Wednesday, December 30, 2009

Top Radiology Blog Posts Of 2009

Thank you for reading along this year. Hopefully you have learned something from the content provided here. Looking for more great stuff? Here are the top posts of 2009:

Happy 2010! Thanks for reading!

Monday, November 30, 2009

Does Radiologist Salary Matter?

Before answering the question does radiologist salary matter, it is important to know what we are discussing in the first place, namely the salary range for a radiologist. The question is more complex than it seems on the face of it, as there are many factors that play into what a radiologist's salary ultimately is. Do they work in the Southwest or the Northeast? Is it fair to compare the salary of a mammographer to the salary for an interventional radiologist? How much experience does the radiologist have? All these questions enter into the equation. However, to simplify, most people would agree that most radiologists earn between $300,000 and $500,000 across sub-specialties and regions. Clearly, a good salary by any standard, but that brings us to the questions posed above:

Does Radiologist Salary Matter?

The knee-jerk response is, of course! Sure it does! Would all these doctors be radiologists if salary did not play a role? And yes, of course, salary mattters - it is doubtful that most radiologist, or most doctors in general, would work for free. However, the point of this question isn't to question the amount of salary radiologists receive, but whether a higher salary is correlated with higher job satisfaction.

Like radiologist salary, many factors play into radiologist job satisfaction. These factors include scheduling flexibility, opportunities for career advancement, job security, and workload. Interestingly though, another factor to consider that is more intangible is the work environment. Across practice settings, having a sense of teamwork and camaraderie based on mutual respect can enhance the work experience for everyone involved, from x ray technician to the senior parter or chair of the department. This concept cannot be overstated - you will be around these people for a majority of your day, so you might as well like them.

If salary were the only consideration, you would expect to see all radiologists competing for the jobs with the highest compensation, but clearly this is not the case. In fact, some commentators view an excessive emphasis on income as a sign of job dissatisfaction. The sense that salary is all that matters implies that the physician has lost interest in the work itself and is looking for other outlets in order to feel a sense of worth. Fortunately, practices and hospitals are increasingly likely to provide resources these issues earlier instead of letting them fester and affect job performance. Ultimately, salary is only one of many items that play into a radiologist's job satisfaction.

Friday, November 20, 2009

Locum Tenens Radiology Jobs Gaining Popularity

Locum tenens radiology jobs have been around for a long time but have recently become more popular. This trend is especially marked among mid-career radiologists looking for more career flexibility. According to Medscape:
Plagued by issues of managed care, mounting paperwork, malpractice costs, and diminishing reimbursements, a percentage of physicians are stepping away from traditional practices to explore alternative career options. Some have chosen to hang out a new shingle: doctor for hire.

In previous years, locum tenens (a Latin phrase meaning "to stand in another's place") positions were typically filled by early career and semiretired physicians, but recently more midcareer physicians are choosing temporary assignments. A 2008 survey of 12,000 doctors, most of them primary care physicians, reported that 7.5% expected to work as locums in the next 3 years. In 2009, the number of physicians working as locums is anticipated to increase by 16% over that of 2008, according to a report by the Braff Group, a healthcare merger and acquisitions company.

For some physicians, working as a locum is a bridge between full-time assignments or a way to experience how medicine is practiced in various parts of the country before choosing to move to one area. For others, locum tenens work is a way to supplement retirement savings hit hard by the recession. Yet, for a growing number of physicians, locum tenens work is their preferred form of medical practice.

Clearly, the motivations for working locum tenens are quite varied, but the increasingly rigid nature of U.S. healthcare is driving physicians to consider what practice settings best fit their career goals. What are your career goals? Does locum tenens make sense for what you want to achieve? The New England Journal of Medicine recently explored this topic and noted the following:
A decade ago, physicians who elected the free-spirited locum tenens lifestyle — as a way to try out practice settings or merely explore new places — tended to cluster at either end of the career spectrum: doctors just out of training and those nearing retirement.

Those two groups still account for the majority of medical professionals who take temporary assignments, an estimated 60 percent, but there’s a shift afoot. Surveys conducted in recent years have found that a growing number of physicians who might be deemed “mid-career” are looking to locums as either a bridge to a potential career change or a semi-permanent practice option.

For New York City internist and infectious disease specialist John L. Ho, MD, locums has proved a good foundation for making his move from a 22-year stint in academia to the next chapter — whatever that may be. He is working as a hospitalist at Southern Maine Medical Center in Biddeford, filling in for a physician who is currently serving in the National Guard. He landed in coastal Maine after completing his first Staff Care assignment at rural Eastern Maine Medical Center.

“I always maintained my love of acute care medicine, even though my major activity at Cornell was research based. I truly got tired of running from grant to grant,” Dr. Ho said. “I am enjoying these assignments and all of the patient interactions I have now,” said Dr. Ho. He also likes the non-urban setting far more than he expected. His colleagues have been welcoming and collegial, and the patients surprisingly cordial, based on his previous experience in a large urban center. “They’re much more grateful. They actually say ‘thank you’ — and that has been gratifying,” he said.
Marci Malone, MD, is among the growing number of physicians who take locum tenens assignments regularly in addition to working full time in a practice. In fact, many colleagues look at the New York anesthesiologist quizzically when she talks about spending her “vacation” working locum tenens in remote corners of the Southwest. Since 2001, she has spent roughly a month each year working at Indian Health Service (IHS) hospitals in places like Gallup, New Mexico, and isolated Chinle, Arizona, where she has gone several times. “I have a hard time taking a vacation, so this is my idea of what to do with my spare time,” Dr. Malone said.

She finds both the work and the setting a welcome reprieve from the urban rat race, and the facilities, contrary to what some physicians might expect, she observed, are modern and well run. “The facilities may not be completely computerized, but from the anesthesia standpoint, they have almost all of the toys any of us could want,” she said. “The case load is different at IHS hospitals than at urban centers, however, because we’re not usually dealing with typical ER patients. The cases can be less demanding because most of the patients who need surgery, even if they have four comorbidities, have received a lot of regular and preventive care.”

The OR workday is often slightly shorter than her typical New York shift, but the call duty can offset that plus. “It can be just as brutal at times,” she said. Those challenges are easier to deal with, she added, because she enjoys the patients. She has grown especially fond of the Navajo Nation patients she cares for during her Arizona assignments. “They are very gracious people who have little but are willing to share what they have. Working with them helps me reset my expectations about life,” Dr. Malone said.

Hearing the experiences of these physicians shows that you could get more out of locum tenens than you would have initially expected. In addition to extra radiologist salary, you may also experience a new part of the country or new setting, interacting with patients and colleagues you never would have otherwise. Locum tenens radiology jobs could potentially broaden not only your intellectual horizons but your social ones as well.

Tuesday, November 10, 2009

Radiology Locum Tenens Salaries And Jobs

As with any job, an important consideration is salary, whether it be mammographer salary trends or interventional radiologist salaries or radiology salary trends in general. However, one aspect these discussions do not fully capture is the availability of temporary employment within radiology, also known as locum tenens positions.

What are locum tenens radiology jobs?

Locum tenens is Latin for a placeholder, or one who temporarily fulfills the duties of another. Within American medical practice, there are many opportunities for locum tenens work, especially in hospitals that are under-staffed or are work in underserved areas. Of course, by definition, these jobs are temporary in nature. Still, many practitioners find them desirable for a variety of reasons.

What are the advantages and disadvantages of locum tenens radiology positions?

As locum tenens radiology jobs are temporary, they are afforded certain benefits not available to permanent employees while denied others. In general, per Wikipedia, there are several common advantages and disadvantages to a locum tenens position in any field:
Locums provide a ready means for organisations to fill positions that are either only temporarily empty (during sickness, leave or for other reasons) or for which no long-term funding is available. Locuming also allows a professional to try (and get experienced in) a wide range of work environments or specialisation fields which a permanent employee may not encounter.

However, the locum situation also has a number of disadvantages - the transient nature means extra stress and work for the locums whenever they have to fit into a new position, and for the hiring organisation, this generally means that the required flexibility (and often, the lack of a guaranteed income) has to be rewarded with high salaries. These may in the long term create higher costs for the hiring organisation than adding more full-time positions (especially in highly-skilled, accredited professions, and unlike the situation in some professions where cheap temporary labour or significant use of interns actually undercuts wages and reduces total staff costs).

Also, and especially true in professions where knowing all procedures and past case histories is important (such as for doctors working on patients, who may dislike not being treated by their own doctor, or by constantly shifting doctors), locums may provide lesser-quality work (or be seen as posing such a risk, fairly or not). Further, locums often experience resentment from permanent staff, for example because they are paid more, or because they are considered to shoulder less responsibility.
It is up to you to weight the advantages and disadvantages of any particular situation as compared to your career goals. If you are unsure, locum tenens is something to consider trying because by its nature, it does not require a significant commitment.

Why do practices offer locum tenens jobs?

Another important to consider is the motivation of your potential employer in offering the job. Is a partner taking a sabbatical? Are they looking for someone to 'tryout' before offering a full-time position? Are they trying to provide a service for which they have a low but still significant volume of business? All of these are possible reasons, and most employers will be up-front about their reasons for creating the opportunity. Indeed, they have little incentive not to be. However, it is still your responsibility to make sure you have this question answered for that particular opportunity before making a final decision.

How much do radiologists working locum tenens get paid?

There is a wide range of compensation available for locum tenens radiology positions, depending on the specifics of the job and the work required. While it is difficult to draw a direct comparison to the salaries of, say, interventional radiologist salaries, radiologists working locum tenens can make up to $1200 to $1500 per 8 hour shift. Again, this number can vary significantly by number of studies read, the type of study being read, the specific shift (daytime vs night, weekday vs weekend), the practice setting, and geographic location.

Whether you are starting out in radiology and want to sample different practice settings, in mid career and want to broaden your clinical experience, or in the twilight of your career but still want to be an active radiologist, a locum tenens radiology job may be the right option for you. Start searching today!

Sunday, October 25, 2009

How To Read A Pelvis Plain X-Ray

There is a great post on Bone Broke? Me Fix!, a blog by an orthopedics resident, about how to read a pelvis film:
I saw the Quick Guide to reading a Chest X-ray over at ScrubNotes, and decided to publish the ortho version: How to read an AP Radiograph of the Pelvis. As with the CXR, it is important to evaluate the AP radiograph of the pelvis using a systematic approach. Here is that approach that I have been taught.

There are six lines that one should evaluate when looking at an AP radiograph of the Pelvis.
1. The iliopectional line to evaluate the anterior column.
2. The ilioischial line to evaluate the posterior column.
3. The dome of the acetabulums.
4. The 'tear drop' to evaluate the anteroinferior portion of the acetabular fossa.
5. The anterior rim of the acetabulum.
6. The posterior rim of the acetabulum.

It is also, of course, important to evaluate the rest of the bony structures visible on the radiograph, including the pubic rami, the SI joints, the neck of each femur, the visualized lumbar spine and sacrum, and the pubic symphysis.

Fractures in the pelvis can be difficult to visualize and if there is doubt, one can order additional views, including inlet and outlet views to further evaluate for rami fractures. The inlet view will allow for evaluation of the superior rami for fractures and the pelvis for anterior-posterior displacement of the pelvis. Outlet views will allow for evaluation of the inferior rami for fractures and for determination of superior-inferior displacement of the pelvis. Judet views are one additional study that can be ordered to evaluate the acetabulum. These views are shot at a 45 degree angle to the pelvis. The obturator oblique radiograph will allow for evaluation of the anterior column and the posterior wall of the acetabulum. The iliac oblique, conversely, will allow for evaluation of the posterior column and the anterior wall of the acetabulum.

For more, check out the full post: How To Read An AP Pelvis

Sunday, September 13, 2009

What Is Ultrasound Imaging?

There are several major modalities in radiology: plain x-ray, computed tomography (CT), magnetic resonance imaging (MRI). Today, we cover another major tool in the radiologist's toolbox, ultrasound.

What is ultrasound imaging or medical sonography?

