicine and Yale-New Haven Hospital are just a few blocks from the main Yale University campus in New Haven, CT. Yale University offers world renowned art galleries, museums and theaters.

Living accommodations are affordable and readily available in New Haven and surrounding areas including the Long Island Sound Shoreline. New Haven, founded in 1638 and known as the Elm City, combines the urban sophistication of nearby New York City and Boston, with the charm of traditional New England. More information can be found at

http://www.infonewhaven.com

Yale-New Haven Hospital (YNHH) was founded in 1826 and is the fourth voluntary hospital in the United States. Today Yale-New Haven Hospital is a 1,541 bed tertiary care hospital spread over two campuses in New Haven, Connecticut with an NCI cancer center, active organ transplant services, surgical oncology, GYN oncology, a Children’s Hospital, and a Heart and Vascular Center.

YNHH has 9,000+ employees, including 1,200 registered nurses and a medical staff of 2,400.

Each year, Yale-New Haven Hospital treats about 40,000 inpatients and registers over 700,000 outpatient visits at its various clinics, including one-day surgery, specialty clinics, the emergency department, the Primary Care Center and others. The main campus includes Yale-New Haven Hospital, Yale-New Haven Children's Hospital, Yale-New Haven Psychiatric Hospital, Smilow Cancer Center and the Saint Raphael Campus.

Fellows  2013-14

Patricia Balcacer, MD
Elon Granader, MD
Balji Rao, MD
Adeel Sabir, MD

Applications

Interested applicants should send a universal application, their curriculum vitae, and three letters of recommendation to our fellowship director. Copies of ECFMG and USMLE scores are NOT required for the application process. A photograph is requested but not required.

Applications for our 2015-16 Cross-Sectional Imaging fellowship are now being accepted.  Applications must be received by September 30th, 2013. though interviews and positions will be offered earlier on a rolling basis.



Daniel Cornfeld, MD
Associate Professor of Radiology, Fellowship Director
Yale University School of Medicine
333 Cedar Street
P.O. Box 208042
New Haven, CT 06520

For further information please contact:
M. Lisa Varipapa, MPH
Cross-Sectional Imaging Fellowship Coordinator
Tel: 203-200-5590
Fax: 203-200-5264
lisa.varipapa@yale.edu