UW Radiology

Body Imaging Fellowship (ACGME)

We are still accepting applications for the 2018-2019 & 2019-2020 academic year. Please contact us at fellowbi@uw.edu for application forms and more information.

 We also offer a separate non-ACGME Body Oncology Fellowship and a non-ACGME Body Imaging Fellowship of Cancer

 Overview:

The Department of Radiology at the University of Washington offers a one-year ACGME (Accreditation Council for Graduate Medical Education) fellowship training program in body imaging and includes diagnostic ultrasound, CT, MR, and imaging guided interventions. The program, which began in 1979, is designed to provide balanced, in-depth experience in all aspects of body imaging for radiologists who have completed formal residency training in diagnostic radiology. Up to eight fellows are accepted each year.

Our faculty members have extensive experience in body imaging and are widely published and recognized at local, national, and international levels.

ACGME accreditation provides both the prospective fellow and his/her prospective employer with guarantees of the quality and quantity of the educational experience provided. The University of Washington offers the only ACGME-accredited abdominal/body imaging fellowship program on the West Coast of the United States.

We adhere to the most up-to-date national and international institutional and consensus guidelines in all aspects of body imaging and contrast media to facilitate a safe, standardized and uniformly recognized approach to diagnosis and management.

Our fellows rotate through all disciplines at least twice during the twelve months of fellowship to ensure consolidation of knowledge and skills and increase confidence with each modality and task.

Facilities and Equipment:

We use top-notch equipment from General Electric, Siemens and Philips and are in the fortunate position to offer the newest generations of ultrasound, CT and MR on all sites. For a more detailed description of equipment please refer to our [home page]. All sites (except the Puget Sound Veterans’ Affairs Hospital) are linked through one integrated PACS system, which may be accessed from home on call as well. Integrated speech recognition dictation software is standard on all workstations.

Rotations:

The fellowship year includes seven different rotations at a total of four sites. Each fellow rotates through each rotation twice to consolidate knowledge, increase expertise and broaden skills and comfort level on various imaging modalities and procedures. In addition to more traditional diagnostic cross-sectional body imaging fellows receive training in dedicated applications such as transplant, high-risk obstetrical and contrast enhanced ultrasound, dual energy CT, functional pelvic floor MR, MR lymphangiography, image-guided biopsy procedures including fusion technology, image post-processing and other. Additional training and/or exposure to cardiac CT and MR, or other image-guided procedures in interventional radiology is often available upon request and depending on scheduling and staffing needs. Fellows attend and present at several multidisciplinary tumor boards and conferences during various rotations.

We emphasize close and professional interactions with our radiology and clinical colleagues and compassionate care for all of our patients.

Body Rotations at UWMC

With 450 beds the University of Washington Medical Center (UWMC) is the largest of our facilities. UWMC has a busy solid organ transplant service as well as multiple subspecialty services that refer a wide variety of patients to our department. Complicated clinical questions in patients with numerous comorbidities and complex postoperative patients characterize our patient spectrum at UWMC.  In addition, multiple external providers from the metropolitan area of Seattle, surrounding counties and out of state refer patients to UWMC with a large variety of clinical indications for imaging.

Computed Tomography (CT)

Fellows on this rotation interpret CT exams of the chest, abdomen, and pelvis with attending radiologists in the section. They gain experience in common and more specialized CT techniques including CT angiography, CT colonography, low dose CT, CT angiography and dual energy CT applications as well as in CT post-processing. Fellows learn how to protocol CT examinations, function as consultants and discuss with providers appropriateness criteria, protocol options and contrast related safety matters.

Magnetic Resonance Imaging (MR)

Fellows are responsible in numerous ways for abdominal, pelvic and vascular MR examinations: they interpret images, consult clinical colleagues, discuss MR indications and MR safety issues with providers and protocol MR examinations. Abdominal MR includes a large volume of patients with liver related questions, as three multidisciplinary liver boards are being held every week, which fellows participate in. Besides the use of various gadolinium contrast agents for liver imaging and MRCP, functional liver MR of the liver including iron and fat quantification, diffusion weighted imaging and MR elastography are being offered on a routine basis and as needed. Other exams of the abdomen include pancreas, renal and adrenal MR, and MR enterography.