Ultrasound imaging, also known as medical sonography, utilizes the principles of sound waves and physics to generate images without using radiation. Ultraound is a type of sound wave. All sound waves can be characterized by their frequency and amplitude, which denote the amount of energy carried by the wave. Ultrasound refers to spectrum of acoustic waves with a frequency above the range of human hearing, approximately 20,000 hertz.

The basic question regarding ultrasound is how are sound waves converted into a diagnostic image? The basic process involves three steps: the creation of appropriate sound waves, the reception of the echoes, and the processing of those echoes into an image. A transducer on the ultrasound machine produces sound waves in the 2 to 18 megahertz range. These waves are then transmitted into the body via an interface, typically a rubber-coated probe with a gel interface with the patient's skin in order to produce efficient transfer of waves into body tissues. Once the wave is in the body, it propagates until it hits tissue of sufficient density to create a reflection, or echo. The echo travels in reverse, eventually striking the transducer, which contains a receiver. The receiver's vibration is translated into an electronic signal. The ultrasound machine contains a processor which calculates the time it took the echo to return and how strong the echo was in order to determine which pixel on the screen to light up, and at what intensity. Repeating this process for each wave and each pixel yields the image seen on the ultrasound machine's screen. This covers the basics of ultrasound image production, but more technical discussions are easily found.

What are the benefits of ultrasound?

The main benefit of ultrasound is that it does not use radiation, which makes it safer to use in general. Ultrasound is particularly useful in pregnant women to image the fetus, as well as in newborns who are still undergoing tissue development which may be susceptible to radation. Another major benefit of ultrasound is portability. Although the machines are expensive, they can be wheeled around on a cart, which makes it easy to do bedside imaging or imaging on critical patients who cannot be moved easily. Furthermore, this reduces expense as a dedicated ultrasound facility is not necessarily needed.

What are the applications of ultrasound?

Ultrasound has applications in nearly every field of medicine. Some of the most prominent are cardiology, obstetrics, gastroenterology, and gynecology/urology. In cardiology, ultrasound in combination with Doppler sonography is used to produce echocardiograms, which assess both the structure of the heart as well as flow within the heart. Obstetric ultrasounds are very common, and are used to track healthy pregnancies as well as diagnose problems in difficult pregnancies. In gastroenterology, ultrasound is better at producing images of certain pathologies, such as biliary disease like gallstones and liver imaging. For urology / gynecology, ultrasound is used to image the kidneys, bladder, ovaries, and other pelvic structures for a variety of pathologies.

Friday, August 21, 2009

What Is An MRI (Magnetic Resonance Imaging)?

After the development of computed tomography (aka the CT scan), the next big jump in radiology was the development of the imaging modality known as magnetic resonance imaging, or MRI.


The History of Magnetic Resonance Imaging (MRI) Development


The basis of MRI lies in understanding how to apply the chemical principle of nuclear magnetic resonance to living tissue to produce an image (discussed more fully below). While there are many people involved in the research that brought MRI to fruition, the Nobel Prize Committee recognized two individuals in particular: Paul C. Lauterbur and Sir Peter Mansfield. In Lauterbur's own words, here is how he came upon the idea of using NMR for biomedical imaging:
After I returned to Stony Brook, by a long, leisurely automobile drive from California with my family, and settled in again to my department (where I found the same arguments continuing that had been going on when I left) another unexpected event occurred. It had its beginning several years earlier, when a field service engineer for Varian, the leading NMR company, saw an opportunity and asked for my opinion on his idea of starting his own company to make or distribute specialized NMR equipment and supplies. His business plan seemed reasonable, and I encouraged him to go ahead. For a time the company thrived, and I was a member of the Board of Directors.

In May of 1971, however, some other members of the board compared notes with the company's banker and found that the company had engaged in some very dubious business practices and was, in fact, bankrupt. At a hastily-called Board meeting, appropriate actions were weighed, and the banker, there as a guest, threatened to close the company that day unless someone he trusted could be persuaded to take over as President, Chairman of the Board, and Chief Executive Officer. I was the only academic on the Board, the semester had just ended, and the others believed that I was free for the summer, so that I was asked to take the job. I agreed, flew to the company headquarters in New Kensington, PA, near Pittsburgh, at the beginning of each week and back to Stony Brook and my family and students for the weekend.

The developments at the company could supply the plot for a novel, but the incident that is important for my purpose here is that a post-doc arrived with tumor-bearing rats to check the proton NMR relaxation times of their tumors and normal tissues and organs. I was there to observe the experiments, and noted that large and consistent differences were observed for specimens from all parts of the sacrificed animals and that the experiments seemed well-done. Some individuals were speculating that similar measurements might supplement or replace the observations of cell structure in tissues by pathologists, but the invasive nature of the animal procedure was distasteful to me, the data too complex, and the sources of differences too obscure, to be relied upon for medical decisions. As I pondered the problem that evening, I realized that there might be a way to locate the precise origins of NMR signals in complex objects, and hence to form an image of their distributions in two or even three dimensions. That story, and its consequences, is told more fully elsewhere.
As for the first MRI image itself, here is Mansfield's account:
I was still very much concerned with imaging speed and also the question of sliced definition. After a lot of thought and discussion with Peter Grannell we came up with a method of slice selection which looked as though it might work reasonably well. Alan Garroway also came up with a different method of slice selection using a string of short pulses to define the slice and between us we thought that the sensible approach would be to combine our efforts and publish a short note on the general technique of slice selection. This was sent to the Journal of Physics and was published in the form of a letter. The question of imaging times was still concerning me and during the course of 1974 I spent a great deal of time turning over my thoughts on how this may be achieved. One way forward was what I called line scan imaging. In this method a line of magnetization in a specimen was selectively excited and read out. This process was repeated until the object had been scanned. The technique was much faster than the sensitive point scan method of Hinshaw and also turned out to be faster than the projection reconstruction method of Paul Lauterbur, but I was still not satisfied. Nevertheless, line scanning was used to produce a number of images and in particular it was used to scan the finger of one of my early research students, Dr Andrew Maudsley. The scan times for these finger images were 15-23 minutes. These were the first images of a live human subject and were presented at a special meeting of the Medical Research Council which was convened in 1976 to review the work of the several imaging groups that had sprung up both at Nottingham and also in Aberdeen. All groups were vying for MRC support and this meeting was called specially to review the topic and to decide how best to support the work. The images demonstrating live human anatomy were annotated by Professor Rex Coupland, then head of the Department of Human Morphology. They produced a startling response at this meeting and convinced the MRC that our work should be supported. We produced a grant application requesting a substantial sum of money to produce a whole body MRI machine.
Since the 1970s, the rapid development of technology in broad terms has fostered the development of MRI as a practical, and in some cases now, essential tool for physicians, changing the standard of care forever.


The Principles Behind Magnetic Resonance Imaging (MRI)


A detailed explanation of the physics and chemistry that go into using magnets to produce images is beyond the scope of this blog. However, Wikipedia has a nice section that explains MRI in plain and easy-to-follow terms:
The body is largely composed of water molecules which each contain two hydrogen nuclei or protons. When a person goes inside the powerful magnetic field of the scanner, the magnetic moments of these protons align with the direction of the field.
A radio frequency electromagnetic field is then briefly turned on, causing the protons to alter their alignment relative to the field. When this field is turned off the protons return to the original magnetization alignment. These alignment changes create a signal which can be detected by the scanner. The frequency of the emitted signal depends on the strength of the magnetic field. The position of protons in the body can be determined by applying additional magnetic fields during the scan which allows an image of the body to be built up. These are created by turning gradients coils on and off which creates the knocking sounds heard during an MR scan.
Diseased tissue, such as tumors, can be detected because the protons in different tissues return to their equilibrium state at different rates. By changing the parameters on the scanner this effect is used to create contrast between different types of body tissue.

Contrast agents may be injected intravenously to enhance the appearance of blood vessels, tumors or inflammation. Contrast agents may also be directly injected into a joint in the case of arthrograms, MR images of joints. Unlike CT, MRI uses no ionizing radiation and is generally a very safe procedure. Patients with some metal implants, cochlear implants, and cardiac pacemakers are prevented from having an MRI scan due to effects of the strong magnetic field and powerful radio frequency pulses.

The Future of Magnetic Resonance Imaging (MRI)

MRI has found many applications in the medical field. Functional MRIs are used to assess how differential delivery of glucose reflects neurological function in conscious subjects. There are many potential applications of functional MRIs, ranging from studies in psychology and economics to more medically-related applications in psychiatry. In oncology, MRIs are being paired with PET scans to further improve the sensitivity of tumor detection. If the last few decades are any indication, the next ten years will likely see an explosion of MRI installations and application development, to the degree that one day an MRI might be as routine as a plain x-ray.

Friday, August 14, 2009

What is PACS?

Imagine you writing a blog about, say, vegetarian Indian food recipes. The blog would consist of a collection of recipes (text data) and images of the food prepared (visual data). To transfer this information to other people, you would need some kind of system that would store the data and then be able to transfer it at will to other interested parties. This structure is the blog software and the server hardware. In other words, this is a picture archival and communication system, or PACS.


The History of Picture Archival and Communication System (PACS)


The concept of a PACS was first discusssed in the early 1980s. While no one individual can be credited with the full development of PACS, this article in Imaging Economics describes some of the contributions of early leaders in PACS development:
"Any image, anytime, anywhere—that's the mantra," says Reuben Mezrich, MD, PhD, describing the capability of the modern PACS (picture archiving and communications system). "But none of this could have happened without DICOM (digital imaging and communication in medicine).

"If you could give a Nobel Prize for DICOM, that would be a good thing," adds Mezrich, professor of radiology and chairman of the radiology department at the University of Maryland School of Medicine, Baltimore.

DICOM is a meticulously developed set of standards that allow systems to interface. It specifies how devices built in conformance with the standards react to commands and data being exchanged. DICOM, for instance, lets a CT scanner made by one manufacturer, an MRI scanner made by a second company, and an ultrasound machine made by a third company all communicate with the same PACS. It is because of DICOM that images from all three modalities, and others as well, can be displayed and interpreted at the same PACS workstation. The images can all be sent to the same PACS archive. DICOM is the computer standard that lets a PACS do its work.

If, as Mezrich suggests, a prize were given for DICOM, the recipient would most likely be Steven C. Horii, MD, who is now a professor of radiology and clinical director of medical informatics at the Hospital of the University of Pennsylvania, Philadelphia. By informal acclaim from his peers, Horii is credited with being the DICOM point man. He is cited for putting in the long hours and the blood, sweat, and perseverance that were necessary to DICOM's creation.
As with the development of any new standard, many people from many different backgrounds were involved to help create PACS and DICOM and secure their interoperability with other systems, which was the key to the success of the standard.


Picture Archival and Communication System (PACS) And Radiology

Almost all modern radiology services now use some kind of PACS system to manage their data and communicate with other services. The four basic components of PACS are:
  • Imaging Modality - CT, MRI, X-ray
  • Secure Network - to transmit data, typically over a VPN or SSL connection
  • Workstations - to view and manipulate images
  • Archives - to store and retrieve images
The most common format used on PACS is DICOM (Digital Imaging and Communication in Medicine). Although the format is widely used, it is not a strictly defined format. Vendors have the ability to define their own metadata tags for new features unique to their own systems. While this gives DICOM flexibility, it limits interoperability, as legacy viewers are unable to interpret novel metadata tags. Another issue for PACS is the integration of full field digital mammography (FFDM) into existing PACS systems versus the non-integrated solution of buying separate mini PACS workstations for digital mammography.

Regardless, PACS is key to the functioning of a modern filmless radiology department. Beyond simply proving image archival and display, a PACS must be able communicate with other hospital information systems, such as the hospital information server (typically where the full patient's EMR and biodata is stored) as well as the radiology information server (RIS).

The future of radiology is dependent on the continual development of PACS as a standard and as a tool that lets radiologists communicate their findings to their own colleagues, to other specialties, and ultimately to patients themselves.

