pediatric fellowship program manual
TRANSCRIPT
Pediatric Radiology Fellowship Program Policy Manual: 2009-2010
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i. INTRODUCTION
DEPARTMENT OF RADIOLOGY PROGRAM MANUAL
All physicians-in-training at the University are classified as either residents or fellows. The information contained in this Program Manual pertains to all residents in the Department’s programs except as otherwise identified in the Program Manual or addendum. This Manual outlines benefits, policies, guidelines and other regulations that apply to all resident training in the Department of Radiology.
The Institutional Policy Manual contains policies, procedures and information that apply to all residents throughout the University of Minnesota Medical School. The Program Manual is specific to each program. All materials are intended to be written in accordance with the Accreditation Council for Graduate Medical Education (ACGME). Please note that the Institutional Policy Manual and the Department Program Manual are designed to work together. Information contained in Institutional Policy Manual may not be replicated in Program Manual.
All information outlined in this Program Manual is subject to periodic review and change. All residents are subject to, and required to be familiar with and to comply with all policies and procedures of the University including the Institutional Policy and Department Program Manuals.
Throughout this Manual, individual institutions will be identified as follows:- University of Minnesota Medical Center:UMMC - Hennepin County Medical Center: HCMC- Veterans Affairs Medical Center: VAMC
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ii. DEPARTMENT MISSION STATEMENT
The mission of the Department of Radiology is to be a leader in enhancing the health of people through education, biomedical research, and clinical programs.
iii. PROGRAM MISSION STATEMENT
The Department of Radiology at the University of Minnesota School of Medicine, in conjunction with its affiliated institutions (including but not limited to the Veterans Affairs Medical Center and Hennepin County Medical Center) provides graduate medical education in Diagnostic Radiology and its subspecialties programs:
Breast Imaging Fellowship Diagnostic Radiology Residency Neuroradiology Fellowship Nuclear Medicine Fellowship Pediatric Fellowship Thoraco-Abdominal Radiology Fellowship Vascular and Interventional Radiology Fellowship
Our educational mission is to provide an atmosphere of learning and academic curiosity, and to provide strong basic training in diagnostic radiology and its subspecialties including but not limited to breast, cardiac, abdominal, musculoskeletal, neuro-, pediatric, noninvasive vascular, and thoracic imaging, as well as nuclear radiology and ultrasound.
Administrative oversight of these programs is provided by the ALRT Administrative Center - Departments of:AnesthesiologyLaboratory Medicine and Pathology, Diagnostic Radiology Therapeutic Radiology
The mission of the A.L.R.T. Administrative Center, as part of the University of Minnesota School of Medicine, is to provide uniform service delivery to our departments and institutes. These services consist of human resources, payroll, communication, education, grants management, financial reporting and budget. Our goal is to provide exceptional service while balancing the expectations of the multiple constituents. To achieve this goal we will foster a community based on communication, cooperation and expertise by drawing on our individual backgrounds, strengths and unique histories.
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TABLE OF CONTENTS
SECTION i. INTRODUCTION Page 2SECTION ii DEPARTMENT AND PROGRAM MISSION STATEMENTS Page 3SECTION I. Student Services
Universal University Pagers Page 6E-mail and Internet Access Page 6Weekly E-Newsletter Page 6Campus Mail Page 6Tuition and Fees Page 6HIPAA Training & Data Security Page 7USB Drives Page 7Department USB Drive Page 7
SECTION II. BENEFITSStipends Page 8Paychecks and Pay Periods Page 8Resident/Fellow Leave Page 8 Vacation Page 9 Illness Page 9 Other Leaves Page 9
Personal Leaves of Absence Page 9 Family Medical Leave Page 9 Family Medical Leave Act (FMLA) Page 9 Parental Leave for Childbirth Page 9 Parental/Domestic Partnership Leave – Adoption Page 10 Professional Leave Page 10 Military Leave Page 10 Jury Witness Duty Page 10 Bereavement Leave Page 10 Interview Time Off Page 10
Policy on Effect of Leave - ABR Certificate of Added Qualification Requirement Page 10Holiday Schedule Block Out Dates
Page 11Page 12
Department Policy Regarding Pregnancy for Resident/Fellow & Radiation Page 12Notary Service Page 12Resident/Fellow Exercise Room Page 13Health and Dental Insurance Page 13Long-Term Disability Insurance Page 13Short-Term Disability Insurance Page 13Professional Liability Insurance Page 13Life Insurance Page 13Voluntary Life Insurance Page 13Insurance Coverage Change Page 13Worker’s Compensation Page 13Meal/Food Services Page 13Laundry Services Page 14Parking Page 14 UMMC Page 14 HCMC Page 14 VAMC Page 15Travel Fund Page 15SECTION III. INSTITUTIONAL RESPONSIBILITIES Page 16 SECTION IV. DISCIPLINARY AND GRIEVANCE PROCEDURES Page 16 Discipline/Dismissal for Academic Reasons Page 16Discipline/Dismissal for Non-academic Reasons Page 16Grievance Procedure and Due Process Page 16
SECTION V. GENERAL POLICIES AND PROCEDURES PAGE 17Program Goals Page 17Program Curriculum Page 18Program Schedules Page 19Program Requirements Page 19Training/Graduation Requirements Page 19
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ACGME Competencies Page 20Duty Hours Page 20RMS – Residency Management Suite
Duty Hour Approval Policy/ProcedurePage 20
Duty Hours – Entering Hours Into RMS Page 20
On-call Activities Page 21On-call Rooms Page 21Support Services Page 21Laboratory Medicine/Radiology Services Page 22Medical Records Page 22Security/Safety Page 22Radiation Badges Page 22Moonlighting Page 22-23Supervision/Graded Responsibility Page 23Steps in Evaluation Process Page 23Evaluation System - Electronic Page 23Completing Evaluations in RMS Page 24Monitoring of Fellow Well-being Page 24ACLS/BLS Certification Requirements Page 24Travel Page 24Libraries
Institutional Departmental
Page 25
Goals and Objective for Teaching Medical Students Page 25-28SECTION VII. ADMINISTRATION CONTACT INFORMATION Page 28Graduate Medical Education Directors and Coordinators Page 28Site Addresses, Phone and Fax Numbers Page 29ADDENDUM I: PROGRAM OBJECTIVES, GOALS, AND EXPECTATIONSSchedule of Pediatric Radiology Conferences Page 31Rotation Schedule Page 31Didactic Conference Schedule Page 32Reading Room/General Radiography Page 33-35Fluoroscopy Page 36-38Ultrasound Page 39-41Body Imaging CT/MRI Page 42-44Neuroimaging Page 45-47Nuclear Medicine Page 48-50Vascular and Interventional Page 51-53Recommended Reading Page54-58Declaration of Duty Hours Page 59Confirmation of Receipt of Program Manual Page 60
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SECTION I. STUDENT SERVICES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Academic Health Center (AHC) Portal Access; Child Care; Computer Discount/University Bookstore; Credit Unions; Disability Accommodations; Legal Services; Library Services; Medical School Campus Maps; Resident Assistance Program; Tuition Reciprocity; University Card (UCard); University Events Box Office; University Recreation Sports Center(s))
UNIVERSAL UNIVERSITY PAGERSFellows are assigned UMMC-Fairview pagers at the beginning of their year. Contact the Trisha Pederson, Program Coordinator, 612-626-5548 or [email protected] to report any missing or malfunctioning cards.
E-MAIL AND INTERNET ACCESSAs students at the University, all fellows are provided with a University E-mail/Internet access account. With this account trainees can access the Internet and E-mail from any of their assigned training sites.
If you are using an independent ISP, you must forward your University E-mail account to your preferred E-mail account as required by the Medical School. Log on to http://www.umn.edu/validate to do so. (To learn the E-mail address assigned to you, go to the University’s web page, www.umn.edu, click on “People Search” then type your name into the “Search” box.)
Information regarding the University of Minnesota School of Medicine, Graduate Medical Education and/or the Department of Radiology can be located at the following web sites:
Medical School Web Site: http://www.med.umn.eduGraduate Medical Education Administration Web Site:
http://www.med.umn.edu/gmeDepartment of Radiology Web Site:http://www.radiology.umn.edu
Trainees are required to maintain an E-mail account and to check their E-mail daily for Program, Medical School and University notices.
CAMPUS MAILDEPARTMENT MAILROOM: ROOM B-221, MAYO MEMORIAL BUILDING
OUTGOING MAIL Can be left in the “Outgoing Hospital/Campus Mail” basket.
INCOMING MAIL Fellows may receive professional related mail in their mailbox.
DEPARTMENT MAILING ADDRESS420 Delaware Street. S.E., MMC 292Minneapolis, MN. 55455
Fellows are not to send or receive personal mail through the University system. Outgoing U.S. mail may also be placed in the United States Postal Service mailbox located just outside the main entrance of the University of Minnesota Medical Center (on Harvard Street).
Fellows are required to check their mailboxes a WEEKLY basis for Program, Medical School and University notices. Fellows are also required to empty their mailboxes on a regular basis.
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TUITION AND FEESTuition and fees are being waived at this time. Fellows who are enrolled in Graduate School pay tuition and fees.
HIPAA AND DATA SECURITY TRAINING
The University of Minnesota is required to remain in compliance with the training component of the Federal Health Information Portability and Accountability Act (HIPAA) privacy regulations and Data Security. All faculty, trainees and staff must be trained regarding this regulation as well as University-specific policies and procedures. Multi-media online training has been developed to facilitate this training as well as the required documentation in the regulation. Four courses have been developed and are available through the “My AHC” and “My U” portals.
All University faculty, staff, student workers and health science students and volunteers are required to complete the following HIPAA Privacy and Data Security courses:
HIPAA Privacy Introduction to HIPAA Privacy Video Privacy and Confidentiality in Research (for research faculty and staff) Privacy and Confidentiality in Clinical settings (for clinical faculty and staff)
HIPAA Data Security Data Security in Your Job Securing Your Computer Workstation Using University Data Managing Health Data Securely
To access your HIPAA and Data Security Training and to complete the course(s), please follow this link: www.myU.umn.edu (log in with your x500).
Please remember to LOG OUT of the portal when you are finished. If you leave the computer while you remain logged in, others could use your log-in to access your private information.
SECURITY/PRIVACY COORDINATOR Sally Sawyer, Graduate Medical Education Manager, serves as the ALRT Center Privacy Coordinator. Questions and/or concerns can be directed to Sally at 612-625-3518 or [email protected].
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SECTION II. BENEFITS (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical
School Policies on the following: Boynton Health Services; Employee Health Services; Exercise Room at UMMC-F; FICA; Dental Insurance; Health Insurance; Life Insurance; Voluntary Life Insurance; Long-Term Disability; Short-Term Disability; Insurance Coverage Changes; Bereavement Leave; Family Medical Leave Act (FMLA); Holidays; Medical Leave; Military Leave; Parental Leave; Personal Leave; Professional Leave; Vacation/Sick Leave; Witness/Jury Duty; Effect of Leave for Satisfying Completion of Program; Loan Deferment; Minnesota Medical Association Membership; Minnesota Medical Foundation Emergency Loan Program; Pre-Tax Flexible Spending Accounts; Professional Liability Insurance; Stipends; Workers’ Compensation Benefits; Veterans Certification for Education Benefits).
STIPENDSMedical Fellows who meet Departmental, Medical School and University requirements are appointed to one-year training positions from July 1 through June 30 of the following year (unless otherwise agreed to in writing).
Base stipend rates are posted at http://www.med.umn.edu/gme/directors/finance.html
Medical Residents/Fellows are subject to withholding of Federal and State income taxes, as well as FICA taxes (Social Security). Medical Residents/Fellows pay insurance fees by payroll deduction over 26 pay periods.
PAYCHECKS AND PAY PERIODSBiweekly paychecks are issued every-other Wednesday beginning July 1st, 2009.
You are encouraged to have your checks automatically deposited to your banking institution to avoid loss or delay. Your pay statement can be viewed online at http://hrss.umn.edu. If you do not have direct deposit you will receive a check on payday. This check must be picked-up from ALRT Payroll (7th floor Mayo Building). It cannot be placed in your mailbox or mailed to your home. Please keep your pay statements for future reference, as they contain deduction amounts that you’ll need when you prepare your tax returns. The Department of Radiology keeps no record of your deductions.
Payroll forms (i.e., automatic deposit, W4, duplicate W2, etc.), can be obtained online at http://hrss.umn.edu A new W4 form must be completed each time a name or address change occurs.
CONTACT PERSON:Contact Sandy Connor at 612-6253682 or [email protected] regarding questions pertaining to payroll, taxes, deductions, W2s, etc.
RESIDENT/FELLOW LEAVE (INCLUDING VACATION, ILLNESS AND OTHER TYPES OF LEAVE)
Except for unexpected absence related to illness, all leave must be pre-approved. All leave must be documented in RMS duty hours.
The Program Coordinator should be concurrently notified of leave requests by e-mail as soon as possible. The type of leave, as noted below, should be specified. Depending on scheduling considerations and in a timely manner,send an e-mail to the Program Coordinator including attached revised schedule noting changes for final approval by the Program Director.
Unpaid Leave While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly).
1. VACATION
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Holiday schedule (including variation by location) and “block out dates” are indicated on page 12. Up to twenty (20) working days per year may be taken as vacation which is paid leave. Unused vacation time may not be carried over to the next year. Depending on rotation up to five (5) vacation days may be taken during a given month. Requests to exceed this limit must be approved by the Program Director in advance. No more than ten (10) total vacation days can be taken from any section during the fellowship without the Program Director’s approval.
TERMINAL LEAVE IN THE EVENT THE GRADUATING FELLOW HAS VACATION TIME REMAINING, VACATION MAY BE REQUESTED DURING THE BLOCKED OUT TERMINAL LEAVE PERIOD AT THE END OF THEIR FELLOWSHIP.
2. ILLNESS
Fellows must call in sick as soon as they know they are unable to show up for work because of acute illness of themselves or child/children. They must inform the Program Coordinator, Trisha Pederson (612-626-5548), and the rotation they’re on. They should speak in person with either the fellowship coordinator, or someone in their rotation.
Days of absence due to illness are considered paid leave up to ten (10) days per year. Absence due to illness exceeding ten (10) work days in an academic year will be charged as vacation. There is no carryover from preceding years. In the event that a fellows has exhausted all of his/her vacation leave, this time will be charged as unpaid leave. While on unpaid leave, the fellow is responsible for payment of any insurance fellows on unpaid leave will be billed monthly).
3. OTHER LEAVES PERSONAL LEAVE OF ABSENCE If vacation time is used up for the year, and upon the approval of the Program Director, a
fellow may arrange for a unpaid leave of absence away from the training program. While on unpaid leave, the fellow is responsible for payment of any insurance (residents on unpaid leave will be billed monthly).
