Radiology Education

About Our Residency Curriculum

The Radiology residency provides four years of training in Diagnostic Imaging. Appointments are held jointly as a resident at Beth Israel Deaconess Medical Center (BIDMC) and as a clinical fellow at Harvard Medical School (HMS). There are eight diagnostic radiology residency positions available annually.

With a central role in clinical service, teaching, and research, the Radiology Department performs over 400,000 radiologic examinations each year. The department provides radiography, CT, ultrasound, MRI, nuclear medicine, mammography, angiography, and interventional radiology services to both the medical center as well as our affiliated health care facilities. There are over 69 full- and part-time clinical diagnostic radiologists, 13 additional research faculty and technical/adjunct staff, plus 35 clinical and post-doctoral research fellows. All residents, fellows, and faculty have appointments at Harvard Medical School. All radiologic studies are interpreted under the supervision of staff radiologists.

Our department prides itself on being supportive of its residents and places a strong emphasis on the quality of teaching—both in didactic lectures and individual case-based learning. Radiologic physics has also been integrated into daily didactic sessions. In addition, many didactic sessions use audience-response technology.

Training Program Curriculum and Radiology Quality Academy

In addition to world-class clinical radiology training, our curriculum allows for highly motivated residents with strong interests in research, education, and quality improvement to tailor more individual pathways in their four years at BIDMC. For example, we offer participation in the ABR Holman Pathway, which includes protected research time during the standard four years of radiology training.

We are also excited to showcase our Radiology Quality Academy (RQA). Building on our Radiology Department’s international reputation for Quality Improvement/Assurance expertise, the RQA formally establishes three levels of expertise based on the completion of fundamental to advanced coursework and publication of a Quality project. RQA residents will earn Certificates of Completion at each level.

There are nine formal sections in the department:

Abdominal imaging
Breast imaging
Cardiovascular and interventional radiology (CVIR)
MRI
Musculoskeletal imaging
Neuroradiology
Nuclear medicine
Ultrasound
Thoracic imaging

Most non-angiographic interventional procedures are performed by the respective services and a procedural “mini-fellowship” is available to cement this strong foundation. Residents rotating through these sections are provided with reading suggestions and material. At the end of each rotation, residents receive written evaluations and have the opportunity to evaluate the staff.

First-year rotations emphasize fundamentals and common radiologic examinations in preparation for inpatient and emergency department responsibilities. Before taking call, all first-year residents rotate through abdominal imaging, breast imaging, emergency radiology, fluoroscopy, musculoskeletal imaging, neuroradiology, nuclear medicine, thoracic imaging, and ultrasound.

During the second year, residents continue to gain experience in these sections, performing and interpreting more advanced examinations and interventions as their levels of expertise increase. Additional rotations in more specialized topics occur throughout residency, including interventional radiology, body MRI, head and neck imaging, and pediatric radiology. In addition, all residents participate in our Friday morning practice management and leadership curriculum to learn essential non-interpretive skills.

"Away" rotations during the second and third years of training include:

Three months of training in pediatric radiology at Boston Children's Hospital during the second year.
One month of training in head and neck radiology at Massachusetts Eye and Ear Infirmary during the third year.
One month in radiologic-pathologic correlation at the American Institute of Radiologic Pathology (AIRP), sponsored by the American College of Radiology in Silver Spring, Maryland, during the third year. Funding for lodging and travel is provided by the residency.

Upon completion of the second year of residency training, residents select an area of academic focus for their fourth year that will guide choices for the 3-month mini-fellowships and another 1-2 months of elective time. In addition, each fourth-year resident participates in a week-long online informatics course focused on the informatics systems that underlie the daily workflow in radiology.

Our Flexible and Individualized Curriculum

Our current and alumni residents have chosen to pursue augmented training in the following:

Subspecialty clinical electives
Education
Research
Global health
Information technology
Quality improvement
Health policy/health economics

Many residents in their fourth year will have the opportunity to advance their training in their specific area of interest. For example, a past resident spent up to one month abroad providing clinical radiology services and undertaking a global health project.

