Fellowship Director: Elissa L. Kramer, MD
The aim of the Nuclear Radiology fellowship program at NYU is to train individuals to become well-versed and knowledgeable in this subspecialty so that they are able to aurthorittively and expertly interface with both clinicians and other Radiologic subspecialists. To achieve this goal, our fellow are provided with thorough instruction in the diverse aspects of Nuclear Radiology, including the single photon and PET evaluation of tumors, cardiac disease, musculoskeletal disease, endocrine disorders, and neurologic disease. In addition, we provide training and a varied experience in radionuclide therapy of thyroid diseases and cancers. The richness of experience derives from the fellow’s participation in a myriad of clinical and educational activities of the New York University Medical Center, combining a broad spectrum of clinical pathology with the resources of a renowned medical research center.
With few exceptions, our faculty members are full-time and devote their entire professional energies to the activities of our training program and hospitals. Moreover, several are acknowledged authorities in their field. Each of our faculty members also have areas of interest that naturally complement one another. Thus, we are able to offer our fellows a broad range of skills and interests from which to learn. In addition, great depth of expertise in the practice of clinical nuclear medicine, our faculty has interests in several cutting edge areas of research: radioimmunotherapy, molecular imaging, PET in tumors, inflammation and infection, image fusion, and computer technology.
We draw on the particular expertise of each faculty member to provide a rich and varied learning environment for the fellow. Each faculty member provides instruction in their area of expertise. This is provided in the context of daily reading sessions, didactic lectures, interactive conferences, and supervised research and writing.
Our program currently enjoys a very favorable faculty/fellow ration (4.5 FTE’s/1 fellow). Along with the full time status of four of our faculty members, this ensures a high level of support and supervision for the fellow. Our aim is to provide the fellow with increasing degrees of autonomy and responsibility as the fellowship year and their experience progresses. As the fellow demonstrates greater degrees of competency and confidence, he or she is granted the privileges and responsibilities which are commensurate with his/her level of professional responsibility: assessment of patients for appropriateness of studies, review of scans for completeness and technical adequacy, design of patient-specific protocols, preliminary interpretations of studies, processing of quantitative digital studies, e.g. renograms, MUGA scans, PET, SPECT), final review and dictations of examinations ( always with the supervision of an attending).
The fellow’s participation at Tisch hospital involves a mixture of clinical, educational and research-related activities. The emphasis is clearly on the clinical. As patients arrive in our department for a nuclear medicine examination, studies must be approved and assigned a protocol, patients must be assessed with medical histories taken and conflicting medical conditions ascertained. When the technologists complete the acquisition and processing of the studies, they bring the studies to the attention of the fellow for assessment of completeness and adequacy of information for interpretation. These studies are then reviewed with the Nuclear Medicine faculty member and the fellow is asked to generate a clinical report. Formal review sessions are held each morning for single photon cases. PET cases are reviewed in the afternoons. Nuclear Cardiology studies are reviewed with a Nuclear Medicine faculty member and a Cardiology attending each day. Cardiology fellows also often join the reading sessions making this a unique in –depth assessment of the cardiac studies. Nuclear Medicine faculty support and supervision are always available to the fellow.
The fellow spends much of his/her clinical day in the reading room in Nuclear Medicine which is fully PACS enabled. All of the Nuclear Medicine images and most of the other radiographic images obtained in the medical center are available there for the fellow. Four days a week the fellow is expected to attend to these clinical responsibilities. The fifth day is reserved for research activities: development of protocols, gathering of data, analysis, and writing of abstracts, case reports and papers. In addition, two weeks out of the year, the fellow will spend their mornings in the cardiology stress laboratory to observe the performance of exercise and pharmacologic stress tests. A Nuclear Radiology physics laboratory tailored to the more advanced expertise of the fellow is provided in the afternoons of those weeks.
Conferences are held specific to Nuclear Medicine on an every four week rotation with the exception of Nuclear Endocrine conference which is held weekly with Dr. Manfred Blum. The other conferences include a fellow/resident run journal club, interesting single photon cases, and interesting PET cases. In addition a didactic lecture is held once or twice a month encompassing clinical issues, physics, statistics, radiochemistry and pharmacokinetics.
In addition the fellow may draw on a wealth of Radiology Department conferences including noon conference, multidisciplinary cardiology, CT,, multidisciplinary, neurology and neurosurgical, epilepsy, lung cancer, gastrointestinal cancer and head and neck conference. Radiology grand rounds are held every other month and Radiology Research lectures occur at least monthly.
In sum, the experience of the nuclear radiology fellow provides in-depth exposure to both clinical and research Nuclear Medicine in the context of an exceptionally strong Department of Radiology.