MEDICAL LEAVE An unpaid leave of absence for serious illness of the resident; serious health condition of a spouse, parent or child/children; shall be granted through formal request. The Program Coordinator should be concurrently notified of the leave request by e-mail as soon as possible. The length of leave will be determined by the Program Director based upon an individual’s particular circumstances and the needs of the department, not to exceed twelve (12) weeks in any 12-month period. Fellows taking family medical leave must submit the following documents to the Program Coordinator:
FMLA: Certification of Health Care ProviderFMLA: Leave Response/Notification
The above forms can be accessed online in the Forms Library under “Human Resources” at http://www.fpd.finop.umn.edu/groups/ppd/documents/main/formhome.cfm. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly).
FAMILY MEDICAL LEAVE ACT (FMLA) FMLA is intended to allow employees to balance their work and family life by taking reasonable unpaid leave for a serious health condition, for the birth or adoption of a child, and for the care of a child, spouse, and registered same-sex domestic partner provided for by the University, or parent who has a serious health condition. The Act is intended to balance the demands of the workplace with the needs of families, to promote the stability and economic security of families, and to promote national interests in preserving family integrity.
http://www1.umn.edu/ohr/policies/leaves/fmla.html
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PARENTAL LEAVE FOR CHILDBIRTH A female fellow may, upon written request of the Program director copied to the Program Coordinator, take up to six weeks paid maternity leave related to the birth of her child.
The paid leave must fall within the term of appointment and must be taken consecutively and without interruption. After using paid maternity leave and all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellow on unpaid leave will be billed monthly)
A male fellow or a partner in a registered domestic partnership may upon formal request, take up to two weeks paid paternity/partnership leave related to the birth of a child. The Program Coordinator should be concurrently notified of leave requests by e-mail as soon as possible. All leave time must fall within the term of appointment and must be taken consecutively and without interruption. After using all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly)
Disabilities associated with childbirth and pregnancy will be treated like any other disability.
PARENTAL/DOMESTIC PARTNERSHIP LEAVE - ADOPTION A female fellow may, upon request, may take up to two weeks paid leave and up to two
weeks leave without pay related to the adoption/birth of a child. All leave time must fall within the term of appointment. All leave must be taken consecutively and without interruption. After using all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly).
A male fellow or partner in a registered domestic partnership may, upon request, take up to two weeks paid leave related to the adoption of a child. All leave time must fall within the term of appointment. All leave must be taken consecutively and without interruption. After using all unused vacation, any additional leave will be without pay. While on unpaid leave, the fellow is responsible for payment of any insurance (fellows on unpaid leave will be billed monthly).
ACADEMIC/PROFESSIONAL LEAVE Up to five (5) working days per year may be taken as paid leave for academic leave and conferences. This time is in addition to regular vacation time and is at the discretion of the Program Director or Department Head. The Department may cover up to three days of reasonable expenses for fellows presenting at national meetings.
MILITARY LEAVE Military leave is granted in full accordance with State and Federal regulations. The Program Director must be promptly notified in writing when a Medical Fellows requires military leave.
JURY/WITNESS DUTY Jury duty and court leave will be authorized consistent with State and Federal Court requirements. The Program Director must be promptly notified in writing when a Medical Fellow requires jury duty or court leave.
BEREAVEMENT LEAVE A fellow may request bereavement leave through formal request of the Program Director.
Either sick or vacation time must be used. The Program Coordinator should be concurrently notified of leave requests by e-mail as soon as possible.
INTERVIEW TIME OFF
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A senior resident may take up to five (5) calendar days of non-vacation time to interview for a job or fellowship position.
POLICY ON EFFECT OF LEAVE FOR SATISFYING COMPLETION OF PROGRAM As is required by the American Board of Radiology (ABR), all fellow leave is reported to the ABR on an annual basis. Per the ABR, the following terms in regards to leave must be met in order to be eligible to sit for the Certifiecate of Added Qualification examination:
“Leaves of absence and vacation may be granted to fellows at the discretion of the program director in
accordance with local rules.
Within the required period(s) of graduate medical education, the total such leave and vacation time may
not exceed six calendar weeks (30 working days) for fellows in a program for one year.”
ABR REQUIREMENTS:
Requirements
You must successfully complete one year of fellowship training (after residency) in a pediatric radiology program
approved for such training and accredited by the ACGME or by the RCPSC (Canada). You must also complete one
year of practice or additional approved training, with one-third of that year spent in pediatric radiology.
Fellowship training must be documented by letter from the program director.
Practice experience must be verified by letter from the chief of service or department chairman.
Provide evidence of a current state medical license with an expiration date.
HOLIDAY SCHEDULE AND BLOCK-OUT DATESHoliday schedules vary, depending on the institution. When rotating to a particular site, the holiday schedule for that institution must be followed.
NOTE: Residents on UMMC rotations follow the UMMC Fairview holiday schedule, not the “U of MN Staff” holiday schedule. Residents on outpatient rotations will make themselves available for hospital coverage in the event that the outpatient location is closed and the hospital is not.
The fellowship program also follows a schedule of Block-out Dates. These are dates during which staffing shortages are anticipated. Leave requests will not be granted during these periods without specific approval from the Program Director.
Date HolidayUMM
C HCM
CVAMC
Friday, July 3rd, 2009Independence Day Yes Yes Yes
Monday, September 7th, 2009
Labor Day Yes Yes Yes
Monday, October 12, 2009Columbus Day No No Yes
Wednesday, November 11, Veterans Day No No Yes
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2009
Thursday, November 26, 2009
Floating Holiday No No No
Friday, November 27, 2009Thanksgiving Day Yes Yes Yes
Friday, December 25th, 2009Christmas Yes Yes Yes
Friday, January 1, 2010New Year’s Day
(Observed)Yes Yes Yes
Monday, January 18, 2010ML King Day (Observed)
No No Yes
Monday, February 15, 2010Presidents’ Day
No No Yes
Monday, May 31, 2010 Memorial Day Yes Yes Yes
BLOCK-OUT DATESEvent From: Through:
New Residents and Fellows July 1st, 2009 July 3rd, 2009
ABR Written Examinations September 10th, 2009 September 11th, 2009
Radiological Society of North America Meeting
November 29th, 2009 December 4th, 2009
ACR In-training Examination February 4th, 2010 February 4th, 2010
Senior Hot Seat Review Courses TBA TBA
Society for Pediatric Radiology Annual Meeting
April 13th, 2010 April 17th, 2010
Association of University Radiologists Meeting
March 23rd, 2010 March 26th, 2010
ACR Conference
ABR Oral Examination May 29th, 2010 June 1st, 2010
Terminal Leave/Vacation(Only Seniors)
June 21st, 2010June 25th, 28th – 30th,
2010
DEPARTMENTAL POLICY REGARDING PREGNANCY FOR FELLOWSThe Department of Radiology will not differentiate in the treatment of potentially pregnant or confirmed pregnant fellows. Specifically, on-call and fluoroscopy assignments will not be modified solely on the basis of a female resident being potentially pregnant or pregnant, in accordance with the official position of the American Association of Women in Radiology which states: “On the basis of available data, the elimination of fluoroscopy at
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any time during pregnancy cannot be justified on scientific grounds. Rationally, women of child-bearing age who enter the specialty of radiology should be willing to accept the theoretical risks involved in fluoroscopy.”
NOTARY SERVICE Shari Johnston
Phone: 612.626.5589Office: Mayo B-211
Trisha PedersonPhone: 612.626.5548Office: Mayo B-292
RESIDENT/FELLOW EXERCISE ROOMThe University of Minnesota Medical Center, Fairview Medical Executive Committee has graciously provided an exercise facility for use by University of Minnesota residents and fellows.
Location:Room C-496 Mayo Memorial Building(Locker rooms/showers are located directly across the hall)
Hours:The facility is open 24 hours a day, 7 days a week
Access Code to Exercise Room and Locker Rooms:9111 (Please do not share with anyone other than residents and fellows)
The space also includes a small kitchenette area with refrigerator, microwave, coffeemaker and hot/cold water dispenser.
HEALTH AND DENTAL NSURANCE COVERAGEPlease refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator.
FLEXIBLE SPENDING ACCOUNTPlease refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator.
LONG-TERM DISABILITY NSURANCE COVERAGEPlease refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator.
SHORT-TERM DISABILITY NSURANCE COVERAGEPlease refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator.
PROFESSIONAL LIABILITY NSURANCE COVERAGEPlease refer to Institutional Policy Manual for further information. You may also contact the Risk Management Office:
Office of Risk Management and Insurance 1300 South 2nd Street, Suite #208 WBOBMinneapolis, MN 55454Phone: 612-624-5884
LIFE NSURANCE COVERAGEPlease refer to Institutional Policy Manual for further information. You may also contact the Program Coordinator.
VOLUNTARY LIFE NSURANCE COVERAGEYou may also contact the Program Coordinator.
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INSURANCE COVERAGE CHANGESYou may also contact the Program Coordinator.
WORKER’S COMPENSATIONUniversity employees must promptly report on-the-job injuries/illnesses to the employee's supervisor. Within 24 hours of the employee's report the supervisor shall complete the First Report of Injury and the Employee Incident Report forms and forward these to the University's vendor and a copy to the University Workers' Compensation Department.
http://www.policy.umn.edu/groups/ppd/documents/policy/workers_comp
Meals/Food ServicesFellows on duty have access to adequate and appropriate food services at all institutions.
UMMC Fellowsmay visit the Bridges Cafeteria (University campus) or the East Side Market Café (Riverside
campus).
There are no meal plans provided by the Department for Fellows.
LAUNDRY SERVICESTwo lab coats will be provided at the beginning of your fellowship. If you should require a
replacement lab coat during your fellowship program, please contact, Trisha Pederson, Program Coordinator.
No laundry services are provided for Radiology fellows. Scrubs are provided when you are on an appropriate rotation for scrubs. These are the property of the institutions and are to be used for this purpose only.
- UMMC:Scrubs are available on a sign-out basis by using your UMMC identification badge in Room J2-104. The required bar code for the backside of your ID badge is provided by Kathy Monitor in Linen Services: 612-273-5793.
PARKINGUMMC The Department provides general parking at Oak Street Ramp C for fellows. Fellows receive a parking card during their department orientation at the beginning of the year. If you encounter a problem with your parking card, contact Trisha Pederson, Program Coordinator at 612-626-5548.
DO NOT TAKE YOUR KEY CARD INTO ANY MRI FACILITY, AS THESE UNITS WILL ERASE THE CARD’S MEMORY. EXITING PARKING FACILITY WITHOUT SCANNING CARD WILL AUTOMATICALLY RESULT IN YOUR CARD BEING LOCKED
ON-CALL PARKING: The Department covers parking expenses for residents taking departmental call. Those with departmental parking cards will use the same card for on-call parking as for daily parking when rotating to UMMC.
AFTER-HOURS PARKING Parking validation is available to fellows for the sole purpose of attending Program-related conferences and activities while on rotations based away from UMMC (i.e., Diagnostic Radiology and Medical School Core Curriculum lectures, First-year Lecture Series, Physics Review, Senior Review and resident meetings). Parking tickets can be validated by the Program Coordinator.
TRAVEL FUND
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Residents beyond their fifth clinical year are considered to be in fellowship positions and are not eligible for the reimbursement program.
However, submission and acceptance of work to a national or international society meeting, notably Society of Pediatric Radiology or the Radiological Society of North America, will be the only exception. In that circumstance, all allowable expenses of the fellow in attending the meeting and presenting are paid by the Department of Radiology.
Call your Program Coordinator, Trisha Pederson, with any questions at 612-626-5548.
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SECTION III. INSTITUTIONAL RESPONSBILITIES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: ACGME Resident Survey Requirements; ACGME Site Visit Preparation Services; Institution Affiliation Agreements; Program Letters of Agreement; Confirmation of Receipt of Program Policy Manuals; Duty Hour Monitoring at the Institution Level Policy and Procedure; Funding; GME Competency Teaching Resources and Core Curriculum; Graduate Medical Education Committee Responsibilities; Graduate Medical Education Committee Resident Council Responsibilities; Institution and Program Requirements; Internal Review Process; International Medical Graduates Visa Requirements; New Training Program Approval Process; Orientation; Registration Policy ).
SECTION IV. DISCIPLINARY AND GRIEVANCE PROCEDURES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Discipline/Dismissal/Nonrenewal; Conflict Resolution Process for Student Academic Complaints; Academic Incivility Policy and Procedure; University Senate on Sexual Harassment Policy; Sexual Harassment and Discrimination Reporting; Sexual Assault Victim’s Rights Policy; Dispute Resolution Policy)
Discipline/Dismissal for Academic ReasonsTrainee academic performance is determined by a review of evaluations and examination scores (see Section IV: Steps in Evaluation Process). If resident performance is felt to be below an acceptable level, discipline and possible dismissal will follow guidelines set forth in the Institutional Policy Manual (see Disciplinary and Grievance Procedures).
Procedures: The resident/fellow will be given verbal notice of performance deficiencies by the Program Director, an opportunity to remedy deficiencies, and the notice of possible dismissal or contract non-renewal if the deficiencies are not corrected, and a record of this will be placed in the trainee’s file.
When the resident continues to demonstrate a pattern of marginal or unsatisfactory academic performance, they will be placed on academic probation as specified in the Institutional Manual. A Radiology Graduate Medical Education Committee will meet to discuss the outcome of the probation, and may recommend: Removal from probation with a return to good academic standing; continued probation with new or remaining deficiencies sited; Non-promotion to the next level of training; Contract non-renewal and/or dismissal.
Discipline/Dismissal for Non-Academic ReasonsDiscipline/dismissal for non-academic reasons will follow the guidelines set forth in the Institutional Policy Manual.
Grievance Procedure and Due Process Refer to the Institutional Policy Manual
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SECTION V. GENERAL POLICIES AND PROCEDURES (Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: Academic Health Center (AHC) Student Background Study Policy; Background Study Policy and Procedure; Applicant Privacy Policy; Appointment Letter Policy and Procedure; Blood Borne Pathogen Diseases Policy; Certificate of Completion Policy; Classification and Appointment Policy; Compact for Teaching and Learning; Disability Policy; Disaster Planning Policy and Procedure; Documentation Requirements Policy; Documentation Retention Requirements for FICA Purposes Policy; Dress Code Policy; Duty Hours/On-Call Schedules; Duty Hours Policy; Duty Hours/Prioritization of On-Call Room Assignments; Effective Date for Stipends and Benefits Policy; Eligibility and Selection Policy; Essential Capacities for Matriculation, Promotion and Graduation for U of M GME Programs; Evaluation Policy; Health Insurance Portability and Accountability Act; Immunizations and Vaccinations; Immunizations: Hepatitis B Declination Form; Impaired Resident/Fellow Policy and Procedure; Licensure Policy: Life Support Certification Policy; Moonlighting Policy; National Provider Identification (NPI) Policy and Procedure; Nepotism Policy; Observer Policy; Post Call Cab Voucher Policy (UMMC-F; HCMC); Registered Same Sex Domestic Partner Policy; Release of Contact Information Policy; Residency Management Suite (RMS): Updating and Approving Assignments and Hours in the Duty Hours Module of RMS; Restrictive Covenants; Standing and Promotion Policy; Stipend Level Policy; Stipend Funding from External Organizations Policy; Supervision Policy; Training Program and/or Institution Closure or Reduction Policy; Transitional Year Policy; USMLE Step 3 Policy; Vendor Policy; Verification of Training and Summary for Credentialing Policy; Voluntary Life Insurance Procedure; Without Salary Appointment Policy ).
