Sports, Orthopedic and Emergency Imaging Fellowship

Sports, Orthopedic, and Emergency Imaging Fellowship

The Sports, Orthopedic, and Emergency Imaging Fellowship in the Department of Diagnostic and Interventional Imaging is designed to train radiologists in both musculoskeletal and emergency imaging.  Musculoskeletal imaging is focused on high-end sports imaging, image-guided musculoskeletal procedures, and musculoskeletal trauma.  Emergency radiology training takes place at Memorial Hermann Hospital, one of the busiest level I trauma centers in the country.

 

Goal

The fellowship in Sports, Orthopedics, and Emergency Imaging is designed to provide advanced training in computed tomography, ultrasound, and magnetic resonance imaging.

 

Length of program

Twelve months

 

Qualifications

The candidate must have completed a diagnostic radiology residency. The candidate should be eligible to obtain a Full Texas Medical license.

 

We are unable to support J1 or H1B visas, and hence unable to entertain overseas applicants with visa restrictions.

 

Positions available

Applications for 2021-2022 fellowship position open on October 1, 2019.  We currently accept 3 fellows annually.

  • Application form
  • Curriculum vitae
  • Personal statement
  • Copy of Medical Diploma and Internship Certificate
  • Three Letters of Recommendation (one from your Residency Director or Head of Department – current employment)
  • A copy of your Board Certification, if applicable
  • A current passport-size photograph

Three positions are available: one with a primarily MSK focus, one with a primarily ER focus and one combined program (about 50/50).

 

Clinical emphasis

Fellow accepted to the Sports, Orthopedic, and Emergency Imaging fellowship will have the flexibility to choose from predominately musculoskeletal, predominately emergency imaging, or combined musculoskeletal/emergency imaging tracks.  Two elective rotations in other specialties such as body MRI, neuroradiology, and breast imaging are available for fellows to further customize their fellowship to suit the needs of their future employment.

Fellows may be promoted to Instructor in the Department of Diagnostic and Interventional Imaging during their training. This change in status allows increased clinical responsibility (average of one day per week of faculty responsibility) with a corresponding increase in salary. This also provides valuable experience for independent practice, and experience in supervising residents.

 

MUSCULOSKELETAL IMAGING

Musculoskeletal imaging rotations are primarily at the Memorial Hermann outpatient imaging department in the Texas Medical Center with 2 rotations at Lyndon B. Johnson Hospital, part of the Harris County Health District.  Fellows will also have the opportunity to rotate at the MD Anderson Cancer Center and the Memorial Hermann Orthopedic and Spine Hospital.

Fellows have the opportunity to interact with orthopedic surgeons, rheumatologists, PM & R, and many other specialties both in interdisciplinary conferences and daily clinical work.  The program provides imaging for many professional and collegiate athletes, including providing imaging services for the Houston Rockets and University of Houston.  Memorial Hermann is one of only two level I trauma centers servicing the greater Houston area and is home to many regionally and nationally renowned sports, joint replacement, orthopedic oncology, and orthopedic trauma surgeons.  Fellows get exposure not just to a wide array of orthopedic pathology but also learn about the latest surgical techniques.

Fellows read musculoskeletal imaging and provide image-guided musculoskeletal injections for Children’s Memorial Hermann Hospital.  Children’s Memorial Hermann Hospital is one of only two children’s hospitals in the region and is the primary referral center for the 16 hospital Memorial Hermann Health System.  Fellows interact and provide services for many pediatric musculoskeletal specialties including rheumatology, orthopedics, and PM & R.

Memorial Hermann Hospital has an orthopedic oncology specialty team that receives both region and national referrals.  Fellows read both initial and follow-up imaging on a wide range of orthopedic soft tissue and bone tumors as well as participate in weekly interdisciplinary orthopedic tumor conferences.  Fellows can further supplement their musculoskeletal oncology experience by rotating through the MD Anderson Cancer Center, one of the premier cancer treatment centers in the nation.

Musculoskeletal interventional procedures are an emphasis of our program.  Fellows are trained in fluoroscopic, ultrasound, and CT guided injections including arthrography, cyst/joint aspirations, tendon/muscle/fascial injections, and peripheral nerve blocks.  Fellows receive training in utilization of various steroids, visco-supplements, platelet rich plasma (PRP), and some prolotherapy.  The opportunity for experience in some spine procedures, such as epidural steroid injections and myelography, is available through elective rotations.

Education is an emphasis for our program.  Fellows participate in weekly orthopedic interdisciplinary conferences as well as weekly musculoskeletal teleconferences with other academic institutions.  Fellows are also encouraged to attend regional orthopedic conferences like the Edward T. Smith Lectureship.  Fellows are expected to assist in preparation for some of the interdisciplinary conferences as well as participate in the teaching of residents as they rotate through the service.

