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Curriculum

The training program is designed to teach the principles (scientific basis) and the practice (clinical experience) of Diagnostic Radiology.

The training experience is centered at Dartmouth-Hitchcock Medical Center. This is integrated with annual rotations at the White River Junction Veterans Administration Hospital, a three-month rotation in Pediatric Radiology at Boston Children's Hospital, and a four-week course in radiologic-pathologic correlation at the AIRP of the ACR in Washington, DC, for all of our residents.

Over the years of residency, we expect residents to develop a thorough understanding of cross-sectional anatomy in both health and disease. The resident should be able to distinguish normal versus abnormal findings, including normal variants. He or she is expected to obtain a thorough knowledge of all indications for particular exams and what studies would enhance the diagnostic workup of various disorders. The resident should be able to describe an abnormality concisely and objectively, and generate an accurate differential diagnosis based on imaging from various modalities.

First year

The first year begins with an introductory period to orient new residents to general principles of diagnostic radiology and radiographic technique, and to introduce the various imaging modalities.

Residents rotate through general film-reading, with emphasis on bone and chest; through fluoroscopy, with emphasis on gastrointestinal and genitourinary radiology; and through neuro, ultrasound, CT, VIR, MRI and nuclear medicine, they are exposed to all facets of radiology and all disease processes we encounter, as well as trauma.

Members of the staff present daily teaching sessions geared to the new residents. Observation and performance of radiography under the supervision of our chief radiologic technologists acquaints the trainees with the fundamentals of x-ray technique and the general operation of the department.

Following the orientation period, residents begin four-week rotations through the sub-specialty divisions within the department, taking on greater responsibility for patient care and the performance and interpretation of routine diagnostic studies under the tutelage of a staff radiologist. The department physicist teaches a comprehensive didactic physics course in the second half of the year.

Second year

The first Veterans Affairs Hospital rotation occurs in the second year. The VA experience allows residents to integrate subspecialty skills and experience radiology in a "general practice" model, with an integrated faculty who share teaching and supervisory responsibilities, and participate actively in conferences.

The VA Hospital's radiology department uses all diagnostic imaging modalities except PET and mammography. Residents are able to be involved in complete diagnostic workups of their patients, examining them in various modalities to assess clinical problems. Residents are exposed to a different patient population, as well as to the reality of the economics involved in VA care. Time not spent at the VA during the rotations is spent at DHMC in a rotation approved by the Program Director.

The pediatric rotation at Children's Hospital Boston usually occurs in the second year. The remainder of the year consists of four-week rotations in the subspecialty divisions of radiology at DHMC and the VA, with residents gradually assuming responsibility for specific imaging services as their skills and experience increase. Rotations include Chest, Bone, Vascular and Interventional Radiology, Computed Tomography, Magnetic Resonance Imaging, Fluoroscopy, Ultrasound, Nuclear Medicine, and Mammography.

Second year residents will particiate in the integrated physics course, which takes place in the second half of the year.

Third year

During the third year, the resident participates in the four-week AIRP Course at the ACR in Washington, D.C., and continues with four-week rotations at DHMC and the VA.  Third year residents, starting in January 2013, will participate in the integrated physics course, which takes place in the second half of the year.

Fourth year (DR)

The fourth year is spent at DHMC, usually with a rotation at the White River Junction Veterans Affairs Hospital.

This year, as in year three, consists of four-week specialty rotations with the residents assuming greater levels of responsibility for managing individual services. The fourth year may consist of rotations of up to three months, depending upon resident preferences and departmental resources.  Mammography and nuclear medicine rotations will continue in the fourth year per MQSA and NRC requirements.

Fourth year (IR)

The fourth year begins the Interventional Radiology emphasis.  Rotations are at DHMC, and 3 of the four-week rotations will be in Diagnostic Radiology for the requisite mammography and nuclear medicine rotations.  The remainder of the year consists of IR and IR-related rotations, including an ICU rotation and 1-2 other clinical rotations.   There are two elective months for research, or additional clinical or IR exposure of interest to the trainee.

Fifth year (IR)

The fifth year residents assume greater levels of responsibility for managing the IR service and for the performance of procedures.  DHMC clinical rotations include two dedicated rotations on the Vascular Surgery service, where the resident participates in interventions for aneurysmal and peripheral vascular disease.  Additional dedicated rotations include pain medicine, and Neuro-Interventional Radiology, and again there are two potential elective months.

Physics

Dr. Walter Huda, PhD has been a part Dartmouth-Hitchcock Department of Radiology faculty for a number of years.  Dr. Huda is a renowned figure in the field of Radiologic Physics education, and has helped to revamp the resident physics curriculum.  We are very excited to have him at Dartmouth, and enjoy what he provides for our residents as well as numerous other programs across the globe.

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