Musculoskeletal Radiology Fellowship

Department of Radiology

The Department of Radiology of the University of Michigan offers a one-year fellowship in Musculoskeletal (MSK) Radiology. Four funded positions are offered each year. Non-funded fellowship positions can also be offered for research or military applicants. Fellows receive well-balanced, excellent subspecialty training in all areas of MSK Radiology from a very large and experienced MSK Radiology Division. Fellows emerge from the fellowship well-prepared for careers in private practice or academic subspecialty MSK Radiology.

The Department of Radiology at the University of Michigan/Michigan Medicine is the primary department responsible for diagnostic imaging at the University's medical center, which has over 1,000 hospital beds and multiple large outpatient facilities in Ann Arbor and nearby communities. The radiology department performs greater than 700,000 exams annually. As a large tertiary referral center, a very high percentage of cases performed in our radiology department have significant pathology and the variety of clinical material is outstanding.

Musculoskeletal Radiology Division and Fellowship

The MSK Radiology Division provides comprehensive musculoskeletal imaging services, including digital radiography, fluoroscopy, computed tomography, magnetic resonance imaging, and sonography. The MSK Radiology Division performs image-guided bone and soft tissue biopsies, aspirations, diagnostic and therapeutic injections of joints, tendons, and nerves, arthrography, and radiofrequency ablation (RFA) of bone tumors. The University of Michigan is one of very few institutions performing MSK MRI-guided biopsies. The Department of Radiology has state-of-the-art equipment and high quality technical and ancillary staff.

The MSK fellowship at the University of Michigan is one of the few that includes high-volume training in MSK ultrasound. As an international leader in MSK ultrasound we have six, dedicated diagnostic MSK ultrasound rooms operating daily, nine dedicated MSK sonographers, and we perform multiple ultrasound-guided interventions.

At the University of Michigan, we see a wide range of MSK pathology, as our patient population ranges from primary care to quaternary care. Notable areas include sports medicine, orthopaedic trauma, joint reconstruction, soft tissue and bone tumors, and rheumatologic disorders. The sports medicine orthopaedic surgeons and physicians support all the collegiate athletes from the University of Michigan, and this provides exposure to a wide range of sports-related MSK pathology since we serve as the MSK radiologists for all University of Michigan athletics. The University of Michigan has a busy Musculoskeletal Oncology and Sarcoma Center with vast pathology and offering high-volume interventions. MSK fellows and division members participate in numerous intradepartmental conferences as well as interdisciplinary working conferences.

Teaching is highly valued by MSK division members, as shown by the Division's top rating in this area by its radiology residents. Fellows are provided a series of weekly didactics taught by the faculty, a daily MSK noon conference, and ample hands-on training in MSK ultrasound. As University of Michigan junior faculty/clinical instructors, fellows are encouraged to develop their own teaching style, and to participate in local, regional, and national conferences. Funding and time off are provided for such participation. The faculty are actively engaged in clinical research and strongly encourage fellows to become involved in research projects, culminating in presentations at national meetings and publications in major journals. Academic time, mentoring by faculty members, and quality ancillary support are provided to promote a rewarding academic experience.

The MSK Fellows work closely with MSK faculty members in clinical work, with progressive independence as their experience grows. Fellows will develop the complete range of technical and consultative skills needed to successfully manage complex MSK imaging cases. The atmosphere is professional, friendly, and promotes the highest quality in clinical services, teaching, and research.

Fellowship Curriculum

During the one-year fellowship in Musculoskeletal Radiology, each fellow will develop expertise in MSK MRI, CT, US, radiography, and interventional procedures. Through hard work, education, and sharing of responsibilities, our fellows emerge from their training as well-rounded MSK consultants, equipped with the knowledge and experience that will allow them to succeed in any type of practice, clinical, or academic. We emphasize the team approach to our division, with the goal of completing the daily work in an efficient manner, in an atmosphere that is positive, supportive, friendly, and educational.

As junior faculty/clinical instructors at the University of Michigan, fellows have gradually increased clinical responsibilities throughout the year. The faculty and each fellow decide when the time is right for this transition. Limited independent interpretation of radiographs usually begins early in the year, followed by other imaging studies when the fellow is comfortable. At all times, there are several MSK faculty present to assist with difficult cases and consultations. We encourage fellows to strive to continually improve speed and accuracy of interpretation and dictation as they progress through the fellowship.

We have developed a fellowship-level MSK curriculum based on the ACGME core competencies to serve as a guide for independent study. In addition, the faculty teach a series of weekly didactics and seminars geared to the fellowship level, to augment material learned in the daily readout sessions.