Friday, August 7, 2009

Mammographer Salary For 2009

Many of you have heard about mammography and the various trends in this field over the past 10 or 15 years. After hitting a low point a few years ago, the field seems to be making a comeback, primarily due to tort reform. The field has many opportunities for young practitioners.


What is a mammographer?

Before discussing salary issues, we should first define which field and specialists we are talking about. Mammographers are diagnostic radiologists who are fellowship-trained in imaging of the breast. Some centers are moving away from the name of 'mammography' towards the broader field of women's imaging, which would include imaging of the female genitourinary tract, as well as have a broader role in patient care, specifically women's health issues. Regardless, the main focus would still remain on diagnosing and intervening on disease of the breast using various imaging modalities. The main modality is, of course, a mammogram, which uses intense radiation beams in special machines at various planes to produce 2-D images of the breast. However, new imaging including MRI and musculoskeletal radiology are opening new avenues for imaging of the breast. Some programs now offer a combined mammography/musculoskeletal fellowship for radiology residents interested in pursuing the cutting edge in mammography.

In addition to diagnosing lesions of the breast, mammographers are involved in biopsying such lesions through stereotactic biopsies, in which the biopsy is performed via large bore needles in the radiology suites instead of in an operating room. Furthermore, a mammographer may be heavily involved in patient care, as the mammographer often may be the first physician to inform a patient of a suspicious breast lesion which may turn out to be cancerous. Such a diagnosis can have a huge impact on a patient's life, even if the lesion eventually turns out to be benign. Given the gravity of the situation, it is important for mammographers to be fully trained to deal with all the dimensions of their job.


Why is mammography making a comeback?

A few years ago, litigation posed a serious threat to mammography. A mammogram is a screening tool, but it offers no guarantee of preventing breast cancer. Sometimes, unfortunately, women would receive regular mammograms and still receive a diagnosis of advanced breast cancer. There is no way for the mammographer to prevent this unfortunate combination of circumstance and genetics. However, a subset of these patients would involve a lawyer. Once a lesion has been diagnosed, it is easy for a lawyer to look back at old mammograms and highlight the suspicious area and ask of the mammographer why more was not done at an earlier time. This approach utilizes a logical fallacy which can be easily summarized as "hindsight 20/20." In reality, there are many suspicious lesions on mammograms, but working up every questionable spot on a mammogram would lead to more harm than good, so the mammographer must be judicious in following questionable areas, with the risk that sometimes this conservative approach more produce more harm in a particular individual.

Some states have realized that this puts the mammographer in an untenable positions. By instituting tort reform, they do not free the mammographer of liability but rather acknowledge that such errors are not born out of malice but rather are a function of the system we inhabit. This reform has helped mammographers function more appropriately, thus increasing demand for the field. According to the Centers for Medicare Services, mammographers are one of the highest compensated medical specialities as of 2008:
Diagnostic Radiology - M.D.s Interventional - $463,219
Diagnostic Radiology - M.D.s Neuro-Interventional - $500,000
Diagnostic Radiology - M.D.s Non-Interventional - $420,858
Mammography - $540,028
Nuclear Medicine (M.D.s Only) - $331,866
Radiation Therapy (M.D.s Only) - $395,166

Source: http://www.cms.hhs.gov/AcuteInpatientPPS/Downloads/AMGA_08_data.pdf
Given this data, if you were considering mammography before but were unsure of the future of the field, give it another look. You might be surprised by what you find.

Thursday, July 30, 2009

How To Read A Chest X-Ray

Let's say you are trekking in the Himalayas and suddenly become short of breath. Even though you are on your way to Annapurna Base Camp in a remote corner of the world, you would most likely be taken to a local clinic and have a plain film chest x-ray taken of your chest to help determine the etiology of your dyspnea, just like in any other part of the world. This post is not a comprehensive account of how to read a chest x-ray, but rather a collection of tips and tricks that should help one read most plain chest x-ray films.


The Plain Film Chest X-Ray: PA And Lateral Views

While there are many possible views that can be taken of the chest, the two most common are the PA view and the lateral view. The PA view, or Posterior-Anterior view, positions the beam at the patient's back. The radiation then travels through the spine, lungs, heart, and finally skin until it meets the detector or film anterior to the patient. The advantage of a PA film over an AP, or anterior-posterior, view is a reduction in the enlargement of the cardiac silhouette. Since the heart is closer to the film, its shadow is less distorted.

The PA view is often taken simultaneously with a lateral view. The benefit of having two views is that the radiologist is better able to visualize abnormalities in 3-D space with two views. Otherwise, there is a chance that two abnormalities can be in the same sagittal plane, yielding only one shadow on the PA view. The lateral view would distinguish between these two lesions. In other words, the PA view tells you where things are, medial to lateral, while the lateral view tells you where things are in an anterior to posterior sense.


How To Read A Plain Film Chest X-Ray

There is no right or wrong way to read a chest x-ray, but it is beneficial to develop a systematic method of doing so. The first thing to always check is that the film is associated with the correct patient. After doing so, to read a PA view, I utilize a mnemonic called RIP ABCDEFGH. Here is how it works:

Rotation: Check to see that the patient is not rotated. You can look at the clavicles and make sure the vertebral processes line up nicely in between them.
Inspiration: Check to see that you can see about 9 ribs on each side. Less than 8? It is likely poor inspiration.
Penetration: You should be able to see lucencies in the middle of the film representing the intervertebral discs. If there are none, the film is over-penetrated; if they are too well-defined, the film is under-penetrated.

Airway: Trace the lucency from the neck down towards the carina. It should be midline and you should be able to see two bronchi splitting from it.
Bones: Look at the shoulder joint and trace out each rib contour to check for fractures or other abnormalities.
Cardiac Silhouette: Check the right and left heart borders.
Diaphragms: These should be well-defined with no obscuration of their margins.
Empty Space =)
Fields: Look at the lung fields bilaterally and compare. Don't forget the apices.
Gastric Bubble: Check for a lucency in the left upper abdominal quadrant.
Hardware: Make sure the placement of any lines or other hardware is appropriate.

Pretty simple, no? After going through this process several times, it becomes routines. You can then use the lateral view to confirm your findings. Develop a process for evaluating lateral films as well, but in general, they are used to confirm what is seen on the PA view. While simple, learning how to read a chest x-ray is a basic skill all radiologists should know well before moving on to reading more advanced imaging, even in the remote reaches of Nepal =)

For patients, there are several advantages to using x-rays when possible, including lower radiation doses, faster acquisition times, and lower total cost. Often, the cost of x-rays will be covered by the patient's health insurance provider. This can be a significant issue, especially for patients who do not have great access to care.

Saturday, July 18, 2009

How A CT Abdomen/Pelvis Is Performed

CT Scan of the Abdomen (Source: Wikipedia)

The patient was having nonspecific abdominal pain that had not resolved after several days in the hospital. On the suggestion of her kidney doctors, a computed tomography (CT) scan of the abdomen and pelvis with contrast was ordered. The patient desired the exam in order to find out the etiology (origin) of her pain.

When ordering any imaging study, CTs in particular, it is important to consider several things beforehand:
  1. Is this study necessary?
  2. Is this study appropriate?
  3. What are the risks of this study?
  4. What are the benefits of the study?
  5. Will the study reveal new information that will affect the management of the patient?
  6. For hospitalized patients, does this study need to be performed in-house, or can it done on an outpatient basis?
In the case of this patient, the answers to these questions were as follows:
  1. Yes, to determine the etiology of her pain, which could have potentially been serious.
  2. One could argue about whether an ultrasound should have been performed first, but a CT provides a great deal more information, so the CT was preferred.
  3. The major risks include radiation and contrast-induced nephropathy. The risk of radiation is development of a future cancer, but this is tied to cumulative radiation exposure, so one CT by itself is not a huge harm. Contrast-induced nephropathy is potentially quite serious, but in this patient, her kidney function was so depressed that there was not much kidney function to preserve to begin with.
  4. The benefits would be to rule out any potentially urgent, addressable causes of her pain.
  5. Yes, potentially (see #4)
  6. In practical terms, it made sense to do this study as an inpatient, versus having the patient come back for a separate study.
After the order was sent by the primary team, the radiologist has to look over the order to ensure that it is appropriate and then protocol it. The protocol is the specific routine that the scanner will run while acquiring the images. After approval, the patient was taken down to the CT scanner room. Contrast was infused into her via an intravenous (IV) line. Since the area of interest was any soft tissue mass causing the pain, the scanner was programmed to wait until the contrast had entered the venous phase after perfusing through the arteries, roughly 80 seconds after the infusion began. At this point, the scanner spun into action, using its radiation beam and detectors to create the typical cross-sectional images of a CT scan. The scanner only scanned the patient's abdomen and pelvis in order to ensure a limited dose of radiation. After the scan, the patient was returned to her room. The images were sent to the radiologist's Picture Archiving and Communication System (PACS) machine, where she was able to interpret the images minutes after the scan had been taken.

Fortunately for the patient, the scan was negative and she was discharged home. The contrast would be dialyzed off at a later date.


Sunday, February 8, 2009

Interventional Radiologist Salary

An interventional radiologist is a sub-specialized radiologist. After completing an internship and four year diagnostic radiology residency, one must also complete a one year fellowship in interventional radiology (IR) to become an interventional radiologist. 

What does someone in interventional radiology (IR) do? 

An interventional radiologist is actually quite different from the typical diagnostic radiologist. In IR, the focus is on performing procedures using imaging techniques rather than interpreting studies. An IR specialist can utilize a number of modalities, including ultrasound, CT, and fluoroscopy. Procedures can range from simple line placements to complex procedures involving delivery of therapeutics, long term implantable devices, or embolizations. 

What is compensation like in interventional radiology?

Like most radiologists, IR specialists are well compensated. The numbers change from year to year due to radiologist salary trends, but if one presumes the average diagnostic radiologist's salary to be $350,000, then the average interventionalist will make roughly $50,000 more. Bear in mind that many factors impact this differential. First, location and years out of residency will have a significant impact on the actual salary. Second, your practice setting will also matter a great deal. In general, private practice interventionalists can expect to earn double academic interventionalists, but will also likely work more as well as parttake of more of the traditional diagnostic film reading. Even within private practice, one must consider whether the partners are compensated on equal terms or based on revenue generated. Still, compared to other surgical subspecialties, IR is very competitive with basically all of them, expect perhaps neurosurgery / spine surgery. 

Is the salary differential worth it?

This is a difficult question to answer. First and foremost, you should pursue a field that you love. However, that's easier said than done. If you have an interest in vascular surgery vs. interventional radiology, or neuroradiology vs. interventional radiology, how does one decide? You should try talking to peers or others within the field, but at some point, compensation does become an issue. One must realize that IR is more demanding than other fields within radiology, and the compensation boost is not necessarily proportional to that difference. However, if it is a field that you find interesting, the incentive itself will not matter so much. The work will be rewarding and that in itself will make it worthwhile. And, hey, it's radiology: the salary will be adequate in any case. 

What does the future hold for interventional radiology?

No one can predict the future. However, it seems a pretty safe assumption that IR will continue to compensate well. While this economy has made everyone more cautious, one of the benefits of a career in medicine is relatively good job and salary stability compared to other fields. While no one knows exactly what the future holds, it is hard to envision a future where IR is "outsourced" or compensation declines, especially as new technologies are developed which expand the span and scope of the field. 

Thursday, January 29, 2009

Radiologist Salary Trends

The trend of radiologist salaries is, needless to say, one of great import to those within the field of radiology, whether they like to admit it or not. I was recently talking to a friend of mine, who is an excellent student, and will no doubt make a great pediatrician some day. Fortunately for them, pediatrics is not too competitive, so they had their choice of programs. After complimenting them on how easy life must be, they retorted, "Well, don't worry, you'll be fine, and you'll end up making three times as much as me!" They said it jokingly, but it was the first time someone had ever associated me directly with the earning potential of a radiologist and compared it to their chosen specialty.

Radiology Salary Trends: Will It Last?


