Curriculum Overview

Section Descriptions

Rotations Descriptions

Appendix

Curriculum Overview

Introduction

Overall goals of the University of Minnesota's Radiology Residency Program are to exceed ACGME RRC program requirements, to have residents successfully complete the residency program and become ABR certified (or in the case of fellow/subspecialty residents and where applicable, become CAQ certified), and to produce outstanding radiologists fully engaged in lifelong learning in all walks of medical practice including patient care, research, administration, and education, while in private practice, university or other academic practice, government, industry or charitable organization. Residents receive training through rotations and other educational activities at the University of Minnesota (UMMC), the Hennepin County Medical Center (HCMC), and the Veterans Affairs Medical Center (VAMC).

This Radiology Residency Curriculum Description documents educational goals and objectives of the program. This document describes the organization of the program, the relation between rotations and subspecialty training, and the goals, objectives, standards, and evaluation methods that apply to each rotation.

In this section . . .

This Curriculum Overview identifies the Sections and Rotations through which residency training is delivered - including "curriculum-wide" rotations that are not tied to any subspecialty. It also describes how the documentation is organized, and introduces the reference codes for evaluation mechanisms that will be used to assess achievement of objectives for specific rotations.

Curriculum Structure

After this Overview, this Radiology Residency Curriculum Description has three main sections:

•  Section Descriptions for each of the subspecialties. These briefly describe the rotations and experience associated with each Section, identify the Body of Knowledge to be mastered by the resident in regard to the subspecialty, and list the required rotations.

•  Rotation Descriptions and Duty Sheets for each major rotation. ("Curriculum-wide" rotations are described below, in this Overview.) Each major rotation has a list of goals, objectives, and evaluation methods built around the required competencies, and a Duty Sheet that provides practical details for residents working the rotation.

•  Appendix. This contains more detail on evaluation mechanisms, and includes the Body of Knowledge lists for each of the ten subspecialty sections.

Subspecialty Sections

The Radiology Residency Curriculum is organized into ten Sections, representing various subspecialties. These Sections are based on organ systems for the most part, with exceptions such as Ultrasound. Additional rotations provide focus on topics that do not quality as a Section (e.g., "Women's Imaging", AFIP pathology course), or provide practical experience in delivering diagnostic imaging services (e.g., call-related rotations at the Hennepin County Medical Center).

The ten subspecialty Sections, along with the faculty member responsible for each one, are listed here:

Section Descriptions

Two documents are provided for each of these ten Sections:

•  The Section Description is a (usually) one-page summary document that provides an overview of the patient populations, disease processes, and imaging techniques the resident is exposed to, along with a list of the major rotations and locations where they acquire that training. The Section Description also identifies the Body of Knowledge for that Section.

•  The Body of Knowledge lists the medical and technical knowledge that residents are expected to master to complete their training in the Section. This separate list of knowledge is identified in the Section Description, but the actual list is made available elsewhere. In many cases, the Body of Knowledge will point to a Society curriculum, on a web site. In other cases, it will be a custom document prepared at the University of Minnesota. In all cases, the Body of Knowledge for each Section will be reproduced in the appendix.

Rotation Descriptions and Duty Sheets

Major rotations focus on areas such as interventional radiology, breast imaging, and similar topics directly relevant to particular subspecialties. We also provide some rotations that are not directly linked to specific subspecialty sections:

•  Some rotations focus on topics that cut across several areas, such as Women's Imaging, or the radiologic-pathologic correlation.

•  Others provide specific skills that are more practice-related than medical-knowledge based. These would include the call rotations at Hennepin County Medical Center.

•  In addition to these pre-defined rotations, there are several curriculum-wide rotations that round out resident training. These are described under the heading Curriculum-Wide Rotations below.

Each of the major rotations, focusing on specific content, is described in two documents:

•  The Rotation Description provides the detailed list of goals, objectives, and evaluation methods tied to each of the required competencies. It also provides a brief overview of the locations involved in the rotation, the experience the resident gains through the rotation, and the subspecialty Sections (if any) that the rotation directly supports.

Some rotations are 'progressive', in the sense that what residents develop medical knowledge and techniques in a second month that are new, compared to what they learned in the first month. Others are 'quantity of experience' rotations, meaning that the basic content and objectives are quite similar for all months of the rotation, but it will take more than one (or two) months in that rotation to acquire the knowledge and skills desired.

•  The Duty Sheet provides specific working and educational details of the rotation. This will include standards for professional conduct, work hours, responsibilities, recommended reading, required conferences, and any details that clarify expectations of the rotation supervisor for residents during the rotation.

It is expected that the Duty Sheets will be updated more frequently than the Rotation Description. Changes in conference schedules, availability of new recommended readings, and simple administrative or organizational changes will all be updated in the Duty Sheet.

A resident, then, is required to review the Duty Sheet frequently, as it could change even in the course of a one-month rotation. The goals and objectives detailed in the Rotation Description, on the other hand, will be less sensitive to the day-to-day working conditions of the rotations, and will be reviewed and revised, as necessary, on at least an annual basis.

Section - Rotation Relationships

The following table lists the ten subspecialty Sections with the major rotations that support them. Each Rotation Code in the list below will have its own Rotation Description and Duty Sheet. (If you are reading this in online or PDF form, clicking on any of the Section titles or Rotation codes below will take you to the relevant Section/Rotation description. Duty Sheets are reached through the Rotation Descriptions.)

Curriculum-Wide Rotations

In addition to the major rotations that directly support subspecialty training, other rotations draw on knowledge acquired throughout the program, and focus on effective application of that knowledge and on responsible, responsive performance in typical work environments.