Residents interested in furthering their ability to pursue independent research can delve deeply into research projects of their choice, with mentorship and dedicated time to write or conduct their experiments. Many residents have also successfully secured grant funding, such as RSNA grants. For residents interested in quality improvement, in addition to the Radiology Quality Academy, there are multiple departmental, hospital, regional, and national opportunities, including the radiology resident “ideas” committee, the BIDMC HouseStaff quality improvement council (HSQIC), and the Massachusetts Radiological Society Quality and Safety Committee. Additionally, previous residents with interests in this aspect of radiology have developed data-driven quality improvement projects, participated in a quality panel reviewing abstracts at RSNA, and developed the ACR RadImprove peer-learning platform. Additionally, one of our residents currently sits on the Practice Policy and Quality Initiatives Panel for the RSNA journal, RadioGraphics.

Regardless of their specific interests, every resident will have the opportunity to undertake a substantial project during residency that will culminate in a presentation at a national meeting and/or publication.

A representative curriculum for the first three years is composed of the following:

Abdominal Imaging: 12 weeks
Angiography: 8 weeks
Body Procedures: 4 weeks
Breast Imaging: 8 weeks
Cardiac Imaging: 4 weeks
ED+Evening Call: 12 weeks
Night Float: 4 weeks
Head and Neck Imaging: 4 weeks
MRI: 12 weeks
Musculoskeletal: 12 weeks
Neuroradiology: 12 weeks
Nuclear Medicine: 12 weeks
Pediatric Imaging: 12 weeks
Thoracic Radiology: 12 weeks
Ultrasound: 12 weeks
AIRP: 4 weeks
Vacation: 12 weeks

A representative curriculum for the fourth year of residency would be:

Mini-fellowship 1: 12 weeks
Mini-fellowship 2: 12 weeks
Elective: 4-8 weeks
Breast Imaging: 4 weeks
Nuclear Imaging: 4 weeks
ED+Evening Call: 2-3 weeks
Night Float: 1-2 weeks
Departmental Coverage: 4 weeks
Vacation: 4 weeks

Education

Resident teaching conferences occur Monday-Thursday, between 7:30 - 9:00 am. Many of the sections provide their sessions in 1-2 week blocks to provide residents the opportunity to focus on one area for a period of time. Overall, these sessions are evenly divided between "hot seat" case reviews and didactic lectures. Some of the lectures utilize audience response technology. Residents are expected to attend these morning conferences, with coverage for clinical services provided by staff and fellows during these times.

On Fridays, sessions cover practice management, leadership, and non-interpretative skills, many of which are covered on the core examination and others of which are important to future success in practice.

In addition, the radiology residency begins with a one-month “Bootcamp” course for first-year residents to learn the essentials of radiology as we recognize that residents who enter our program come to us with varied experiences in medical school. From day one of clinical service, residents learn how to approach cases and how to communicate the important radiologic findings.

Radiologic physics is fully integrated into the morning conferences with dedicated sessions given by both physicists and practicing radiologists. In addition, the Department continues to support residents to attend a local physics board review course during the third year of training.

Weekly multidisciplinary and specialty conferences are conducted in the Radiology Department in conjunction with these services:

Cardiology
Gastroenterology
Urology
Neurology
Surgical oncology
Orthopaedic surgery
Cardiothoracic surgery
Pulmonology

Active participation in many of these conferences serves as an optimal way for residents to understand how imaging findings are integrated into patient management. This experience translates into stronger clinical radiologists. Also, daily didactic sessions and weekly journal clubs are held in the Division of Nuclear Medicine.

BIDMC has a regular Grand Rounds series that covers a wide variety of topics related to radiologic imaging. Approximately once a month, there is an invited visiting professor to the department who gives a formal grand rounds lecture. In addition, some of our clinical faculty and faculty from other departments provide lectures. Finally, once a month, more senior residents present interesting cases from the Department, which offers a great opportunity to develop teaching and presentation skills as we all participate in peer coaching during these sessions.

Boston is an outstanding city to train in Radiology; many local, regional, and national conferences are held locally. For example, the New England Roentgen Ray Society holds bi-monthly resident conferences on Friday afternoons in which selected faculty from regional institutions, including BIDMC, Brigham and Women's Hospital, Boston Medical Center, Massachusetts General Hospital, Brown University, Dartmouth, Maine Medical Center, and Tufts/New England Medical Center, give outstanding lectures. BIDMC attendings cover the clinical services during these times so that residents may attend these meetings.