As I replied to my friend, I noted that radiology often faces encroachment from other specialties, such as cardiology, gastroenterology, and neurosurgery, as these referrers bring their own patients. At any time, they (as a group) could decide to not refer to a radiologist and start reading their own films. While it's not truly as simple as that, you can see that some areas, they have succeeded, such as wresting interventional cardiology away from the radiologists and into the hands of the cardiologists. My friend was not buying it: you're still going to make more than me, they retorted, but perhaps not as high a multiple! 

Are Radiologist Salaries Too High?

Some influential radiologists have considered whether we in fact are getting paid too much. In one opinion piece, the radiologist Howard P. Forman of Yale Radiology notes:

"Unlike other specialists and primary care providers, we perform a service that is requested. Simple supply and demand economics would dictate a higher salary for radiologists since the number of radiologists in practice has not kept pace with the increased demand for our services. In 2001, 4,176 diagnostic and 274 therapeutic radiology procedures were performed per 1,000 Medicare non–managed care enrollees [3]. The study, which appeared inRadiology in 2005 found that "on average, between 1998 and 2001, utilization per Medicare enrollee increased 16% per year for MRI and 7%–15% per year for CT, ultrasound, interventional radiology, and nuclear medicine, while that for radiography increased 1% per year." [3] At the same time, the number of those certified by the American Board of Radiology remains somewhat steady. In 1999, the American Board of Radiology issued 1,218 new general certificates; in 2002, 1,114 certificates were issued and in 2005, 1,335 new certificates were issued [4].

Our salaries are assumedly set by the market with fees negotiated with and set by commercial and government payers. However, the assumption that our fees are market-based rests on the premise of open competition. Open competition requires relatively low barriers to entry, among other things. In fact, our market is not quite so "open," and one could argue that the supply of radiologists is held back by nonmarket forces, including the Medicare and Accreditation Council on Graduate Medical Education (ACGME) limits on training positions offered.

The disproportionate number of medical students eager to enter our profession compared with the number of training positions available would, indeed, suggest that salaries are higher than a competitive market would offer. Do we benefit from this? Assuredly! We are attracting the brightest and most ambitious of our graduating medical students in this country. Ultimately, this comes at the expense of other equally important medical fields. Put a differentway, the relative attractiveness of radiology as a profession must be due, in part, to the salaries that we are paid. If radiology, in and of itself, is a very fulfilling specialty, then the salaries would be expected to be lower than average. If, on the other hand, the field had serious lifestyle obstacles, the salary might reasonably be expected to be higher than average. If the latter is the case, then one would not expect such a huge excess of medical student interest relative to training positions."

Source: http://www.ajronline.org/cgi/content/full/189/4/755

The Radiologist Salary Rebuttal

Dr. Forman goes on to note that radiologist do work hard for their income, but where does one find that balance between radiologist salaries and the other costs in the system. On the one hand, the radiologist is often highly trained, being able to spot not only a variety of natural disease processes, but also the reactions to external factors, such as chemotherapy drugs or gout treatments, or even new agents such as vivimind (an anti-Alzheimer's drug).  On the other hand though, the marginal cost of a read once a radiologist is fully trained is very low, so it is hard to justify a high salary when the only tangible outlay on the part of the radiologist is their time. Given how many other costs are facing the system, it is hard to defend this rate, even if it is nominally pegged to images read instead of time directly. 

Regardless, the debate shall continue, but I do not envy the policymaker who has to make the decisions about reimbursement rates!

Monday, January 12, 2009

What Is A Good Radiology Resident Salary?

Before entering the field of radiology, many medical students are curious about the rumors they hear about lucrative careers in radiology. The curiosity is often dashed when students realize that they will have to wait until they complete an internship, 4 years of residency training and possibly another year of fellowship before being paid as a full-time radiologist. Still, for the more persistent rumor-chasers, the curiosity persists. Residents earning six figure incomes? How is this possible?

Well, for starters, most radiology residents do not earn that much during residency. For example, at Virginia Commonwealth University, the radiology residents are paid as follows:

PGY 2 – $46,026
PGY 3 – $47,684
PGY 4 – $48,581
PGY 5 – $50,808

By most Americans' standards, these salaries are reasonably competitive. However, given the additional hours of work and call that residents suffer through, the salaries approach minimum wage when considered on an hourly basis. Imagine if a residency works on average 60 hours a week for 48 weeks a year. The total hours, 48 x 60 = 2880 hours. At a salary of $48,000, this works out to $16.67 per hour before taxes. While these numbers are used solely for demonstration, many residents would agree that the pay is not as competitive, especially when compared to other professionals with graduate degrees (JD, PhD). 

At many institutions though, the salary can be augmented during residency. The first method is to provide the residents with a book fund, anywhere from $500 to $2000, that can be used to purchase textbooks and other educational materials (including laptops in some cases). The second, and potentially most lucrative method, is through a process known as moonlighting. Often performed by third and fourth year residents, moonlighting can either be performed within the hospitals affiliated with the program or externally at another, unaffiliated hospital. During the moonlighting, the resident can perform a variety of tasks, just as a fulltime radiologist would, providing that they have the appropriate insurance coverage and license. Moonlighting can pay quite well, with some places offering up to $1000 per night of work. The resident still has to abide by resident work-hour restrictions, as well as by any restrictions imposed by the residency program. 

When you consider moonlighting opportunities, a resident who decided to utilize them religiously could conceivably make over $100,000 a year. However, the reality seems to be that this is true of only a few residents, mostly those with families or large debt who really need the funds. The majority of residents who are able to moonlight seem to do a small amount, simply to supplement their income or have a little extra spending money. Ultimately, the compensation one receives when one starts to work full-time as a radiologist will dwarf the amounts involved during residency, but it is reassuring to know that there are avenues available to supplement your income as a radiology resident. 

Thursday, January 8, 2009

Accredited U.S. Diagnostic Radiology Residency Programs 2009

The table below reflects all the programs accredited for residency training in diagnostic radiology by the American Council of Graduate Medical Education as of 2009. 


Program Number / Name / AddressSpecialtyDirectorPhone / Fax / Email
[4200111007]  University of Alabama Medical Center Program
University of Alabama at Birmingham
Department of Radiology
619 South 19th Street
Birmingham, AL 35249-6830
Radiology-DiagnosticJoseph  C. Sullivan, MD(205)934-3166
(205)975-4413
jcsullivan@uabmc.edu   
[4200111008]  University of South Alabama Program
University of South Alabama Medical Center
Department of Radiology
2451 Fillingim Street
Mobile, AL 36617
Radiology-DiagnosticJeffrey Campbell  Brandon, MD(251)471-7879
(251)471-7882
jbrandon@usouthal.edu   
[4200121006]  Baptist Health System Program
Trinity Medical Center
800 Montclair Road
Department of Radiology
Birmingham, AL 35213
Radiology-DiagnosticBibb  Allen, MD(205)592-1257
(205)592-5211
patricia.logan@bhsala.com   
[4200312010]  St Joseph's Hospital and Medical Center Program
St Joseph's Hospital and Medical Center
Department of Diagnostic Imaging
350 West Thomas Road
Phoenix, AZ 85013
Radiology-DiagnosticRandy  Richardson, MD(602)406-6994
(602)406-7191
[4200313258]  University of Arizona/UPHK Graduate Medical Education Consortium Program
University Physicians Hospital at Kino
2800 East Ajo Way
Graduate Medical Education
Tucson, AZ 85713
Radiology-DiagnosticTheron  W. Ovitt, MD(520)626-6007
(520)626-3669
[4200321011]  University of Arizona Program
University of Arizona Health Sciences Center
P.O. Box 245067
1501 North Campbell
Tucson, AZ 85724
Radiology-DiagnosticWilliam  K. Erly, MD(520)626-7368
(520)626-3669
[4200331255]  Maricopa Medical Center Program
Maricopa Medical Center
2601 E Roosevelt
Phoenix, AZ 85008
Radiology-DiagnosticMary  J. Connell, MD(602)344-1513
(602)344-1004
[4200421012]  University of Arkansas for Medical Sciences Program
University of Arkansas For Medical Sciences
Arkansas Children's Hospital
800 Marshall Street
Little Rock, AR 72202
Radiology-DiagnosticRobert  F. Buchmann, DO(501)364-4865
(501)364-4863
[4200511013]  University of California (Davis) Health System Program
University of California (Davis) Medical Center
Department of Radiology
4860 Y Street, Suite 3100
Sacramento, CA 95817
Radiology-DiagnosticRebecca  Stein-Wexler, MD(916)703-2271
(916)703-2258
rebecca.steinwexler@ucdmc.ucdavis.edu   
[4200511021]  University of Southern California/LAC+USC Medical Center Program
Los Angeles County-USC Medical Center
Department of Diagnostic Radiology
1200 North State Street, D&T 3D321
Los Angeles, CA 90033
Radiology-DiagnosticM. Victoria  Marx, MD(323)409-7270
(323)226-2280
[4200511023]  UCLA Medical Center Program
Ronald Reagan-UCLA Medical Center
David Geffen School of Medicine at UCLA
10833 Le Conte Avenue, B2-170 CHS
Los Angeles, CA 90095
Radiology-DiagnosticRobert  D. Suh, MD(310)825-7532
(310)794-5734
[4200511035]  Los Angeles County-Harbor-UCLA Medical Center Program
Los Angeles County-Harbor-UCLA Medical Center
Box 27
1000 W Carson Street
Torrance, CA 90509
Radiology-DiagnosticRichard  Renslo, MD(310)222-2847
(310)618-9500
phamm@labiomed.org   
[4200512020]  Kaiser Permanente Southern California (Los Angeles) Program
Kaiser Foundation Hospital
Center for Medical Education
4733 Sunset Blvd, 3rd Floor
Los Angeles, CA 90027
Radiology-DiagnosticGeorge  G. Vatakencherry, MD(323)783-4631

