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Winthrop University Hospital


Diagnostic Radiology

Course Description: This elective in Diagnostic Radiology familiarize the student with imaging procedures, their importance in the diagnostic armamentaria, and help them develop an intelligent approach to ordering imaging studies. The student will understand the physical consequences to the patient. The impact, both financial as well as utilization of increasingly scarce and expensive resources, will be emphasized. Communication between the requesting physician and the radiologist will be discussed with a focus on what each wants from the other and how to best serve the patient. The student will achieve sufficient understand of common imaging studies to be able to engage in a more meaningful dialog with the radiologist consultant. The student will attend didactic lectures specifically for the students and participate in procedures that will enable the student to better understand the stress patients have to endure in these procedures as well as give the student a better three dimensional idea of imaging anatomy. The student will participate in image interpretation in an active manner. In addition, the student may undertake a research project with one of the faculty members. Such a project may require additional time and/or ongoing work after the elective is complete. If suitable, the project may be submitted for publication.

Duration: 2 or 4 weeks
Max: # Students: 3
Pre-requisite: 2 week Radiology clerkship

Emergency Radiology
Rakesh A. Shah, MD

Course Description: The Emergency Radiology elective is designed to familiarize the student with the major imaging modalities utilized in the ER setting and the imaging features of the most common imaging diagnosis encountered in the emergency room setting. This will include developing an approach to the interpretation of emergency room x-rays of all parts of the body, and understanding the role of CT and MRI in the diagnosis and management of both traumatic and non traumatic emergencies. Time will be divided between plain film ER radiography, the body CT service, and the neuroradiology service all of which have a high volume of emergent studies from the emergency room. Students will also be provided the opportunity to gain some exposure to the role of ultrasound and interventional procedures which may be performed on emergency room patients. The student will participate in twice daily radiology conferences in the department.

Duration: 2 weeks
Max: # Students: 2
Pre-requisite: None

Interventional Radiology
Jason Hoffmann, MD

Course Description: The Division of Interventional Radiology (IR) supports all departments throughout Winthrop-University Hospital. Three fellowship-trained Interventional Radiologists work in the division, which provides inpatient, outpatient, and emergency department services. Winthrop?s IR section is actively involved in all aspects of patient care, ranging from clinic visits, immediate pre-procedure patient evaluation, procedures, and post-procedural management. All imaging modalities are used in pre-procedural evaluation and procedural planning. Most of the IR procedures are performed under ultrasound, fluoroscopy, or CT scan guidance.
The Interventional Radiologists are trained to perform the full gamut of IR procedures, including venous access, percutaneous biopsy and fiducial marker placement, percutaneous drainage tube placement, inferior vena cava filter placement and removal, interventional oncology procedures (chemoembolization, radioembolization, radiofrequency/cryo/microwave ablation), TIPS placement and revision, percutaneous biliary drain placement, portal vein embolization, uterine artery embolization, dialysis fistula and graft angiography/angioplasty/stenting, peripheral arterial and venous angiography and angioplasty/stenting/thrombolysis, and varicose vein laser ablation. This is not a complete list, but highlights the variety of cases performed by the IR division.
The elective is open to third or fourth year medical students. Generally, it is expected that most interested third year medical students would complete a two-week rotation. Fourth year medical students interested in applying for radiology residency may consider a four-week elective rotation. However, rotation lengths can be altered on a case-by-case basis. The medical students on service (maximum of two per rotation) will join the Interventional Radiologists and residents on service for patient rounds, clinic visits, and procedures. Students will have ample opportunity to scrub for procedures and become actively involved in performing procedures. Students will also have the opportunity to attend at least three multi-disciplinary conferences per week. The IR attending physicians will also give lectures to the students throughout their rotation, covering a wide range of basic IR procedures and topics. Students will be expected to give a brief (8-10 minute) presentation at the end of their rotation, on an IR topic of their choice.

Duration: 2 or 4 weeks
Max: # Students: 2
Pre-requisite: Completion of Radiology Clerkship

Multidisciplinary Approach to Breast Cancer
Susana Fuchs, MD
Irina Rapoport, MD
Frank Monteleone, MD

Course Description: This elective is designed to introduce the student to diagnosis and management of breast cancer.  Observation and participation in breast imaging and intervention comprise about half of the elective.  Multiple imaging modalities are utilized for the care of patients, including mammography, ultrasound, and MRI studies. Additionally the student will be exposed to the interventional procedures, such as pre-operative needle localization for patients undergoing excisional biopsy or lumpectomy, stereotactic, ultrasound, and MRI guided biopsies. The student will rotate in Breast Surgery (in both the operating room and the surgical breast clinic) and in Oncology breast clinic.  During the rotation, the student will have the opportunity to become acquainted with Radiation Oncology and with Pathology.  Attendance at a weekly interdepartmental conference (breast tumor board) provides additional exposure to the interrelationship of clinical disciplines in patient care.

Duration: 2 weeks
Max: # Students: 1
Pre-requisite: Basic Radiology Clerkship and Surgery Clerkship

R105 R105A
Musculoskeletal Radiology
Joseph P. Mazzie, DO

Course Description: Musculoskeletal symptoms are amongst the most common chief complaints in both the routine outpatient office setting, as well as to the emergency department in the pediatric and adult populations. It is for this reason that the Winthrop- University Hospital radiology department has developed a comprehensive musculoskeletal rotation which is available to both third and fourth year medical students for either 2 or 4 week elective blocks. Medical students during this elective will shadow a fellowship trained musculoskeletal attending radiologist and will review diagnostic exams (x-ray, CT, MRI and US), as well as participate in various musculoskeletal interventions including bone and soft tissue biopsies, ultrasound-guided diagnostic and interventional exams, and arthography.

