Curriculum and Rotations

Our program prides itself on providing excellent training to its residents with graduated responsibility for each individual resident for performance of procedures and interpretation of images under the supervision of the attending physicians. The academic year consists of 13 four-week block rotations.

  • Year One training consists of rotations in Body CT/MR, Fluoroscopy/Inpatient, Plain Films, Ultrasound, Emergency Radiology, Neuroradiology (CT & MR), Pediatric Radiology, and Vascular/Interventional Radiology, providing residents with a solid foundation upon which to begin their training.
  • Years Two and Three of residency training build upon this solid foundation with rotations throughout all areas of radiology, including: Body CT/MR, Breast Imaging, Emergency Radiology, Musculoskeletal Radiology, Neuroradiology, Nuclear Medicine, Pediatric Radiology, Ultrasound, Procedure Service, and Vascular/Interventional Radiology. In addition, third-year residents attend the American Institute for Radiologic Pathology (AIRP) four-week course in Silver Spring, Maryland.
  • During Year Four of training, senior residents are encouraged to create two separate 3-month mini-fellowships tailored to their personal educational needs and interests, within the ABR and ACGME requirements. Prior mini-fellowships have included electives in clinical research, away rotations, or advanced-imaging blocks focused on subspecialty MR techniques.

In addition to a core radiology lecture series, our residents are exposed to a “non-interpretive skills” curriculum throughout the four-year residency. This curriculum includes lectures dedicated to a variety of diverse subjects, including research methods, quality and safety, healthcare ethics, personal finance, and healthcare economics. In addition to didactics, this curriculum also includes small group workshops in which the residents hone their leadership skills and teaching methods.

Rotations

Interventional Radiology

The Interventional Radiology Department provides an exciting training opportunity for residents with hands-on participation from day 1. Residents play a vital role in the functioning of the service and have the opportunity to learn and perform a wide array of interventional procedures including peripheral vascular procedures, interventional oncology, and cerebrovascular interventions. Resident education is integrated into daily activities with extensive one-on-one training with our staff. In addition to developing excellent procedural skills, residents will become proficient in patient consultation and treatment planning as well as post procedure care.

Because MetroHealth is the Cleveland area’s busiest and longest-established Level I Trauma Center, residents directly participate in a multitude of emergent life-saving procedures including endovascular solid organ embolization and vascular repair. The Interventional Radiology department maintains a close and collaborative relationship with the Vascular Surgery division for the treatment of peripheral vascular disease management. Weekly vascular conference is attended by both divisions.

MetroHealth is certified by the American Heart Association and American Stroke Association as a Comprehensive Stroke Center, and the radiology department at MetroHealth Medical Center is home to a thriving Neurointerventional Service. In addition, the chair of the Radiology department is an Interventional Neuroradiologist who is internationally recognized as a pioneer in endovascular stroke therapy. While on the Interventional Radiology rotation, residents will be exposed to, and can assist on, carotid stents, cerebral angiograms, and cerebral aneurysm coil embolizations, all of which occur daily.

Biopsy/Procedure Service

Interventional Radiology's biopsy service performs image-guided biopsies, tumor ablation, and other procedures utilizing a multimodality approach including US, CT, and Fluoroscopy. A variety of interventional procedures are performed including paracentesis, thoracentesis, abdominal organ biopsies, thyroid biopsies, abscess drainages, and vascular access. 

Residents on this service also receive training in the interpretation of noninvasive CTA and MRA studies with IR staff. Our vascular studies are performed on a 256-slice CT scanner and a 3.0 T MRI which provide excellent spatial and temporal resolution.

Body CT/MRI

Body CT/MR is one of our busiest services and typical daily staffing consists of two attendings and two to three residents. This team interprets a high volume of complex diagnostic studies and provides in-person consultative services. Residents rotate on the Body CT/MRI service throughout all 4 years of training and become experienced in the interpretation of a wide variety of chest, abdomen, and pelvis CT and MRI studies.

Body MRI volume continues to grow with increased utilization for hepatic and renal mass characterization, MRCP, staging of rectal cancer, evaluation of benign and malignant gynecologic disease, prostate cancer screening and staging, and cardiac MRI. Residents gain early experience in MRI beginning year one, and steadily build their fund of knowledge throughout residency, frequently becoming experts in MR interpretation by the completion of training.