george.g.vatakencherry@kp.org   
[4200521001]  David Grant Medical Center Program
David Grant USAF Medical Center
Department of Radiology
101 Bodin Circle
Travis AFB, CA 94535
Radiology-DiagnosticRobert  A. Jesinger, MD, MS(707)423-7669
(707)423-7207
robert.jesinger@travis.af.mil   
[4200521014]  University of California (Irvine) Program
University of California, Irvine Medical Center
101 The City Drive South
Route 140, Radiology
Orange, CA 92868
Radiology-DiagnosticArash  Anavim, MD(714)456-6579
(714)456-6832
aanavim@uci.edu   
[4200521015]  Loma Linda University Program
Loma Linda University Medical Center
11234 Anderson Street
PO Box 2000
Loma Linda, CA 92354
Radiology-DiagnosticDouglas  C. Smith, MD(909)558-7814
(909)558-0202
pthomas@llu.edu   
[4200521018]  Cedars-Sinai Medical Center Program
Cedars-Sinai Medical Center
Attn: Dora Thompson
S Mark Taper, 8700 Beverly Boulevard, M335
Los Angeles, CA 90048
Radiology-DiagnosticMarcel  Maya, MD(310)423-3419
(310)423-8335
thompsonda@cshs.org   
[4200521027]  University of California (San Diego) Program
University of California (San Diego) Medical Center
200 West Arbor Drive
San Diego, CA 92103
Radiology-DiagnosticMahmood  F. Mafee, MD(619)543-6641
(619)543-3746
[4200521031]  University of California (San Francisco) Program
University of California, San Francisco
Department of Radiology, Box 0628
505 Parnassus Avenue, Suite M391
San Francisco, CA 94143
Radiology-DiagnosticAliya  Qayyum, MBBS(415)353-8753
(415)476-0616
[4200521034]  Stanford University Program
Stanford University School of Medicine
Department of Diagnostic Radiology
300 Pasteur Drive, Mail code 5621
Stanford, CA 94305
Radiology-DiagnosticTerry  S. Desser, MD(650)723-7816
(650)723-1909
iworthey@stanford.edu   
[4200521914]  Naval Medical Center (San Diego) Program
Naval Medical Center San Diego
Radiology, Suite 204
34800 Bob Wilson Drive
San Diego, CA 92134
Radiology-DiagnosticStephen  L. Ferrara, MD(619)532-6755
(619)532-8714
stephen.ferrara@med.navy.mil   
[4200522033]  Santa Barbara Cottage Hospital Program
Santa Barbara Cottage Hospital
PO Box 689
Pueblo at Bath Street
Santa Barbara, CA 93102-0689
Radiology-DiagnosticBernard  Chow, MD(805)569-7279
(805)569-8279
[4200531032]  Santa Clara Valley Medical Center Program
Santa Clara Valley Medical Center
Department of Radiology
751 South Bascom Avenue
San Jose, CA 95128
Radiology-DiagnosticRajul  Pandit, MD(408)885-6370
(408)885-6360
[4200721038]  University of Colorado Denver Program
University of Colorado Denver
Department of Radiology
12631 E. 17th Avenue, MS 8200
Aurora, CO 80045
Radiology-DiagnosticDavid  Rubinstein, MD(303)724-1982
(303)724-1983
david.rubinstein@uchsc.edu   
[4200811040]  St Vincent's Medical Center Program
St Vincent's Medical Center
2800 Main Street
Bridgeport, CT 06606
Radiology-DiagnosticJoseph  A. Gagliardi, MD(203)576-5533
(203)581-6537
bhastava@stvincents.org   
[4200812039]  Bridgeport Hospital/Yale University Program
Bridgeport Hospital
Diagnostic Radiology
267 Grant Street
Bridgeport, CT 06610
Radiology-DiagnosticNoel  Velasco, MD(203)384-3834
(203)384-3833
pnvela@bpthosp.org   
[4200821043]  Yale-New Haven Medical Center Program
Yale-New Haven Hospital
20 York Street
New Haven, CT 06520
Radiology-DiagnosticSyed Ahmad Jamal  Bokhari, MD(203)785-7377
(203)785-4328
jamal.bokhari@yale.edu   
[4200821216]  Norwalk Hospital Program
Norwalk Hospital
Department of Radiology
Maple Street
Norwalk, CT 06856
Radiology-DiagnosticEdward  B. Strauss, MD(203)852-2715
(203)855-3967
susie.mccusker@norwalkhealth.org   
[4200821225]  University of Connecticut Program
University of Connecticut Health Center
263 Farmington Avenue
Farmington, CT 06030
Radiology-DiagnosticHarold  Moskowitz, MD(860)679-2345
(860)679-1090
moskowitz@uchc.edu   
[4200822041]  Hartford Hospital Program
Hartford Hospital
PO Box 5037
80 Seymour Street
Hartford, CT 06102-5037
Radiology-DiagnosticFrederick  U. Conard, MD(860)545-5114
(860)545-4074
[4200822042]  Hospital of St Raphael Program
Hospital of St. Raphael
Department of Radiology
1450 Chapel Street
New Haven, CT 06511
Radiology-DiagnosticPhilip  A. Dinauer, MD(203)789-6289
(203)789-4118
[4200911044]  Christiana Care Health Services Program
Christiana Care Health System
4755 Ogletown-Stanton Road
Newark, DE 19718
Radiology-DiagnosticMichael  B. Sneider, MD(302)733-5582
(302)733-5589
msneider@christianacare.org   
[4201011045]  Georgetown University Hospital Program
Georgetown University Hospital
Department of Radiology
3800 Reservoir Road, NW
Washington, DC 20007
Radiology-DiagnosticSandra  J. Allison, MD(202)444-3380
(202)444-1804
villaros@gunet.georgetown.edu   
[4201021046]  George Washington University Program
George Washington University Hospital
900 23rd Street, NW
Room G-113
Washington, DC 20037
Radiology-DiagnosticRobert  K. Zeman, MD(202)715-5154
(202)715-4901
gwuradrz@yahoo.com   
[4201021247]  National Capital Consortium Program
Walter Reed Army Medical Center
Department of Radiology
6900 Geogia Avenue NW
Washington, DC 20307
Radiology-DiagnosticFletcher  M. Munter, MD(202)782-1679
(202)782-3393
fletcher.munter@amedd.army.mil   
[4201121048]  University of Florida Program
University of Florida Medical Center
Department of Radiology
PO Box 100374
Gainesville, FL 32610
Radiology-DiagnosticLori  A. Deitte, MD(352)265-0291
(352)265-0279
[4201121049]  Jackson Memorial Hospital/Jackson Health System Program
Jackson Memorial Hospital/Jackson Health System
Department of Radiology (R-130)
1611 NW 12th Avenue, WW 279
Miami, FL 33136
Radiology-DiagnosticRobert  P. Henry, MD, BA(305)585-7500
(305)355-4051
rphenry@med.miami.edu   
[4201121050]  Mount Sinai Medical Center of Florida Program
Mount Sinai Medical Center of Florida
Department of Radiology
4300 Alton Road
Miami Beach, FL 33140
Radiology-DiagnosticTyler  Neitlich, MD(305)674-2680
(305)674-3919
[4201121051]  University of South Florida Program
University of South Florida College of Medicine
Box 17
12901 Bruce B Downs Blvd
Tampa, FL 33612
Radiology-DiagnosticTodd  R. Hazelton, MD(813)974-6311
(813)974-3482
[4201121223]  University of Florida College of Medicine Jacksonville Program
Univ of Florida College of Medicine/Jacksonville
655 W 8th Street, Box C90
Department of Radiology
Jacksonville, FL 32209
Radiology-DiagnosticBarry  M. McCook, MD(904)244-4225
(904)244-4296
johneise.croxton@jax.ufl.edu   
[4201121250]  College of Medicine, Mayo Clinic (Jacksonville) Program
Mayo School of Graduate Medical Education
4500 San Pablo Road
Jacksonville, FL 32224
Radiology-DiagnosticThomas  H. Berquist, MD(904)953-0490
(904)953-0430
[4201212054]  Mercer University School of Medicine (Savannah) Program
Memorial Health University Medical Center
Department of Radiology
4700 Waters Avenue
Savannah, GA 31403
Radiology-DiagnosticDeborah  J. Conway, MD(912)350-7394
(912)350-7363
larismi1@memorialhealth.com   
[4201221052]  Emory University Program
Emory University Hospital
Dept of Radiology
1364 Clifton Road, NE, Rm D125A
Atlanta, GA 30322
Radiology-DiagnosticMark  E. Mullins, MD, PhD(404)712-2916
(404)712-7908
[4201221053]  Medical College of Georgia Program
Medical College of Georgia
BA -1411
1120 15th Street
Augusta, GA 30912
Radiology-DiagnosticGilberto  Sostre, MD(706)721-3214
(706)721-5213
nucradgil@aol.com   
[4201421933]  Tripler Army Medical Center Program
Tripler Army Medical Center
Department of Radiology
1 Jarrett White Road
Tripler AMC, HI 96859-5000
Radiology-DiagnosticKevin  M. Nakamura, MD(808)433-6588
(808)433-4688
[4201611060]  Rush University Medical Center Program
Rush University Medical Center
Department of Diagnostic Radiology
1653 West Congress Parkway
Chicago, IL 60612
Radiology-DiagnosticJoy  S. Sclamberg, MD(312)942-5781
(312)942-8180
[4201611061]  University of Chicago Program
University of Chicago Medical Center
Dept of Radiology, MC 2026
5841 South Maryland Avenue
Chicago, IL 60637
Radiology-DiagnosticGregory  S. Stacy, MD(773)834-3046
(773)702-1161
sstacy@radiology.bsd.uchicago.edu   
[4201611064]  Loyola University Program
Foster G. McGaw Hospital-Loyola University of Chicago
Department of Radiology
2160 South First Avenue
Maywood, IL 60153
Radiology-DiagnosticLaurie  M. Lomasney, MD(708)216-1084
(708)216-0899
[4201612063]  St Francis Hospital of Evanston Program
St Francis Hospital of Evanston
355 Ridge Avenue
Evanston, IL 60202
Radiology-DiagnosticJoseph  D. Calandra, MD(847)316-6101
(847)316-2241
[4201621055]  John H Stroger Hospital of Cook County Program
John H. Stroger, Jr. Hospital of Cook County
Department of Radiology
1901 W Harrison
Chicago, IL 60612
Radiology-DiagnosticPatrick  M. Dunne, MD(312)864-3731
(312)864-9855
[4201621059]  McGaw Medical Center of Northwestern University Program
Northwestern University's Feinberg School of Medic
676 N St Clair Street
Suite 800
Chicago, IL 60611
Radiology-DiagnosticRobert  K. Ryu, MD(312)695-3718
(312)695-5645
jclark@nmff.org   
[4201621062]  University of Illinois College of Medicine at Chicago Program
University of Illinois Hospital
1740 W Taylor Street, Suite 2483
Chicago, IL 60612
Radiology-DiagnosticEdward  A. Michals, MD(312)996-0235
(312)355-2098
[4201621065]  Southern Illinois University Program
Southern Illinois University School of Medicine
MMC Box 101
701 N 1st Street
Springfield, IL 62781
Radiology-DiagnosticJohn  B. Becker, MD(217)757-2387
(217)788-5588
skelton.stacie@mhsil.com   
[4201621217]  Advocate Illinois Masonic Medical Center Program
Advocate Illinois Masonic Medical Center
836 West Wellington Avenue
Chicago, IL 60657
Radiology-DiagnosticKevin  J. Kirshenbaum, MD(773)296-7820
(773)296-7821
[4201621243]  University of Illinois College of Medicine at Peoria Program
University of Illinois College of Medicine at Peoria
530 NE Glen Oak Avenue
Peoria, IL 61637
Radiology-DiagnosticTerry  M. Brady, MD(309)655-7768
(309)655-7365
lorid@uic.edu   
[4201721066]  Indiana University School of Medicine Program
Indiana University Medical Center
Department of Radiology
550 North University Avenue, Room 0641
Indianapolis, IN 46202
Radiology-DiagnosticDarel  E. Heitkamp, MD(317)274-3424

