Radiology Residency Rotations
Residents are assigned for two- to four-week rotations at either the University of New Mexico (UNM) or the Raymond G. Murphy VA Medical Center (VAMC). Approximately 3/4 of the total residency experience is at UNM, with 1/4 at the VAMC. All radiology faculty working with residents hold either full or joint appointments at UNM, and many faculty spend time at both institutions.
Most UNM rotations take place at the main University of New Mexico Hospital (UNMH), with Outpatient Body Imaging and Breast Imaging rotations at the nearby UNM Cancer Center and Outpatient Surgery and Imaging Services (OSIS), respectively. The UNM Cancer Center and OSIS are interconnected and lie within walking distance or a short drive or shuttle ride from UNMH. Examinations performed at any UNM-affiliated facility, including UNMH, OSIS, Sandoval Regional Medical Center (SRMC), and Carrie Tingley Hospital (CTH), are interpretable from any UNMH, OSIS, or UNM Cancer Center reading room via the integrated PACS system.
Residents receive comprehensive diagnostic, interventional, and therapeutic radiologic training via the following rotations:
|University of New Mexico||New Mexico VA Healthcare System|
|Body Imaging-Inpatient||Body Imaging|
|Body Imaging-Outpatient||Musculoskeletal Radiology|
|Cardiothoracic Radiology||Nuclear Medicine|
- Inpatient: At UNMH, residents work with attending radiologists to interpret abdominopelvic exams performed for inpatient evaluations. These examinations address the complexities of acutely ill and post-operative patients.
- Outpatient: This reading room is embedded at the University of New Mexico Cancer Center, facilitating consultation with referring physicians and a collaborative approach to patient care. Residents work with an attending radiologists to interpret abdominal CT/MRI exams performed at the OSIS and the outpatient examinations performed at UNMH.
- VAMC: Residents work alongside attending radiologists to interpret thoracic and abdominopelvic body imaging studies, including radiographs, ultrasound, CT and MRI.
These rotations, at the nearby Outpatient Surgery and Imaging Services (OSIS) center, give residents experience in all aspects of breast imaging, including digital screening and diagnostic mammography, breast MRI and ultrasound, stereotactic biopsy, ultrasound- and MR-guided breast biopsy, and wire localizations for surgical biopsy. Breast MRI is performed on the Siemens 3-Tesla MR scanner at OSIS. This multimodality rotation ensures compliance with FDA requirements for independent interpretation of mammography upon completion of the residency program.
Cardiothoracic Radiology Rotations
During these rotations, residents work with attending radiologists in interpretation of chest radiographs, CT, and MR on patients in the ICU, inpatient, and outpatient settings. Advanced training includes pulmonary artery and coronary CT angiographic, high-resolution chest CT, and cardiac MRI studies.
Emergency Radiology Rotations
On this rotation, residents work with attending radiologists to interpret non-neurologic radiographic, CT, and MR exams performed in the UNM Emergency Department. UNMH is the only Level I trauma center in New Mexico and receives high-acuity patients by ambulance and helicopter from the entire state and surrounding regions. The Emergency Radiology reading room is located directly adjacent to the Emergency Department, facilitating direct communication with Emergency Medicine and Trauma Surgery physicians.
Gastrointestinal / Genitourinary Fluoroscopy Rotations
Residents become proficient in performing all types of non-interventional fluoroscopic examinations, including single contrast and biphasic examinations of the alimentary tract, fistulography, contrasted genitourinary tract studies, and placement of enteric feeding tubes. The Department of Radiology collaborates with the Department of Speech Pathology for swallowing studies and the Department of OB/GYN for hysterosalpingograms.
Interventional Radiology Rotations
Working one-on-one with attending physicians and fellows, residents actively participate in all types of angiography and interventional procedures. Pre-procedure evaluation of patients, including obtaining informed consent, review of pertinent studies, procedure planning, patient monitoring, and short and long-term follow-up are completed with supervision. Studies performed include arteriography, venography, angioplasty, stent placement, biliary intervention, genitourinary procedures, liver and renal transplant evaluation and treatment, TIPS (transjugular intrahepatic portosystemic shunt) placement, thrombolysis, embolization, vertebroplasty, spine injections, IVC filter placement, central venous access, and biopsies and drainages under fluoroscopic, CT, and US guidance. Oncologic interventions include TACE (trans-arterial chemoembolization), radiofrequency ablation, cryoablation, and Yttrium-90 microsphere therapies. Neurointerventional procedures include intracranial aneurysm coiling and embolization of intracranial masses and vascular lesions.