Conferences

  • Daily 12:30–1:00 p.m. (12:45 p.m. on Tuesdays)
    • Daily working conference. Review of biopsy/procedure requests, discussion of tumor board cases or other interesting cases.
  • Tuesdays 12:00-12:45 p.m.
    • Faculty didactics for residents in Sept. – June.
  • Wednesdays 7:30-8:30 a.m., Sept. – June.
    • Fellow case conferences for residents, 3 per fellow per year
  • Wednesdays, 4:45–6 p.m.
    • Sarcoma tumor board multidisciplinary conference.
  • Ortho Surgery Sports Conference – Once a month
  • Ortho Surgery Arthroplasty Conference – Once a month
  • Ortho & Plastic Surgery Hand Conference – Once a month
  • Rheumatology Fellow Conference – Once a month, Sept. – May.
  • Sports Medicine (non-op) Fellow Conferences – Once a month
  • Orthopaedic Surgery Grand Rounds/ M&M (optional) - Thursdays, 6:30-7:30 a.m.
  • MSK Journal Club – Once a month
  • MSK US Conference – Every other month
  • MSK US Hands-on Sessions – Frequent
  • Multi-institutional Bone Club - Quarterly 5:30-7 p.m. - fellows present one interesting case virtually in a multi-institutional conference for MSK fellows from multiple institutions.

Didactics

Fellowship-level didactics are taught by faculty throughout the year. These include practice teaching points at the daily “working conference” and focused teaching sessions on advanced MSK concepts, including the following: fracture fixation, joint reconstruction, tumor and infection imaging, imaging of metallic implants, sports medicine, interventions, MSK ultrasound didactics and hands-on training sessions, career planning and practice development.

Fellow Teaching

As junior faculty/clinical instructors, teaching residents and medical students is an integral part of the fellowship, both in conference format and one-to-one at the workstation. Each fellow is assigned three, 7:30 a.m. resident teaching conferences from September - June. The preparation of conferences not only allows fellows to gain expertise, but to create a teaching file and lectures, develop their own style of teaching, and increase confidence in public speaking. Faculty are always available to help fellows prepare if there are questions and attend these resident teaching conferences.

  • Resident conferences – didactic case conference format. Fellows may present a topic of their choice.
  • Teaching of residents and medical students at the workstation. Every 2 weeks we have a rotating group of M2’s in the MSK reading room. We occasionally have M3’s and M4’s on electives, in addition to med students visiting from other institutions. Occasionally we have visiting international residents and faculty.
  • Interdisciplinary conferences
    • Sarcoma tumor board (weekly)
    • Ortho Surgery Sports Conference (monthly)
    • Ortho Surgery Arthroplasty Conference (monthly)
    • Others – Rheumatology, sports medicine (non-op), etc.

Professional Development (PD) Time

Fellows get 2-4 PD days per month, depending on staffing. Fellows receive one PD day prior to the day of sarcoma tumor board to prepare. PD time can also be used for the following:

  • Study/Reviewing cases
  • Lecture/Abstract preparation
  • Observation of procedures or readouts
  • Research, review article preparation, QA
  • Observation of orthopaedic surgery
  • Cadaveric dissection is possible

Electives

Three weeks for electives in other University of Michigan Radiology divisions is allotted. These are tailored per fellow to afford additional educational experience prior to starting practice.

Moonlighting:

Several moonlighting opportunities exist within the department.

  1. Contrast coverage: We have several outpatient centers requiring paid radiologist CT and MRI contrast coverage.
  2. ED plain film coverage: Moonlighting shifts may be available to fellows who work in the capacity of staff radiologists in the ED.

Online Educational Materials

In the Fellows’ online folder, there is an articles archive, organized by body part, modality, procedures, medical education, etc. We try to continuously update the archive. In addition, there are multiple other resources including PowerPoint presentations and multiple free MSK textbooks.

Evaluations

Each fellow’s progress will be discussed among the bone faculty during our monthly division meetings and any concerns will be shared with the fellow in real time. In addition, comments will be gathered from our faculty, PAs, MSK sonographers, and clerks to be used to complete the evaluation form. This form and your progress to date will be reviewed by Dr. Soliman with the fellow throughout the year. Formal feedback will be given to the fellows regarding progress achieving the MSK Fellowship Milestones. At that time, we will also solicit formal feedback from you to the faculty, with faculty assessment forms. We encourage you to tell us what you want out of this fellowship.

Vacation and Meeting Time

  • 22 days per year for vacation
  • Paid major holidays include: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Day after Thanksgiving, and Christmas Day
  • 4 “season” days to use either at Christmas or New Year’s week
  • 5 days for conferences
  • 3 days for interviewing
  • Additional time may be available if presenting research
  • Additional ½ week to attend RSNA and ARRS (2 fellows must remain to staff the division; fellows decide among themselves how to split the weeks)
  • As clinical lecturers/junior faculty, fellows receive 15 medical days per year to be used for the following: illness; preventive medical/dental appointments/procedures; maternity/paternity leave; and care for a sick child or parent.

Professional Development Account

A total of $2500 per year can be used to pay professional society dues, medical licenses, books, journal subscriptions, computer software, and travel funds for professional enhancement. See Carol Kruise for details on how to submit expenses for reimbursement from your fund. An additional $1500 is available once per year as a presentation bonus (when presenting research done at this institution only) at a national meeting.

