RD525M.23

Advanced Clerkship in Neuroradiology

Sites: BWH, DFCI, Faulkner Hospital
Director(s): Matthew Desalvo
Prerequisites: The student must have completed a core rotation or equivalent in diagnostic radiology.
Offered: Monthly except July and December.
Location: BWH - Brigham and Women's Hospital (23)
Open to Exclerks: No (HMS only)
Description: Brigham and Women’s Hospital offers a four-week course for students who have completed a core clerkship or equivalent in radiology and would like further exposure to neuroradiology. The schedule will be customized to the student’s interests and goals. The student will observe and participate in interpretation of brain, spine, and head and neck imaging while paired with a resident or fellow with overall supervision by neuroradiology faculty. The student will have opportunity to independently review cases prior to discussion with a resident or fellow and then faculty member. In addition to traditional reading room consultations at Brigham and Women’s Hospital, the student may also observe consultations in the Neuroradiology Virtual Reading Room or within oncology clinic at the Dana Farber Cancer Institute. Basic procedural exposure will include fluoroscopically guided lumbar punctures and myelograms. Required educational conferences include daily radiology didactic and case conferences. A variety of multidisciplinary meetings are also available for attendance, including brain tumor board, head and neck conference, neurology conference, neurosurgery conference, and spine conference. Optional activities include but are not exclusive to the following: - Exposure to functional MRI, including the pre-imaging patient interview and training, test administration, and final study interpretation - Time on the neurointerventional radiology and/or cross-sectional interventional neuroradiology services - Observation in the Advanced Multimodality Image Guided Operating (AMIGO) suite The student will select a case to present to the course director at the end of the rotation, and appropriate cases can be considered to submit for publication, if desired. Opportunities for assisting in research projects may be accommodated.
Incorporation of Basic Science Content and Evidence-Based Medicine:
1. Participate in daily case readout (or procedures and periprocedural care if involved in lumbar punctures, myelograms, neurointerventional radiology, or cross-sectional interventional neuroradiology) with residents, fellows, and faculty. 2. Attend daily didactic and case-based teaching conferences as well as relevant multidisciplinary conferences.
Grade Criteria:
Honors with Distinction: Confident use of radiology PACS to demonstrate a thorough understanding of the anatomy and pathophysiology of the cases seen during the course. Superior understanding of the utilization of CT, MRI, and intravenous contrast for neuroimaging. Excellent, systematic approach pattern and recognition of basic pathologies when interpreting head CT with insightful incorporation of clinical presentation. Outstanding comprehension of periprocedural care for lumbar punctures and myelograms. A concise, well-organized, well-researched PowerPoint presentation with well-selected and labeled images, discussion of the major findings and clinical significance, and excellent oral delivery. Attendance at daily noon and case conferences. Enthusiastic comments from supervising staff.
Honors: Adequate use of radiology PACS to demonstrate most radiologic findings and with a basic knowledge of the anatomy and pathophysiology of the cases. Good understanding of the utilization of CT, MRI, and intravenous contrast for neuroimaging. Good approach pattern and recognition of basic pathologies when interpreting head CT with incorporation of clinical presentation. Comprehension of periprocedural care for lumbar punctures and myelograms. Reasonably organized final PowerPoint presentation with appropriate radiology focus. Attendance at majority of daily noon and case conferences. Good staff feedback supporting the student's attendance in the reading room.
Satisfactory: Limited ability to use radiology PACS to present some findings relative to the cases seen; rudimentary knowledge of anatomy and pathophysiology. Limited understanding of the utilization of CT, MRI, and intravenous contrast for neuroimaging. Adequate approach pattern and recognition of basic pathologies when interpreting head CT with some incorporation of clinical presentation. Some awareness of periprocedural care for lumbar punctures and myelograms. Organized PowerPoint presentation but without sufficient radiology focus. Attendance at less than half of daily noon and case conferences. No feedback or mediocre feedback from supervising staff.
Unsatisfactory: Inability to retrieve and display cases on radiology PACS. No coherent approach pattern or recognition of basic pathologies when interpreting head CT and little or no incorporation of clinical presentation. Lack of periprocedural care consideration for lumbar punctures and myelograms. Disorganized, rambling final PowerPoint presentation without radiology focus or representing non-original or recycled material. Consistent failure of attendance at daily noon and case conferences. Disruptive behavior in reading room, negative feedback from the staff, or unexplained absences.