Radiology and Biomedical Imaging

This elective will introduce the student to the fundamentals and basic principles of radiologic imaging and interpretation necessary for clinical management. The student will rotate through one week blocks on the Chest, Musculoskeletal (MSK), and GI/GU services as well as the radiology section of the Emergency Department (ED), with the goal of learning the fundamentals of interpreting plain films in these various sections. The emphasis on the Chest service will be the interpretation of plain films seen in the ICUs and imaging related to acute and chronic chest pathology. On the MSK service, emphasis will be placed on interpretation of fractures, plain film findings of bone disease, and post-operative imaging.  On the GI/GU service, students will be able to observe and participate in fluoroscopic gastrointestinal studies and their interpretation. The ED rotation will expose the student to the wide array of imaging performed through the ED including trauma.  In addition to learning to interpret plain film imaging, the students will also be exposed to more advanced imaging modalities (CT, Ultrasound, and MRI). The students will be paired with a dedicated resident on their weekly rotations and will also participate in read outs with attending radiologists on the services. The students will be taught relevant radiologic anatomy, the appropriateness of ordering various studies in the diagnosis of disease, and will also be exposed to what the performance of various studies entail.  Students will be introduced to the basics of radiologic reporting and dictation.

Students, if desired, will have the option to tailor the rotations to specific interests within radiology outside the core areas discussed above (e.g. US, mammography, interventional radiology, neuroradiology, nuclear medicine).

The students will attend the twice daily departmental resident lectures and weekly medical student radiologic lectures. In addition, at least two core introductory lectures in each subspecialty of chest, MSK, GI/GU and ED imaging will be given. Self-teaching material will be available on-line and students will be expected to review this during each of their weeks. There are no call responsibilities although students do have the option of participating in evening shifts in the ED to gain more experience and broader exposure to this busy service, if desired. At the conclusion of the elective, each student will give a short presentation of an interesting case of his/her choosing with discussion of relevant imaging.

Length of Rotation: 4 weeks (maximum-6 students)
Scheduling Restriction(s): N/A
Student’s Class Level: 3rd, 4th, 5th year
Prerequisite(s): N/A
Accept Visiting Students: Yes

Learning Objectives

The IR subinternship is designed for medical students interested in pursuing a career in interventional radiology, but also for those interested in diagnostic radiology, surgical specialties and other fields that interact intimately with interventional radiology such as urology, transplant surgery, oncology, and hepatology, among many others.
 
Enrolled students will participate in a wide spectrum of interventional procedures, which include body systems spanning human anatomy from head to toe. In the vascular system, these include arterial and venous angiography, angioplasty, thrombolysis and stenting; embolization for bleeding; tumor treatments (chemoembolizations, radioembolizations); vascular malformation and venous reflux management; inferior vena cava filter placement and retrieval; management of portal hypertension (TIPS, BRTO); hemodialysis access management and placement of a variety of venous access devices, such as ports, hemodialysis and medication infusion catheters. Nonvascular procedures include image-guided biopsies and tumor ablations, percutaneous approaches to gastric, biliary and urinary track pathology, and drainage of abscesses and fluid collections among others.
 
In addition to being expected to engage actively in procedures, students will participate in the pre- and post-procedural evaluation of patients in the IR clinic (which operates full-day all week), engage in the post procedural care of patients admitted to the IR service and other services (including rounding, note writing, and discharging), and rotate on the interventional radiology consult service, at times carrying the IR consult pager.  Students on this rotation will be clearly identified to faculty/staff, with their increased responsibilities made clear, and furthermore these students will be expected to make a greater overall effort to engross themselves in and master the material during the rotation.

Educational components include weekly IR lectures, weekly peripheral vascular multidisciplinary conferences, and weekly liver tumor board meetings.  Students will be expected to take approximately one weeknight call per week and one weekend call during the rotation, but are strictly limited to PGY-1 work duty hours, as prescribed by the Yale School of Medicine.
 