Morphologic and dedicated functional MR exams of the pelvis include locoregional rectal cancer staging, imaging of the sphincter complex, pelvic floor dysfunction and urologic and gynecologic MR indications. Specific indications on fetal and placental abnormalities are also addressed by dedicated protocols.

MR lymphangiography is a protocol that was developed at our institution and is being applied with great success for specific preoperative questions on patients with lymphedema and lymphatic leaks on a regular basis.

Ultrasound

Fellows on this rotation learn to scan with sonographers whenever possible and are oriented to a large variety of abdominal and pelvic sonographic examinations including transplant (liver, kidney and pancreas) Doppler ultrasound, high-risk obstetric ultrasound, as well as general ultrasound protocols. Transplant ultrasound, but also other surgical indications include intraoperative ultrasound, which is mainly covered by ultrasound attendings, however fellows may attend if workload allows. Ultrasound applications also include thyroid gland and neck, abdominal wall, scrotum and soft tissues.

Other dedicated applications are ultrasound for neonatal indications on the neonatal intensive care unit and ultrasound elastography for assessment hepatic stiffness in the setting of hepatitis and fibrosis.

A specialty of our ultrasound section is the use of ultrasound contrast agents for diagnosis and image guided procedures. Indication, technique and assessment of contrast enhanced exams for focal liver and kidney lesions are part of the curriculum.

By the end of this rotation, fellows should be capable of confidently scanning patients, interpreting complex pre- and postoperative B-mode, Doppler, contrast and elastography exams, consulting clinical teams and should know about the strengths and limitations of various ultrasound applications.

Image Guided Procedures

In this rotation fellows perform ultrasound and CT guided interventions under direct supervision of a selected pool of body imaging attendings. During that rotation, fellows perform biopsies, aspirations and placements of metallic fiducial markers to the liver and lungs prior to surgery or radiation treatment. We emphasize the use of ultrasound as our first guidance tool wherever possible as this allows real time guidance and no radiation with maximum flexibility at bedsite in the unit as well as in the procedure suite.

Goals of this rotation are to learn about the safety and feasibility of image guided procedures as every request goes through a standardized approval process, to learn about a variety of interventional techniques and devices, to improve scanning skills and hand-eye coordination with ultrasound-guided procedures and to proactively learn to apply low-dose CT and ultrasound-CT fusion and navigation techniques.

A library of dedicated publications on procedures we perform, consensus based policies and a quality assurance process to identify potentially discordant biopsy results ensure a standardized and safe approach to image guided procedures for our patients.

CT/MR/US at Harborview Medical Center (HMC)

In this 431 bed level I trauma center), which is the largest trauma specialized and designated disaster control hospital in the region, all imaging modalities and image guided procedures are applied in one rotation. Fellows here receive additional ultrasound training in abdominal, pelvic, obstetrical, thyroid, and scrotal ultrasound centered mainly on trauma and outpatients. HMC includes a large population from the International Clinic as well, where patients of diverse backgrounds are referred for sonographic liver tumor screening, prenatal care and other ambulatory indications. In addition, fellows gain experience in interpretation of contrast-enhanced ultrasound, body CT and MR with an emphasis on trauma and indigent patients from high-risk populations. Fellows also perform image-guided biopsies of tumors and fine needle aspirations of fluid collections and abscesses. Multidisciplinary tumor boards are covered by fellows and attendings.

CT/MR/US at Seattle Cancer Care Alliance (SCCA)

The Seattle Cancer Care Alliance (SCCA) is a National Cancer Institute designated cancer center that brings together the leading research teams and cancer specialists of Fred Hutch, Seattle Children’s, and UW Medicine including several Nobel Laureates.  This outpatient rotation offers extensive training with a high caseload of oncology imaging with CT, US and MR. Emphasis is on staging and treatment of cancer and learning appropriate radiologic workup of a variety of cancers. SCCA clinics are actively involved in both cellular and non-cellular immunotherapy treatments, which offer the unique opportunity of learning imaging assessment and complications associated with these new therapies.

Fellows will have the opportunity to participate in multidisciplinary case management conferences for pancreas, colorectal and sarcoma patients.

CT/MR/US at Seattle’s Puget Sound Veteran’s Affairs Hospital (VAMC)

The VAMC rotation offers instruction in body and thoracic applications of advanced medical imaging as they apply to a variety of disease processes, including oncology, gastroenterology, hepatology, urology, and infectious and vascular diseases, among others. This includes experience in image-guided procedures within the chest, abdomen and pelvis. In addition, there are opportunities for fellows to participate in rehabilitation medicine and orthopedic/sports medicine disease care through interpretation of some musculoskeletal MR and CT studies.

