Fellowship

Diagnostic Neuroradiology Fellowship

One of the primary educational missions of the Neuroradiology Division is our ACGME-accredited fellowship.

Overview The Division of Neuroradiology offers a one-year diagnostic neuroradiology fellowship program that is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) for six positions per year. We participate in the Radiology Specialty Match sponsored by the National Resident Matching Program (NRMP). Internal applicants are selected prior to the match registration start date. All other applicants are considered through the match process.

Curriculum

The entirety of the ACGME fellow training occurs at the University of Michigan Health System (UMHS), which includes dedicated rotations at C. S. Mott Children’s Hospital and Women’s Hospital which are attached to the main University Hospital and at our East Ann Arbor (EAA) Health and Geriatrics Center which includes an outpatient imaging facility and the VA Ann Arbor Heathcare System.

Our fellows rotate through the following areas.

Angiography: We have a busy angiography service with over 700 diagnostic agiograms performed by members of our division and the Neuro Interventional Division in the last year. Additionally, over 250 neurointerventional procedures were performed during this time by the Neuro Interventional Division, with whom our fellows work closely. We have two primary neuroangiography rooms. One is a Siemens Axiom Artis biplane unit with a Leonardo 3D workstation and the second is a combined CT-biplane neuroangiography unit. We also have a Siemens multipurpose room with 3D rotational angiography capabilities. All of our fellows easily meet the ACGME requirement for 50 catheter-based angiographic procedures and participation in at least 5 intracranial microcatheter procedures.

Special Procedures: Fellows also easily meet the requirement for 50 image-guided invasive procedures (CT, MR, or fluoroscopically guided). We performed over 600 interventional procedures in the last year which consisted of biopsies (mainly of the spine, but also the head and neck), myelograms and lumbar punctures. The fellows perform these procedures on adults during their “Specials” rotation at the University Hospital and on pediatric patients during their pediatric neuroradiology rotation at C. S. Mott Children’s Hospital. Through a collaborative agreement with the Department of Anesthesiology Pain Clinic, our fellows can gain exposure to additional image-guided spine procedures, including steroid injections, facet injections and nerve blocks. Additionally, along with neuroradiology faculty, our fellows interpret the CT portion of all PET/CT exams performed for head and neck cancer. This affords close collaboration and interaction with the nuclear medicine faculty.

CT: The CT equipment at the UMHS includes a total of 12 scanners. This includes four 64 slice MDCT scanners and six other MDCT machines. One of these CT scanners is located within our Emergency Department. In addition, we recently installed a modular craniofacial CT for dedicated ENT imaging. During their CT rotation, fellows gain competence in routine neuroradiologic exams as well as advanced head/neck, spine and cerebrovascular imaging (including over 1500 CT angiograms and perfusion CT).

MRI: There are 11 clinical MRI units (including 3T) and one 3T research unit at UMHS. The 3T research unit is located at the main hospital and administrated by the Department of Radiology. Fellows become competent at all aspects of neuro MRI including advanced imaging procedures such as MR angiography (including time-resolved MRA), MR spectroscopy, diffusion tensor imaging and MR perfusion.

Between the CT and MRI rotations the fellows far exceed the ACGME requirement of 250 non-invasive (CT and/or MR) angiograms.

Pediatric Neuroradiology: This rotation entails CT and MRI exams and special procedures performed on pediatric patients at C. S. Mott Children’s Hospital where there is a 1.5T MRI scanner, a MDCT scanner, and fluoroscopy rooms for special procedures. Our fellows spend a minimum of 4 weeks on this rotation, as per ACGME requirements. We have several faculty who have completed pediatric neuroradiology fellowships or have extensive long term interest and experience in pediatric neuroradiology. Construction is underway on a new C. S. Mott Children's Hospital and Women's Hospital.

East Ann Arbor (EAA): This rotation exposes our fellows to neuroimaging in an outpatient setting, and includes both MRI and CT. There are 2 MRI scanners and 1 CT scanner at EAA, plus CT exams are sent from another UMHS outpatient facility.

Research: Fellows are expected to complete at least one research project with submission to a national meeting and or journal or other scholarly project such as a review article or book chapter with a faculty mentor. On average, the fellows have approximately one professional development day per week during which they can work on their project. Early in the academic year the faculty discuss their research interests and ongoing projects with the new fellows. The fellows can then choose with whom they would like to work. All of our fellows have easily accomplished the research requirement and many have had more than one project accepted to meetings or published.

Fellows are assigned to home call approximately once every six weeks, always with support from neuroradiology faculty members. Any angiograms or myelograms performed after hours are always done along with the neuroradiology faculty on call. There is no in house call for our fellows.

All of the neuroradiology faculty at UMHS participate in the teaching of our fellows, as do the neuro interventional faculty.

Each week a Fellow’s Conference is held with the format varying weekly. This conference includes didactic lectures by the faculty, journal club, morbidity and mortality conference, pediatric neuroradiology conference, and neurology/neuroradiology conference. Fellows assist in the presentation of journal club, morbidity and mortality conference, and neurology/neuroradiology conference. There is also a weekly interesting case conference, where fellows and faculty informally discuss difficult or unusual cases.

Our fellows also participate in the teaching efforts of the neuroradiology division. Fellows participate in the teaching of third and fourth year medical students, radiology residents and residents from other services who rotate through our division. Each fellow also prepares approximately two conferences each year for our radiology residents. The topic is at the discretion of the fellow and the format can be a didactic lecture or a case conference.

