Clinical Experience

The clinical curriculum at BMC is fully compliant with the Residency Review Committee (RRC) of the ACGME, follows recommendations from the Association of Program Directors in Radiology (APDR), and fulfills requirements of the American Board of Radiology (ABR).

Residents train in a resident-centered, hands-on environment, with minimal fellow coverage (typically 6-7 fellows per year across all specialties), allowing residents to perform and preliminarily interpret nearly all radiologic examinations before review by attending radiologists. Cases are then discussed with faculty to highlight key findings and teaching points.

Orientation and Early Training

  • Introductory Lectures: First-year residents attend a series of lectures during July and August to augment early clinical exposure.

  • Radiology Boot Camp: During the first few weeks, residents learn specialty-oriented basics and practical departmental workflow.

  • Early Rotations: First-year residents develop skills in general radiography, fluoroscopy, and subspecialty exposure, including Body Imaging, Pediatric Radiology, and Neuroradiology.

Rotation Structure

  • Most first-year clinical rotations are four weeks in duration, while rotations during the second and third years typically last 2–3 weeks. Residents spend the majority of their time at BMC, with a subset of rotations at VABHS.

  • Third-year residents attend the four-week American Institute of Radiologic Pathology (AIRP) course in Washington, D.C., either virtually or in person. The department covers tuition costs and provides a travel stipend for those attending on site.

  • Graded responsibility ensures residents gain increasing autonomy, graduating as skilled, confident radiologists.

  • Fourth-year residents have six months of elective time, including 2–3 month “mini-fellowship” blocks.

  • The physics curriculum begins at the start of residency and continues through the ABR Core Exam and the fourth year, using multiple departmental and external resources.

BMC Rotations

Body and Cardiothoracic Imaging

  • CT, MR, and US rotations with 4 dual-energy CT scanners (64–256 detectors) and CT fluoroscopy for interventions.

  • Exposure to thoracic, gastrointestinal, genitourinary, and trauma imaging. Coronary CTA and Virtual Colonoscopy post-processing uses TeraRecon, Intellispace, Advantage Workstation, Circle CVI42, and DynaCAD.

  • MR includes abdominal/pelvic exams, MRCP, MR enterography, rectal MRI, pelvic floor imaging, MR elastography, iron quantification, and cardiovascular MR (cardiac MRI with late gadolinium enhancement, T1/T2 relaxometry, and MR angiography).

  • US training includes general abdominal, head & neck, soft tissue, obstetrical, gynecologic, and musculoskeletal exams, including interventions.

Breast Imaging

  • Approximately 12,000 screening mammograms are performed annually with total breast imaging volume averaging ~18,000 cases including diagnostic mammograms, ultrasounds, MRI, needle localization, ductography, and core biopsies.

Emergency Radiology

  • Interpretation of STAT and inpatient cases from our high-volume Emergency Department, working in close collaboration with referring physicians to ensure timely and optimized patient care.

General Radiology

  • Interpretation of plain films from BMC and affiliated clinics, including barium GI fluoroscopy and genitourinary studies. Experience includes outpatient, inpatient, and trauma imaging.

Musculoskeletal Imaging

  • Interpretation of plain films, CT, MR, and US of the musculoskeletal system. Opportunities to participate in US- and CT-guided procedures.

Neuroradiology

  • Full spectrum of CNS disorders. Modalities include CT (dual-energy), MR (advanced techniques: fMRI, MR spectroscopy, perfusion), angiography, and myelography.

Nuclear Radiology

  • Wide variety of adult and pediatric studies with 4 dual-detector gamma cameras, SPECT, attenuation correction, gated SPECT for cardiac imaging, and PET/CT at Moakley Medical Services Building. Residents participate in radionuclide therapies (e.g., I-131).

Pediatrics

  • Rotations at Boston Medical Center and Boston Children’s Hospital, including radiography, fluoroscopy, CT, and US for patients from premature infants to young adults. Cases include emergency, acute, and trauma imaging.

Vascular/Interventional Radiology

  • Hands-on participation in diagnostic angiography, angioplasty, stent/graft placement, GU/GI/biliary interventions, venous access, dialysis fistula management, TIPS, uterine artery embolization, image-guided biopsies, and abscess drainage. Residents benefit from limited IR fellow coverage, increasing hands-on experience.

Boston VA Medical Center (VABHS) Rotations

General Radiology

  • Interpretation of plain films on inpatients and outpatients. Focus on thoracic radiology, ICU radiology, and onco-radiology, including fluoroscopic studies on complex cases.

Musculoskeletal/Body MR

  • Comprehensive overview of body MRI with emphasis on musculoskeletal imaging, including MR angiography studies.

CT

  • Broad-based CT experience on all organ systems. Scanners include 64-slice (Jamaica Plain), 64-slice, and 320-slice (West Roxbury).

Nuclear Medicine and Interventional Radiology

  • Residents participate in a variety of procedures, gaining expertise in patient management, decision-making, and hands-on interventional techniques.