Curriculum - Diagnostic Radiology Residency

• Core Rotations and Lecture Series – Core rotations provide residents with a broad variety of learning opportunities designed to educate competent and skilled radiologists. Attendings work one-on-one with residents throughout the day and are able to provide continuous teaching and feedback. The Lecture Series includes a mixture of didactic and case-based learning. The first three years are designed to prepare residents for the Core Board Examination taken in June of the third radiology year.
• R2 Pre-call Preparation – Dedicated teaching for call preparation including emergency radiology didactics with the attendings, structured online call simulation with fully scrollable cases, quiz cases with group review, and designated reading assignments. At least five “Buddy Call” shifts with a more senior resident to coach on the practical ins and outs of independent call. Residents are independently working during night call shifts which helps residents build independence, autonomy, and confidence skills that are essential for advancing professionally. Attendings are available by phone/pager during the entire call shift.
• Hands-on Simulation Sessions – These sessions are for residents to safely practice and increase their comfort level with crucial skills. We routinely run simulation sessions for handling contrast reactions and performing complex procedures such as MR and US guided breast biopsy.
• Research and Other Scholarly Activity – Opportunities are available throughout the department as well as through the Center for Health Care Improvement Science. Residents have published original clinical research and review articles, written book chapters, and presented talks and posters at regional and national meetings. Travel funds are available for residents presenting at meetings.
• Training in the Virginia Mason Production System (VMPS) – VMPS is our nationally-recognized management methodology focused on improving quality of care and patient safety. All residents participate in VMPS activities with opportunities for leadership, publication and research. Residents have been involved in multidisciplinary Kaizen Events, Rapid Process Improvement Workshops, and other Quality Improvement measures. These skills are highly relevant to the Practice Quality Improvement activities now required for achieving Maintenance of Certification by the American Board of Radiology.
• Training in Radiologic-Pathologic Correlation at the American Institute of Radiologic Pathology (AIRP) – Four-week course offered by the American College of Radiology in Silver Springs, Md. A travel and housing stipend is provided, which covers the cost.
• The Senior Elective Program – Nine months of elective time provides opportunities for focused training and skill development. Electives are selected and tailored by the senior resident in conjunction with the program directors and other attending mentors.
• National Imaging Informatics Course – Online course offered once during residency with the intention to provide practical knowledge in the rapidly popular world of informatics and data science. Sponsored by the RSNA and the Society for Imaging Informatics in Medicine (SIIM).
• RLI Healthcare Economics Course – Annual online course offered to R2 and R5 year residents in order to improve understanding of ACGME health care economics milestones. Covered topics include components of imaging costs, reimbursement models and measurements of productivity. Sponsored by the ACR̠s Radiology Leadership Institute.
• RLI Leadership Essentials Course – Comprehensive live and online program offered to R5 year residents, focusing on topics such as contracts, negotiations, rookie leadership and personal

Contrast reaction simulation

• Quarterly workshop supervised by an abdominal imaging or IR attending
• Residents identify contents of "contrast reaction box," review all equipment, and participate in managing various contrast reaction scenarios such as anaphylaxis, vasovagal reaction, bronchospasm, etc.

MR guided breast biopsy workshop

• Residents are guided through the steps of setting up and performing MR guided breast biopsies (using a grapefruit as a phantom). Residents then take turns targeting lesions and performing vacuum-assisted biopsy of the phantom using standard software and equipment.

Ultrasound guided breast biopsy workshop

• Once-a-year workshop supervised by breast imaging attendings
• Residents review all the steps of properly visualizing and setting up for ultrasound-guided biopsy. Subsequently, residents take turns performing targeted biopsy of various inclusions at various depths using ballistic gel phantoms or store-bought turkey breast.

Ultrasound hands-on workshop with pelvic phantom

• Once-a-year workshop supervised by ultrasound attendings
• Residents learn how to handle a transvaginal probe in order to properly evaluate and document images of the uterus and adnexa

Call prep simulation

• Full day of advanced call prep simulation using WIDI SIM software designed by University of Florida to mimic case selection and cadence of a typical call shift
• Buddy call shifts at the end of PGY2 year where junior residents are encouraged to act independently with background supervision from senior residents

Future / In planning phase

• Guided simulation to improve communications skills during difficult conversations including:
   
  
  • Disclosure of adverse events
  • "Breaking bad news" after a critical outcome
     
• Ultrasound hands-on workshop with ballistic Gel phantoms
   
  
  • Gel phantoms are used to demonstrate physics principles and artifacts in ultrasound
  • Inclusions are targeted to practice needle guidance, a skill that is beneficial in various

Our full schedule of teaching conferences for radiology residents includes a wide variety of educational experiences, including formal lectures given by Virginia Mason staff radiologists, lectures at the University of Washington, case conferences, quizzes, journal club, and other department meetings.

• The Introductory Summer Lecture Series covers the basics of radiology during July and August.
• Morning and noon lecture given by radiology attendings occur throughout the rest of the academic year. These occur on a two-year rotation cycle and cover major fundamental topics in radiology.
• Residents have an active role in planning and presenting the monthly Quality Assurance Conference. Our attendings actively participate in the ACR-sponsored peer-review system eRadPeer.
• Monthly multidisciplinary ultrasound conference includes residents, attendings and sonographers, which allows review of image acquisition and interpretation of interesting cases.
• Journal club occurs once a month covering hot topics in the current radiology literature.
• Residents function as team members in our multidisciplinary approach to patient care through case conferences and tumor boards with physicians from Urology, Neurology, Gastroenterology, and other departments. At some of these conferences, residents gain experience preparing and presenting cases as well as teaching the audience.
• Thursday afternoon Didactic Lecture Series at the University of Washington with UW radiology residents and attendings.
• Diagnostic radiology physics course at the University of Washington is provided by a medical physicist. Quizzes are administered every few months to provide feedback to the resident. There are additional physics lectures at Virginia Mason to help supplement/reinforce the concepts.
• Case Review Series at University of Washington reviewing all major topics in radiology in preparation for the Core Board Exam in the months prior to the exam.
• Virginia Mason Grand Rounds occur on Friday mornings.
• Attendance at local and regional meetings such as the Washington State Radiological Society and the Pacific Northwest Radiological Society is highly encouraged. Our residents have held leadership positions in the resident sections of these and other radiologic societies.

We have 13 rotations per year with each rotation being four weeks long. The majority of the rotations occur at Virginia Mason, but there are also a few rotations at other local institutions to further enhance the resident learning experience. These outside rotations include:

• Seattle Children's Hospital—Each resident devotes four rotations to training in Pediatric Radiology at this academic hospital that is one of the teaching hospitals of the University of Washington.
    
• University of Washington Medical Center—Residents attend didactic conferences on Thursday afternoons at the University of Washington. The Radiologic Physics and Case Review courses are also taken at the University of Washington.
    
• Harborview Medical Center—Each resident devotes two-and-a-half rotations to training in Emergency and Trauma Radiology at this regional Level I trauma center, which includes one night float rotation. Harborview is a major teaching hospital of the University of Washington.