Breast Imaging

The Breast Imaging and Intervention section utilizes screening and diagnostic imaging and CAD (Computer Aided Detection) to identify and characterize breast abnormalities. Diagnostic and therapeutic breast interventional procedures are also offered, including stereotactic, ultrasound-guided, and MRI-guided procedures. The Breast Division at MetroHealth was among the first in Cleveland to utilize 3D breast tomosynthesis and the first to perform Automated Breast Ultrasound Screening (ABUS). While on this rotation, residents will become facile with each modality as well as minimally invasive breast interventions.

All breast imaging studies are interpreted at our state-of-the-art outpatient breast imaging center at MetroHealth's West 150th Health & Surgery Center.

Emergency Department

Due to the integral nature of the Emergency Department (ED) and Trauma Surgery at MetroHealth, a substantial portion of our Radiology Department services are provided for trauma and emergency patients. Residents on this rotation learn how Radiology can directly impact patient care by working closely with colleagues of these clinical services and gain mastery of the interpretation of emergency radiographs and CTs for this patient population. 

As a result of the partnership of the radiology residencies of MetroHealth and Cleveland Clinic Foundation, radiology residents from the Cleveland Clinic also rotate on this service for training in emergency radiology.

Plain Films/Fluoroscopy

While on this rotation, residents gain mastery of basic GI, GU, and reproductive system fluoroscopy techniques under direct attending supervision.

MetroHealth continues to expand into the community, and as a result, the department’s outpatient imaging volume continues to grow. Another primary focus of the rotation for the residents is learning the fundamentals of plain films through the interpretation of inpatient and ambulatory radiographs, one-on-one with the attending radiologist.

Musculoskeletal Imaging

Musculoskeletal Radiology involves the imaging evaluation of bones, joints, muscles, tendons, and ligamentous structures of the body. The pathologic entities encountered include traumatic musculoskeletal injuries, sports injuries, benign and malignant bone and soft tissue neoplasms, metabolic bone diseases, arthritis, congenital/developmental lesions, and bone and soft tissue infections.

Virtually all imaging modalities are utilized in Musculoskeletal Radiology, including plain radiographs, CT, ultrasound, and MRI studies. This service continues to grow, especially in the fields of musculoskeletal MRI and ultrasound.

Neuroradiology

CT and MRI are the primary diagnostic tools of the Neuroradiology section, including advanced imaging techniques such as CTA, MR perfusion and spectroscopy. Our CT volume is particularly intensive given the hospital’s role as a center of excellence for both trauma and stroke.

Residents on this service learn to interpret both routine and advanced neuro studies beginning in year one of training and are taught daily by a vibrant group of 7 Neuroradiology faculty with a combined experience of decades in the field.

In addition to cerebrovascular disease and trauma, the neuro case mix includes comprehensive experience in neuro-oncology, CNS inflammatory disease, extra-cranial head and neck pathology, pediatric neuroradiology, and diseases of the spine.

Nuclear Medicine

A wide array of examinations are performed in the Nuclear Medicine Section, including nuclear cardiac imaging, lymphoscintograms for pre-operative sentinel node localization in patients with malignant melanoma and breast cancer, and PET/CT imaging. Also, radioactive iodine is extensively used in the Nuclear Medicine Section for treatment of benign and malignant diseases of the thyroid gland.

The Nuclear Medicine Section strives to provide reliable and efficient service through our dedicated technologists and radiologists. Our staff is highly trained, including special competency certification in Nuclear Medicine from the American Board of Radiology.

Pediatrics

The Department of Radiology at MetroHealth Medical Center has aligned with University Hospitals Health System in Cleveland to provide Pediatric Radiology services to our patients. Through this partnership, radiology residents at MetroHealth receive education in pediatric radiology at Rainbow Babies and Children’s Hospital.

This experience provides our residents with valuable educational opportunities interpreting pediatric imaging studies and performing interventions at a quaternary care referral center. The administration of both the MetroHealth and University Hospitals Radiology residencies are committed to ensuring that this is a beneficial educational experience for our residents.

Ultrasound

Residents rotate on the Ultrasound service all 4 years of training and gain mastery with both interpretation and performance of ultrasound studies. On this service residents learn to interpret right upper quadrant, renal, pelvic, small parts, vascular and first trimester obstetrical ultrasound. Residents in their 3rd year of training also rotate on the obstetrical ultrasound service in the Fetal Diagnostic Center to gain familiarity with 2nd and 3rd trimester obstetrical ultrasound.

Additionally, we provide ultrasound guidance for a variety of surgical procedures including brain, liver, and pancreas biopsies/resections, and various gynecologic procedures. While on the ultrasound service, residents will become familiar with each of these applications.