Additional Major Rotations (specific)

The following rotations, although not specific to any subspecialty, have Rotation Descriptions and Duty Sheets.

•  UMWI (Women's Imaging)

•  UMPATH (radiologic-pathologic correlation)

•  HCCP and HCNF (call rotations at HCMC)

UMWI is very similar to other major rotations described in this document, but cuts across various organ systems and modalities.

The pathology and call components are described below.

Radiologic-Pathologic Correlation

All residents study the radiologic-pathologic correlation during the program by completing the UMPATH rotation, which is not tied to any particular subspecialty of diagnostic imaging.

•  The majority of residents will meet this requirements by taking the AFIP course.

•  Some residents may not be able to attend the AFIP course. They will take the "Non-AFIP Option" described in the UMPATH Rotation Description. This option involves participating in resident programs and conferences offered by the Department of Lab Medicine and Pathology at the University of Minnesota.

Call rotations (HCMC)

Two rotations conducted at the Hennepin County Medical Center develop the resident's time management, efficiency, ability to set priorities, and capacity for working in a high-volume environment that often presents urgent or emergent cases. Rotation Descriptions and Duty Sheets are available for the following rotations, but they are not tied to particular subspecialties of diagnostic imaging:

•  HCCP: Hennepin County Call Prep is basically an apprenticeship in performing in the on-call setting. Residents develop the skills they will need, and the familiarity with the setting, population, team, and resources, to be effective and responsible when they later take the HCNF rotation.

•  HCNF: Hennepin County Night Float is the overnight shift at Hennepin County Medical Center. Residents will complete the HCCP rotation before they do the Night Float. Night Float provides practical experience in a high-volume, acute-care facility, in the role of on-call radiologist (with appropriate support and supervision).

Additional Practical Rotations (unique experience)

The Radiology Residency Curriculum also provides the following rotation experiences that will be unique for each resident:

•  Focused Independent Study

•  General Medical Center Rotations

Because every resident will have a different experience, there are no Rotation Descriptions or Duty Sheets listing objectives and working requirements. These rotations are described directly below.

Focused Independent Study

In addition to the specific rotations required under each of the subspecialty sections, all residents will perform an additional rotation (generally three months) of individually guided practice. This independent study rotation provides an opportunity for the resident to gain additional knowledge and skills in a particular area of interest, at the same time it allows the faculty to ensure that any weaknesses or gaps in the resident's training are corrected. Most commonly, this independent study rotation will take place after the 2 nd year of residency, but the timing may vary on an individual basis.

Typical independent study rotations may have a predominantly academic or clinical focus. For example, one resident may prepare an article or do extensive literature review and writing. A second resident might spend more time in clinical rotations at the Medical Centers, gaining experience with particular organ systems, procedures, or modalities.

In all cases:

•  The program of study for the rotation, including goals, objectives, and assessment, will be developed by the resident with a faculty Mentor, and approved by the Program Director and Department Chair.

•  The independent study will include learning about non-clinical requirements of the radiology profession, such as ethics and practice management.

•  Identifying knowledge, skills, and behaviors that should be strengthened will be a core consideration for the independent study rotation. The rotation plan will focus on correcting weaknesses at the same time that it addresses particular interests of the resident.

•  Many objectives of the Focused Independent Study may be achieved by repeating existing rotations covered elsewhere in this Radiology Residency Curriculum Description, but with additional experience and detail related to the plan developed with the mentor. All of the goals, objectives, and duty sheet requirements of those rotations will apply while the resident is performing independent study.

General Medical Center Rotations

In addition to all of the major rotations listed above, each resident will take an additional one-month rotation at each of the three medical centers (UMMC, HCMC, VAMC). In the Medical Center Rotations, residents will be scheduled to support the Medical Center's imaging needs on a day-by-day basis. They will function much as do the radiology staff at any hospital, responding to the day's staffing/patient/physician needs, but, of course, with guidance, supervision, and support from the radiology and medical teams at these institutions.

These rotations provide experience closer to real-world practice, as well as building a quantity of experience with multiple modalities, organ systems, patient populations, and administrative/organizational units. Through the general Medical Center Rotations, residents have the opportunity to apply what they have learned in the specific major rotations and other educational experiences, and to develop the flexibility and responsiveness needed to be professionally successful in diagnostic imaging.

For all three Medical Center Rotations:

•  Residents will be under the supervision of, and be evaluated by, the faculty/staff person at the Medical Center who is responsible for scheduling their day-to-day work.

•  Residents will have had experience at each of these Medical Centers before taking the general Medical Center rotation. That means they are familiar with the standards for professional conduct, and reading resources, from the Duty Sheets associated with their earlier, specific rotations. Residents are expected to conform to those standards as they apply to their daily schedule on these rotations.

Practice Performance Measurement

The University of Minnesota Radiology Residency Program is committed to evaluating resident knowledge, skills, and performance to ensure that the objectives and standards listed in the Rotation Descriptions and Duty Sheets are met. Evaluation mechanisms in use by the program are consistent with those described in "Competencies Definitions and Practice Performance Measurements from the RRC for Diagnostic Radiology" (reproduced in the Appendix) .

To avoid constant duplication throughout the Rotation Descriptions, the most commonly used evaluation methods have been assigned these letter codes:

These letter codes will appear next to the objectives for specific competencies in the individual Rotation Descriptions.

For more detail about each of these evaluation mechanisms, please see Evaluation Mechanisms for the Radiology Residency Curriculum in the Appendix.