Curriculum/Duties/Responsibilities

Procedures

The Independent IR resident easily meets the 1,000 invasive image-guided procedures required during their training. Overall the Interventional Radiology section performs more than 8,000 procedures per year, interacting with almost all medical specialties.

• Interventional oncology: hepatic chemoembolization, radioembolization, immunoembolization and percutaneous ablation for hepatocellular cancer and renal cancer, and metastatic ocular melanoma.
• Post-transplant interventions: renal artery stenosis, hepatic artery stenosis, portal vein and hepatic vein interventions, biliary stricture.
• Liver and biliary interventions: TIPS, BRTO, portal vein recanalization, percutaneous biliary drainage, and portal vein embolization.
• Pulmonary artery: PE thrombolysis, AVM embolization.
• Gender specific health interventions: Uterine fibroid embolization, pelvic congestion syndrome treatment, prostate artery embolization, varicocele embolization.
• Venous disease: acute and chronic DVT thrombolysis and recanalization, complex IVC filter removal, superficial venous ablation, microphlebectomy, sclerotherotherapy.
• Dialysis intervention: Central vein recanalization/stenting, fistula and graft interventions, Hero graft placements, endovascular arteriovenous fistula creation.
• Non-oncological embolotherapy: vascular malformation, trauma, gastrointestinal bleeding.
• pain management: percutaneous nerve blocks and neurolysis.
• GI tract: Gastric and jejunal feeding tube placements.
• GU tract: nephrostomy, ureteral stent placement/removal, complex access of nephrolithiasis.
• Lymphatic interventions: Lymphangiography, thoracic duct embolization.

Rotations

Rotations The IR resident will spend the majority of their time at UCMC, a level 1 Trauma Center and regional referral center, where they will have dedicated IR clinic time and exposure to a diverse patient population with complex cases. Furthermore, the resident will rotate through West Chester Hospital, an community hospital, where they will develop their skills in managing various outpatient procedures and performing image-guided interventions in a more efficient workflow. These experience will enable the resident to gain valuable skills in managing a demanding clinical schedule, working closely with referring physicians, and collaborating within a team structure.

To enhance their skills and knowledge, the IR resident will participate in critical care rotations, including the SICU, where they will be part of the team. They will also rotate with the Vascular Surgery section to gain expertise in endovascular and open surgical techniques for peripheral vascular disease, aortic intervention, and other vascular abnormalities. For advanced IR residents who have completed their ICU rotation during their ESIR year, they may opt-out of the SICU rotation if they wish.

There are various elective rotations available to the IR resident to enhance their skills and knowledge. During their rotation in spine interventions, the resident will work with both diagnostic and therapeutic procedures for spinal procedures. They will learn how to use advanced imaging techniques, such as CT and MRI, to diagnose and treat spinal disorders. The resident will also gain expertise in various techniques for spine injections, vertebroplasty, and kyphoplasty.

During their neurovascular interventions rotation, the IR resident will work within the neurovascular team to diagnose and treat a range of complex neurovascular conditions, such as strokes, aneurysms, and arteriovenous malformations (AVMs). The rotation will provide an opportunity to become proficient in advanced imaging techniques, including angiography and CT perfusion, and learn various endovascular techniques such as mechanical thrombectomy, embolization, and stent and balloon angioplasty for the treatment of cerebrovascular diseases.

The transplant surgery rotation offers the resident an opportunity to learn about both living and deceased donor transplantation. They will gain experience in techniques for organ procurement and preservation, as well as different surgical techniques necessary for transplant surgery. This rotation will provide the resident with an understanding of the transplant process and the role of interventional radiology in transplantation medicine.

At the Cincinnati VA center, the resident will gain additional experience in vascular ultrasounds and learn the techniques for assessing peripheral vascular disease. They will learn how to use Doppler ultrasound and other modalities to diagnose and monitor peripheral vascular disease.

During the outpatient-based private practice rotation, the resident will gain hands-on experience in the diagnosis and treatment of peripheral vascular disease. This rotation will provide them with an opportunity to learn about minimally invasive procedures outside of the hospital setting.

Collectively, the diverse elective rotations will offer the IR resident a well-rounded experience in a variety of IR disciplines. They will be able to apply their knowledge and skills in different settings, learn from experienced physicians, and develop the ability to work collaboratively with a diverse patient population.

Duties and Responsibilities

The IR resident will be responsible for managing the Interventional Radiology service at UCMC, with close supervision and guidance from attending faculty. Their level of clinical and procedural responsibility will correspond to their skills and abilities. Additionally, the IR resident will share on-call duties with the diagnostic radiology resident on the IR service, with an average of q4 weekday and weekend calls.

The IR resident will have a set schedule for both academic time and IR clinical time. They will be required to contribute to the production of at least one scholarly project and participate in a QI activity. Additionally, the resident will have the opportunity to conduct research and present their findings at national conferences like SIR and RSNA.

Supervision and Evaluation

All residents will be directly supervised by an attending physician during the initial phase of their training. The attending physician will be physically present in the procedure room and will actively monitor the resident's actions and decisions. As the resident gains more skills and experience, they will transition to become the primary operator for the procedure, under the supervision of the attending physician. The attending physician will remain in the procedure room and will provide guidance and oversight as needed.

All residents will take initial clinical consultations with the supervision of an attending physician, who will provide guidance and oversight throughout the consultation process. The resident will gather the patient's medical history, perform a physical examination, and review any relevant diagnostic tests. Based on the information gathered during the consultation, the resident will develop a treatment plan for the patient. The attending physician will review and approve the treatment plan, ensuring that it is appropriate and in line with best practices.

To help residents improve their skills and knowledge, attending physicians will provide immediate feedback and guidance. In addition, residents will receive quarterly formal feedback from attending physicians, co-residents, IR staff, and IR patients via a standardized evaluation form. This feedback will help residents identify areas where they can improve and help attending physicians track their progress over time.

Residents will meet with the Program Director on a semi-annual basis, or as often as needed, to review their progress to date. This meeting will provide an opportunity for the residents to discuss their performance, receive feedback on their progress, and identify areas where they can improve.

Finally, residents will have the opportunity to evaluate the faculty via a standardized evaluation form. This feedback will help attending physicians identify areas where they can improve and help ensure that the supervision and guidance provided to residents is of the highest quality.