Completion of a research project during fellowship is not required, but is highly encouraged.  Presentation of research material at national conferences is supported financially by the department.  Dedicated academic time for work on a research project is granted on a case-by-case basis.

 

EMERGENCY IMAGING

The emergency radiology component of the SOEI Fellowship Program at UTHealth – McGovern Medical School is designed to provide advanced education and training for candidates wishing to seek a career in emergency radiology. With over 8,000 trauma admissions in 2016, Memorial Hermann Healthcare System – TMC Emergency Center (MHHS-TMC or, simply, MH EC) is consistently one of the busiest level one trauma centers in the world, serving a population of approximately 6 million people, in a 150 mile region surrounding Houston, Texas. Fellows receive training in imaging protocol management, hospital informatics, disaster management planning and, most importantly, imaging interpretation for critically injured patients suffering from blunt and penetrating trauma. Fellows are also exposed to research, education and mentoring opportunities within the department.

 

Rotations

The majority of the clinical rotations for emergency radiology fellows will be in the MH EC. The fellow will begin on weekday shifts, typically M-F, 7am – 5pm. Once the fellows skills are established, the work schedule will be altered to include evening hours, 11am – 7pm and/or 3pm – 11pm. Weekend call duty, 7am – 3pm, will be added as well, with the fellow assigned no more than an average of 1 in 4 weekends. The overall coverage model is subject to change, but has been stable for several years now.

When covering the busy trauma service, fellows will be responsible for ensuring all examinations read by the section are preliminarily interpreted in a timely fashion. As the year progresses, residents will increasingly perform the preliminary interpretations. There will be a gradual increase in fellow responsibility towards supervising and over-reading resident interpretations, based on experience. Eventually, fellows will be asked to provide final interpretations, as part of their faculty responsibilities outlined elsewhere in this document. As we operate our service using a team approach, there will be times when the faculty assists in dictating to keep the service running smoothly. Additionally, fellows will have an opportunity to teach, advise and mentor senior medical students seeking careers primarily in radiology, emergency medicine and surgery when on our service during electives.

MH EC sees a large number of blunt and penetrating trauma patients, from a wide variety of mechanisms. Fellows will gain an appreciation for trends in injury patterns and learn to prioritize patients according to level of severity. Live timely consultation to the emergency medicine and trauma surgery services is encouraged.

A widely varied breadth and volume of medical emergencies are also encountered in the MH EC and our county facility, LBJ Hospital, and many of these examinations will be interpreted by the emergency radiology section.  Some final interpretation of imaging studies of the central nervous system, ultrasonograms and most CTA examinations are provided by the relevant radiology subspeciality section. Similarly, there is a robust pediatric radiology section which handles most of the examinations obtained on pediatric patients.

At times, fellows may be asked to perform and/or supervise radiology/surgery residents doing retrograde urethrography procedures in one of the trauma bays or a dedicated XRay room in the emergency radiology suite. Emergency fluoroscopic examinations, while rare, are also a possibility.

 

Research & Academic Time

Each fellow is expected to complete at least one research project during their year. This will begin with preparing and submitting a research proposal for IRB approval, conducting the data acquisition, drafting a manuscript and submitting it to a peer-reviewed journal for publication. There is also an opportunity for fellows to prepare and submit their work for conference presentation to radiology societies, such as ASER, ARRS or RSNA.

Emergency radiology fellows will be given one full day of office time on most weeks to pursue academic efforts such as research, development of educational materials, and independent study. This will typically fall on a Tuesday or Thursday.

 

Conferences

I3C2 – Monthly national emergency radiology conference hosted online by Emory University. Conference runs on Thursdays from 2pm-3pm CST. Fellow is expected to present at least one case per month. At the time of this writing, this conference is on hiatus.

Multidisciplinary Trauma M & M – Monthly multidisciplinary conference to review problematic cases. The conference, run by the trauma surgery service, is held on 3 Jones, in the Trauma Conference room from 7am-8am. Fellow should attend when possible.

Didactic Conferences – There are two conference series for radiology residents. The weekly Fundamentals course is given to PGY II residents every Wednesday from 1:30pm – 4:30pm. Pertinent lectures are typically given by the Emergency Radiology faculty. However, interested fellows may inquire with the section chief regarding an opportunity to participate by presenting part or all of a session assigned to the emergency radiology section. There is also a daily noon conference given to all radiology residents. Fellows are not expected to attend, but may request permission to attend one or more of these, if of particular interest. At times, fellows may be asked to cover the ERad clinical service while faculty is lecturing or attending meetings. When possible, fellows are expected to attend the radiology department M&M conferences, which are held monthly during the noon hour, typically on a Friday.

 

Emergency Radiology Section Meetings – Fellows may, at times, be asked to attend section meetings, which are typically held monthly on Tuesdays from 5pm – 6pm.