These rotations at UNMH and the VAMC teach the diagnosis of musculoskeletal diseases, including arthropathies, neoplasia, and trauma through interpretation of radiographs, CT, MRI. Residents learn techniques for joint aspiration and intra-articular contrast injection for MR and CT arthrography.
During neuroradiology rotations at UNMH and the VAMC, residents learn anatomy, pathology, and differential diagnoses of diseases of the spine, brain, head, and neck. This rotation covers technical aspects of CT and MR imaging, as well as myelograms. Residents attend weekly combined neuroimaging conferences with the neurology and neurosurgery departments. Neurovascular procedures are performed as part of Interventional Radiology rotation.
These rotations at UNMH and the VAMC provide broad training in general, cardiovascular, pediatric, PET, and therapeutic nuclear medicine, including PET/CT and SPECT/CT technology. A dedicated radiopharmacy rotation at the VAMC provides hands-on instruction in radiopharmaceutical preparation and quality control. Nuclear medicine therapy training includes using radioiodine (I-131) for hyperthyroidism and thyroid cancer, with exposure to other advanced nuclear medicine therapies, such as Yttrium-90 Zevalin for lymphoma and therapy for painful osseous metastases.
The pediatric radiology section performs and interprets imaging for the Childrens’ Hospital of New Mexico and Carrie Tingley Hospital. Residents work with pediatric attending radiologists to interpret radiographs, fluoroscopy, ultrasound, CT, and MRI. A rotation through pediatric orthopedic radiology offers residents the opportunity to learn about musculoskeletal diseases in children. The Pediatric Intensive Care Unit staff, ward staff, housestaff, and medical students meet each day in the pediatric radiology reading room to review in-house patient exams and to discuss imaging strategies.
During this rotation, residents train in the interpretation of ultrasound examinations of the neck, breast, abdomen, and pelvis, as well as spend time with the ultrasonographers learning ultrasound imaging techniques. Residents learn to perform ultrasound-guided biopsies.
Teaching Blocks & Conferences
Our didactic schedule consists of conferences Monday through Friday at noon, plus one morning each week, as follows:
- Brant and Helms rounds - Required for R1s and optional for others. Residents are provided with structured weekly reading assignments from Brant and Helms, Fundamentals of Diagnostic Radiology (provided free of charge to all residents). Residents meet with faculty one morning each week to review and discuss the material. The goal is to read the entirety of this introductory radiology textbook during the year.
- Core exam teaching blocks - During each 4-week block, the Monday/Wednesday/Friday noon lectures all pertain to a particular section from the ABR Core Examination (e.g., thoracic radiology, musculoskeletal radiology, nuclear medicine, etc). Each radiology subspecialty has a four-week block, and two additional four-week blocks cover Emergency Radiology and Physics/Non-Interpretive Skills (relevant to the practice of radiology).
- Case conferences - On a rotating basis throughout the year, case conferences on Tuesdays and Thursdays also address all the radiology subspecialties. Case conferences are usually led by faculty; residents also may prepare up to one case conference per year. These conferences typically use either the ‘hot seat’ approach or our audience response system to engage resident participation.
- Physics - Our physics curriculum now spans all years of residency, in order to prepare residents for the physics component of the ABR Core Examination. R1 residents participate in a physics ‘boot camp’ to develop basic knowledge, then physics topics are presented to all residents in a two-week didactic block annually. R3 residents preparing for the Core Examination are provided with an Advanced Boot Camp in December, followed by a structured review during the last semester before the core.
Lectures and case conferences are given daily in the department's multimedia conference room with audience response system available. Residents working at the VA Medical Center, the Outpatient Surgery and Imaging Center, and the UNM Cancer Center participate in didactics from their respective sites via broadcast. A typical didactic schedule is shown below:
|7:00 – 8:00 AM||-||Brant and Helms Rounds||-|
|12:00 - 1:00 PM||Lecture||Case Conference||Lecture||Case Conference or Journal Club||Lecture|