Duration: 2 or 4 weeks
Max: # Students: 1
Pre-requisite: None

R106 R106A

Course Description: The Neuroradiology elective consists of daily imaging review sessions in CT and MR imaging. Additionally, there will be review of neuroradiologic interventions, i.e. CT myelography and head, neck and spine angiography. Emphasis will be placed on head and neck and neuroanatomy in the various imaging modalities, including detailed reviews of the pertinent vascular anatomy (CTA and MRA techniques are utilized and reviewed on a daily basis). Clinical case material is reviewed in consideration of differential diagnoses and indications for further diagnostic evaluation.  Weekly combined conferences are held with the neurology and neurosurgery clinical services. Once familiar with imaging anatomy, and clinical indications for procedures, students may observe these procedures under the direct supervision of faculty.

Duration: 2 or 4 weeks
Max: # Students: 1
Pre-requisite: None

R107 R107A
Pediatric Radiology
Dan Barlev, MD

Course Description: The division of Pediatric Radiology supports Pediatrics at Winthrop University Hospital, including the inpatient, outpatient and emergency department services. All imaging modalities are utilized for the care of pediatric patients, including plain film, ultrasound, CT, MRI and nuclear medicine studies. Additionally, there is an active fluoroscopy schedule consisting of upper and lower GI studies and voiding cystourethrograms. The elective is open to third or fourth year medical students for either 2 or 4 week rotations. Students will join radiology and pediatrics residents rotating on service and will attend daily clinical work rounds in the NICU and on the general pediatrics ward, weekly pediatrics grand rounds and daily radiology resident conferences. Additionally, students will participate in daily 'at the boards' teaching sessions with the pediatric radiologist. There will be ample time for individual projects for the interested student.

Duration: 2 or 4 weeks
Max: # Students: 1
Pre-requisite: None

R108 Subinternship in Radiology
Man Hon, MD

Course Description: This elective allows the student an active part in the daily film interpretation in the subspecialty of their choice and in the procedural aspects of Diagnostic Radiology. Daily morning and afternoon teaching conferences are held. Teaching cases and reading materials supplement the teaching program.  All effort will be made to accommodate the student in his/her choice of subspecialty, however the concentration will be in general radiology. He/she will participate in general radiological interpretations, conferences and seminars. The student will be assessed by the attending with whom they interact. In addition, they will be required to deliver a 45-minute oral presentation on the radiological manifestations of a topic of their choice.  In addition, the student may be required to undertake a research project with one of the faculty members. Such a project may require additional time and/or ongoing work after the elective is complete. If suitable, the project may be submitted for publication.

Duration: 4 weeks
Max: # Students: 1
Pre-requisite: Completion of the 2 week Radiology elective

R109 R109A
Ultrasound Radiology
Sabrina Mahboob, MD

Course Description: The elective will provide medical students with an enhanced learning experience that will help to integrate ultrasound imaging skill and knowledge with clinical medicine. The curriculum will promote understanding of the benefits of ultrasound as an accessible and important diagnostic tool which is being used in every facet of medicine. The ultrasound department performs a wide range of examinations which include but are not limited to the abdomen, pelvis, obstetric, head, neck and vascular imaging. During this rotation, students will spend their time in the ultrasound department. Their time will be split between case read-outs with the attending physicians and in the examination rooms. The student will participate in departmental didactic sessions as well. Participation in a research project is encouraged but not required.

Duration: 2 or 4 weeks
Max: # Students: 1
Pre-requisite: 2 week Diagnostic Radiology clerkship

R110 Radiology Research
Orlando Ortiz, MD, PhD
Douglas Katz, MD

Course Description: The purpose of this radiology research elective (typically 1 month in length, but potentially longer) is for the 4th year medical student (from SUNY at Stony Brook or from an outside medical school) to conduct a clinical research project or projects. Such an elective has already existed for some time in our Department, and we have hosted multiple medical students over the past decade in this capacity. Since the student will work very closely with a faculty mentor (Dr. Ortiz or Katz, but potentially another faculty member), the student will be expected to meet with the potential mentor prior to approval of the elective, and to select an appropriate project or projects. The expectation is that the student will spend the entire month in the Hospital/Department working on such a project, and that the student will also attend as many departmental 7:30 and noon teaching conferences as possible (other than Monday/Tuesday am physics). Given the constraints of completing a meaningful project in one month, the expectation is that the student will continue to work with the attending mentor until the project is completed, which may require additional after hours work and work following formal completion of the rotation. Past projects have ranged from preparation of educational/teaching materials, to preparation of case reports and review articles, to preparation of peer-reviewed clinical research and education posters as well as scientific abstracts for presentation at regional, national, and international radiology meetings. Past projects have led to student authorship of abstracts and publications. The student may also be involved in multi-institutional projects as well as projects collaborating with other departments/divisions within the Hospital.

Duration: 4 weeks
Max: # Students: 1
Pre-requisite: None
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