Many IR residencies to which students may apply will require an IR subinternship, but even if they don't, students who do have an official IR subinternship on their transcripts will presumably have a competitive advantage.  A major goal of this subinternship is to afford Yale medical students applying to IR residency that advantage.

Length of Rotation:  4 weeks (maximum-2 students) 
Scheduling Restriction(s):  Not offered: 1/2/18 - 1/26/18. The month of July, when fellows are still new
Prerequisite(s):  Completion of all required Clerkships
Accept Visiting Students:  Yes 

Learning Objectives

This rotation is designed as an introduction to neuroradiology. The student will become an integral part of the neuroradiology team, which consists of the resident, fellow and attending. The Neuroradiology Elective is somewhat different from other as there is less “hands on” and more observation and it tends to be more self-motivated and self directed. Students are encouraged and expected to interact during readouts by asking questions and being involved. They are also encouraged to review cases on their own prior to readout. By the end of the elective, students should be familiar with the normal radiographic anatomy of the brain, spine and head & neck and should have developed a systematic approach to interpreting CTs and MRIs of this region as well as recognizing basic pathology. Students will also be exposed to the various subsections of neuroradiology including brain, spine, head & neck, peds, etc. Upon request, those interested may also be exposed to Neuro special procedures including image guided biopsies, myelography, angiography and neurointerventional procedures. An interactive PowerPoint program will be provided to the student which covers neuroradiology and there are also teaching aids on the neuroradiology web site. A number of teaching conferences are offered as follows:
a. Neuroradiology Fellow’s Conferences. Tuesdays and Wednesdays at noon in Fitkin Basement Neuroradiology Reading Room. These are didactic lectures. Lunch is provided.
b. Interesting/Missed Case Conference. Fridays at noon in Greenspan Radiology Conference room. Presentation of interesting cases. Lunch is provided.
c. Interdisciplinary Conferences. There are conferences in ENT, Neurosurgery, Neurology, Pathology, Peds, etc. Since the time, location, and date are subject to change, interested students are encouraged to ask the Neuroradiology Fellow about these conferences.
d. Radiology Resident Conferences. Daily general radiology conferences in the Greenspan Radiology Conference Room at 1:00. There are also daily resident conferences at 7:30 am for those interested.


Length of Rotation: 2 or 4 weeks (maximum-2 students)
Scheduling Restriction(s): N/A
Student’s Class Level: 3rd, 4th, 5th year
Prerequisite(s): N/A

Visiting Students: Yes

Learning Objectives

This elective serves as an introduction to the clinical management of infants, children, and adolescents through the use of integrated diagnostic imaging. Students will participate through a review of imaging studies with residents and attendings, observation of fluoroscopic, ultrasound, computed tomography procedures, and attendance at daily clinical conferences. Students are encouraged to present interesting cases or to participate in research projects during their elective.

Length of Rotation: 2 or 4 weeks (maximum-2 students)
Student’s Class Level: 3rd, 4th, 5th year
Scheduling Restriction(s): N/A
Prerequisite(s): N/A
Accept Visiting Students: yes

Learning Objectives

This two-week elective is an introduction to vascular and interventional radiology: the use of radiological imaging to guide procedures in various organ systems of the body and the evaluation and management of patients who are candidates for these. In the vascular system, this includes arterial and venous angiography, angioplasty, stenting, embolization for bleeding, tumors (such as uterine fibroids), and vascular malformations, venous reflux management, inferior vena cava filter placement, hemodialysis access management, and placement of a variety of venous access devices. Nonvascular experience includes percutaneous approaches to biliary and urinary track pathology, drainage of abscesses and other fluid collections, and tumor ablation. Students will participate in the interventional radiology clinic and admitting service.

Length of Rotation: 2 weeks (maximum-1 student)
Scheduling Restriction(s): Not offered: 1/2/18 - 1/26/18
Student’s Class Level: 4th, 5th year
Prerequisite(s): N/A
Accept Visiting Students: Yes

Learning Objectives