PROGRAM GOALS AND OBJECTIVES
This Program’s goal is to develop a sturdy medical knowledge/skill base and professional attributes that allowfellows to independently and competently practice Pediatric radiology with a life-long commitment to continuedlearning and excellence. “The training program in the subspecialty of pediatric radiology constitutes a supervised experience in the pediatric applications and interpretation of radiography, computed tomography, ultrasonography, angiography, interventional techniques, nuclear radiology, magnetic resonance, and any other imaging modality customarily included within the specialty of diagnostic radiology.
The program is structured to enhance substantially the subspecialty fellows’ knowledge of the applications of all forms of diagnostic imaging to the unique clinical/pathophysiologic problems of the newborn, infant, child, and adolescent. The fundamentals of radiobiology, radiologic physics, and radiation protection as they relate to the infant, child, and adolescent will be reviewed during the pediatric radiology training experience. The program will provide fellows direct and progressively responsible experience in pediatric imaging as they advance through training. This training must culminate in sufficiently independent responsibility for clinical decision making such that the program is assured that the graduating resident has achieved the ability to execute sound clinical judgment.” [Accreditation Council for Graduate Medical Education Program Requirements for Residency Education in Pediatric Radiology]
A. Duration of Training
“Prerequisite training for entry into a diagnostic radiology subspecialty program should include the satisfactory
completion of a diagnostic radiology residency accredited by the Accreditation Council for Graduate Medical
Education (ACGME) or the Royal College of Physicians and Surgeons of Canada (RCPSC), or other training
judged suitable by the program director.”
The Division of Pediatric Radiology in the Department of Radiology offers a one year ACGME accredited fellowship training program in Pediatric Radiology leading to eligibility for examination for the American Board of Radiology’s (ABR) Certificate of Added Qualification (CAQ) in Pediatric Radiology. Completion of the
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fellowship and of one subsequent year of further pediatric radiology fellowship training and/or of clinical practice experience in the field of Pediatric Radiology qualifies the individual for membership in the Society of Pediatric Radiology (SPR).
B. Objectives and Goals
Special training and skills, beyond those provided by residency training in diagnostic radiology, are required to enable the pediatric radiologist to function as an expert diagnostic and therapeutic consultant and practitioner. This program is designed to provide fellows with an organized, comprehensive, and highly supervised full time educational experience. It involves the selection, design, performance and interpretation of Pediatric Radiology examinations and procedures. Lastly, the fellowship will provide the development of skills and opportunities for research in the field of pediatric radiology.
The Fellowship is designed so that, at its completion, a Fellow will be able to:
1. Understand the developmental and acquired disease processes of the newborn, infant, child, and adolescent that are basic to the practice of pediatric and adolescent medicine.
2. Perform and interpret radiological and imaging studies of the pediatric patient. 3. Supervise and teach the elements of radiography and radiology as they pertain to infants and
children. 4. Understand how to design and perform research 5. Prepare material suitable for presentation and publication.
The program provides the fellow with the opportunity to develop, under graduated supervision, progressively independent skills in the evaluation of the clinical diagnostic problem and the selection, design, performance and interpretation of pediatric radiological imaging studies and invasive procedures. At the conclusion of the fellowship, the fellow should be able to independently determine the appropriate diagnostic test for a given clinical problem, deliver a cogent consultation to clinical colleagues, accurately determine the choice of imaging modality, define the protocol for the appropriate study, conduct and/or supervise the performance of the examination and provide a complete and competent interpretation of the diagnostic findings on that study and the therapeutic implications of those findings.
The training program must provide education in, and the fellow must be thoroughly familiar with, the physics of ionizing radiation and magnetic resonance; understanding of the theory and application of computerized image reconstruction techniques; knowledge of radiation biology of the infant and adolescent; and the pharmacology of radiographic and magnetic contrast materials.
The fellowship program provides the fellow with an organized, comprehensive, and supervised full-time educational experience in the selection, interpretation, and performance of pediatric radiological examinations and procedures. With the aid of, and daily clinical exposure to, a large and varied population of patients in related clinical fields and contact (and correlation) with Pediatricians and Radiologists, the fellow should be capable of independent and accurate clinical decision making in all areas of Pediatric Radiology at the culmination of the year of training.
The program provides the opportunity for fellows to consult, perform, and interpret, under close supervision with graduated responsibility, invasive diagnostic and therapeutic pediatric interventional procedures At the conclusion of the fellowship, the fellow should be thoroughly familiar with and knowledgeable in the indications and contraindications for such procedures; be able to select the appropriate needle, catheter, or device; safely position it under image guidance within the target; select and administer the appropriate dose of contrast or therapeutic material; and evaluate and manage the post-procedural condition and care of the patient.
The Fellowship and evaluation of the fellow will also be centered around the six core competencies of the ACGME. Those competencies include: patient care, medical knowledge, interpersonal and communications skills, practice based learning and improvement, professionalism, and systems based practice.
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Please see Addendum 1: Goals, Objectives, and Expectations starting on page 32 of the manual.
PROGRAM SCHEDULES
Please see Addendum 1: Goals, Objectives, and Expectations, page 33, of the manual.
PROGRAM REQUIREMENTSAll fellows are governed by the requirements in both the Institutional and Program Manual.
Thisprogram is accredited by the Accreditation Council for Graduate Medical Education and follows therequirements set forth by the ACGME. To view these requirements, go to http://www.acgme.org.
The Graduate Medical Education Committee, chaired by the Program Director, evaluates the progress of the fellows, and makes recommendations for advancement or disciplinary actions. The Program Director with advice from Graduate Medical Education Committee members, determines candidates for admission to the training program, fellows’ progress in the program, and fellows satisfactory completion of graduation requirements.
Fellows are expected to successfully complete their monthly rotations.
Fellows are required to comply in a timely manner with administrative directives including those from the Program Coordinator. This includes, but not limited to:
Proper notification of all time away Weekly submission of duty hours in RMS Record conference attendance in RMS Conference Module for UMMC Conferences Prompt completion of RMS evaluations Reading/Studying during regular work hours – must be patient care related Compliance to USMLE policy (see below) Regular attendance at conferences is a mandatory requirement of this program
and trainees are required to document their attendance at appropriate conferences at their institution on days they are at work. Only those on call, post-call, ill, on leave, or attending the Armed Forces Institute of Pathology will be considered to have excused absences.
Fellows are required to attend Grand Rounds and Core Curriculum Conferences at the University on days they are at work, regardless of which institution they are working at.
TRAINING/GRADUATION REQUIREMENTS This program is adheres to the training requirements set forth by the American Board of Radiology and the Accreditation Council for Graduate Medical Education. These requirements can be reviewed at http://www.theabr.org and http://www.acgme.org
Graduation certificates are awarded to fellows who successfully complete all of the Program requirements, have shown satisfactory progress toward the competent, independent practice of Pediatric Radiology, and demonstrate professional and personal attributes dedicated to the life-long learning process associated with the practice of medicine.
ACGME CORE COMPETENCIES
All University of Minnesota Medical School Residency/Fellowship training programs define the specific knowledge, skills, attitudes, and educational experiences required by the
ACGME/RRC to ensure its residents/fellows demonstrate the following:
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1) Patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
2) Medical knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
3) Practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care.
4) Interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals.
5) Professionalism , as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
6) Systems-based practice , as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value.
DUTY HOURSDuty hours are defined as all clinical and academic activities related to the training program, i.e., patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours DO NOT include reading and preparation time spent away from the duty site.
- Duty hours are limited to eighty (80) hours per week, averaged over a 4-week period, inclusive of all in-house call activities.
- Fellows are provided with one (1) day in seven (7) free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call.
- The training program provides adequate time for rest and personal activities, which consists of a 10-hour time period provided between all daily duty periods and after in-house call.
- Fellows track their duty hours through the RMS System. The duty hours reports are then reviewed by the Program Coordinator for any violations.
- Violators will be notified and required to submit written documentation as to why violation occurred.
Federal regulations mandates that GME programs account for all fellow hours worked in order to maintain Medical Education funding. In addition to these federal regulations, ACGME also mandates programs monitor duty hours to ensure compliance with duty hour requirements. This means that fellows must complete an online timecard of their hours worked in order to be compliant with these mandates and continue funding, accreditation, and flexibility of the program.
Duty hour violations are prohibited. Residents are responsible for making the program aware of impending violations before they occur.
RMS – RESIDENCY MANAGEMENT SUITEThe Minnesota Medical Council of Graduate Medical Education mandates the University of Minnesota use RMS to track resident duty hours. The department also uses RMS as an evaluation tool.
DUTY HOUR APPROVAL POLICY & PROCEDUREAll activities performed by residents during their rotations are documented in an online system called Residency Management Suite (RMS). The data held within RMS is used to document and reconcile payments with the institutions where the fellows/residents rotate. Residents are required to enter their duty hours into RMS weekly and review for accuracy.
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Residents are responsible for making any changes such as; start time, duration, applying activities they participated in and indicating those activities they did not participate in with “Did Not Work”.
Maintaining your duty hours is not only a GME requirement it is also a requirement for the completion of your degree.
Note: Failure to ensure accuracy of your rotation activities will be considered an act of Medicare fraud.
Duty hours are to be entered by 7AM on the first working day of the month. We are granting you the weekend now to get things in order.
All fixes indentified by Program Coordinator must be corrected by the following morning.
If the above do not occur:
Residents and Fellows on a U of M rotation will have their parking privileges revoked beginning the next day and will be in effect until the residency/fellowship office has cleared you.
Fellows will have a letter placed in their permanent file reflecting a lack of professionalism if pattern continues.
Use of the New Innovations Residency Management Suite (RMS)Logging into RMS:
Use your browser to go to www.new-innov.com/login. Internet Explorer is the preferred browser.
Enter MMCGME for the Institution ID.
Enter your User Name and Password in the appropriate boxes.
Make sure that you have arrived at your Welcome Page. You should see your Department name in the upper left section of the screen, and your User Name will be listed just below that.
Duty Hours – Entry and Approval or Modification of Already Entered HoursA) Entry of New Duty Hours
1. From the Main Menu, select Duty Hours.
2. Select the Add Duty Hours link and ensure that Graphical entry is selected. Select the date you wish to enter hours for and click Continue
3. Choose an Assignment from the drop down menu and “paint” in your hours by holding your left mouse button down and dragging across the grid. Click Save regularly to avoid loosing the hours entered.
B) Approval or Modification of Already Entered Hours
1. Select the Approve Existing Hours link.
2. If necessary, enter a date range to restrict the unapproved or conflicting logged Duty Hours to display, and then click the Update Table button.
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3. Where appropriate, place a check in one or more of the checkboxes located to the left of the entries. Then click the Approve Selected Entries or the Did Not Work button.
Note: A red asterisk (*) indicates that the entry conflicts with an existing entry (time periods overlap).
Note: Text in bold red indicates the entry has caused a Duty Hour rule exception.
Note: Hours will not be automatically approved if they were logged for future dates or times, if they conflict with existing logged hours, or if they trigger a Duty Hour exception. Hours that trigger a Duty Hour exception CAN be approved, although you may want to enter an explanation in the Comment box. Conflicting Duty Hour entries must be resolved before the entry can be successfully approved. Duty hours logged for any time in the future cannot be approved.
Tip: Click the Details link to the far right of a entry to see more information about the entry (see second screenshot below).
Tip: Click the Comments link to view, edit, or delete any comments that are associated with the logged hour entry OR to add another (see third screenshot below).
ON-CALL ACTIVITIES
The objective of on-call and night float activities is to provide residents with emergency radiology experience, and is scheduled by the section after approval of the Fellowship Program Director and Chairman.
Radiology fellows are assigned call at UMMC, HCMC and VAMC. Call averages no more than one-in-four, but can change on an as-needed basis. Scheduling of the fellows for call is the direct responsibility of the section with Program Director approval.
ON-CALL ROOMSAn on-call room within the Department of Radiology is available to residents taking departmental call or night float at both UMMC and HCMC, where fellows receive their in-house on-call experience. Any questions or concerns regarding departmental on-call rooms should be directed to your Program Director.
On-call fellows are also eligible to use one of eighteen (18) Mayo Building call rooms provided by UMMC. All rooms have punch code security access changed daily, and a security monitor on duty daily from 2:00 PM – 7:00 AM. All rooms have a desk, television, radio clocks and air conditioning.Check-in can only occur during designated check-in hours: 2:00 PM – 7:00 AM. - Go to the check-in desk located in the Resident Lounge (Mayo C-496). The check-in
desk is staffed by a security monitor during set hours seven (7) days/week and will require you to present your ID badge.
- The security monitor will assign you a room, the room access code, and the locker room and lounge access codes.
- All individuals must be out of their room by 8:00 AM. Housekeeping will begin cleaning by 7:00 AM. If you wish to sleep past 7:00 or 8:00 AM, make sure your “Do Not Disturb” sign is indicated on your door.
SUPPORT SERVICESA full range of patient support services are provided in a manner appropriate to and consistent with educational objectives and patient care. These include but are not limited to Care Management Services, Cardiopulmonary Services, Employee Health Service, Health Information Management, Infection Control, Laboratory Medicine and Pathology, Nursing Administration, Nutrition Services, Patient Relations, Patient Transport, Pharmacy Services, Radiology Film File Services, Rehabilitation Services, Security Services, Social
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Services, Spiritual Health Services, and Shuttle Service between the Riverside and University campuses.
LABORATORY / PATHOLOGY / RADIOLOGY SERVICESFederal and state regulations and regulatory agencies mandate competency validation for testing personnel (including physicians), documentation, quality assurance, quality control, etc. The regulations cover hospitals, clinics, physicians’ offices, nursing homes, and any site where testing is performed. Testing performed by physicians, practitioners, nursing staff, and laboratorians must meet regulatory guidelines. Failure to comply with the mandates can lead to suspension, revocation, or limitation of certification and denial of reimbursement.
MEDICAL RECORDS - HEALTH INFORMATION MANAGEMENTA medical record system that documents the course of each patient’s illness and care is available at all times to support quality patient care, the education of residents, quality assurance activities, and provide a resource for scholarly activity. Additionally a provision of information systems is made for timely retrieval of medical records and radiologic information. To access please contact: UMMC Health Information Management Office at 612-626-3535.
SECURITY / SAFETYSecurity and personal safety measures are provided to fellows at all locations including but not limited to parking facilities, on-call quarters, hospital and institutional grounds, and related clinical facilities (e.g., medical office buildings).
UMMCFairviewCampus
UMMCRiverside Campus
HCMC VAMCUniversityofMinnesota
SECURITY
612-672-4544
612-672-4544
612-873-3232
612-467-2007
612-624-9255
RADIATION BADGESRadiation badges must be worn in controlled radiation areas under penalty of State law. You may be fined by the State Health Department if found not wearing a badge during an inspection.