deheitka@iupui.edu   
[4201821068]  University of Iowa Hospitals and Clinics Program
University of Iowa Hospitals and Clinics
200 Hawkins Drive
Department of Radiology
Iowa City, IA 52242
Radiology-DiagnosticJoan  E. Maley, MD(319)356-3452
(319)356-2220
joan-maley@uiowa.edu   
[4201911069]  University of Kansas School of Medicine Program
University of Kansas Medical Center
Department of Radiology, Mail Stop 4032
3901 Rainbow Blvd
Kansas City, KS 66160
Radiology-DiagnosticPhilip  L. Johnson, MD(913)588-6805
(913)588-7899
pjohnson@kumc.edu   
[4201912070]  University of Kansas (Wichita) Program
Wesley Medical Center
Medical Education - Radiology
550 N Hillside
Wichita, KS 67214
Radiology-DiagnosticKamran  Ali, MD(316)962-2211
(316)962-7231
becky.mann@wesleymc.com   
[4202021071]  University of Kentucky College of Medicine Program
University of Kentucky Medical Center
Department of Diagnostic Radiology
800 Rose Street, Room HX315E
Lexington, KY 40536-0293
Radiology-DiagnosticMichael  A. Brooks, MD(859)323-7209
(859)323-2510
sajone2@email.uky.edu   
[4202021230]  University of Louisville Program
University of Louisville School of Medicine
Department of Radiology
530 S. Jackson Street, Suite C07
Louisville, KY 40202
Radiology-DiagnosticPeter  C. Hentzen, MD, PhD(502)852-5875
(502)852-1754
[4202111075]  Louisiana State University (Shreveport) Program
Louisiana State University Health Sciences Center
PO Box 33932
1501 Kings Highway
Shreveport, LA 71130
Radiology-DiagnosticMardjohan  Hardjasudarma, MD, MS(318)675-6232
(318)675-6351
[4202112074]  Ochsner Clinic Foundation Program
Ochsner Clinic Foundation
1514 Jefferson Highway
New Orleans, LA 70121
Radiology-DiagnosticJames  M. Milburn, MD(504)842-4796
(504)842-7132
kdixon@ochsner.org   
[4202121235]  Tulane University Program
Tulane University Medical Center
1430 Tulane Avenue SL54
New Orleans, LA 70112
Radiology-DiagnosticCynthia  W. Hanemann, MD(504)988-7627
(504)988-7616
chaneman@tulane.edu   
[4202131259]  Louisiana State University Program
LSU Health Sciences Center
Department of Radiology
2020 Gravier Street, Room 755
New Orleans, LA 70112
Radiology-DiagnosticLeonard  Bok, MD, MBA(504)568-4647
(504)568-8955
sjoh21@lsuhsc.edu   
[4202211076]  Maine Medical Center Program
Maine Medical Center
Department of Diagnostic Radiology
22 Bramhall Street
Portland, ME 04102
Radiology-DiagnosticScott  E. Fredericks, MD(207)662-2571
(207)662-5255
[4202311077]  Johns Hopkins University Program
The Johns Hopkins Hospital
601 North Caroline Street
Room 4210
Baltimore, MD 21287-0801
Radiology-DiagnosticStanley  S. Siegelman, MD(410)955-5677
(410)955-8597
[4202311079]  University of Maryland Program
University of Maryland Medical Center
Department of Radiology
22 South Greene Street
Baltimore, MD 21201
Radiology-DiagnosticCharles  S. Resnik, MD(410)328-3477
(410)328-0641
bstewart@umm.edu   
[4202411087]  Mount Auburn Hospital Program
Mount Auburn Hospital
Department of Radiology
330 Mount Auburn Street
Cambridge, MA 02138
Radiology-DiagnosticPierre  Sasson, MD(617)441-1610
(617)499-5193
[4202412088]  Baystate Medical Center/Tufts University School of Medicine Program
Baystate Medical Center
Department of Radiology
759 Chestnut Street
Springfield, MA 01199
Radiology-DiagnosticStephen  C. O'Connor, MD(413)794-3333
(413)794-4382
teresa.lalli@bhs.org   
[4202412089]  St Vincent Hospital Program
Saint Vincent Hospital
Department of Radiology
123 Summer Street
Worcester, MA 01608
Radiology-DiagnosticDavid  A. Bader, MD(508)363-7034
(508)363-7224
alice.persico@stvincenthospital.com   
[4202421080]  Beth Israel Deaconess Medical Center Program
Beth Israel Deaconess Medical Center
330 Brookline Avenue
E CC-4 Radiology
Boston, MA 02215
Radiology-DiagnosticBettina  Siewert, MD(617)667-3532
(617)667-3537
[4202421081]  Boston University Medical Center Program
Boston University Medical Center
88 East Newton Street
Boston, MA 02118
Radiology-DiagnosticAvneesh  Gupta, MD(617)638-6610
(617)638-6616
[4202421085]  Brigham and Women's Hospital/Harvard Medical School Program
Brigham &Women's Hospital
Department of Radiology
75 Francis Street
Boston, MA 02115
Radiology-DiagnosticBarbara  N. Weissman, MD(617)732-6295
(617)264-5250
bwhradres@partners.org   
[4202421086]  Tufts Medical Center Program
Tufts Medical Center
Department of Radiology
800 Washington Street, #299
Boston, MA 02111
Radiology-DiagnosticJudith  Katz, MD(617)636-4564
(617)636-0041
jkatz@tuftsmedicalcenter.org   
[4202421090]  University of Massachusetts Program
University of Massachusetts Medical School
55 Lake Avenue North
Worcester, MA 01655
Radiology-DiagnosticJoseph  Makris, MD(508)856-2783

rad.residency@umassmed.edu   
[4202422082]  Lahey Clinic Program
Lahey Clinic Medical Center
Department of Diagnostic Radiology
41 Mall Road
Burlington, MA 01805
Radiology-DiagnosticChristopher  D. Scheirey, MD(781)744-8170
(781)744-5232
christopher.scheirey@lahey.org   
[4202431083]  Massachusetts General Hospital/Harvard Medical School Program
Massachusetts General Hospital
Dept of Radiology, FND 216
Boston, MA 02114
Radiology-DiagnosticTheresa  C. McLoud, MD(617)724-4255
(617)726-3077
[4202511093]  Henry Ford Hospital Program
Henry Ford Hospital
Department of Radiology
2799 West Grand Boulevard
Detroit, MI 48202
Radiology-DiagnosticEric  M. Spickler, MD(313)916-1384
(313)916-8857
[4202512092]  Oakwood Hospital Program
Oakwood Hospital and Medical Center
18101 Oakwood Boulevard
Dearborn, MI 48124
Radiology-DiagnosticJohn  H. Finger, MD(313)436-2583
(313)436-2809
john.finger@oakwood.org   
[4202512102]  William Beaumont Hospital Program
William Beaumont Hospital
Department of Radiology
3601 West Thirteen Mile Road
Royal Oak, MI 48073
Radiology-DiagnosticMatthias  J. Kirsch, MD(248)898-6047
(248)898-2496
[4202521091]  University of Michigan Program
University of Michigan Health System
Department of Radiology
1500 East Medical Center Drive
Ann Arbor, MI 48109
Radiology-DiagnosticJanet  E. Bailey, MD(734)936-8869
(734)763-9523
[4202521096]  Wayne State University/Detroit Medical Center Program
Wayne State University School of Medicine
4201 St Antoine, DRH 3L8
Detroit, MI 48201
Radiology-DiagnosticWilbur  L. Smith, MD(313)745-3430
(313)577-8600
[4202521099]  Grand Rapids Medical Education and Research Center/Michigan State University Program
Grand Rapids Medical Education & Research Center
Diagnostic Radiology Residency
1000 Monroe NW
Grand Rapids, MI 49503
Radiology-DiagnosticCharles  R. Luttenton, MD(616)732-6232
(616)732-6228
raddoc11@comcast.net   
[4202521103]  Providence Hospital and Medical Centers Program
Providence Hospital and Medical Centers
16001 West Nine Mile Road
Department of Radiology
Southfield, MI 48075
Radiology-DiagnosticRoger  L. Gonda, MD(248)849-2203
(248)849-3931
roger.gonda@providence-stjohnhealth.org   
[4202531100]  Michigan State University (Flint) Program
Michigan State University Flint Area Medical Educa
One Hurley Plaza-7W
Flint, MI 48503
Radiology-DiagnosticUreddi  R. Mullangi, MD(810)232-7000
(810)232-7020
umullangi@msufame.msu.edu   
[4202532101]  St Joseph Mercy-Oakland Program
St Joseph Mercy-Oakland
Department of Radiology, H-23
44405 Woodward Avenue
Pontiac, MI 48341
Radiology-DiagnosticJames  Denier, MD(248)858-3233
(248)858-3244
denierja@trinity-health.org   
[4202621104]  University of Minnesota Program
University of Minnesota Medical Center, Fairview
Department of Radiology, MMC 292
420 Delaware Street, SE
Minneapolis, MN 55455
Radiology-DiagnosticTim  H. Emory, MD(612)626-5529
(612)626-5580
emory002@umn.edu   
[4202621105]  College of Medicine, Mayo Clinic (Rochester) Program
Mayo Graduate School of Medicine
Department of Radiology
200 First Street, SW
Rochester, MN 55905
Radiology-DiagnosticKristen  B. Thomas, MD(507)284-0440
(507)293-3680
[4202711107]  University of Mississippi Medical Center Program
University of Mississippi Medical Center
Department of Radiology
2500 North State Street
Jackson, MS 39216
Radiology-DiagnosticAnson  L. Thaggard, MD(601)984-2695
(601)984-2683
bedmonds@radiology.umsmed.edu   
[4202811108]  University of Missouri-Columbia Program
University of Missouri Medical Center
Department of Radiology
One Hospital Drive
Columbia, MO 65212
Radiology-DiagnosticYash  Sethi, MD(573)882-1026
(573)884-8876
SethiY@health.missouri.edu   
[4202811111]  Washington University/B-JH/SLCH Consortium Program
Mallinckrodt Institute of Radiology
510 South Kingshighway
St Louis, MO 63110
Radiology-DiagnosticJennifer  E. Gould, MD(314)362-2978
(314)747-4671
lammersl@mir.wustl.edu   
[4202821110]  St Louis University School of Medicine Program
St Louis University School of Medicine
3635 Vista Avenue at Grand Blvd
PO Box 15250
St Louis, MO 63110
Radiology-DiagnosticB. Kirke  Bieneman, MD(314)268-5781
(314)268-5116
[4202821231]  University of Missouri at Kansas City Program
Saint Luke's Hospital of Kansas City
c/o Daphne Urquhart; Medical Education
4401 Wornall Road
Kansas City, MO 64111
Radiology-DiagnosticLisa  H. Lowe, MD(816)234-3725
(816)983-6912
durquhart@saint-lukes.org   
[4203021112]  University of Nebraska Medical Center College of Medicine Program
University of Nebraska Medical Center
981045 Nebraska Medical Center
Department of Radiology
Omaha, NE 68198
Radiology-DiagnosticMary Kay  Drake, MD(402)559-1018
(402)559-1011
[4203021220]  Creighton University Program
Creighton University School of Medicine
Department of Radiology
601 North 30th Street
Omaha, NE 68131
Radiology-DiagnosticJames  J. Phalen, MD(402)449-4753
(402)449-4525
[4203211113]  Dartmouth-Hitchcock Medical Center Program
Dartmouth-Hitchcock Medical Center
One Medical Center Drive
Lebanon, NH 03756
Radiology-DiagnosticJocelyn  D. Chertoff, MD, MS(603)650-7480
(603)650-5455
[4203311116]  Atlantic Health (Morristown) Program
Morristown Memorial Hospital
100 Madison Avenue
PO Box 1956
Morristown, NJ 07962
Radiology-DiagnosticJeanne  R. Schwartz, MD(973)971-5372
(973)290-7294
[4203321215]  St Barnabas Medical Center Program
Saint Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
Radiology-DiagnosticLyle  R. Gesner, MD(973)322-5267
(973)322-2851
lgesner@sbhcs.com   
[4203321226]  UMDNJ-New Jersey Medical School Program
U M D N J-New Jersey Medical School
Department of Radiology, Room C-318
150 Bergen Street
Newark, NJ 07103
Radiology-DiagnosticStephen  R. Baker, MD(973)972-5188
(973)972-7429
[4203321228]  UMDNJ-Robert Wood Johnson Medical School Program
UMDNJ-Robert Wood Johnson Medical School
Department of Radiology
One Robert Wood Johnson Place
New Brunswick, NJ 08903
Radiology-DiagnosticJudith  K. Amorosa, MD, FACR(732)235-7721
(732)235-6889
amorosa@umdnj.edu   
[4203321244]  UMDNJ-Robert Wood Johnson Medical School (Camden) Program
Cooper Hospital/University Medical Center
One Cooper Plaza
B23
Camden, NJ 08103
Radiology-DiagnosticJoshua  D. Brody, DO(856)342-2383
(856)365-0472
brody-joshua@cooperhealth.edu   
[4203331115]  Monmouth Medical Center Program
Monmouth Medical Center
Department of Radiology
300 Second Avenue
Long Branch, NJ 07740
Radiology-DiagnosticRichard  B. Ruchman, MD(732)923-6806
(732)923-6216
RRuchman@sbhcs.com   
[4203331118]  Newark Beth Israel Medical Center Program
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
Radiology-DiagnosticVivian  Rivera, MD(973)926-7960
(973)926-7688
kdargon@sbhcs.com   
[4203421120]  University of New Mexico Program
University of New Mexico Medical Center
Department of Radiology
MSC10 5530, 1 University of New Mexico
Albuquerque, NM 87131
Radiology-DiagnosticJennifer  Pohl, PhD, MD(505)272-0932
(505)272-5821
raderas@salud.unm.edu   
[4203511121]  Albany Medical Center Program
Albany Medical Center Hospital
Department of Radiology MC113
43 New Scotland Avenue
Albany, NY 12208
Radiology-DiagnosticPaul  R. Silk, MD(518)262-3371
(518)262-8203
[4203511123]  Nassau University Medical Center Program
Nassau University Medical Center
Department of Radiology
2201 Hempstead Turnpike
East Meadow, NY 11554
Radiology-DiagnosticNalini  Kanth, MD(516)572-6785
(516)572-5941
nkanth@numc.edu   
[4203511131]  Long Island College Hospital Program
Long Island College Hospital
339 Hicks Street
Brooklyn, NY 11201
Radiology-DiagnosticDeborah  L. Reede, MD(718)780-1793
(718)780-1611
[4203511138]  New York Presbyterian Hospital (Columbia Campus) Program
New York and Presbyterian Hospital (Columbia Campus)
HP-3-320
180 Fort Washington Avenue
New York, NY 10032
Radiology-DiagnosticAnna  Rozenshtein, MD(212)305-6495
(212)305-5777
[4203511146]  University of Rochester Program
University of Rochester Medical Center
601 Elmwood Avenue
PO Box 648
Rochester, NY 14642-8648
Radiology-DiagnosticJohn  C. Wandtke, MD(585)275-7493
(585)273-3549
iona_mackey@urmc.rochester.edu   
[4203512128]  Bronx-Lebanon Hospital Center Program
Bronx-Lebanon Hospital Center
1650 Grand Concourse
Bronx, NY 10457
Radiology-DiagnosticHelen  T. Morehouse, MD(718)518-5272
(718)518-5224
[4203512141]  New York Medical College at St Vincent's Hospital and Medical Center of New York Program
St. Vincent's Hospital and Medical Center
170 West 12th Street
New York, NY 10011
Radiology-DiagnosticSteven  R. Parmett, MD(212)604-2416
(212)604-2929
[4203512145]  Rochester General Hospital Program
Rochester General Hospital
Department of Radiology
1425 Portland Avenue
Rochester, NY 14621
Radiology-DiagnosticJames  J. Montesinos, MD(585)922-3220
(585)922-3518
[4203512254]  Staten Island University Hospital Program
Staten Island University Hospital
475 Seaview Avenue
Staten Island, NY 10305
Radiology-DiagnosticMary  M. Salvatore, MD(718)226-3518
(718)226-8335
msalvatore@siuh.edu   
[4203521126]  Albert Einstein College of Medicine Program
Montefiore Medical Center
Dept. of Radiology
111 East 210th Street
Bronx, NY 10467
Radiology-DiagnosticMordecai  Koenigsberg, MD(718)920-5506

