Fellowship Training Program in Advanced Cardiovascular Imaging

We currently have an opening for academic year 2020-2021.

  • Applications are accepted on a rolling basis
  • All qualified candidates are considered upon completion of their application
  • Interviews offered: TBD

  Please submit the online application via https://informatics.med.nyu.edu/apps/fellowship/app.

Proposal:

The Department of Radiology has established a non-ACGME-accredited training program in Advanced Cardiovascular Imaging for individuals who have interest and qualifications to pursue highly specialized training in advanced cardiovascular imaging, particularly involving CT and MR.

Program Summary:

The program consists of a 12-month clinical fellowship under the auspices of the Cardiac Imaging Section of the Department of Radiology, with rotations occurring through the Thoracic Imaging Section of the Department of Radiology and the Division of Cardiology at NYU School of Medicine. The curriculum comprises interpretation of clinical cardiovascular and cardiothoracic examinations, didactic teaching sessions, presentation of cases at departmental conferences, and involvement in clinical and basic science research. The Cardiac Imaging Section provides clinical cardiovascular imaging services for both outpatient and inpatient services at the NYU Langone Medical Center including Tisch Hospital, and at the Bellevue Hospital Center.

The curriculum is designed to allow the advanced cardiovascular imaging fellow to learn the indications for, the techniques of, and the practical application and interpretation of state-of-the-art cardiovascular and cardiothoracic imaging, with emphasis on CT and MR. In particular the trainee will gain knowledge of CT and MR physics, scanning principles related to cardiovascular and cardiothoracic imaging protocols, basic ECG interpretation skills as applicable to imaging protocols, contrast agents used for safe and optimal imaging, interpretative skills for reading clinical cardiovascular and cardiothoracic imaging studies, including data post-processing tools for analysis, an in-depth knowledge of normal and pathologic cardiovascular and cardiothoracic anatomy, and the physiology of acquired and congenital heart disease, cardiothoracic diseases, and vascular diseases of the aorta. In addition, the fellow will receive an overview of information obtained with other cardiovascular imaging technologies including echocardiography, nuclear cardiology and invasive x-ray angiography. The collaborative interaction with both Radiology and Cardiology faculty is an important feature of the program; it combines the strengths of faculty with different training backgrounds to provide a balanced perspective on the utilization and interpretation of advanced cardiovascular imaging techniques in the diagnosis and management of patients presenting for evaluation of cardiovascular diseases. In addition to gaining advanced cardiovascular knowledge, the fellowship integrates training in advanced thoracic imaging, including education in advanced chest CT, including high-resolution CT, and MRI imaging techniques, radiographic interpretation, and research. The fellow will gain knowledge and expertise in identifying thoracic diseases encountered in clinical practice when interpreting cardiac imaging examinations, including infections, lung nodules, cancer, and interstitial lung disease. The training in thoracic imaging entails a collaborative environment with clinicians involved in multidisciplinary care of thoracic disease so that the understanding of the diagnosis and management of chest disease is gained.

Instruction will be performed under the direction of expert faculty in the Cardiac Imaging Section during the performance and interpretation of cardiovascular studies. Fellows will participate in study supervision, image acquisition, data post-processing, image interpretation, and preparation of the final report. Since cardiovascular and thoracic CT and MR play an important part of both adult and pediatric cardiovascular and cardiothoracic medicine, the advanced cardiovascular imaging fellow will be expected to attend and present cases with clinical or other imaging modality correlation at various conferences including cardiology clinical case conference, nuclear cardiology case conference, echocardiography conference, pediatric cardiology catheterization conference, and thoracic imaging conferences that include lung cancer conference, pulmonary conference, and interstitial lung disease conference.

The curriculum is designed to allow fellows to meet the American College of Radiology practice guidelines for performing and interpreting cardiovascular CT and MR. The Cardiac Imaging Section currently performs over 800 contrast cardiovascular CT exams a year and over 500 cardiovascular MR exams a year.

