PEDIATRIC RADIOLOGY

General Educational Goals and Objectives for fellows in Pediatric Radiology

Our objective during the one year fellowship in Pediatric Radiology is to teach the fellow the basic skills needed to interpret and integrate all pediatric imaging modalities, including plain films, ultrasound, CT, MRI and nuclear medicine. We expect the pediatric radiology fellow, by the end of the fellowship, to be able to function as a consultant for both other radiologists and pediatricians.  We emphasize the concept that children are not miniature adults, are subject to different diseases than adults, and, therefore, have different differential diagnoses than adults.  We instruct the fellow in the handling of infants and children.  We expect the fellow to become comfortable performing low dose fluoroscopy appropriate to children.

We feel that ongoing communication with our pediatric colleagues is a useful and important way of enabling the fellow to acquire sensitivity to the concerns of pediatric clinicians, expertise in differential diagnosis of the pediatric patient and communication skills.  We participate in many conferences in the pediatric subspecialties every week, which the fellow attends.  We also take advantage of being part of a large academic radiology department with extensive expertise in many radiology subspecialties.  Our fellow attends daily noontime teaching conferences given by members of the radiology department as well as weekly grand round sessions.

The pediatric radiology fellows spends approximately half their time doing our general pediatric rotations and the remainder of the fellowship doing “specials”.   Throughout the year, the daily routine of the General Pediatric Radiology rotation includes reviewing the day’s studies including a portion of the plain radiographs, body CTs and body MRIs, and performing and interpreting pediatric ultrasound and fluoroscopic contrast procedures.  The routine varies slightly by month, with each month having a special focus and defined learning objectives related to the area of concentration.  (see attached Goals and Objectives) 

Every other week the fellow is on the “specials” rotation.  The “specials” week is as follows:  Mondays of the rotation are spent doing general nuclear medicine and PET and reviewing pediatric nuclear studies from the prior week.  Tuesdays are spent doing pediatric interventional procedures.  Wednesdays are spent doing pediatric neuroradiology.  Thursdays are spent doing pediatric cardiac and vascular MRI.  Fridays are for pursuing research and educational endeavors.  The fellow works one on one with an accredited sub specialist in nuclear radiology, interventional radiology, neuroradiology or pediatric cardiology during this time period. The fellow performs procedures, protocols examinations, and dictates reports, and is treated on par with fellows in these subspecialties.

The goals and objectives of each rotation, as well as the evaluations at the end of the rotations, are organized using the core competencies of the ACGME.  This allows clear delineation of expectations for both the trainee and the faculty.

The role of the pediatric radiology fellow evolves over time.  Initially the fellow is heavily supervised: reviewing films before dictating, fluoroscoping with a partner and having all ultrasounds checked.  By the end of the year, the pediatric radiology fellows will supervise the diagnostic radiology residents in fluoroscopy and ultrasound, and the fellows will give preliminary readings of radiographs on a weekend call day, with attending back-up.  Initially all CT and MRI scans are planned in conjunction with an attending.  By the end of the year the pediatric radiology fellow protocols and monitors studies and patients with attending back-up and input as needed.  Throughout the year, all studies and reports are reviewed with an attending.

There are daily teaching sessions for the pediatric radiology fellows and diagnostic radiology residents on the Pediatric Radiology rotation.  The fellow attends these conferences, and like the resident, is questioned on unknown cases.  Towards the end of the fellowship, the fellow assumes the role of session leader.  Numerous pediatric and radiology residents from outlying community hospitals rotate through the Children’s Hospital of New York Presbyterian radiology department.  This enriches the experience for all concerned, making for lively discussions and intellectual stimulation.

By the end of the fellowship, the fellow will have evolved from a general radiologist to a sub specialist with the ability to consult and problem solve.  S/he will be a mentor to radiology residents, a consultant to the clinician, a source of advice for fellow radiologists and a teacher to the community of children and their parents.  S/he will practice radiology compassionately and responsible.  S/he will know how to ask for help as needed and know that s/he always has a place (CHONY) to come with questions and problems.

We follow the curriculum for training supplied by the Society of Pediatric Radiology