eofrias@montefiore.org   
[4203521127]  Albert Einstein College of Medicine at Beth Israel Medical Center Program
Beth Israel Medical Center
First Avenue at 16th street
New York, NY 10003
Radiology-DiagnosticMarlene  Rackson, MD(212)420-4654
(212)420-2510
mrackson@bethisraelny.org   
[4203521129]  New York Presbyterian Hospital (Cornell Campus) Program
New York and Presbyterian Hospital (Cornell Campus)
525 East 68th Street
New York, NY 10065
Radiology-DiagnosticKevin  W. Mennitt, MD(212)746-3655
(212)746-8596
kem9003@med.cornell.edu   
[4203521132]  NSLIJHS-Albert Einstein College of Medicine at Long Island Jewish Medical Center Program
Long Island Jewish Medical Center
270-05 76th Avenue
New Hyde Park, NY 11040
Radiology-DiagnosticLawrence  P. Davis, MD(718)470-7235
(718)343-3893
eacobacc@lij.edu   
[4203521135]  Mount Sinai School of Medicine Program
Mount Sinai Medical Center
Department of Radiology Box 1234
One Gustave L Levy Place
New York, NY 10029
Radiology-DiagnosticKathleen  P. Halton, MD(212)241-4013
(212)241-4234
[4203521136]  New York Medical College at Westchester Medical Center Program
New York Medical College
Macy Pavilion, Room 1319
Department of Radiology
Valhalla, NY 10595
Radiology-DiagnosticSusan  Rachlin, MD(914)493-8550
(914)493-7407
linkowskir@wcmc.com   
[4203521137]  New York University School of Medicine Program
Bellevue Hospital
Department of Radiology
462 First Avenue
New York, NY 10016
Radiology-DiagnosticMichael  M. Ambrosino, MD(212)263-6369
(212)263-7666
[4203521143]  SUNY Health Science Center at Brooklyn Program
S U N Y Health Science Ctr at Brooklyn, Dept of Radiology
Box 45
450 Clarkson Avenue
Brooklyn, NY 11203
Radiology-DiagnosticJohn  Amodio, MD(718)270-6730

john.amodio@downstate.edu   
[4203521147]  SUNY Upstate Medical University Program
SUNY Health Science Center at Syracuse
750 East Adams Street
Syracuse, NY 13210
Radiology-DiagnosticRolf  A. Grage, MD(315)464-7434
(315)464-2570
Jonesae@upstate.edu   
[4203521214]  Harlem Hospital Center Program
Harlem Hospital Center
506 Lenox Avenue
New York, NY 10037
Radiology-DiagnosticRoberta  C. Locko, MD(212)939-4901
(212)939-4836
[4203521218]  Lenox Hill Hospital Program
Lenox Hill Hospital
Department of Radiology
100 E 77th Street
New York, NY 10021
Radiology-DiagnosticNeal  F. Epstein, MD(212)434-2522
(212)434-2253
[4203521221]  Maimonides Medical Center Program
Maimonides Medical Center
4802 Tenth Avenue
Brooklyn, NY 11219
Radiology-DiagnosticSteven  Shankman, MD(718)283-7117
(718)635-8411
csmith@maimonidesmed.org   
[4203521222]  SUNY at Stony Brook Program
University Hospital-SUNY at Stony Brook
Dept of Radiology
School of Medicine, Stony Brook University
Stony Brook, NY 11794-8460
Radiology-DiagnosticWilliam  H. Moore, MD(631)444-3580
(631)444-7538
[4203521224]  St Luke's-Roosevelt Hospital Center Program
St Luke's Roosevelt Hospital Center
1000 Tenth Avenue, 4th Floor, Rm 4C-12
Dept of Radiology
New York, NY 10019
Radiology-DiagnosticNolan  J. Kagetsu, MD(212)523-7048
(212)523-6019
[4203521229]  New York Medical College (Richmond) Program
Richmond University Medical Center
Department of Radiology
355 Bard Avenue
Staten Island, NY 10310
Radiology-DiagnosticKikkeri  Vinaya, MD(718)818-3153
(718)818-4180
kvinaya@rumcsi.org   
[4203521240]  Winthrop-University Hospital Program
Winthrop University Hospital
259 First Street
Mineola, NY 11501
Radiology-DiagnosticJonathan  Luchs, MD(516)663-3682
(516)663-8467
[4203521251]  Albert Einstein College of Medicine (Jacobi) Program
Albert Einstein College of Medicine (Jacobi) Progr
1300 Morris Park Avenue
Bronx, NY 10461
Radiology-DiagnosticMelvin  Zelefsky, MD(718)918-4595
(718)918-7535
angela.trotta@nbhn.net   
[4203531124]  NSLIJHS-North Shore University Hospital/NYU School of Medicine Program
North Shore University Hospital
Department of Radiology
300 Community Drive
Manhasset, NY 11030
Radiology-DiagnosticJames  B. Naidich, MD(516)562-4797
(516)562-4794
jnaidich@yahoo.com   
[4203611148]  University of North Carolina Hospitals Program
UNC Dept. of Radiology
CB 7510
Chapel Hill, NC 27599-7510
Radiology-DiagnosticJeffrey  K. Smith, MD, PhD(919)966-2885
(919)966-1994
jksmith@med.unc.edu   
[4203611150]  Wake Forest University School of Medicine Program
Wake Forest University School of Medicine
Department of Radiology
Medical Center Blvd
Winston-Salem, NC 27157
Radiology-DiagnosticRita  I. Freimanis, MD(336)716-8048
(336)716-2029
[4203631149]  Duke University Hospital Program
Duke University Medical Center
Department of Radiology
Box 3808
Durham, NC 27710
Radiology-DiagnosticCharles  M. Maxfield, MD(919)684-7585
(919)684-7151
mitzi.chambers@duke.edu   
[4203812154]  Cleveland Clinic Foundation Program
Cleveland Clinic
9500 Euclid Avenue
Mailcode Hb6
Cleveland, OH 44195
Radiology-DiagnosticTan-Lucien  Mohammed, MD(216)444-2136
(216)636-5030
[4203821152]  University Hospital/University of Cincinnati College of Medicine Program
University of Cincinnati Medical Center
234 Goodman Street
Mail Location 761
Cincinnati, OH 45219-0761
Radiology-DiagnosticRobert  D. Wissman, MD(513)584-6016
(513)584-0431
Robert.Wissman@healthall.com   
[4203821153]  University Hospitals Case Medical Center Program
Case Western Reserve University Program
11100 Euclid Avenue
Cleveland, OH 44106
Radiology-DiagnosticMark  R. Robbin, MD(216)844-3113
(216)844-5922
mark.robbin@uhhospitals.org   
[4203821156]  Ohio State University Hospital Program
Ohio State University
1654 Upham Drive
610 Means Hall
Columbus, OH 43210
Radiology-DiagnosticGreg  Christoforidis, MD(614)293-8369