New badges will be placed in your mailbox at the institution to which you are assigned on the first working day of the month. Always keep your old badges until you get a replacement. Badges from the previous month must be returned to your mailbox by the 8th of each month.
Under University policy, late badges will result in a fine of $50 per badge (unless replacement badges have not arrived in time to make the exchange). The amount of the fine will be deducted from your travel fund; if adequate funds do not remain, the fellow will be billed for the amount owed. Fellows who plan to be away during the exchange period are required to make arrangements with someone to exchange their badges in their absence.
Lost or stolen badges must be reported to Pamela Hansen at 612-626-6638 or [email protected] .
MOONLIGHTINGThis policy does not acknowledge in any way, any departmental acknowledgement of the fellow’s ability to satisfactorily perform any moonlighting activities. Malpractice insurance
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is the responsibility of the fellow involved. Accreditation is up to the party hiring the fellow. Fellows are not required to engage in moonlighting.
Because fellowship education is a full-time endeavor, moonlighting must not interfere with the ability of the fellow to achieve the goals and objectives of the educational program.
Fellows are required to notify the Program Director of their moonlighting activities. They shall email the Program Coordinator the dates, times and locations of all moonlighting activities and will become a part of the fellows file.
Moonlighting activities will not be allowed to conflict with the scheduled and unscheduled time demands of the educational program and its facility.
The fellow’s performance will be monitored for the effect of these activities upon performance and that adverse effects may lead to withdrawal of permission.
Internal moonlighting must be counted toward the 80-hour weekly limit on duty hours.
Fellows on J1 visas are NOT permitted to be employed outside the fellowship program.
A fellow on an H-1B visa wishing to moonlight must obtain a separate H1-B visa for each facility where the fellow works outside the training program.
SUPERVISION / GRADED RESPONSIBILITYAll patient care is supervised by qualified faculty. The Program Director ensures, directs, and documents adequate supervision of fellows at all times. Fellows are provided with rapid, reliable systems for communication with supervising faculty. Fellows are supervised by teaching staff in such a way that the residents assume progressively increasing responsibility according to their level of education, ability, and experience.
On-call schedules for teaching staff are structured to ensure that supervision is readily available to fellows on duty. The teaching staff determines the level of responsibility given to each resident/fellow. Faculty, residents, and fellows are educated to recognize the signs of fatigue and adopt and apply policies to prevent and counteract the potential negative effects.
Fellow participation at all of our institutions is one of active participation under direct (and graded) supervision of full-time teaching staff. However, at all times, final responsibility for patient care resides with the full-time staff. In this manner, the fellows receive excellent training in pediatric radiology with an appropriate degree of responsibility.
STEPS IN EVALUATION PROCESSIn a small program (maximum of 2 fellows per year), evaluation of the fellow’s capabilities and progress is mainly on an informal day-to-day basis, with immediate feedback. Formal written reviews are generated quarterly following one-on-one meetings between the Program Director and the fellow. These quarterly reviews are discussed with the remainder of the faculty both informally and at regular staff meetings. A quarterly review of the fellows’ case logbook will be done as well.
Of course, the performance of graduates of our program in their post-fellowship positions and on the American Board of Radiology’s Certification of Added Qualification in Pediatric Radiology examination will provide additional quantifiable measure of our fellows’ performance
- Monthly and 360 Evaluations: At the end of each clinical rotation, an evaluation of the fellow’s progress is prepared by the faculty member(s) in that area. This is done via RMS. Evaluations are accessible to fellows on-line. Fellows also evaluate their rotations at the end of each clinical rotation and faculty twice annually.
EVALUATION SYSTEM - ELECTRONIC
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This Program has integrated a web-based electronic evaluation system. Evaluations both of and by fellows are essential parts of maintaining our status as an accredited fellowship program and producing superior fellow-physicians. While traditional paper-based systems allow for simple data tracking, they do not provide an easy means for improving the quality of the program. The information obtained from the analysis of evaluation data is instrumental in objectively assessing the quality of all aspects of the fellowship program and for identifying and continuously monitoring areas for improvement.
RMS is a completely web-based computer system that allows us all to enter evaluations, receive rapid feedback, view reports, and compare teaching performance with other programs. The system is highly secure and flexible. Faculty and trainees are expected to complete evaluations on a monthly basis.
The web address for RMS is https://www.new-innov.com. If you experience any problems with logging into, please contact the Program Coordinator at 612-626-5548.
COMPLETING EVALUATIONS IN RMS
• Log into RMS
• Enter your User ID & password – Click “login”
• Click “continue”
• Under the notifications box you will see the number of evaluations you have pending completion. Click the text that reads “complete them”.
• Click the “evaluate” link next to the evaluation you wish to complete; this will bring you to the evaluation.
• NOTE: If you have not worked with the faculty - place a check mark in the box and click “submit selected evaluation as NET”.
1. Login to RMS. From the Main Menu, select Evaluations or click the link in your Notifications box on your Welcome Page.
2. Select the evaluations you wish to complete from the list. For evaluations where you did not spend enough time with the person to warrant an evaluation, place a check mark in the box and click NET.
3. To view your evaluations select Evaluations from the main menu and click View Completed Evaluations.
MONITORING OF RESIDENT WELL-BEINGBoth the Program Director and faculty are sensitive to the need for timely provision of confidential counseling and psychological support services to the fellows.
Fellows feeling fatigued or stressed are encouraged to discuss their concerns with the Program Director, or to contact the (RAP) Resident Assistance Program at 651-430-3383 or 1-800-632-7643, especially if unable to provide safe patient care.
ACLS/BLS/PALS CERTIFICATION REQUIREMENTS
BLS – All residents must remain current on their Basic Life Support Training. ACLS – It is recommended that residents maintain Advanced Life Support Training
Travel
The Department may cover up to three days of expenses for fellows presenting at national meetings. Individuals traveling on University business are covered under the Worldwide
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Travel Accident Policy, providing they have obtained permission to travel before travel begins.
Requests to travel are made via the University’s Travel Authorization form. This form can be obtained from the Travel Services website.
BEFORE THE TRIP :1. Submit complete conference registration form to Program Coordinator along with
department approval documentation for processing.2. Submit proposed flight plan Program Coordinator for processing.3. Fellow is responsible for making travel arrangements.
AFTER THE TRIP: 1. Receipts are required for reimbursements of $25 and above (accept for Per Diem
meals).2. Gather all receipts and submit to Program Coordinator for processing reimbursement. Program Coordinator will contact fellow when the University Employee Reimbursement Form is ready for their signature.
LIBRARIES
INSTITUTIONAL LIBRARIES University of Minnesota Biomedical Library (Diehl Hall)
Hours of operation:Monday through Friday: 7:00 AM – 12:00 AMSaturday: 8:00 AM – 8:00 PMSunday: 12:00 PM – 12:00 AM
DEPARTMENTAL LIBRARIES University of Minnesota Medical Center, Fairview Radiology Department
Eugene Gedgaudas Learning Center, Mayo – Room B-218Hours of operation:
Accessible via combination lock 24 hours per day, 7 days per weekIn addition to the departmental library, there are subspecialty reference books and online access in each reading room.
YOU WILL NOT BE ABLE TO PARTICIPATE IF YOU FAIL TO SUBMIT YOUR DOCUMENTATION
Application Form Confidentiality Agreement Immune Status Form Immunization Documentation – must be current (obtain from Boynton Clinic) Positive mantoux - (obtain from Boynton Clinic) Background check – will be submitted by the program coordinator
Teaching Medical Students
Fellows are an essential part of the teaching of medical students. It is critical that any fellow who supervises or teaches medical students must be familiar with the educational objectives of the course or clerkship and be prepared for their roles in teaching and evaluation. Therefore, we’ve included in this manual the URL to the objectives for the Clerkship(s) specific to our Department as well as the overall Educational Program Objectives.
Educational Program ObjectivesUniversity of Minnesota Medical School
Graduates of the University of Minnesota Medical School should be able to:
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OBJECTIVE OUTCOME MEASURES ACGME ESSENTIAL COMPETENCY
1. Demonstrate mastery of key concepts and principles in the basic sciences and clinical disciplines that are the basis of current and future medical practice.
USMLE Steps 1 and 2 Year 1 and 2 course performance,
based on standardized examinations
Clinical rotation performance Feedback from residency directors
Medical Knowledge
2. Demonstrate mastery of key concepts and principles of other sciences and humanities that apply to current and future medical practice, including epidemiology, biostatistics, healthcare delivery and finance, ethics, human behavior, nutrition, preventive medicine, and the cultural contexts of medical care.
USMLE Steps 1 and 2 Course performance (esp. in Physician
and Society, Nutrition, and Human Behavior at TC campus; Medical Sociology, Medical Epidemiology and biometrics, Family Medicine I, Medical Ethics, Human Behavioral Development and Problems, and Psycho-Social-Spiritual Aspects of Life-Threatening Illness at DU campus)
Clinical rotation performance Feedback from residency directors
Medical Knowledge
3. Competently gather and present in oral and written form relevant patient information through the performance of a complete history and physical examination.
Yr 2 OSCE Physician and Patient (PAP) course
performance at TC campus, assessed by tutors using global rating forms and observed practical exams
Course performance at DU campus in Applied Anatomy, Clinical Rounds & Clerkship (CR & C), Clinical Pathology Conference, and Integrated Clinical Medicine
Clinical rotation performance
Patient Care;Interpersonal and Communication Skills
4. Competently establish a doctor-patient relationship that facilitates patients’ abilities to effectively contribute to the decision making and management of their own health maintenance and disease treatment.
Yr 2 OSCE and Primary Care Clerkship (PCC) OSCE
PAP course performance at TC campus, assessed by tutors using global rating forms and observed practical exams
Preceptorship and CR & C course performance at DU campus
Clinical rotation performance
Patient Care; Interpersonal and Communication Skills
5. Competently diagnose and manage common medical problems in patients.
PCC OSCE Clinical rotation performance
Medical Knowledge;Patient Care
6. Assist in the diagnosis and management of uncommon medical problems; and, through knowing the limits of her/his own knowledge, adequately determine the need for referral.
Clinical rotation performance Documented achievement of
procedural skills in the Competencies Required for Graduation
Medical Knowledge; Patient Care;Practice-Based Learning and Improvement
7. Begin to individualize care through integration of knowledge from the basic sciences, clinical disciplines, evidence-based medicine, and population-based medicine with specific information about the patient and patient’s life situation.
Clinical rotation performance Feedback from residency directors
Patient Care; Medical Knowledge; Interpersonal and Communication Skills; Professionalism
8. Demonstrate competence practicing in ambulatory and hospital settings, effectively working with other health professionals in a team approach towardintegrative care.
Yr 2 and PCC OSCE PAP course performance at TC
campus, assessed by tutors using global rating forms and observed practical exams
Practice-Based Learning and Improvement; Systems-Based Practice
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Physician and Society (PAS) course performance at TC campus
Preceptorship, CR & C, and Introduction to Rural Primary Care Medicine course performance at DU campus
Clinical rotation performance9. Demonstrate basic understanding of health
systems and how physicians can work effectively in health care organizations, including: Use of electronic communication and
database management for patient care. Quality assessment and improvement. Cost-effectiveness of health interventions. Assessment of patient satisfaction. Identification and alleviation of medical
errors.
PAS course performance at TC campus Medical Sociology and CR & C course
performance at DU campus Clinical rotation performance,
especially the PCC Feedback from residency directors Feedback from local health plans
Practice-Based Learning and Improvement; Systems-Based Practice
10. Competently evaluate and manage medical information.
Critical reading exercises in PAS and other courses at TC campus
Clinical Pathology Conference performance and exercises in Problem Based Learning Cases at DU campus
Year 2 Health disparities project PCC EBM project
Patient Care; Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice
11. Uphold and demonstrate in action/practice basic precepts of the medical profession: altruism, respect, compassion, honesty, integrity and confidentiality.
PAS course performance at TC campus Preceptorship and Cr & C course
performance at DU campus Clinical rotation performance Participation in honor code and student
peer assessment program Participation in anatomy memorial Participation in volunteer service
activities
Professionalism
12. Exhibit the beginning of a pattern of continuous learning and self-care through self-directed learning and systematic reflection on their experiences.
PBL cases at DU campus Yr 2 Health disparities project Clinical rotation performance Participation in research
Professionalism
13. Demonstrate a basic understanding of the healthcare needs of society and a commitment to contribute to society both in the medical field and in the broader contexts of society needs.
Course performance in all years Introduction to Rural Primary Care
Medicine course project at DU campus
Involvement of students in international study
Enrollment in RPAP, RCAM, and UCAM
Yr 2 Health disparities project Feedback from residency directors Participation in volunteer service
activities
Patient Care; Medical Knowledge; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice
These objectives are written to reflect the qualities and competencies expected of our graduates. Each objective specifies the expected competency level to be attained by our students, the outcome measures used to evaluate attainment of the objective, and the essential qualities and competencies of a physician (as defined by the six ACGME Essential Competencies) addressed by the objective. The Accreditation Council for Graduate Medical
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Education (ACGME) has formulated essential competencies felt to be necessary for physicians practicing in the current health care climate. They are:
Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide optimal patient care
The objectives for the undergraduate curriculum can be grouped as follows:
Objectives 1-3: Knowledge and skills addressed principally in the first two (preclinical) curricular years;
Objectives 4-9: Knowledge and skills addressed principally in the second two (clinical) curricular years;
Objectives 10-13: Knowledge, attitudes, and skills addressed throughout the curriculum.
The objectives, which relate to the ACGME essential competencies, are designed to be modified for use also by the graduate (GME) programs at the University of Minnesota Medical School. Fellowship programs can modify the competency level stated in the objectives and the outcome measures to reflect their own programs, while maintaining the overall integration of basic learning objectives across undergraduate and graduate medical education.
