Fellowship Overview

Orientation 2009

Typical Week

Comments from Former Fellows

Fellowship Application Forms

Maps of San Diego

Places of work

Fellowship Organisers

Moonlighting oppourtunities

Rheumatology fellowship

Thank you for your request for information regarding the Musculoskeletal Fellowship Program to begin in July 2010. We sincerely appreciate you interest concerning our program.  We have opted out of the fellowship match program and interview starting  November 1st approximately 19 months prior to the fellowship.

First, I would like to give you some idea about our fellowship. It is one year in duration and consists of clinical, teaching, and research responsibilities restricted to musculoskeletal imaging at four hospitals: the University Hospital, Thornton Hospital (second University hospital), Veterans Affairs Medical Center, and Scripps Clinic. I am in charge of Osteoradiology at the VA Medical Center and my colleagues, Dr. Mini Pathria, Dr Amil Gentili, Dr. Christine Chung,  Dr Evelyn Flizar,Dr Lucas Hiller, Dr Karen Chen and Dr. Tudor Hughes are the bone radiologists at the two University Hospitals. We all rotate to each of the three hospitals, however, and spend time at Scripps Clinic. This fellowship has been in existence for approximately 32 years, and during that time we have trained two to eleven fellows each year. The program is geared toward but not restricted to the person who is considering a career in academic osteoradiology, a field in which great opportunities exist.

With regard to clinical activities, each hospital has an active Osteoradiology Service in which a resident rotates for a 4-week period. The osteoradiology fellow will spend approximately 80% of his/her time on the clinical service at each one of the hospitals, and 20% of his/her time is reserved for research activities. During the clinical time, he/she will be actively involved in the performance of special procedures. We perform approximately 30 to 250 routine radiographic examinations dealing with the musculoskeletal system at each hospital per day. In addition, at each hospital, we perform one or two special procedures daily, including arthrography, and bone biopsies. The fellow will be responsible for performing and interpreting these procedures. In addition, he/she will be actively involved in the interpretation of computed tomograms, ultrasound and magnetic resonance images dealing with musculoskeletal disease. He/she will also become knowledgeable in the quantitative assessment of bone mineral content using such techniques as dual photon absorptiometry, computed tomography, and dual energy radiography. He/she will be closely supervised by myself, Dr. Gentili, Dr. Chung, Dr. Pathria, Dr Flizar, Dr. Hughes Dr Hiller or Dr Chen during these clinical activities.

In recent years, we have become active in teleradiology in which clinical MR imaging cases are received each day from both American and European sources. The volume of cases varies but generally 15 - 70 cases are received each day for interpretation. The fellow and faculty member review together each of these cases. Approximately 2 – 4 additional consultation cases (usually related to MR imaging) are received by regular or express mail each day.  There is a routine Saturday and Sunday morning Teleradiology read out for the fellow on call.

A separate rotation in osteoradiology exists at Scripps Clinic. Fellows will take turns spending time at this clinic, where they will gain further experience interpreting routine and advanced imaging studies and performing procedures. A faculty member also is assigned to Scripps Clinic each day. This rotation is extremely busy with 75 to 125 general bone cases, 2 to 3 arthrograms, and 10 to 30 CT and MR examinations each day. We also have recently initiated a separate rotation concentrating on spinal imaging and intervention during which the fellow is supervised by both bone radiologists and neuroradiologists, and another rotation emphasizing techniques of quantitative bone mineral analysis.

With regard to teaching responsibilities, the Osteoradiology Service of the Radiology Department has a weekly one-hour conference for radiology residents, a weekly one-hour conference for orthopedic surgeons, a monthly one-hour conference for rheumatologists, a weekly one-hour conference in which interesting radiographs at the University Hospital are reviewed, a weekly two-hour city-wide orthopedic surgery conference, and a monthly conference at Scripps Clinic in San Diego. Several times each year, a conference also is held at the Navy Hospital. The fellow will be expected to attend each of these conferences and occasionally, to present cases to our clinical colleagues. In general, the conferences are organized by one or all of the faculty. (See enclosed schedule)  I also give a regular Saturday morning lecture to the residents and fellows lasting 90 minutes.  Further course lectures that can be attended occur on a regular basis with a visiting MR fellowship program and multiple courses in San Diego.

With regard to research activities, we are fortunate to have a fully funded osteoradiology laboratory on the 6th floor of the VA Medical Center with a full-time technician who is available to help the fellow during his/her research. The laboratory contains the latest radiographic equipment. Furthermore, the laboratory is equipped to allow close imaging-pathologic correlation of musculoskeletal diseases using cadaveric parts.

During the one-year period, the fellow is encouraged to organize and complete several research projects dealing with some aspect of musculoskeletal disease. These projects may be formulated on the basis of questions that arise during the clinical aspect of the fellowship. Presentations at national meetings or publications in scientific journals, or both, may result from these research endeavors. Additional research opportunities exist in the areas of quantitative bone mineral assessment and magnetic resonance imaging. Fourth-generation computed tomographic equipment is available at all hospitals, and magnetic resonance imaging equipment is housed adjacent to or within the University Hospitals, at the VA Medical Center and at Scripps Clinic. Further resources available to the fellow include a teaching file containing more than 40,000 interesting musculoskeletal cases, over 200 teaching videotapes, and photography equipment that can be used to make teaching slides.

Each fellow is entitled to four weeks of vacation. Furthermore, we will provide funding to allow travel to any scientific meetings in which the fellow is presenting the results of his/her research activities. Although each fellow also carries a beeper for night call every four or five weeks, only rarely is it necessary for that fellow to report to any of the hospitals.  There is a routine Saturday and Sunday morning staffed read out at both the University and VA hospitals for the on call fellow.

Each year we have approximately 13 funded fellowship positions. In recent years, we have trained about 10-13 fellows annually. We believe it is wise that each applicant visit our department, see our facilities, and meet Mini, Amil, Christine, Tudor, Evelyn and myself. 

It is necessary that you complete the enclosed forms. We also require at least two letters of recommendation as well as a copy of your curriculum vitae. Additionally, if you are accepted for a fellowship, you will be expected to obtain a California medical license before beginning your fellowship. Please contact my secretary Paradorn Thiel, as soon as possible, at Phone 858-552-9210, Fax 858-552-9126  to arrange a visit to our facilities and interviews with our osteoradiology staff members. If your wish to talk to me about the program, feel free to call. Also, if you wish to speak to our current fellows or any of our previous ones, this can be easily arranged.

In summary, Mini, Amil, Christine, Tudor, Evelyn, Karen, Luke and I believe we offer a valuable year devoted to study in osteoradiology with a balanced program devoted to clinical, teaching and research activities. We also believe that if you contact any of our previous fellows, they will indicate that their year in San Diego was an educational (and enjoyable) experience. We all are very committed to the training of osteoradiologists and derive considerable satisfaction in seeing their progress. I realize, however, that a much more accurate appraisal of the program can be determined by speaking to our current or previous fellows, and I encourage you to contact them, or read their comments.

I look forward to hearing from you.

Sincerely yours,

Donald Resnick, M.D.

UCSD Teleradiology & Education Center

8899 University Center Lane., Suite 370

San Diego, CA  92122

Phone 858-246-1011

Fax     858-552-9126

Paradorn Thiel

Manager of Clinical and Research Education,

and Immigration Administrator

Department of Radiology Business Office

University of California, San Diego

4094 4th Avenue, Suite 200

Mail Code: 0834

San Diego, California 92103

Telephone: 619-543-7636

Fax: 619-543-7898

E-mail: pthiel@ucsd.edu