Schedules

Monthly Fellow schedules are integrated into the faculty schedule and can be viewed online. The following is a general overview of the musculoskeletal fellow schedule:

Daily Schedules

General: Check in with daily assigned bone faculty for details. The day begins at 8 a.m.

Bone 1: ER and Inpatient MRI, CT, and XR. Then outpatient MRI and CT. This rotation is staffed by 1 faculty, 1 fellow, and 1-2 residents.

Bone 2: Outpatient MSK Ultrasound from Taubman and Domino’s Farms as well as outpatient MRI and XR. Ample time is offered for hands-on scanning for MSK ultrasound and fellows are encouraged to get as much “hands-on” scanning practice as possible. Additionally, days are provided for the fellow to scan their own patients with the MSK sonographer or faculty present as a backup. Fellow can help with some ultrasound-guided and fluoroscopic-guided procedures. This rotation is staffed by 1 faculty, 1 fellow, and 1 resident.

Bone 3: Outpatient biopsies (CT-guided, US-guided, & MRI-guided), outpatient and inpatient US-guided procedures, some MRI and XR reading. We average 1-2 CT- or US-guided biopsies and 3-6 US-guided injections per day. MSK faculty supervise all biopsies. We average one osteoid osteoma radiofrequency ablation every 2-3 months. This rotation is staffed by 1 faculty, 1 fellow, and 1 resident.

Bone 4: Outpatient MRI and XR, MSK ultrasound from Northville and Brighton. This rotation is staffed by 1 faculty and 1 fellow.

Bone XR: After spending some time on our clinical service early in the year, fellows have the opportunity to function as independent staff interpreting radiographs on this rotation.

Research Opportunities

The Musculoskeletal Faculty have diverse backgrounds and diverse research interests. Areas of research interest include but are not limited to MRI, ultrasound, cadaveric studies, comparative anatomy, arthritis, sports medicine, pelvic floor imaging, bone mineral density and metabolism, osteoarthritis, and procedures. Collaboration with Orthopaedic Surgery and Rheumatology, among others, is common with most research projects. Please see the individual Musculoskeletal Faculty web pages for specific research interests. Musculoskeletal Fellows and Residents often work with Musculoskeletal Faculty on research projects, which are expected to result in exhibits, presentations, and manuscripts. The Musculoskeletal Faculty will serve as mentors for such projects and provide guidance to achieve such results.

Fellows are expected to participate in at least one type of project listed below. Reviews or QA projects tend to be easier to accomplish in one year.

Research projects:

  • Each faculty has several IRBs and projects in various stages of development
  • Fellows can participate in all areas of literature search, data collection and analysis and manuscript preparation (First authorship is not required if time is limited)

Education exhibits

  • Aim to submit education exhibits, case of the day, scientific posters or abstracts to RSNA, SSR, ISS, ARRS, and other conferences.

Review papers

  • Many of our faculty are invited to submit review papers to various journals every year and they frequently offer first authorship to interested fellows.

QA projects

Living in Ann Arbor

  • This University town of approximately 120,000, is a comfortable place to live and work for families and young adults alike. It is frequently ranked among the top best cities in which to live.
  • The University and city provide a wealth of art, cultural, and educational experiences throughout the year.
  • It is a major scene of college sports, boasting the largest football stadium in the world.
  • There is an excellent bus system and the city is bike-friendly.
  • The Huron River and many city parks provide opportunities for outdoor relaxation and recreational activities.
  • Michigan, otherwise known as the Great Lakes state, has innumerable beautiful destinations in its lower and upper peninsulas, for those who love adventure, summer and winter sports.
  • An international airport, Detroit Metropolitan (DTW), is less than 30 minutes driving distance from the city.

To learn more, go to Life at Michigan.

Apply

We support the NRMP MSK Fellowship Match for the fellowship year 2026-27. The MSK match will follow the SCARD/NRMP timeline for fellowship applications and interviews. We will begin accepting applications November 1, 2024 and will offer interviews from January through March 2025.

All interviews will be virtual. We will accept the SSR common application. Since ERAS does not support the MSK Match, please email the following documents directly to us:

  1. SSR common application form
  2. CV including USMLE scores
  3. Personal statement
  4. Three letters of recommendation. One of these letters should be from your Residency Program Director. Please have your letter writers email the letters directly to us.

Please send all documents via email to:

Carol Kruise
Fellowship Coordinator
[email protected]

Ph. 734-936-4367
Fax. 734-936-9723

Steven Soliman, DO, RMSK, FAIUM, FAOCR
Clinical Associate Professor
Program Director, Musculoskeletal Radiology Fellowship
[email protected]

Fellowship Director

Associate Fellowship Director

Samer Soussahn

Samer Soussahn, MD

Clinical Assistant Professor, Radiology
Associate Director, Musculoskeletal Radiology Fellowship Program
Division of Musculoskeletal Radiology
734-936-4365