One of the primary outcome measures for the objectives is clinical rotation performance. To expand on this; clinical rotation performance is assessed by attending physicians and residents using a Web-based global rating form, evaluating the following knowledge, competencies, skills, and attitudes:
Medical knowledge and the ability to apply knowledge in clinical situations Competency in patient care including communication and relationships with
patients/families Skills in data gathering from the history, physical examination, clinical and
academic sources, and diagnostic tests Assessment and prioritization of problems Management of problems, including knowledge of patient data and progress Appropriate decision making Communication in written and oral reports Professionalism, including: patient care and management in teams (work habits),
independent learning, personal characteristics, and commitment to medicine Specific procedural skills (see report outlining Competencies Required for
Graduation)
Ratified by Education Council 2/18/03
SECTION VI. ADMINISTRATION 4/12/2023 30 | P a g e
(Please refer to Institution Policy Manual at http://www.med.umn.edu/gme/residents/parta.html for Medical School Policies on the following: University of Minnesota Physicians, GME Administration Contact List, GME Administration by Job Duty; GME Organization Chart)
UMMC PROGRAM ADMINISTRATION
DIRECTOR & CHAIRMAN: CHARLES DIETZ, JR. M.D.Office:B234 Mayo Bldg
Phone:612.626.3345
Fax:612.626.3366
Pager:612.899.7591
Mail Code:MMC292
Email:[email protected]
PROGRAM DIRECTOR, F. GLEN SEIDEL, M.D.Office:B292 Mayo Bldg
Phone:612.626.4511
Fax:612.626.5580
Pager:612.899.9237
Mail Code:MMC292
Email:[email protected]
PROGRAM COORDINATOR, TRISHA PEDERSONOffice:B292 Mayo Bldg
Phone:612.626.5548
Fax:612.625.5580
Pager:N/A
Mail Code:MMC292
Email:[email protected]
ALRT GRADUATE MEDICAL EDUCATION MANAGER: SALLY SAWYEROffice:763 Mayo Bldg
Phone:612.625.3518
Fax:612.626.2696
Pager:N/A
Mail Code:MMC609
Email:[email protected]
HCMC PROGRAM ADMINISTRATION
ASSOCIATE DIRECTOR: ANOTHONY SEVERT, M.D.Office:2E-20 HCMC
Phone:612.873.2036
Fax:612.904.4567
Pager:612.530.8654
Mail Code:MMC822
Email:[email protected]
PROGRAM COORDINATOR: PAMELA THOMPSONOffice:P4-221 HCMC
Phone:612.873.2036
Fax:612.904.4567
Pager:N/A
Mail Code:P4
Email:[email protected]
PROGRAM COORDINATOR, SHARI JOHNSTONOffice:P4-221 HCMC
Phone:612.873.2718
Fax:612.904.4567
Pager:N/A
Mail Code:P4
Email:[email protected]
VAMC PROGRAM ADMINISTRATION
ASSOCIATE DIRECTOR: HOWARD ANSEL, M.D.Office:1Q-109
Phone:612.725.2038
Fax:612.727.5635
Pager:612.660.7016
Mail Code:114
Email:[email protected]
PROGRAM COORDINATOR: CAROL STEVENSOffice: Phone:
612.467.2929
Fax:612.467.5635
Pager:N/A
Mail Code:114
Email:[email protected]
PARK NICOLLET PROGRAM ADMINISTRATION
DIRECTOR: TBAOffice:
Phone:612.
Fax:612.
Pager:612.
Mail Code:
Email:
PROGRAM COORDINATOR: BARB RICKEOffice: Phone:
952.993.6106
Fax:952.993.0212
Pager:N/A
Mail Code: Email:[email protected]
REGIONS PROGRAM ADMINISTRATION
DIRECTOR: JOSEPH TASHJIAN, M.D.
4/12/2023 31 | P a g e
Email Preferred: [email protected] ROTATION COORDINATOR: DAVID LEE, M.D.Email Preferred: [email protected] COORDINATOR: DEB COLLIEROffice:125
Phone:651.254.3456
Email: [email protected]
SITE CENTRAL CONTACT INFORMATION
UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW
420 DELAWARE STREET SE
MINNEAPOLIS, MN 55455PHONE 612.273.6004FAX: 612.626.3366
HENNEPIN COUNTY MEDICAL CENTER
701 PARK AVE SOUTH
MINNEAPOLIS, MN 55415PHONE 612.873.2036FAX: 612.94.4258
VETERANS ADMINISTRATION MEDICAL CENTER
ONE VETERANS DRIVE
MINNEAPOLIS, MN 55417PHONE 612.725.2038FAX: 612.727.5635
REGIONS HOSPITAL
640 JACKSON STREET
ST. PAUL, MN 55101PHONE 651.221.3793FAX: 651.221.2849
PARK NICOLLET MEDICAL
3800 PARK NICOLLET BLVD.ST. LOUIS PARK, MN 55416PHONE 952.993.6106FAX: 952.993.0212
Addendum I:Goals, Objectives, and Expectations of Fellows
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University of Minnesota Children’s Hospital-FairviewDepartment of Radiology
Division of PediatricsJune 2009
Schedule of Pediatric Radiology Conferences
Conference Frequency Responsible Individual or Service/DepartmentNeonatal Working Rounds Daily Pediatric Radiology Faculty, Fellow, and Resident
ICU & In-Patient Rounds Daily Pediatric Radiology Faculty, Fellow, and Resident
MSK/Ortho Tumor Board Weekly Dr. Hoggard
Pediatric Cardiac Conference Weekly Dr. Hoggard
Pediatric Grand Rounds Weekly Pediatric Radiology Faculty and Fellow
Pediatric Morbid. & Mortality Weekly Dr. Holm
Tumor Board Weekly Dr. Holm
GI & Surgical Conference Bi-Weekly Pediatric Radiology Faculty, Fellow, and Resident
Neuroradiology Conference Bi-Weekly Pediatric Radiology Faculty, Fellow, and Resident
Radiology Res. Conference Bi-Weekly Pediatric Radiology Faculty and Fellow
Pediatric Res. Conference Monthly Dr. Seidel
Radiology Grand Rounds Monthly Pediatric Radiology Faculty, Fellow
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Rad.-Urol.-Nephrol. Rounds Monthly Dr. Seidel
Journal Club Monthly Pediatric Radiology Faculty, Fellow, and Resident
Pediatric Radiology Rotation ScheduleThe fellowship generally consists of twelve months; spending at least one month on each of the following: ultrasound, Body CT/MRI, Fluoroscopy, Plain Films, Nuclear Medicine including PET/CT, NeuroRadiology, and Interventional Radiology. The remaining time will be tailored to the fellow’s interests and/or weaknesses. At least one additional month of plain films and NeuroRadiology will be expected, leaving two months for electives and one month for vacation. The fellow will have one half day a week for academic time.
The rotation schedule is as follows:
Ultrasound 4 weeksX-Ray/Palin Films 4 weeksN.I.C.U. 4 weeksCT/MRI/Cardiac 8 weeksFluoroscopy 4 weeksNuclear Medicine 4 weeksNeuroradiology 8 weeksInterventional 4 weeks Electives 8 weeksVacation 4 weeks
Pediatric Radiology Fellowship Didactic Conference Schedule
Date Rotation LectureWeek 1 Ultrasound Testicles and ovariesWeek 2 Ultrasound Abdominal “Masses”Week 3 Ultrasound Pylorus & BowelWeek 4 Ultrasound TransplantsWeek 1 X-Ray/Plain Films Chest & AirwayWeek 2 X-Ray/Plain Films Musculoskeletal: FracturesWeek 3 X-Ray/Plain Films AbdominalWeek 4 X-Ray/Plain Films MSK TumorsWeek 1 N.I.C.U. ChestWeek 2 N.I.C.U. GI/GUWeek 3 N.I.C.U. Neonatal Head USWeek 4 N.I.C.U. Dysplasias & Metabolic DiseasesWeek 1 CT/MRI/Cardio CT: ChestWeek 2 CT/MRI/Cardio CT Body IWeek 3 CT/MRI/Cardio CT Body IIWeek 4 CT/MRI/Cardio CT Angiogram ProtocolWeek 5 CT/MRI/Cardio Vascular MalformationsWeek 6 CT/MRI/Cardio Musculoskeletal MRIWeek 7 CT/MRI/Cardio Segmental Anatomy of the Heart
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Week 8 CT/MRI/Cardio Radiation Dose ReductionWeek 1 Fluoroscopy Radiation Dosage and TechniqueWeek 2 Fluoroscopy Enemas and Intussusception ReductionWeek 3 Fluoroscopy VCUG Week 4 Fluoroscopy Upper GIWeek 1 Nuclear Medicine Bone scanWeek 2 Nuclear Medicine Thyroid ScintigraphyWeek 3 Nuclear Medicine GI/GUWeek 4 Nuclear Medicine Tumor Imaging and PET CTWeek 1 Neuroradiology NeckWeek 2 Neuroradiology OrbitsWeek 3 Neuroradiology SpineWeek 4 Neuroradiology TraumaWeek 5 Neuroradiology InfectionWeek 6 Neuroradiology Sinuses & Middle EarWeek 7 Neuroradiology Neoplasm& Metabolic DiseaseWeek 8 Neuroradiology Congenital AnomaliesWeek 1 Interventional BiopsyWeek 2 Interventional DrainageWeek 3 Interventional Vascular AccessWeek 4 Interventional GI Access & Tube ManagementWeek 1 Miscellaneous Fetal MRI IWeek 2 Miscellaneous Fetal MRI IIWeek 3 Miscellaneous Cardiac CT and MRI IWeek 4 Miscellaneous Cardiac CT and MRI IIWeek 5 Miscellaneous MR UrographyWeek 6 Miscellaneous MR EnterographyWeek 7 Miscellaneous Imaging Findings after BMTWeek 8 Miscellaneous Pediatric FeetWeek 9 Miscellaneous Pediatric HipsWeek 10 Miscellaneous Pediatric Elbow
READING ROOM/GENERAL RADIOGRAPHY
I. GOALSFellows and Residents will acquire the knowledge, skills, and professionalism necessary for providing quality, appropriate imaging of the pediatric and adolescent patients who present with a need for emergent imaging. They will be able to communicate results to the referring physician.
II. OBJECTIVESFellows and Residents rotate on-call throughout the year and their knowledge base and skills vary according to their experience. The objective of the rotations is to provide important clinical imaging care of infants, children and adolescents who need emergent imaging and to provide results of the imaging in a timely manor.
Fellows and Residents will be able to:1. Be able to interpret imaging procedures on patients including but not limited to recognizing life threatening airway conditions such as croup, recognizing signs of child abuse, trauma patients with injuries, description of fractures and dislocations, and common emergent conditions of the chest and abdomen.2. Be knowledgeable about the clinical protocols for imaging children in ultrasound, radiography, nuclear medicine CT, and MR.3. Be able to effectively multitask and problem solve with clinicians concerning
management decisions and imaging.
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4. Be a valuable consultant and efficiently add on cases to aid treatment or diagnosis.5. Communicate the results to the appropriate individuals.6. Know lines of supervision for on-call issues and use good judgment on when to ask for help.7. Be an active participant in managing trauma cases concerning imaging recommendations and prioritizing cases appropriately.8. Understand the unique clinical situations and significance of diseases of the newborn, infant, child, and adolescent as it applies to emergency imaging.9. Understand the appropriate us of imaging in the evaluation of childhood and adolescent diseases who present with acute and sometime chronic conditions.10. Be able to us on-line resources including www.fairview.org and the Radiology homepage for specific issues that relate to departmental function and or safety issues.
III. LEARNING EXPECTATIONS
A. MEDICAL KNOWLEDGE1. Learn the systems and procedures that support emergency radiology at University of Minnesota Medical Center-Fairview2. Learn the support systems in the department when there are questions including but not limited to the web base, exam preps, protocol books, and others.3. Learn the common and unusual patterns of injury as well as normal variants of skeletal radiology4. Learn findings of child abuse and reporting mechanisms5. Know protocols for emergency imaging6. ACLS/BCLS certification7. Knowledge of contrast reactions and their treatment 8. Learn approach and differential of neonatal emergencies9. Learn approach, and differential of neurological emergencies10. Have knowledge and skills concerning placement of G tubes, or NJ tubes as requested.11. With chest/abdominal imaging, be able to identify the position of various catheters, tubes, lines and inserted monitors such as ph probes.12. Understand appropriateness of imaging the child with abdominal pain 13. Understand low dose techniques or strategies which may be useful in children14. Understand when emergency MRI studies are useful in patient management
B. PATIENT CARE1. Consider requests for add on exams, and work effectively with the health care team to advance and prioritize the diagnostic workup of children who present with acute problems2. Provide safe environment by following standard procedures according to the Procedures and Policy Statements3. Always wash your hands or use the gels before or after touching a patient.4. Avoid using unapproved abbreviations (such as cc, etc.)5. Use “stop” techniques when and where appropriate6. Dictate in a timely manor. All images must be seen by faculty as well as the dictated report. 7. Recheck the correct sidedness of the patient.8. Where appropriate learn significant past history from the chart, the parent or directly from the family.9. Obtain informed consent from patients when indicated 10. Assist in difficult fluoroscopic procedures 11. Perform basic fluoroscopy/IVU with minimal assistance 12. Procedural competency: each of these studies should be done with a faculty
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member and documented. a. Intussusceptions (3 cases)b. Testicular or ovarian torsionc. Place NJ tubed. Placement of G tube or G tube exchangee. Neonatal obstruction with contrast studyf. UGI to rule out malrotationg. Pyloric stenosis USh. Imaging following liver transplanti. CT trauma cases (3)
C. COMMUNICATION1. Must work to insure an accurate dictated report in a timely manor2. For urgent or emergent studies, direct phone to physician or service caring for the patient, with documentation in the report.3. If there is a change in interpretation after reviewing with staff, notify ordering physician of the change and document the notification in the report.4. Must work with the health care team including the technologists, secretarial support for add on cases, necessary information and preparation for emergency cases.5. Know supervisory lines of responsibilities every time one is on call6. Must recognize and call others for support when the fellow is not well, excessively tired and not able to function or needs help in dealing with difficult or unusual case material. 7. Must prioritize the needs of trauma cases or emergency studies8. Must be able to delegate to the residents, faculty, or ancillary help so the effective and appropriate studies can be done. 9. Consultation with ER, or primary service10. Function as primary consultant to ER/Referring physician concerning emergency imaging 11. Patient communication skills at attending level12. Thorough knowledge of case presentation including procedure and outcome13. Presentation of trauma and emergency imaging at case conference.
D. PROFESSIONALISM1. Helpful, appropriate Interaction with attending, ER and resident staff2. Understands concept of patient confidentiality 3. Demonstrates ethical behavior 4. Demonstrates sensitivity to diversity of patient background 5. Know “professionalism” as it is described in handbook6. Always introduce yourself to parent, patient or health care team when doing procedures on patient7. Always inquire about the special needs of the patient8. Always respect the ethnic, economic, religious diversity of the families we serve9. Familiarity with HIPPA requirements10.Avoid negative comments concerning other health care provider
E. SYSTEMS BASED PRACTICE1. Understands how radiology fits into the system of caring for the patient, making the correct diagnosis and helping to improve outcomes.2. Understand appropriateness of imaging guidelines from standard protocols such as ACR or from the department3. Understand best practices and exhibit and promote positive attitudes and behaviors which enhance care4. Always try to create a safe environment and endorse the JCAHO, institution guidelines for a safe environment5. Works to improve systems not only within radiology but with the referring
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physicals or patients.
F. PRACTICE BASED LEARNING1. Reports errors or “Near miss” occasions so as to prevent harm. 2. Improvement in patient care through cognitive knowledge, observational skills, procedural skills and feedback.3. Applies principles of evidence based medicine.4. Critically uses on line resources for information.5. Participates in QC & QA.6. Effectively promotes learning with students, residents, and other healthcare professionals. 7. Directs learning of other residents students and healthcare professionals
IV. EXPECTATIONS OF PERFORMANCE1. The expectation is that the fellow will arrive on time or at least contact the faculty member if there is a delay.2. Connect with the other fellow or faculty member for ongoing studies, and know the importance of “hand-off”
cases3. Quickly update ones knowledge concerning ongoing studies, urgent cases, and the need to plan to meet the
needs of the emergency cases.4. Work with the resident/faculty to insure coverage. Verbalize any issues5. At night, dictate the cases with the faculty member, communicate any changes in interpretation.6. Delegate some interesting cases to the resident. Work with him as he learns
V. EVALUATION1. There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section or designee.3. 360ْ Fellow Evaluations
FLUOROSCOPY
I. GOALSFellows and residents will acquire the knowledge, skills, and attitude necessary for providing quality fluoroscopic imaging of pediatric and adolescent patients.