greg.christoforidis@osumc.edu   
[4203821157]  University of Toledo Program
The University of Toledo
Department of Radiology
Mail Stop#1200 Univ Med Ctr, 3000 Arlington Avenue
Toledo, OH 43614
Radiology-DiagnosticLee  S. Woldenberg, MD(419)383-3428
(419)383-6422
wendy.gobbell@utoledo.edu   
[4203821232]  Aultman/Mercy/NEOUCOM Program
Aultman Hospital
Department of Radiology
2600 Sixth Street, SW
Canton, OH 44710
Radiology-DiagnosticBenedict  Y. Kim, DO(330)363-6267
(330)363-2485
[4203821242]  Case Western Reserve University (MetroHealth) Program
MetroHealth Medical Center
Department of Radiology
2500 MetroHealth Drive
Cleveland, OH 44109-1998
Radiology-DiagnosticMelissa  T. Myers, MD(216)778-4016
(216)778-4375
mbutler@metrohealth.org   
[4203912158]  Integris Baptist Medical Center Program
INTEGRIS Baptist Medical Center
Graduate Medical Education
3300 Northwest Expressway, Room 100-4394
Oklahoma City, OK 73112
Radiology-DiagnosticKerri  J. Kirchhoff, MD(405)552-0926
(405)552-5102
annette.kezbers@integrisok.com   
[4203921159]  University of Oklahoma Health Sciences Center Program
University of Oklahoma Health Sciences Center
Dept of Radiological Sciences
PO Box 26901
Oklahoma City, OK 73190
Radiology-DiagnosticJay  S. Hiller, MD(405)270-5165
(405)297-5973
jay-hiller@ouhsc.edu   
[4204031160]  Oregon Health & Science University Program
Oregon Health & Science University
Diagnostic Radiology, L340
3181 SW Sam Jackson Park Rd.
Portland, OR 97239
Radiology-DiagnosticJim  C. Anderson, MD(503)494-5266
(503)494-4982
gaddisg@ohsu.edu   
[4204111173]  Temple University Hospital Program
Temple University Hospital
3401 North Broad Street
Philadelphia, PA 19140-5189
Radiology-DiagnosticBeverly  L. Hershey, MD(215)707-2640
(215)707-5851
hersheb@tuhs.temple.edu   
[4204111174]  Thomas Jefferson University Program
Thomas Jefferson University
132 S 10th Street
Suite 780 Main Bldg
Philadelphia, PA 19107
Radiology-DiagnosticLevon  Nazarian, MD(215)955-4916
(215)955-5329
levon.nazarian@jefferson.edu   
[4204121162]  Bryn Mawr Hospital Program
Bryn Mawr Hospital
130 S Bryn Mawr Avenue
Department of Radiology
Bryn Mawr, PA 19010
Radiology-DiagnosticVikram  S. Dravid, MD(610)526-3436
(610)526-4590
[4204121163]  Geisinger Health System Program
Geisinger Medical Center
Department of Radiology 2007
100 North Academy Avenue
Danville, PA 17822
Radiology-DiagnosticAnne  P. Dunne, MD(570)271-6203
(570)271-5976
twcordell@geisinger.edu   
[4204121164]  Penn State University/Milton S Hershey Medical Center Program
Milton S Hershey Medical Center
500 University Drive, Dept. of Radiology, H066
PO Box 850
Hershey, PA 17033
Radiology-DiagnosticDonald  Flemming, MD(717)531-8704
(717)531-0922
[4204121165]  Albert Einstein Healthcare Network Program
Albert Einstein Medical Center
5501 Old York Road
Philadelphia, PA 19141
Radiology-DiagnosticWilliam  Herring, MD, FACR(215)456-6226
(215)456-1749
radiology@einstein.edu   
[4204121169]  Drexel University College of Medicine/Hahnemann University Hospital Program
Hahnemann University Hospital
3rd Floor, North Tower MS 206
Broad and Vine Streets
Philadelphia, PA 19102
Radiology-DiagnosticRobert  Koenigsberg, DO, MSc(215)762-8804
(215)762-2350
Robert.Koenigsberg@drexelmed.edu   
[4204121170]  Mercy Catholic Medical Center Program
Mercy Catholic Medical Center
1500 Lansdowne Avenue
Darby, PA 19023
Radiology-DiagnosticBetsy  A. Izes, MD(610)237-4355
(610)237-2599
[4204121175]  University of Pennsylvania Program
Hospital of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
Radiology-DiagnosticMary  H. Scanlon, MD(215)662-2832
(215)662-3093
resprog@rad.upenn.edu   
[4204121176]  Allegheny General Hospital Program
Allegheny General Hospital
Department of Diagnostic Radiology
320 East North Avenue
Pittsburgh, PA 15212
Radiology-DiagnosticMelanie  B. Fukui, MD(412)359-8674
(412)359-6912
lfink1@wpahs.org   
[4204121177]  University of Pittsburgh Medical Center Medical Education Program
University Health Center of Pittsburgh
Medical Arts Building, Suite 503
3708 Fifth Avenue
Pittsburgh, PA 15213
Radiology-DiagnosticPhilip  D. Orons, DO(412)647-7338
(412)647-1137
oronspd@upmc.edu   
[4204131171]  Pennsylvania Hospital of the University of Pennsylvania Health System Program
Pennsylvania Hospital (UPHS)
Department of Radiology
800 Spruce Street
Philadelphia, PA 19107
Radiology-DiagnosticMichael  B. Love, MD(215)829-5699
(215)829-7482
[4204221182]  University of Puerto Rico Program
University of Puerto Rico School of Medicine
PO Box 365067
Medical Sciences Campus
San Juan, PR 00936
Radiology-DiagnosticAngel  A. Gomez, MD, MPH(787)758-2525
(787)777-3855
skeletalrad@gmail.com   
[4204321183]  Brown University Program
Rhode Island Hospital
Department of Radiology
593 Eddy Street
Providence, RI 02903
Radiology-DiagnosticMartha  B. Mainiero, MD(401)444-5184
(401)444-5017
[4204521184]  Medical University of South Carolina Program
Medical University of South Carolina
Department of Radiology
96 Jonathan Lucas, MSC 323
Charleston, SC 29425
Radiology-DiagnosticLeonie  Gordon, MD(843)792-7179
(843)792-9319
[4204712186]  Baptist Memorial Hospital Program
Baptist Memorial Hospital Memphis
Department of Radiology, Attn: Ginger Tubbs
6019 Walnut Grove Road
Memphis, TN 38120
Radiology-DiagnosticJohn  A. Ellzey, MD(901)226-3001
(901)226-3159
[4204721187]  University of Tennessee/Methodist Healthcare Program
UT/Methodist Healthcare Program
Department of Radiology
1265 Union Avenue
Memphis, TN 38104
Radiology-DiagnosticRobert  E. Laster, MD(901)516-8529
(901)516-7490
barnsl@methodisthealth.org   
[4204721189]  Vanderbilt University Program
Vanderbilt University Medical Center - Radiology
1161 21st Avenue South
CCC-1121 Medical Center North
Nashville, TN 37232-2675
Radiology-DiagnosticThomas  S. Dina, MD(615)322-3780
(615)322-3764
radprogram@vanderbilt.edu   
[4204721236]  University of Tennessee Medical Center at Knoxville Program
University of Tennessee Medical Center
1924 Alcoa Highway
Knoxville, TN 37920
Radiology-DiagnosticKathleen  Hudson, MD, MEd(865)305-8685
(865)305-9025
[4204811194]  University of Texas Medical Branch Hospitals Program
University of Texas Medical Branch Hospital
Department of Radiology
301 University Boulevard
Galveston, TX 77555-0709
Radiology-DiagnosticLeonard  E. Swischuk, MD(409)747-2849
(409)772-7120
femcdani@utmb.edu   
[4204811198]  Texas A&M College of Medicine-Scott and White Program
Scott and White Memorial Hospital
2401 South 31st Street
Temple, TX 76508
Radiology-DiagnosticJames  B. Schnitker, MD(254)724-4507
(254)724-6588
[4204812257]  Texas Tech University Health Sciences Center Paul L Foster School of Medicine Program
Texas Tech University Health Sciences Center
4800 Alberta Avenue
El Paso, TX 79905
Radiology-DiagnosticArvin  E. Robinson, MD, MPH(915)545-6845
(915)545-0420
[4204821192]  University of Texas Southwestern Medical School Program
University of Texas Southwestern Medical Center
5323 Harry Hines Boulevard
Dallas, TX 75390
Radiology-DiagnosticDiane  M. Twickler, MD(214)648-9107
(214)648-2678
Dianna.Otterstad@UTSouthwestern.edu   
[4204821195]  Baylor College of Medicine Program
Baylor College of Medicine
Department of Radiology
One Baylor Plaza
Houston, TX 77030
Radiology-DiagnosticPedro  J. Diaz-Marchan, MD(713)798-6362
(713)798-8359
lburlin@bcm.edu   
[4204821196]  University of Texas at Houston Program
University of Texas Medical School
Department of Diagnostic Radiology
6431 Fannin Street, Suite 2.026
Houston, TX 77030
Radiology-DiagnosticSandra  A. Oldham, MD(713)500-7640
(713)500-7647
[4204821197]  University of Texas Health Science Center at San Antonio Program
Univ of Texas Health Science Center
Department of Radiology
7703 Floyd Curl Drive
San Antonio, TX 78229
Radiology-DiagnosticRajeev  Suri, MD(210)567-6482
(210)567-5541
[4204821248]  San Antonio Uniformed Services Health Education Consortium Program
Brooke Army Medical Center
Radiology Residency Program - DOR
3851 Roger Brooke Drive, Room 133-2
Fort Sam Houston, TX 78234-6200
Radiology-DiagnosticLiem  T. Mansfield, MD(210)916-3290
(210)916-9256
LIEM.MANSFIELD@AMEDD.ARMY.MIL   
[4204822190]  Baylor University Medical Center Program
Baylor University Medical Center
Department of Radiology
3500 Gaston Avenue
Dallas, TX 75246
Radiology-DiagnosticKenneth  L. Ford, MD(214)820-3795
(214)820-7577
radres@baylorhealth.edu   
[4204921199]  University of Utah Program
University of Utah School of Medicine
Department of Radiology
30 North 1900 East, #1A71
Salt Lake City, UT 84132
Radiology-DiagnosticH. Christian  Davidson, MD(801)581-7553
(801)581-2414
[4205031200]  University of Vermont Program
University of Vermont College of Medicine
Patrick 113, FAHC, MCHV Campus
111 Colchester Avenue
Burlington, VT 05401
Radiology-DiagnosticKristen  DeStigter, MD(802)847-0794
(802)847-4822
Kristen.Destigter@vtmednet.org   
[4205111201]  University of Virginia Program
University of Virginia Health System
PO Box 800170
Lee Street
Charlottesville, VA 22908
Radiology-DiagnosticSpencer  B. Gay, MD(434)924-9372
(434)924-8698
kr3s@virginia.edu   
[4205113252]  Naval Medical Center (Portsmouth) Program
Portsmouth Naval Medical Center
620 John Paul Jones Circle
Portsmouth, VA 23708
Radiology-DiagnosticRaymond  E. Bozman, MD(757)953-1198
(757)953-7327
bridget.wakefield@med.navy.mil   
[4205121202]  Eastern Virginia Medical School Program
Eastern Virginia Medical School
Department of Radiology
PO Box 1980
Norfolk, VA 23501-1980
Radiology-DiagnosticLester  S. Johnson, MD, PhD(757)446-8990
(757)446-8441
[4205121203]  Virginia Commonwealth University Health System Program
Medical College of Virginia
PO Box 980615
1250 E Marshall Street, Rm 3-406
Richmond, VA 23298-0615
Radiology-DiagnosticLakshmana  D. Narla, MD(804)828-3524
(804)628-2015
klrobb@vcu.edu   
[4205412206]  Virginia Mason Medical Center Program
Virginia Mason Medical Center
Graduate Medical Education
925 Seneca Street H8-GME
Seattle, WA 98111-9943
Radiology-DiagnosticFelicia  P. Cummings, MD(206)583-6079
(206)583-2307
Joanne.VanderDoes@vmmc.org   
[4205421205]  University of Washington Program
University of Washington Medical Center
1959 NE Pacific Street
Box 357115
Seattle, WA 98195
Radiology-DiagnosticAngelisa  M. Paladin, MD(206)685-8307
(206)543-6317
[4205421207]  Spokane Medical Centers Program
Sacred Heart Medical Center
101 West 8th Avenue
PO Box 2555
Spokane, WA 99220-2555
Radiology-DiagnosticTerri  H. Lewis, MD(509)474-3021
(509)474-2891
buchols@shmc.org   
[4205421239]  Madigan Army Medical Center Program
Madigan Army Medical Center
MCHJ-R
Bldg 9040A Jackson Ave
Tacoma, WA 98431-1100
Radiology-DiagnosticMohammad  Naeem, MBBS, MD(253)968-5604
(253)968-3140
mohammad.naeem@us.army.mil   
[4205521208]  West Virginia University Program
West Virginia University Hospitals
Robert C Byrd Health Science Ctr
PO Box 9235
Morgantown, WV 26506
Radiology-DiagnosticRobert  J. Tallaksen, MD(304)293-3092
(304)293-3899
rtallaksen@hsc.wvu.edu   
[4205612213]  Aurora Health Care Program
St. Luke's Medical Center
2900 West Oklahoma Avenue
Milwaukee, WI 53215
Radiology-DiagnosticSean  R. Amoli, MD(414)649-6298
(414)649-5296
camille.dykas@aurora.org   
[4205621210]  University of Wisconsin Program
University of Wisconsin
E3/311 Clinical Sciences Center
600 Highland Avenue
Madison, WI 53792
Radiology-DiagnosticDavid  H. Kim, MD(608)263-8310
(608)263-8297
ARichgels2@uwhealth.org   
[4205621211]  Medical College of Wisconsin Affiliated Hospitals Program
Medical College of Wisconsin
Department of Radiology
9200 West Wisconsin Avenue
Milwaukee, WI 53226
Radiology-DiagnosticGuillermo  F. Carrera, MD(414)805-3750
(414)259-9290
[4205622212]  Wheaton Franciscan Healthcare-St. Joseph Program
Wheaton Franciscan Healthcare - St. Joseph
5000 West Chambers Street
Milwaukee, WI 53210
Radiology-DiagnosticDavid  W. Litzau, MD(414)447-2196
(414)874-4533


Source: American Council on Graduate Medical Education