Another major component of the program will be the involvement of the trainee in the numerous clinical and basic science research projects of the Cardiac Imaging Section faculty. The Advanced Cardiovascular Imaging Fellow will read clinical cases from combined hospital PACS worklists. Approximately 80% of the time they will be physically reading from Tisch Hospital and approximately 20% of the time they will be physically reading from Bellevue Hospital. The training curriculum will also encompass rotations through chest imaging, echocardiography, cardiac catheterization, and nuclear cardiology stress laboratory services to complement the trainee’s experience in cardiovascular and cardiothoracic MR and CT, as outlined below:

Advanced Cardiovascular Imaging Fellowship

6-8 months cardiac CT/cardiac MR interpretation

4-6 months thoracic CT, MR, and plain film interpretation

1 week echocardiography

1 week cardiac catheterization

2 weeks nuclear stress laboratory

1 month vacation

The trainee will be given one month of vacation during the 12-month training period, up to 5 days of conference time, and up to 3 days for job interviews. There are currently no after hours on call duties for the fellow. However, on-call duties are subject to change at any time, as per the requirements of the Department of Radiology and within regulated hospital commission guidelines.

Fellows will be evaluated by the supervising attendings who will meet quarterly to discuss the progress of each fellow. Evaluations are based on the written goals of the fellowship program and on an assessment of the fellow’s performance on each of the ACGME’s core competencies: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, system-based practice and professionalism.  All evaluations are reviewed by the Fellowship Program Director. The evaluations will be entered into the New Innovations website, and the feedback will then be discussed with the fellow on a quarterly basis by the fellowship director. The fellow will be expected to also review the quarterly evaluations on the New Innovations website. If a problem is identified, the fellow is mentored individually or assigned to a selected attending who will monitor progress and focus on identified issues.

Rationale:

Recent advancements in CT and MR imaging have led to an explosion of interest and utilization of these techniques to evaluate various aspects of cardiovascular anatomy and cardiovascular and cardiothoracic physiology and diseases. Given the increasing availability and use of these techniques, familiarity with the indications, benefits and limitations of these techniques is important for practicing radiologists. As a result, recommendations for the inclusion of basic training in cardiovascular and cardiothoracic imaging into diagnostic radiology training programs have been endorsed by multiple radiological and cardiovascular societies. Additionally, however, there is an increasing need for cardiovascular imaging subspecialists adequately trained in the techniques of, and the practical application and interpretation of cardiovascular and cardiothoracic imaging, which is beyond the training received in a general radiology residency.

We believe that the opportunities for clinical and research experience provided in our Advanced Cardiovascular Imaging program are sufficiently extensive to accommodate one non-accredited fellow, supported by the radiology department, without detracting from the educational experience of the radiology residents and rotating general cardiology and radiology fellows in our existing accredited programs. The continued growth of cardiovascular and cardiothoracic imaging both at Tisch Hospital and Bellevue Hospital affords a substantial number of opportunities for radiology residents, general cardiology fellows, and radiology fellows to satisfy their procedure performance and didactic educational requirements. We also believe the additional advanced cardiovascular fellow will enhance the educational and research opportunities of all members of our program.

Qualifications of the Trainee:

Individuals eligible for application to the fellowship will include physicians licensed to practice medicine in the State of New York or with a limited NY license who have completed four years of radiology training. Acceptance into the program will be made by the program director and faculty based on the individual’s qualifications, including curriculum vitae and three letters of recommendations from the training program from which the applicant has graduated. Preference will be given to individuals with an interest in pursuing a career in academic medicine. Matriculation is conditioned on satisfactory credentialing.

Scope of Practice:

Fellows should complete a minimum of 100 cardiac CT angiograms (with off-site/indirect supervision by the cardiac attending who is supervising that day) and 100 cardiac MRI exams (with off-site/indirect supervision by the cardiac attending who is supervising that day) by the completion of their fellowship year.

Funding:

This program is supported by the Department of Radiology.

Fellowship Director:

Larry A. Latson, Jr., MD, MS
Assistant Professor of Radiology
Cardiac and Thoracic Imaging Section
NYU School of Medicine