A. MEDICAL KNOWLEDGE1. Learn the systems and procedures that support emergency fluoroscopy at University of Minnesota Medical Center-Fairview2. Learn the support systems in the department when there are questions including but not limited to the web base “whose on call”, normal findings, fluoroscopy protocol books, and others.3. Learn the common and unusual patterns of fluoroscopic abnormality as well as normal variant fluoroscopic findings of the GI and GU tract4. Learn findings of child abuse and reporting mechanisms5. Know protocols for fluoroscopic imaging exams6. ACLS/BCLS certification7. Knowledge of contrast reactions and their treatment 8. Learn approach and differential of neonatal bowel emergencies9. Learn approach, and differential of bowel obstruction in children10. Have knowledge and skills concerning placement or replacement of G, GJ,
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or NJ/OJ tubes.11. Be able to identify the position of various catheters, tubes, inserted monitors such as ph probes
and modify enteric tubes or pH probes appropriately.12. Understand appropriateness of imaging the child with abdominal pain 13. Understand low dose fluoroscopic techniques or strategies in children Understand appropriate contrast material selection in upper & lower GI studies
B. PATIENT CARE1. Consider requests for add on exams, and work effectively with the health care team to advance and prioritize the diagnostic workup of children who present with acute problems2. Provide safe environment by following standard procedures according to the Procedures and Policy Statements3. When appropriate, utilize child life specialists to manage patients and families needing this assistance to facilitate exam safely and with patient’s best interest in mind.4. Always wash your hands or use the gels before or after touching a patient.5. Avoid using unapproved abbreviations (such as cc, etc.)6. Use “stop” techniques when and where appropriate7. Dictate in a timely manor. All images must be seen by faculty as well as the dictated report. 8. Recheck the correct sidedness of the patient.9. Where appropriate learn significant past history from the chart, the parent or directly from the family.10. Obtain informed consent from patients when indicated 11. Seek assistance if required in difficult fluoroscopic procedures 12. Perform basic fluoroscopy/IVU independently. 13. Obtain H & P when needed for procedures14. Knowledge of ACLS/BCLS15. Knowledge of contrast reaction and treatment 16. Procedural competency: each of these studies should be done with a faculty member and documented.
a. Intussusceptions (3 cases)b. Placement of NJ tubec. GJ tube exchanged. Neonatal obstruction with contrast studiese. UGI to rule out malrotationf. VCUGg. IVPh. Distal colostogram in patient with anorectal malformation
C. COMMUNICATION1. Must work to insure an accurate dictated report in a timely manor2. For urgent or emergent studies, direct phone to physician or service caring for
the patient, with documentation in the report.3. Fellows and Residents must acknowledge using the terminology: Significant change in interpretation…..if there is a change, and also document who was notified and when there was notification of the change.4. Must work with the health care team including the technologists and secretarial support for add on cases, obtaining necessary information and preparation for emergency cases.5. Must know how to use the available resources on the web, procedure preps, etc to facilitate cases.6. Must recognize and call others for support when requiring help in dealing with difficult or unusual case material. 7. Must prioritize the needs of trauma cases or emergency studies8. Must be able to delegate to the residents, faculty, or technologists for help so that effective and appropriate studies can be done.
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9. Consultation with ER, or primary service10. Function as primary consultant to ER/referring physician concerning emergency imaging 11. Patient communication skills at attending level12. Thorough knowledge of case presentation including procedure and outcome.13. Presentation of fluoroscopic imaging at Monday conference.
D. PROFESSIONALISM1. Helpful, appropriate Interaction with attending, ER and resident staff.2. Understand concept of patient confidentiality. 3. Demonstrates ethical behavior. 4. Demonstrate sensitivity to diversity of patient background. 5. Know “professionalism “as it is described in handbook;6. Always introduce yourself to parent, patient or health care team when doing procedures on patient.7. Always inquire about the special needs of the patient8. Always respect the ethnic, economic, and religious diversity of the families we serve.9. Familiarity with HIPPA requirements.10. Avoid negative comments concerning other health care providers.
E. SYSTEMS BASED PRACTICE1. Understanding how radiology fits into the system of caring for the patient, making the correct diagnosis and helping to improve outcomes.2. Understand appropriateness of imaging guidelines from standard protocols such as ACR or from the department3. Understand best practices and exhibit and promote positive attitudes and behaviors which enhance care4. Always try to create a safe environment and endorse the JCAHO, institution guidelines for a safe environment5. Report errors or “Near miss” occasions so as to prevent harm 6. Work to improve systems not only within radiology but with the referring physicals or patients.
F. PRACTICE BASED LEARNING1. Improvement in patient care through cognitive knowledge, observational skills, procedural skills and feedback2. Applies principles of evidence based medicine3. Critically uses on line resources for information4. Participates in QC & QA5. Effectively promotes learning with students, residents, and other healthcare professionals 6. Directs learning of other fellows, residents, students and healthcare professionals
II. EXPECTATIONS OF PERFORMANCE1. The expectation is that the fellow will arrive on time or at least contact the faculty member if there is a delay.2. The fellow will review lines of responsibility from website.3. Connect with the other fellow or faculty member for ongoing studies, and know the importance of “hand-off” cases4. Quickly update ones knowledge concerning ongoing studies, urgent cases, and the need to plan to meet the needs of the emergency cases.5. Work with the resident/faculty to insure coverage. Verbalize any issues.6. At night, dictate the cases with the faculty member, communicate any changes in interpretation.7. Delegate some interesting cases to the resident. Work with him/her as he/she
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learns.
III. EVALUATION1. There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section Or designee.3. 360ْ Fellow Evaluations
ULTRASOUND
I. GOALSFellows and Residents will acquire the knowledge, skills and attitude necessary for providing quality ultrasound imaging of pediatric and adolescent patients.
A. PATIENT CARE1. Be actively involved in patient care that is provided during ultrasound rotation both with outpatient and inpatient children.2. Review the days schedule and the appropriateness of the requested examinations3. Where appropriate, learn significant past history from the chart, the parent or directly from the family.4. Discuss unusual cases with staff and divide scanning of cases with staff.5. Perform hands on scanning as much as time allows6. Personally check portable/exams including ICU cases at the bedside when requested.7. Participate in fetal ultrasound rotation, as elected8. Provide safe environment by following standard procedures according to the Procedures and Policy Statements9. Always wash your hands or use the gels before or after touching a patient.10. Avoid using unapproved abbreviations (such as cc, etc.)11. Dictate in a timely manor. All images must be seen by faculty as well as the
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dictated report. 12. Recheck the correct sidedness of the patient.
Clinical responsibilities include. 1. Be physically present in ultrasound, except during AM conference, noon conference, and specialty
conferences. 2. Review the days schedule; review the appropriateness of the requested exams3. Look at portable list of ultrasound studies. Be familiar with the reason why the study is being done and
other clinical history which will aid the diagnosis.
B. INTERPERSONAL AND COMMUNICATION SKILLS1. Work professional and effectively with the technologists2. Communicate findings effectively with the referring clinicians3. Must work to insure an accurate dictated report in a timely manor4. For urgent or emergent studies, direct phone to physician or service caring for the patient, with documentation in the report.5. Demonstrate respect, compassion and integrity6. Commit to excellence and on going professional development7. Demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
C. PROFESSIONALISM1. Understands concept of patient confidentiality 2. Demonstrates ethical behavior 3. Know “professionalism” as it is described in handbook;4. Always introduce yourself to parent, patient or health care team when doing procedures on patient5. Always inquire about the special needs of the patient6. Always respect the ethnic, economic, religious diversity of the families we serve7. Avoid negative comments concerning other health care providers
D. SYSTEM-BASED PRACTICE1. Understanding how ultrasound fits into the system of caring for the patient, making the correct diagnosis and helping to improve outcomes.2. Understand appropriateness of imaging guidelines from standard protocols such as ACR or from the department3. Understand best practices and exhibit and promote positive attitudes and behaviors which enhance care4. Always try to create a safe environment and endorse the JCAHO, institution guidelines for a safe environment5. Report errors or “Near miss occasions” so as to prevent errors6. Work to improve systems not only within radiology but with the referring physicals or patients.
E. PRACTICE BASED LEARING1. Improvement in patient care through cognitive knowledge, observational skills, procedural skills and feedback2. Applies principles of evidence based medicine3. Critically reviews literature 4. Participates in QC & QA5. Effectively promotes learning with students, residents, and other healthcare professionals 6. Directs learning of other residents students and healthcare professionals.
F. EXPECTATIONS OF PERFORMANCE1. The expectation is that the fellow or resident will arrive on time or at least
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contact the faculty member if there is a delay.2. The fellow or resident will review ultrasound schedule3. Connect with the other fellow or faculty member for ongoing studies, and know the importance of “hand-off” cases4. Quickly update ones knowledge concerning ongoing studies, urgent cases, and the need to plan to meet the needs of the emergency cases.5. If resident or medical student is present, try to spend time teaching and/or tell them where they can learn about specific conditions.6. At night, dictate the cases with the faculty member, communicate any changes in interpretation.
II. OBJECTIVESFellows and residents will acquire the knowledge, technical skills, interpersonal skills, communications skills and team approach for providing quality ultrasound imaging of the pediatric and adolescent patient.
At the end of the year, the fellow should be able to: 1. Understand the appropriate use of sonography in the evaluation of the fetus, infant, childhood and adolescent diseases in the contact of routine and emergency imaging.2. Be able to interpret routine ultrasound imaging studies and to dictate using PowerScribe in timely manor. Dictations should have the key elements of the clinical history, past relevant history, current study, and interpretation. Pre-set dictations may be used particularly with adolescent pelvis or imaging the fetus. 3. Imaging studies that need to be mastered include renal, abdomen, pelvis, right lower quadrant, scrotal, infant head, extremity vascular Doppler, liver and kidney transplant, hip for developmental dysphasia, hip for fluid, and infant spine studies4. Be capable of performing some emergency studies such as but not limited to the pylorus, scrotal for rule out torsion, hip for effusion, pleural effusions, and vascular Doppler of transplants. Be familiar with the ultrasound equipment and also the standard views that are routinely obtained.5. Understand the uses and limitations of sonography in childhood and adolescent diseases. 6. Learn to utilize the on-line resources to enhance knowledge of conditions seen daily. ETEACH is also a good resource of case. This is best accomplished when you "need to know” something or “just in time learning”, or you wish to see additional case material.7. Learn approach and differential diagnoses of neonatal emergencies8. Learn approach, and differential diagnoses of neurological emergencies9. Be able to interpret imaging procedures on patients but not limited to recognizing life threatening airway conditions, child abuse, description of fractures, Salter classifications.10. Understand low dose techniques or strategies which may be useful in children11. Understand when emergency MRI studies are useful in patient management12. Put at least 2 cases per rotation in the teaching file during rotation.
III. EVALUATION1.There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section or designee.3. 360ْ Fellow Evaluations
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BODY IMAGING CT/MRI
I. GOALSFellows and Residents will acquire the knowledge, skills, and attitude necessary for providing quality body imaging of pediatric and adolescent patients.
A. PATIENT CAREFellows and Residents must be able to provide patient care that is compassionate, appropriate and effective for the diagnosis and treatment of health problems. Fellows and Residents are expected to:
1. Demonstrate caring and respectful behaviors when interacting with patients and their families2. Prescribe CT protocols pertinent to the body part being imaged and to the diagnostic question being asked.3. Prescribe MR protocols pertinent to the cardiovascular and musculoskeletal systems and body organs to the
diagnostic question being asked.4. Demonstrate knowledge of CT and MR radiation safety guidelines and contrast safety.5. Be physically present in the reading room except during teaching conferences.6. Review the day’s CT schedule and review the appropriateness of the requested examinations.7. Protocol the scheduled exams and monitor examinations while the imaging is being performed.8. Review cases with the staff and dictate.
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B. MEDICAL KNOWLEDGEFellows and Residents must demonstrate knowledge about established and evolving biomedical, clinical and cognate sciences and the application of this knowledge to patient care:
1. Understand the indications, contraindications and role of CT/MR in body, cardiovascular, and musculoskeletal imaging in pediatric patients.
2. Learn the anatomy and the more common pathologic processes, post surgical appearance, physiology and natural history of postoperative course involved in pediatric patients as it pertains to cardiovascular, oncologic, GI, GU, and orthopedic imaging.
3. Become familiar with body, cardiovascular, and musculoskeletal CT and MR protocols.4. Become familiar with the use and timing of contrast in CT and MR.5. Learn the differences between MR imaging at 1.5 and 3T.6. Become familiar with principle of Phase Contrast measurement of flow, gated CTA, MRCP with secretin, MR urography, and MR enterography. 7. Understand the importance of low-dose techniques in pediatric Body CT and how to implement these techniques.8. Gain a further understanding of MR physics, particularly in relation to its application in daily imaging, protocol design, image contrast, image acquisition and MR sequences.9. Put at least 2 cases per week in the Teaching File while scheduled in CT/MR.
C. PRACTICE BASED LEARNING AND IMPROVEMENTFellows and Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices. Fellows and Residents are expected to:
1. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic effectiveness of CT/MRI.2. Use information technology to manage information, access on-line medical information, and support their
own education.3. Facilitate the learning of students, residents, and other health care professionals.4. Locate, appraise and assimilate evidence from scientific studies about body, Cardiovascular, and musculoskeletal CT/MR in pediatric patients.
D. INTERPERSONAL AND COMMUNICATION SKILLSFellows and Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange with technologists, referring physicians and other medical personnel. Fellows and residents are expected to:
1. Gather essential and accurate medical and radiologic history pertinent to the procedure for which the patient is scheduled including, where appropriate, speaking to the patient, the patient’s family, and the referring physician.
2. Work professionally and effectively with the CT/MR technologists3. Communicate findings effectively with the referring clinicians.4. Communicate and document the communication of critical findings with the appropriate medical personnel in a timely fashion.
E. PROFESSIONALISMFellows and Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient and professional population. Fellows and Residents are expected to:
1. Demonstrate respect, compassion and integrity.2. A commitment to excellence and on-going professional development.3. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care,
confidentiality of patient information and business practices.
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F. SYSTEMS-BASED PRACTICEFellows and Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide that which is optimal value. Fellows and Residents are expected to:
1. Be familiar with the resources of the department of Radiology and other specialties in the diagnosis and care of children.
2. Understand how their professional practice affects other health care professional, the health care organization and the larger society and how these elements affect their own practice.
3. Assist referring clinicians in providing cost effective healthcare.4. Practice cost effective health care and resource allocation that does not compromise quality of care.