There are additional conferences with the Departments of Neurosurgery, Neurology, Otolaryngology, and Radiation Oncology with over 20 multidisciplinary conferences per week. These conferences include teaching conferences, tumor boards, and other clinical working conferences.

Research

There is a tradition of collaborative clinical and basic science research between members of the Division of Neuroradiology and the other clinical Neuroscience departments. Senior research physicists with special interest in MR physics, contrast agents, digital image processing, and MR spectroscopy are available within the Department of Radiology for technical and research support.

All fellows are expected to become involved in a research project during their fellowship under the direction of a faculty mentor and are given dedicated time for this. At least one abstract should be submitted to a national meeting as a result of this research. Fellows will be supported to present all abstracts at national meetings for which they are first author.

Ellen G. Hoeffner, M.D. is the Fellowship Program Director. Please direct any inquiries regarding the fellowship to Dr. Hoeffner. Thank you for your interest in our fellowship program.

Apply

We participate in the National Resident Matching Program's Radiology Specialty Match to fill our ACGME positions not filled by internal applicants prior to the date that match registration begins. The exact interview and match dates are determined each year by the NRMP. You can obtain more information about the Match at the NRMP Web site. Vascular/interventional, Pediatric Radiology, Neuroradiology, and Nuclear Medicine use a unique application form, which can be accessed at the following link:

Downlad the fellowship application at the bottom of this page.

In addition to the application, we also require a copy of your CV, a personal statement and three letters of recommendation, including one from your residency program director confirming your status as a resident in good standing at your institution. We request a photo however it is not mandatory to provide one.

The University of Michigan offers highly competitive salaries and tremendous benefits to our residents/fellows. An overview of salary, benefits and employment eligibility is available on the GME Office website, under “Prospective Residents/Fellows”. 
https://medicine.umich.edu/medschool/education/residency-fellowship

If you would like more information about Ann Arbor, please visit this page About Ann Arbor

Ashok Srinivasan, MBBS, MD is the director of the neuroradiology division. Ellen G. Hoeffner, M.D., is the Fellowship Program Director. They can be contacted as listed below. Please direct any inquiries regarding the fellowship to Dr. Hoeffner. Thank you for your interest in our fellowship program.

Ellen G. Hoeffner, M.D. Fellowship Program Director
University of Michigan Health System
Department of Radiology, UH B2 A209G
1500 East Medical Center Drive
Ann Arbor, Michigan 48109-0030
Phone: 734-615-8314
Fax: 734-764-2412
hoeffner@umich.edu

Ashok Srinivasan, MBBS 
Associate Professor and Division Director of Neuroradiology
University of Michigan Health System
Department of Radiology
1500 E. Medical Center Drive
Ann Arbor, MI 48109-0030
Phone: 734-936-8825
Fax: 734-764-2412
ashoks@umich.edu

Neurointerventional Radiology Fellowship

Joseph Gemmete
Joe Gemmete, MD
Fellowship Director

This fellowship is designed for individuals who desire sub-specialized training in neurointerventional radiology. The fellowship involves extensive clinical and catheter-based training under the supervision of two full-time faculty in neurointerventional radiology plus two full-time faculty from neurosurgery, and provides fellows with an outstanding hands-on experience. We currently have a very busy and diverse practice, which includes but is not limited to interventional treatment of aneurysms; brain, head and neck, and spinal arteriovenous malformations, dural and pial arteriovenous fistulas of the head and spine, carotid and vertebral stenosis, acute stroke, low flow vascular malformations of the head and neck, and intra- and extra-cranial tumors. Fellows actively participate in all neurointerventional cases, and also have the opportunity to perform numerous diagnostic cerebral and spinal angiograms. Additional responsibilities include post-operative management of patients, participation in call, and evaluation of patients in our outpatient clinic. Daily duties are also structured such that there is significant time for research and publication.

Applicants from radiology are required to have completed residency in diagnostic radiology as well as 12 months of diagnostic neuroradiology training. Applicants from neurological surgery or neurology must have completed residency as well as engaged in 100 diagnostic cerebral angiograms. Our program currently accepts 1 trainee per year from Radiology and the fellowship duration is 12-24 months.

Neurointerventional radiology fellowship is integrally tied in with the departments of neurosurgery and neurology to enhance the individuals clinicial exposure. Pre-requisite: 1 year diagnostic neuroradiology training or 100 diagnostic cerebral angiograms performed from other fields of training.

The University of Michigan’s neurointerventional radiology fellowship does not participate in the NRMP Match Program.

If you are interested in applying for Interventional Neuroradiology fellowship, please contact:

Joseph Gemmete, M.D. 
Director, Fellowship Program
Neurointerventional Radiology 
Michigan Medicine
1500 East Medical Center Drive 
Ann Arbor, MI 48109-5030 
Tel. 734-763-5842
Fax 734-615-5111
Email: gemmete@med.umich.edu

Neeraj Chaudhary, M.D., MRCS, FRCR, DABR
Neurointerventional Radiology
Michigan Medicine
1500 East Medical Center Drive
Ann ARbor, MI 48109-5030
Tel. 734-763-2082
FAx 734-615-5111
Email: neerajc@med.umich.edu