Fellowships

Abdominal Imaging Fellowhsip

The Section of Abdominal Imaging currently consists of 12 staff radiologists. Over 40,000 CT, 20,000 ultrasound, and 1,500 MR examinations are interpreted by our section, and 1,400 CT fluoroscopy and ultrasound-guided interventional procedures are performed yearly, including fine-needle aspiration, core biopsy sampling, abscess drainage and percutaneous renal cryoablation.

We interpret examinations for both primary and tertiary care patient populations. We serve a highly-trained and sophisticated group of gastroenterologists, oncologists, and surgeons subspecializing in colon and rectum, hepato-pancreatico-biliary surgery, urology and gynecology. There is heavy emphasis on both oncologic and pre- and post-surgical imaging.

All of the major facets of diagnostic ultrasound are included- abdominal, gynecologic and a large volume of vascular/Doppler scanning, including peripheral venous and transplant studies. Advanced CT and MR studies are commonly performed, including examinations such as CT and MR enterography, imaging for aortic stent grafts, pancreatic MRI with secretin stimulation, imaging for tumor ablation, rectal cancer staging, CT colonography, and pelvic floor imaging.

Imaging hardware is frequently updated and currently includes: One Siemens TrioTim 3T and one Philips Achieva 3T, three Siemens Avanto 1.5T, one Siemens Espree 1.5T MRIs, two Siemens Somatom Definition 64-slice and three 16-slice and one 4-slice CT scanners, and 10 Siemens/Acuson color Doppler equipped ultrasound units. We work in an integrated PACS, RIS, and voice recognition environment. Construction on an integrated MRI intervention suite/OR will soon commence.

Fellows are active participants in resident education, both on a daily informal basis and giving didactic conferences. Our section is involved in seven interdepartmental conferences. Participation in any of a number of ongoing research projects within the section, or organization of a new project, is encouraged.

Breast Imaging Fellowship

Cleveland Clinic’s Imaging Institute is currently accepting applications for one one-year fellowship position in the Section of Breast Imaging, to begin July 1st of each year.

Our section currently performs over 100,000 examinations per year, including over 54,000 screening examinations, 20,000 diagnostic studies, and 1,600 breast MRI’s. In addition to the 3,000 ultrasound guided and stereotactic biopsies/localizations performed annually, we also perform MRI guided biopsies and ductography. We are a state of the art department equipped with digital/analog mammography, dedicated ultrasound units, three prone Lorad stereotactic biopsy tables, and three 1.5 T Siemens magnets with dedicated breast time slots. We also have an automated whole breast ultrasound unit and a research breast CT scanner.

In addition to his/her primary clinical responsibilities, the breast imaging fellow will also have academic obligations including case presentations at weekly interdisciplinary breast conferences, monthly resident didactic/case conferences and resident board review. The fellow will also have four weeks of “elective” time during which he/she may choose to rotate with pathology, surgery, radiation oncology, and/or genetics. Although not mandatory, the fellow is strongly encouraged to participate in research projects, with protected academic time issued on a case by case basis.

Cleveland Clinic’s Section of Breast Imaging is staffed by nine full and part time dedicated breast imaging radiologists, the majority of whom are fellowship trained. Also included among our staff are two Diagnostic Radiology board examiners and the Imaging Institute Vice-Chairman, Alice Rim, MD. The Section of Breast Imaging is physically located within a dedicated breast center, giving the fellow the opportunity to also serve as an integral member of a multi-disciplinary clinical team.

Cleveland Clinic offers a competitive fellowship salary and benefits package. In accordance with the Office of Graduate Medical Education, each fellow is permitted three meeting days with appropriate compensation for CME credits. There is no call nor weekend responsibility, however weekend moonlighting opportunities are available in the regional general radiology practice, pending Ohio State licensing and hospital credentialing.

All applicants must have completed a United States residency training program in diagnostic radiology, and must be board certified or eligible by the American Board of Radiology prior to commencing the fellowship. Foreign applicants must also be board eligible in their country of origin and be USMLE certified, complete with passing scores on Steps one, two, and three.

Cardiovascular Imaging Fellowship

At the end of the training the fellow will achieve level III clinical competence accomplished by 12 months of cumulative training in the CVIL.