II. OBJECTIVESAt the conclusion of this rotation fellow will be able to:
1. Adequately protocol imaging studies which are appropriate to specific clinical conditions and diseases.2. Be knowledgeable about how to interpret imaging of common clinical conditions in children.3. Be able to provide timely and accurate reports on emergent or clinical significant findings to correct referring doctor.4. Provide a safe environment by being knowledgeable about the relevant clinical history, the renal status if contrast is being used, and the appropriateness of imaging.5. In MR imaging following the guidelines established for a safe environment.6. Consider low dose radiologic techniques when imaging with CT/MR and/or alternative imaging modalities.7. Understand the appropriate use of body imaging in the evaluation of childhood and adolescent diseases.8. Be able to perform and interpret body, cardiovascular, and musculoskeletal imaging studies.9. Understand the uses and limitations of body, cardiovascular, and musculoskeletal imaging in childhood and adolescent diseases.
III. EVALUATION1. There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section or designee.3. 360ْ Fellow Evaluations
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NEUROIMAGING
I. GOALSFellows and residents will acquire the knowledge, skills, and attitude necessary for providing quality neuroimaging of pediatric and adolescent patients.
A. PATIENT CAREFellows and Residents must be able to provide patient care that is compassionate, appropriate and effective for the diagnosis and treatment of health problems. Fellows and Residents are expected to:
1. Familiarize themselves with neuro CT and MRI protocols.2. Be physically present in the Neuroradiology reading room(s) except during teaching conferences or other
excused absences3. Review the day’s schedule and assess the appropriateness of requested studies. Review previous studies on
patient prior to examination, and discuss unusual cases with staff.4. Understand the appropriate use of imaging in the neurologic evaluation of childhood
and adolescent diseases.5. Monitor neuroimaging studies as they are being performed.6. Review cases with staff and dictate those cases.
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7. Review cases/requests with consulting physicians8. Educate visiting physicians, housestaff, medical students, and residents
While on-call, the following expectations are to be met:
1. Obtain required information for emergency cases. Review appropriateness of imaging request, including a review of previous studies.
2. Interpret study and dictate a preliminary report. Verbally communicate preliminary reports as requested.3. Check with neuroradiology faculty the following morning to identify any changed interpretations.
B. MEDICAL KNOWLEDGEFellows and Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate sciences and the application of this knowledge to patient care. During this rotation, fellows and residents are expected to:
1. Further enhance knowledge of brain, spine, and neurovascular anatomy2. Put at least two cases per week in the Teaching File while scheduled in Neuro CT/MRI.3. Understand the pathophysiology and significance of neurologic diseases of the newborn, infant, child and
adolescent.4. Become familiar with commonly occurring neural disease processes in the pediatric population and their
CT and MRI imaging manifestations including: Traumatic brain injury Subarachnoid hemorrhage Intracranial mass lesions Cerebral ischemia / Infarction Spinal fractures and dislocations
5. Further enhance knowledge of neck soft tissue anatomy6. Further enhance knowledge of temporal bone anatomy7. Further enhance knowledge of ENT pathologic processes including
Neck masses, locations, spaces Inflammatory conditions Life-threatening airway compromise
8. Become familiar with emergent MRI scenarios including: Sinus Thrombosis Acute Stroke Spine Trauma Neoplastic Spinal Cord Compression
9. Review suggested books
C. PRACTICE BASED LEARNING AND IMPROVEMENTFellows and Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices. Fellows and Residents are expected to:
1. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on the diagnostic effectiveness of Neuroradiology Studies and their role in the clinical care of the patient.
2. Use information technology to manage information, access on-line medical information and support their own education.
3. Facilitate the learning of residents, students and other health care professionals.4. Locate, appraise and assimilate evidence from scientific studies.
D. INTERPERSONAL AND COMMUNICATION SKILLSFellows and Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange with technologists, referring physicians and other medical personnel. Fellows and Residents are expected to:
1. Work professionally and effectively with the technologists.
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2. Communicate findings effectively with the referring clinicians.3. Communicate and document the communication of critical findings with the appropriate medical personnel
in a timely fashion.
E. PROFESSIONALISM Fellows and Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient and professional population. Fellows and Residents are expected to:
1. Demonstrate respect, compassion and integrity.2. Commit to excellence and on-going professional development.3. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care,
confidentiality of patient information and business practices.4. Demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
F. SYSTEMS BASED PRACTICEFellows and Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide that which is of optimal value. Fellows and Residents are expected to:
1. Understand how their professional practice affects other health care professionals, the health care organization and the larger society and how these elements affect their own practice.
2. Assist referring clinicians in providing cost effective healthcare.3. Practice cost effective health care and resource allocation that does not compromise quality of care.
II. OBJECTIVESAt the conclusion of this rotation, fellows will be able to:1.Understand the pathophysiology and significance of neurologic diseases of the newborn, infant, child, and adolescent.2. Understand the appropriate use of imaging in the neurologic evaluation of childhood and adolescent diseases.3. Be able to perform and interpret neuroimaging studies of the pediatric and adolescent patient.4. Understand the uses and limitations of neuroimaging in childhood and adolescent diseases.5. Describe the physics if CT/MRI imaging.6. Perform the sedation for CT/MRI neuroimaging studies.
III. EVALUATION1.There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section or designee.3. 360ْ Fellow Evaluations
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NUCLEAR MEDICINE
I. GOALSFellows and Residents will acquire the knowledge, skills, and attitude necessary for providing quality nuclear medicine imaging of pediatric and adolescent patients.
A. PATIENT CAREFellow and Residents must be able to provide patient care that is compassionate, appropriate, effective, and safe for the diagnosis and treatment of pediatric clinical diseases as they relate to performance of nuclear medicine during their rotations or on call. Fellows and residents are expected to:
1. Communicate effectively and demonstrate caring and respective behaviors when interacting with patients, families and the referring physician.
2. Seek appropriate clinical information in planning the performance of the study to maximize information. This is particularly true for congenital heart patients.
3. Review prior imaging studies to gain insight into the clinical issues 4. Gather essential and accurate medical and history which may improve interpretation pertinent to the
Nuclear Medicine study5. Work with the health care professional, including those from other disciplines to provide patient focused
care.
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B. PRACTICE BASED LEARNING AND IMPROVEMENTFellows and Residents must be able to review their cases, dictate them, and evaluate their own performance with continuous feedback from faculty members. They need to evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices. Fellows and Residents are expected to:
1. Review the imaging protocols and apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information of the diagnostic effectiveness of Nuclear Medicine Studies and their role in the clinical care of the patient.2. Use information technology to manage information, access on-line medical information and support their own education.3. Facilitate the learning of residents and other health care professional.4. Utilize best practices in planning for studies.
C. INTERPERSONAL AND COMMUNICATION SKILLS1. Work professionally and effectively with the technologists.2. Communicate findings effectively with the referring clinicians.3. Communicate and document the communication of critical findings with the appropriate medical personnel in a timely fashion.
D. PROFESSIONALISMFellows and Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient and professional population. Fellows and Residents are expected to:
1. Demonstrate respect, compassion and integrity.2. Commit to excellence and on-going professional development.3. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information and business practices.4. Demonstrate sensitivity and responsiveness to patients’ culture, age, gender and
disabilities.
E. SYSTEMS BASED PRACTICEFellows and Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide that which is of optimal value. Fellows and Residents are expected to:
1. Understand how the professional practice of nuclear medicine provides information for the clinician in caring for infants, children and young adults. 2. Assist referring clinicians in ordering appropriate nuclear medicine studies according to clinical imaging guidelines3. Practice cost effective health care and resource allocation that does not compromise quality of care.4. How results of nuclear medicine studies must be communicated in a timely fashion to facilitate the care of
patients.
II. OBJECTIVESAt the conclusion of this rotation, fellows and residents will be able to:
1. Understand the pathophysiology and significance of diseases of the newborn, infant, child and adolescent, as related to nuclear medicine imaging.
2. Understand the appropriate use of nuclear medicine imaging in the evaluation of childhood and adolescent diseases.
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3. Be able to perform and interpret nuclear medicine imaging of the pediatric and adolescent patient including the bone scan, nuclear cystogram, renal cortical scan, diuretic renal study, PET/CT, MIBG scan, lung perfusion and ventilation scans, thyroid scan, and GE reflux/gastric emptying scan.
4. Understand the uses and limitations of 2-D-quantitation and 3-D image reconstruction of nuclear studies in childhood and adolescent diseases.
III. LEARNING EXPECTATIONS Each nuclear medicine study should be reviewed by the fellow and then dictated. The faculty will review the cases with the fellow or resident and the written report. 1. Radiopharmaceutical dosage schedules2. Technical details for performance of commonly performed techniques
Bone scanNuclear cystogramRenal cortical scanDiuretic renal studyGastroesophageal reflux/gastric emptying scanThyroid ScanVentilation Perfusion Scan
3. Technical details of additional techniquesHepatobiliary imagingLung imagingAdrenal imagingMeasurement of renal functionMeckel diverticulum imaging
4. Technical details of SPECT imaging and pinhole imagingBrain SPECTKidney SPECTSpine SPECTMIBG planar and SPECT imagingPinhole renal imagingPinhole hip imagingPinhole thyroid imagingPET/CT body imagingPET brain imaging
5. Technical Details of SPECT CT studies6. Interpretation of these studies7. Review the teaching file cases and other audiovisual materials.8. Take any self-assessment tests that are available and appropriate for residents.9. Read appropriate background materials in pediatric nuclear medicine.10. Put at least one case per week in the pediatric Nuclear Medicine teaching file.11. Present a case at each “resident/fellow” Interesting Case Conference.
IV. EVALUATION1. There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section or designee.3. 360ْ Fellow Evaluations
V. RADIATION SAFETY ISSUES
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By regulation all radioactive materials (RAM) workers, which include the radiology fellows and residents, must train once a year. Each fellow must attend an annual re-training session.
VASCULAR & INTERVENTIONAL
I. GOALSFellow and residents will acquire the knowledge, skills, and attitude necessary for providing quality interventional studies of pediatric and adolescent patients.
A. PATIENT CAREFellows and residents must be able to provide patient care that is compassionate, appropriate and effective for the diagnosis and treatment of health problems. Fellows and residents are expected to:
Pre-Procedure:1. Review the next day’s schedule, evaluate for the appropriateness for the studies, and familiarize themselves with the procedures to be performed.2. Obtain informed consent from the patient and/or legal guardians. The subject matter for the informed consent should be discussed with staff. Ideally, this should be done the day before the procedure. If not, the fellow must be sure that
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the legal guardian will be arriving with the patient on the day of the procedure. A pre-procedure note documenting indication and risks must be written in the patient’s chart prior to beginning case.3. See the patient on the morning of the examination, establishing that all pertinent laboratory examinations have been ordered and are within normal limits, and establish that the patient has received any needed pre-procedure antibiotics.4. Be available as a consultant to referring physicians when physicians either want to schedule a procedure or have questions about whether an Interventional Radiology (IR) procedure is indicated. Availability to confirm PICC line position or to help with placement is expected
Procedure: 1. Perform all appropriate procedures with the radiology staff assigned to IR. 2. Assist in all other procedures, where needed, with the staff assigned to IR.
Post-Procedure:1. Enter orders for post procedure care in ICIS.2.Write a post-procedure note in the medical chart, explaining the procedure performed and the result of the procedure.3. Page the referring physician with pertinent results.4. See the patient later during the day of the procedure and writing a note in the chart5. Review the case with the staff radiologist who performed the procedure and then dictating the case 6. Arrange follow up where indicated.
B. MEDICAL KNOWLEDGEFellows and residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate sciences and the application of this knowledge to patient care. During this rotation, fellows and residents are expected to:
1. Develop an understanding of the pathophysiology and significance of vascular diseases of the newborn, infant, child and adolescent.
2. Develop an understanding of the appropriate use and limitations of vascular interventional studies in the evaluation and treatment of childhood and adolescent diseases.
3. Become familiar with all IR procedures including angiography, venography, PICC’s nephrostomy tube placement and care, feeding tube management, abscess drainage, and percutaneous biopsy. Specific considerations for the pediatric patient are to be emphasized.
4. Review the IR teaching file and contribute one teaching file case per IR rotation.5. Learn the specifics of operating the Philips IR room and all emergency equipment associated with its use.6. Learn the use of ultrasound, fluoroscopy, and computerized tomography in the guidance of percutaneous
procedures.7. Become familiar with the choices of catheters, needles, guidewires, etc., used in IR.8. Learn about safe sedation of patients for IR procedures.
C. PRACTICE BASED LEARNING AND IMPROVEMENTFellows and residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices. Fellows and residents are expected to:
1. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information regarding the diagnostic and therapeutic effectiveness of IR Studies and their role in the clinical care of the patient.2. Use information technology to manage information, access on-line medical information and support their own education.3. Facilitate the learning of residents, students and other health care professional.
4. Locate, appraise and assimilate evidence from scientific studies.
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D. INTERPERSONAL AND COMMUNICATION SKILLSFellows and residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange with technologists, referring physicians and other medical personnel. Fellows and residents are expected to:
1. Work professionally and effectively with the technologists.2.Communicate findings effectively with the referring clinicians.3.Communicate and document the communication of critical findings with the appropriate medical personnel in a timely fashion.
E. PROFESSIONALISMFellows and residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient and professional population. Fellows and residents are expected to:
1. Demonstrate respect, compassion and integrity.2. Commit to excellence and on-going professional development.3. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information and business practices.4. Demonstrate sensitivity and responsiveness to patients’ culture, age, gender and disabilities.
F. SYSTEMS BASED PRACTICEFellows and residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide that which is of optimal value. Fellows and residents are expected to:
1. Understand how their professional practice affects other health care professionals, the health care organization and the larger society and how these elements affect their own practice.2. Assist referring clinicians in providing cost effective healthcare.3. Practice cost effective health care and resource allocation that does not compromise quality of care.
II. OBJECTIVESAt the conclusion of this rotation, fellows and residents will be able to:
1. Understand the pathophysiology and significance of vascular diseases of the newborn, infant, child, and adolescent.2. Understand the appropriate use of vascular interventional studies in the evaluation and treatment of childhood and adolescent disease.3. Perform and interpret interventional studies of the pediatric and adolescent patient including angiography, venography, PICC and nephrostomy tube placement and care, feeding tube management, abscess drainage, and percutaneous biopsy.4. Understand the uses and limitations of interventional procedures in childhood and adolescent diseases.5. Perform sedation on pediatric patients for vascular and interventional procedures.
III. EVALUATION1.There will be ongoing immediate feedback by staff physicians. 2. At the end of the rotation, an evaluation will be performed by Chief of section Or designee.3. 360ْ Fellow Evaluations
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Recommended Reading for Pediatric Radiology Fellows and Residents
Plain Radiography
1.) Burton EM, Brody AS, Essentials of Pediatric Radiology. Thieme Medical Publishers, 1999.
2.) Greulich WW, Pyle SI, Radiographic Atlas of Skeletal Development of the Hand and Wrist, Stanford University Press.
3.) Keats TE, Atlas of Normal Roentgen Variants That May Simulate Disease, 4th Ed., Year Book Medical Publishers, 1988.
