Residents gain invaluable experience, confidence, and independence as they progress through the tiered call system. The robust on-call experience is designed to fully prepare residents for all aspects of radiology, including both the private practice and academic settings. Residents repeatedly say that their on-call experience is one of the most useful and rewarding learning experiences of residency.
Residents taking junior call independently interpret radiographs and nuclear medicine scans for both adult and pediatric emergency room patients and inpatients. They also independently perform urgent fluoroscopy exams, including image-guided lumbar punctures. Reports are fully dictated and published as preliminary reports in the electronic medical record prior to being finalized by the attending later in the shift or the next morning. Volume averages 80-120 radiographs, 0-2 nuclear medicine scans (predominantly HIDA and V/Q scans), and 0-2 fluoroscopic exams over the course of a full 11 hour shift.
Residents begin gaining experience in the junior call system in the spring of their first year, when they shadow a senior "buddy resident" to learn the system. First-year residents also work with attending supervision on several short shifts in the evening hours. During the second year, residents do 4-5 weeks of independent, overnight junior call along with scattered daytime weekend shifts and short (4-hour) evening shifts. A week of overnight junior call is repeated in the final year of residency to help senior residents refresh their basic skills.
Residents taking senior call independently interpret cross-sectional studies (US, CT, or MRI) across every subspecialty for both adult and pediatric emergency room patients and inpatients. They dictate preliminary reports containing urgent findings and publish them in the electronic medical record. Senior on-call residents are also responsible for protocoling urgent cross-sectional exams, responding to contrast reactions and extravasations, and checking technologist-performed US exams and trauma CT scans for quality control. Two reading room assistants are always present during call shifts to help answer the phone and to facilitate imaging-related requests. Volume averages approximately 70-100 cross-sectional exams over the course of a full 12 hour shift.
Residents do 2 weeks of senior call in the second of their second year, 4-5 weeks during third year, and 4 weeks during their final year. Residents also covered scattered daytime weekend shifts and short (5-hour) evening shifts. Weeks are a mix of evening and overnight shifts and are tiered so that more junior residents are paired with the most senior residents for support.
Residents on call have the best of both worlds: true autonomy to make independent interpretations and supervising faculty available promptly when needed. An Emergency Radiology faculty member interprets cases (after resident preliminary reports are rendered) from 6:00 pm to 3:00 am every day in the hospital. Subspecialty faculty are also available for consultation by phone or pager 24 hours a day.
Graduates of the residency program report that they are supremely confident in fellowship and when entering practice as an attending. This in large part is because our residents make truly independent decisions on complex cases throughout their residency training.