Research and Educational Activities:

Each fellow is required to participate in at least one research project related to the field of Body Imaging under the guidance of one of the section faculty members during the academic year. The section has a number of active research programs and a variety of research projects are available in basic science, clinical science, outcomes research, quality improvement and informatics. This project is expected to culminate in at least one scientific paper or educational paper in a peer-reviewed journal https://rad.washington.edu/about-us/academic-sections/body-imaging/recent-section-publications/ from “Peer-Reviewed Journal”.

However please note that this is a clinical fellowship and evaluations will be focusing on the six ACGME clinical competencies rather than research.

In addition, all fellows are expected to show teaching excellence by giving case conferences to radiology residents while on CT/MR rotations and by uploading teaching cases to our educational repository.

Protected time is provided on a weekly basis to accomplish these academic expectations.

Call:

Fellows take call in weekday and weekend blocks. On-call fellows are in-house on weekends until the day’s work is completed or until noon, whichever is later; they are on pager call at all other times. On-call responsibilities include consulting with the on-call residents as needed, interpreting after-hours cases and emergent cases performed from 8 a.m. to noon on weekends and reading out overnight cases. Fellows are responsible for emergent body CT and ultrasound cases at UWMC and HMC. Our PACS system allows for viewing of studies via the Internet, so cases can often be viewed from home.

A completed application for the Body Imaging Fellowship of the Radiology Department at the University of Washington must include the following materials and/or documents:

Application:

Submission Requirements for the Body Imaging Fellowship of the Radiology Department at the University of Washington.

FOR UNITED STATES, PUERTO RICO, CANADA, AND INTERNATIONAL ACGME-ACCREDITED PROGRAM GRADUATE APPLICANTS:

  1. Completed Application Form
  2. Clinical Experience Questionnaire
  3. Current Curriculum Vitae (CV)
  4. A brief Personal Statement, addressing your interest in body imaging and your career goals/plans

Please follow the instructions below when writing the Personal Statement:

  • One page only, please be concise and to the point
  • NAME on the same page of the Personal Statement
  • DATE on the same page of the Personal Statement
  • SIGNATURE on the bottom of the page
  1. USMLE Scores (Copies of results for Steps 1, 2-CK, 2-CS, and 3)
  2. NMBE/FLEX scores (For American Applicants Only, if taken in lieu of the USMLE)
  3. LMCC (For Canadian applicants only)
  4. Medical School Diploma (official copy with notarized translation, if not in English)
  5. Three (3) Letters of Reference/Recommendation, dated and signed on department letterhead:
  • One (1) from the director of your current residency/fellowship program
  • One (1) from a radiologist familiar with your work
  • One (1) from any physician that you worked with or have observed you professionally

References/Recommenders should write to:

Dr. Jean H. Lee, Program Director

And send the letters to us directly to the address below:

University of Washington

Department of Radiology, Body Image Section

ATTN: Fellowship Program, BB308N

1959 NE Pacific Street, Box 357115

Seattle, WA 98195-7115

USA

FOR NON- ACGME-ACCREDITED PROGRAM GRADUATE INTERNATIONAL APPLICANTS:

From the list above, please turn in requirements from 1-5 and 8-9. In addition to the above requirements:

  1. Medical School Diploma
  2. ECFMG Certificate (For applicants with Medical Degrees issued outside the United States/Canada)
  3. Documentation of completion of your residency program
  4. Board Certification from your country of origin

Download application here:

Fellowship Application

Clinical Experience Questionnaire

If you are applying for the Body Imaging of Cancer Fellowship of the Radiology Department at the University of Washington and the Swedish Cancer Institute (SCI): Please note that this fellowship is funded by Swedish Cancer Institute (SCI) and applicants must be eligible for a full and unrestricted Washington State Medical License. Foreign medical graduates therefore are NOT ordinarily eligible for this fellowship because the license application requires permanent residency status or U.S. Citizenship at the time of application. More information is available at http://www.doh.wa.gov/LicensesPermitsandCertificates/MedicalCommission/MedicalLicensing/Requirements/PhysicianandSurgeon