4.) Keats TE, Lusted LB, Atlas of Roentgenographic Measurement, 5th Ed., Year Book Medical Publishers, 1985.
5.) Kirks DR, Practical Pediatric Imaging, 3rd Ed., Lippincott-Raven, 1998.
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6.) Klienman PK, Diagnostic Imaging of Child Abuse. Williams and Wilkins, 1987.
7.) Kohler/Zimmer, Borderlands of Normal and Early Pathologic Findings of Skeletal Radiography. 4th Ed., Thieme Medical Publishers, 1993.
8.) Letts RM, Manager of Pediatrics Fractures. Churchill Livingston, 1994.
9.) Ogden JA, Skeletal Injury in the Child. 2nd Ed., Saunders, 1979.
10.) Ozonoff MB, Pediatric Orthopaedic Radiology, Saunders, 1990.
11.) Rogers LF, Radiology of Skeletal Trauma, Churchill Livingston, 1982.
12.) Silverman FN, Kuhn JP, Caffey’s Pediatric X-Ray Diagnosis, 9th Ed., Mosby Year Book, 1993.
13.) Swischuk LE, Emergency Imaging of the Acutely Ill or Injured Child, 3rd Ed., Williams and Wilkins, 1994.
14.) Taybi H, Lachman RS, Radiology of Syndromes, Metabolic Disorders, and Skeletal Dysplasias, 4th Ed., Mosby Year Book, 1996.
15.) Bisset GS, Strife JL, Kirks DR, Practical Pediatric Imaging. GU Section, Lippincott-Raven, 3rd Ed., 1998.
16.) Kirks DR, Practical Pediatric Imaging, Fluoroscopy Section, Lippincott-Raven, 3rd Ed., 1998.
17.) Kirks DR, Caron KH, Practical Pediatric Imaging, GI Section, Lippincott-Raven, 3rd Ed., 1998.
18.) Stringer DA, Babyn PS, Pediatric Gastrointestinal Imaging, BC Decker Publishers, 2nd Ed., 1999.
19.) Walsh PC, et al. Campbell’s Urology, Pediatric Urology Section, 7th Ed., Vol 2, WB Saunders, 1998.
20.) Donnelly LF, Fundamentals of Pediatric Radiology. Saunders 2001.
Ultrasound
1.) Babcock DS, In: Ball Jr. WS (ed), Pediatric Neuroimaging, Cranial Sonography, Lippincott-Raven, 1997.
2.) Jeffrey RB, Ralls PW, Sonography of the Abdomen, Raven Press, 1995.
3.) Kurtz AB, Middleton WD, Ultrasound: The Requisities, Hanley & Belfus, 1995.
4.) Polack JF, Peripheral Vascular Sonography: A Practical Guide, Lippincott, Williams & Wilkins, 1991.
5.) Rumak CM, Wilson SR, Charboneau JW, Diagnostic Ultrasound, Pediatric Section, 2nd Ed., Mosby Year Book, 1998.
6.) Siegel MJ, Pediatric Sonography, 2nd Ed., Raven Press, 1995.
7.) Teele RE, Share JC, Ultrasonography of Infants and Children, Saunders, 1991.
8.) Goldberg BB, McGahan JP, Atlas of Ultrasound Measurements, 2nd Ed., Mosby, 2006.
Body CT/MR Imaging
1.) Cohen MD, Imaging of Children With Cancer, Mosby Year Book, 1992.
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2.) Haacke EM, Brown RW, Thompson MR, Magnetic Resonance Imaging. Physical Principles and Sequence Design. Wiley-Liss, 1999.
3.) Kirks DR, Griscom NT, Practical Pediatric Imaging: Diagnostic Radiology of Infants and Children, Lippincott-Raven, 1998.
4.) Mink JH, Reicher MA, Crues JV III, Deutsch AL, MRI of the Knee, 2nd Ed., Raven Press, 1993.
5.) Naidich DP, et al., Computed Tomography and Magnetic Resonance of the Thorax. Lippincott-Raven 1997.
6.) Seigel MT, Pediatric Body CT, Lippincott, Williams, and Wilkins, 1999.
7.) Steinbach L, Shoulder Magnetic Resonance Imaging. Lippincott-Raven 1998.
8.) Stoller DW, Magnetic Resonance Imaging in Orthopaedics and Sports Medicine. Lippincott-Raven 1997.
9.) Stoller DW, MRI Arthroscopy and Surgical Anatomy of the Joints. Lippincott-Raven, 1999.
10.) Webb WR, Muiler NL, Naidich DP, High Resolution CT of the Lung. Lippincott-Raven, 1996.
11.) Donnelly LF, Handbook of Pediatric Radiology
12.) Kirks DK, Practical Pediatric Imaging. Chapter 5. Heart (Strife and Bisset)
13.) Amplatz K, et al: Radiology of Congenital Heart Disease.
14.) Freedom, Culham and Moes: Angiography of Congenital Heart Disease.
15.) My.StatDx.com, Cardiovascular Cases
Angiography
Chung T (2006) Magnetic resonance angiography of the body in pediatric patients: experience with a contrast-enhanced time-resolved technique. Pediatr Radiol 35:3-10.
Mohrs O, Petersen S, Voigtlaender T, et al (2006) Time-resolved contrast-enhanced MR angiography of the thorax in adults with congenital heart disease. AJR 187:1107-1114.
Okuda S, Kikinis R, Geva T et al (2000) 3D-shaded surface rendering of gadolinium-enhanced MR angiography in congenital heart disease. Pediatr Radiol 30:540-545.
Prince MR, Meaney JFM (2006) Expanding role of MR angiography in clinical practice. Eur Radiol Suppl 16:B3-B8.
Sutherland GR, Hess J, Roelandt J et al (1990) The increasing problem of young adults with congenital heart disease. Eur Heart J 11:4-6.
Neuroradiology
1.) Atlas SW, Magnetic Resonance Imaging of the Brain and Spine. Raven Press, 1996.2.) Ball WS, Pediatric Neuroimaging. Raven Press, 2000.
3.) Barkovich AJ, Pediatric Neuroimaging. Lippincott-Raven, 1997.
4.) Kirks DK, Practical Pediatric Imaging. Lippincott-Raven, 1998.
5.) Som PM, Curtin HD, Head and Neck Imaging, Mosby Year Book, 1996.
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6.) Swartz JD, Harnsberger HR, Imaging of the Temporal Bone, Thieme Medical Publishers, 1998.
7.) Barkovitch AJ, Pediatric Neuroimaging, 4th Ed., Lippincott, Williams, & Wilkins, 2005.
8.) Barkovitch AJ, Diagnostic Imaging: Pediatric Neuroradiology, 1st Ed.,Amirsys, 2007.
Nuclear Medicine
1.) Gelfand MJ, Thomas SR, Effective Use of Computers in Nuclear Medicine. McGraw-Hill, 1998.
2.) Treves ST, Pediatric Nuclear Medicine. Springer-Verlag, 1985.ELECTRONIC MEDIA RESOURCES
Washington University, St. Louis, Nuclear Medicine Teaching File (gamma.wustl.edu). Includes 40 pediatric nuclear medicine cases.
Eteach.cchmc.org. Includes 167 pediatric nuclear medicine cases
PET IN PEDIATRICSJadvar H, Alavi A, Mavi A, Shulkin BL. ET in pediatric diseases.Radiol Clin North Am 2005; 43:135-52.
PET – ARTIFACTS AND CONFUSING FINDINGSGoodin GS, Shulkin BL, Kaufman RA, McCarville MB. PET/CT characterization of fibroosseous defects in children: 18F-FDG uptake can mimic metastatic disease.AJR Am J Roentgenol 2006; 187:1124-8.
Gelfand MJ, O'hara SM, Curtwright LA, Maclean JR. Pre-medication to block [(18)F]FDG uptake in the brown adipose tissue of pediatric and adolescent patients.Pediatr Radiol 2005; 35:984-90.
PET – PEDIATRIC CANCER – GENERALBar-Sever Z, Keidar Z, Ben-Barak A, Bar-Shalom R, Postovsky S, Guralnik L, Ben Arush MW, Israel O. The incremental value of (18)F-FDG PET/CT in paediatric
Daldrup-Link HE, Franzius C, Link TM, Laukamp D, Sciuk J, Jurgens H, Schober O, Rummeny EJ. Whole-body MR imaging for detection of bone metastases in children and young adults: comparison with skeletal scintigraphy and FDG PET.AJR Am J Roentgenol 2001; 177:229-36.
PET – SARCOMASHawkins DS, Schuetze SM, Butrynski JE, Rajendran JG, Vernon CB, Conrad EU 3rd, Eary JF. [18F]Fluorodeoxyglucose positron emission tomography predicts outcome for Ewing sarcoma family of tumors. J Clin Oncol 2005; 23:8828-34.
Hawkins DS, Rajendran JG, Conrad EU 3rd, Bruckner JD, Eary JF. Evaluation of chemotherapy response in pediatric bone sarcomas by [F-18]-fluorodeoxy-D-glucose positron emission tomography. Cancer 2002; 94(12):3277-84
Kneisl JS, Patt JC, Johnson JC, Zuger JH. Is PET useful in detecting occult nonpulmonary metastases in pediatric bone sarcomas? Clin Orthop Relat Res 2006; 450:101-4.
Ben Arush MW, Israel O. The incremental value of (18)F-FDG PET/CT in paediatric malignancies. Eur J Nucl Med Mol Imaging 2007; 34:630-637,
McCarville MB, Christie R, Daw NC, Spunt SL, Kaste SC. PET/CT in the evaluation of childhood sarcomas. AJR Am J Roentgenol 2005; 184:1293-304.
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PET – LYMPHOMARhodes MM, Delbeke D, Whitlock JA, Martin W, Kuttesch JF, Frangoul HA, Shankar S. Utility of FDG-PET/CT in follow-up of children treated for Hodgkin and non-Hodgkin lymphoma. J Pediatr Hematol Oncol 2006; 28:300-6.
Kabickova E, Sumerauer D, Cumlivska E, Drahokoupilova E, Nekolna M, Chanova M, Hladikova M, Kodet R, Belohlavek O. Comparison of 18F-FDG-PET and standard procedures for the pretreatment staging of children and adolescents with Hodgkin's disease. Eur J Nucl Med Mol Imaging 2006; 33:1025-31.
PET – LCHBinkovitz LA, Olshefski RS, Adler BH. Coincidence FDG-PET in the evaluation of Langerhans' cell histiocytosis: preliminary findings. Pediatr Radiol. 2003; 33:598-602.
Blum R, Seymour JF, Hicks RJ. Role of 18FDG-positron emission tomography scanning in the management of histiocytosis. Leuk Lymphoma 2002; 43:2155-7.
PET – NERVE SHEATH TUMORSFerner RE, Lucas JD, O'Doherty MJ, Hughes RA, Smith MA, Cronin BF, Bingham J. Evaluation of (18)fluorodeoxyglucose positron emission tomography ((18)FDG PET) in the detection of malignant peripheral nerve sheath tumours arising from within plexiform neurofibromas in neurofibromatosis 1. J Neurol Neurosurg Psychiatry 2000; 68:353-7.
Cardona S, Schwarzbach M, Hinz U, Dimitrakopoulou-Strauss A, Attigah N, Mechtersheimer G, Lehnert T. Evaluation of F18-deoxyglucose positron emission tomography (FDG-PET) to assess the nature of neurogenic tumours. Eur J Surg Oncol 2003; 29:536-41.
Beaulieu S, Rubin B, Djang D, Conrad E, Turcotte E, Eary JF. Positron emission tomography of schwannomas: emphasizing its potential in preoperative planning. AJR Am J Roentgenol 2004;182:971-4.
PET – MISCELLANEOUS NON-CNS TUMORSMody RJ, Pohlen JA, Malde S, Strouse PJ, Shulkin BL. FDG PET for the study of primary hepatic malignancies in children.Pediatr Blood Cancer 2006; 47:51-5.
Shulkin BL, Chang E, Strouse PJ, Bloom DA, Hutchinson RJ. PET FDG studies of Wilms tumors. J Pediatr Hematol Oncol 1997;19:334-8.
Shulkin BL, Hutchinson RJ, Castle VP, Yanik GA, Shapiro B, Sisson JC. Neuroblastoma: positron emission tomography with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose compared with metaiodobenzylguanidine scintigraphy. Radiology 1996; 199:743-50.
Mackie GC, Shulkin BL, Ribeiro RC, Worden FP, Gauger PG, Mody RJ, Connolly LP, Kunter G, Rodriguez-Galindo C, Wallis JW, Hurwitz CA, Schteingart DE. Use of [18F]fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma. J Clin Endocrinol Metab 2006; 91:2665-71.
PET— BRAIN TUMORSTurner CD, Chi S, Marcus KJ, MacDonald T, Packer RJ, Poussaint TY, Vajapeyam S, Ullrich N, Goumnerova LC, Scott RM, Briody C, Chordas C, Zimmerman MA, Kieran MW. Phase II study of thalidomide and radiation in children with newly diagnosed brain stem gliomas and glioblastoma multiforme. J Neurooncol 2007; 82:95-101.
Interventional Radiology
1.) Amplatz K, Lange PH, Atlas of Endourology, Mosby, 1986.
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2.) Cope C, Current Techniques in Interventional Radiology. McGraw-Hill Professional Publishing, 1994.
3.) Kandarpa K, Aruny JE, Handbook of Interventional Radiologic Procedures. 2nd Ed., Lippincott, Williams, and Wilkins, 1997.
4.) Uflacker R, Atlas of Vascular Anatomy an Angiographic Approach, Lippincott, Williams & Wilkins, 1997.
5.) Wojtowycz M, Handbook of Interventional Radiology and Angiography, 2nd Ed., Mosby Year Book.
Confirmation of Receipt Duty Hours Policy for Radiology
By signing this document you are confirming that you acknowledge that penalties will be applied to you for non-compliance of duty hours. This policy is on page 20 of your program manual.
This receipt will be kept in your personnel file.
Maintaining your duty hours is not only a GME requirement it is also a requirement for the completion of your degree.
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Note: Failure to ensure accuracy of your rotation activities will be considered an act of Medicare fraud.
Duty hours are to be entered by 7AM on the first working day of the month. We are granting you the weekend now to get things in order.
All fixes indentified by Program Coordinator must be corrected by the following morning.
If the above do not occur:
Fellows on a U of M rotation will have their parking privileges revoked beginning the next day and will be in effect until the fellowship office has cleared you.
Fellows at HCMC or VAMC will have their vacation revoked or call will be applied at our discretion.
Fellows will have a letter placed in their permanent file reflecting a lack of professionalism if pattern continues.
Fellow Name (Please print)
Fellow Signature ________________________________________________________
Date __________________
Confirmation of Receipt of your Program Policy Manual for Academic Year 2009-2010
By signing this document you are confirming that you have received and will review your Program Policy Manual for this academic year.
This policy manual contains policies and procedures pertinent to your training program. This receipt will be kept in your personnel file.
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Fellow Name (Please print)
Fellow Signature ________________________________________________________
Date __________________
Coordinator Initials ________________
Date __________________
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