Roughly one month is spent on each rotation, including the core areas of fluoroscopy, ultrasound, plain radiography, body CT/MR, neuroradiology and ER (call), as well as in subspecialty areas including fetal imaging, nuclear radiology, MSK, cardiac imaging and interventional radiology. Fellows with specific subspecialty interests may choose to spend more time in one subspecialty area and less time on the other subspecialty rotations.
All of the fellows will rotate through the same introductory core rotations in the first two months, followed by their first overnight call shifts. We then blend advanced rotations with the basic rotations, rotating on a weekly basis unless consecutive weeks on a rotation are desired. The program director meets with the fellows on a quarterly basis to review their progress and identify any areas that need further training.
As the fellows begin identifying areas of specific interest, and/or interviewing for jobs and identifying areas that need further study, we can increase the number of subspecialty rotations.
During the typical work day, the fellow is responsible for dictating all studies assigned to their rotation. All studies are reviewed with and supervised by a faculty member. All rotations have a 1:1 trainee-to-faculty ratio (i.e. residents and fellows are not doubled up on rotations).
Fellows are allowed more and more autonomy as the fellowship year progresses, commensurate with their increasing clinical skills and pediatric radiology acumen. Fellows are expected to take a primary role on each rotation, managing phone calls and protocols, checking studies for completeness, and providing consults by phone and/or in person.
Call at Texas Children’s Hospital is very busy, with a large volume of high acuity studies. Call helps prepare our fellows to be both efficient and accurate when they join the workforce. All call shifts are performed 1:1 with a faculty member who is also in-house, and the fellow and faculty member together cover studies being performed at all three hospital sites from the reading rooms at the main hospital in the Texas Medical Center.
Fellows take call on a night float system, shared with the senior rotating residents. Night float shifts are from 10 p.m. to 7 a.m., Sunday through Thursday, followed by a post-call day off. There are no clinical duties during the day while the fellow is on the night float system. Fellows will do between three-four weeks (15 and 20 shifts) of night float during the fellowship year.
In addition, fellows do five-six weeks (five consecutive days) of evening shift rotations, from 5 to 10 p.m.. The fellows also cover weekend shifts from 9 a.m. to 5 p.m., once per month. Holiday weekends are free of assigned call shifts.
While on call, the fellow is responsible for providing preliminary interpretations on emergency and inpatient studies, including plain films, ultrasounds and CT/MR studies, as well as performing occasional fluoroscopy procedures (air enema for intussusception reduction, for example). Overnight, the fellows also provide preliminary interpretations on neuroradiology studies. There is an ultrasound technologist in-house 24 hours a day, but the fellows are expected to scan each ultrasound patient to arrive at their own impression.
Moonlighting opportunities are available at Texas Children's Hospital, once the fellow has completed their first week of night float. Moonlighting shifts mirror the regular call shifts, but cover overnight on the weekends and holidays.
All rotations take place at Texas Children’s Hospital in the world-renowned Texas Medical Center, and at Texas Children’s Hospital - West Campus, in the suburb of Katy, to the west of Houston. Texas Children’s Hospital has a second community location in the Woodlands, a suburb well to the north of Houston, but its remoteness precludes on-site clinical rotations for the fellows.
Training sites include:
- Texas Children’s Hospital – West Tower (inpatient and emergency services, NICU)
- Texas Children’s Hospital – Legacy Tower (intensive care and outpatient services, including Nuclear Radiology)
- Texas Children’s Pavilion for Women (inpatient and outpatient maternity and labor and delivery services, NICU and well-baby nursery)
- The Abercrombie Building (inpatient services, Medical Staff Services)
- The Mark A. Wallace Center (outpatient services, including the main Radiology reading room)
- The Feigin Tower (research facilities)
- Texas Children’s Hospital – West Campus (inpatient, outpatient and emergency services in a community setting)