 

Compensation & Vacation

Salary and allotted vacation time are given in accordance with the University of Texas System policies, and administered by the Department of Diagnostic & Interventional Imaging. Additional time away from work may be granted, on an individual basis, by the Emergency Radiology Section Chief, with approval of the Department Chair, to present material at or attend one or more professional conferences.

 

FACILITIES

Memorial Hermann- Texas Medical Center:  Memorial Hermann- TMC is a 1082-bed tertiary care facility with an emphasis in trauma care and transplant surgery.   Within Memorial Hermann- TMC is Children’s Memorial Hermann Hospital, a 278 bed children’s hospital that is a major regional pediatric referral center.  Memorial Hermann-TMC is also home to the Heart and Vascular Institute and Mischner Neuroscience Institute, making Memorial Hermann- TMC one of the preeminent institutions in the region for treatment of cardiovascular and neurologic disease.  Memorial Hermann- TMC is currently in the process of building a new 15-story building to house the Texas Trauma Institute, scheduled for completion in early 2019.  This project will result in significant expansion of the emergency center with increase in emergency center imaging facilities.

The Memorial Hermann-Texas Medical Center Emergency Center is one of the busiest Level 1 Trauma Centers in the country, being one of only two Level 1 Trauma Centers in a region of 9 million people. Memorial Hermann is also the only Level 1 Trauma Center in the region with a helipad, accepting critical patients from within a 150 mile radius.

Memorial Hermann- TMC Outpatient Imaging Department:  The Memorial Hermann-TMC outpatient imaging department is located within the outpatient medical plaza across the street from Memorial Hermann- TMC hospital.  The imaging center is self-contained, with both 1.5T and 3T MRI, CT, US, mammographic, radiographic, fluoroscopic, and nuclear medicine facilities on site as well as daily musculoskeletal procedures. The medical plaza is home to multiple specialties, including orthopedics, rheumatology, PM & R, and oncology. The clinical Sports Medicine Institute is currently undergoing a dramatic expansion, with significant increase in number of dedicated orthopedic specialists who specialize in the care of high-end sports athletes, as well as joint replacement, physical therapy, and general orthopedics.

Lydon B. Johnson County Hospital:  LBJ hospital is a 332 bed level 3 hospital that provides a unique exposure to both advanced emergency medicine and musculoskeletal pathology.  LBJ has robust orthopedic and rheumatology services.  Image guided musculoskeletal procedures and diagnostic musculoskeletal ultrasound services are provided a few days each week.

Memorial Hermann Orthopedic and Spine Hospital:  MHOSH is a small (10 OR, 64 Bed) hospital that provides a variety of services, including inpatient and outpatient orthopedic care, sports medicine, orthopedic and neurological spine surgery, and pain management.  Radiology services provided at this hospital primarily involve radiography, CT, and MRI interpretation with some orthopedic and spine interventional procedures.

MD Anderson Cancer Center: One of the nation’s top cancer centers.   Fellows rotating through this hospital read primarily CT and MRI of musculoskeletal tumors and tumor-like lesions.

 

Musculoskeletal Faculty

Manickam Kumaravel, MD; Section Chief

Nicholas M. Beckmann, MD; Program Director

Haitham K. Awdeh, MD

Pritish Bawa, MD

Susanna C. Spence, MD

 

Emergency Radiology Faculty

Clark West, MD; Section Chief

Ronald M. Bilow, MD; Program Director

Jeffrey J. Carlson, MD

Suresh Cheekatla, MD

Naga Ramesh Chinapuvvula, MD

Miguel G. Fabrega, MD

Amanda M. Jarolimek, MD

Latifa Sanhaji, MD

David Zelitt, MD

 

Career opportunities

The Sports, Orthopedic, and Emergency Imaging fellowship provides an excellent opportunity for comprehensive training in musculoskeletal and/or emergency imaging, both of which are consistently in demand in most job markets.  Our program is flexible to allow fellows to tailor training to fit their future academic or private practice career.  Faculty shifts during the fellow provide fellows not only with supplemental income but also allow fellows to maintain general diagnostic radiology skills and become more comfortable working independently.

 

 

Program Directors

Nicholas M. Beckmann, MD

Program Director- Musculoskeletal Imaging

6431 Fannin Street, MSB 2.130B
Houston, Texas 77030

Nicholas.M.Beckmann@uth.tmc.edu
Telephone: 713-500-7706
Fax: 713-500-7710

 

Ronald M. Bilow, MD

Program Director- Emergency Imaging

6431 Fannin Street, MSB 2.130B
Houston, Texas 77030

Ronald.M.Bilow@uth.tmc.edu
Telephone: 713-500-7706
Fax: 713-500-7710

 

 

Contact

Faith E. McDaniel
Senior Fellowship Program Coordinator
Sports, Orthopedic, and Emergency Imaging
6431 Fannin Street, MSB 2.010A
Houston, Texas 77030

Faith.E.McDaniel@uth.tmc.edu
Telephone: 713-500-7488
Fax: 713-500-7653