The curriculum includes:

  • Physics of MRI/MRA
  • Safety issues in MRI
  • Pulse sequences used in cardiovascular MRI/MRA
  • Scanning techniques from basic to advanced
  • Interpretation of cardiac MRI/MRA from basic to advanced
  • MR in coronary artery disease
    • Acquire skills in performance and interpretation of:
      • Left and right ventricular function – both global and segmental, and qualitative and quantitative
      • Tissue characterization in cardiomyopathies and infiltrative disorders mimicking ischemic disease
      • Ischemia evaluation with first pass myocardial perfusion
      • Myocardial viability determination with delayed enhancement imaging
      • Myocardial mechanics using myocardial tagging
  • MRI in valvular disease
    • Scanning techniques for evaluation of native and prosthetic valve function
    • Phase contrast imaging for quantitative calculation of vascular and cardiac chamber flows and volumes
  • Advanced aortic and peripheral vascular imaging with MRA, flow measurements, and compliance evaluations.
  • MRI in congenital heart disease focused on adult CHD.
Endovascular Surgical Neuroradiology Fellowship

The program has been in effect since July 1, 2003. Since the inception of the program, five individuals have completed the fellowship. The duration of the program is two years (ACGME approved program for one year). Applications to the Endovascular Surgical Neuroradiology fellowship program are accepted from candidates who have successfully completed Neurosurgery residencies, as well as Neuroradiology and Vascular Neurology Fellowships; however each requires a preparatory year, which is tailored to their particular background and needs.

In the case of the neurosurgical trainees, a preparatory year is offered with the general goal of expanding their exposure to diagnostic neuroradiology, and neuroangiography in particular. This will include didactic courses in basic radiation safety, radiation physics, digital image quality, angiographic technique, contrast agents, cerebrovascular anatomy and variants, and angiographic diagnosis. Additionally, Cleveland Clinic’s Neuroradiology section and Department of Neurosurgery are fully digital/networked, allowing for nearly real time access to all current and prior cross sectional imaging studies. This provides for a uniquely efficient teaching environment in which correlative findings on diagnostic imaging studies can be reviewed and discussed in the context of diagnoses, clinical decision-making and therapeutics.

In the case of the neuroradiology trainees, a preparatory year is offered with the general goal of expanding their exposure to diagnostic neuroangiography, and in particular broadening their exposure to clinical neurosurgery (including clinical signs/symptoms, natural history, treatment planning, physiological monitoring, intracranial pressure/ pathophysiology, pharmacology and neuro intensive care management). Objectives for the first/preparatory year include:

  • Patient Care – demonstrate ability to perform and interpret diagnostic neuroangiography
  • Demonstrate command of imaging and clinical diagnosis of (endo) vascular disorders
  • Demonstrate competency in directing ward care of endovascular cases

Interpretation of diagnostic and interventional procedures are double read by senior staff throughout the first year. All interpretations are performed based on digital images on workstations distributed throughout the Imaging Institute using voice recognition software to expedite reporting to the referring services. Images are stored centrally on a large digital archive, providing ready access to nearly all of the digital imaging dating back to 1994. Procedures are initially performed by the staff for teaching purposes. Subsequently, the trainee performs the procedures under direct supervision and then assumes more independence once competence is demonstrated. During the second year of Interventional Neuroradiology the Senior Staff will have the responsibility of the primary operator and the trainee serves as first assistant.

Endovascular Neurosurgery fellows and residents are responsible for reviewing diagnostic CT’s and MR’s. Diagnostic angiograms are shared between the first year neuroradiology fellow and the cerebrovascular fellows. During the second year, the fellow assumes a more proactive role, thereby performing interventional procedures. Dictations are also shared during the fellowship and are distributed by the staff.

Endovascular Neurosurgery fellows are expected to participate in clinical conferences, regular daily patient management in conjunction with the Departments of Neurology, Neurosurgery, Neuropathology, Otolaryngology, Ophthalmology, General Medicine and Pediatric subspecialties. The fellow is also expected to participate in the didactic and patient management conferences which are held with the Divisions of Neurology, Neurosurgery, Neuropathology, Otolaryngology and Ophthalmology on a regular basis. All clinical conferences are open to fellows; they are actively encouraged to attend all conferences but are required to attend weekly CV case conferences, weekly neurosurgery patient management, and monthly endovascular M&M as well as journal club.

The fellow is expected to prepare a single one-hour didactic conference during the first year and to prepare two such conferences during the second year. Otherwise, the trainee’s only teaching responsibilities are the one-to-one teaching of residents and medical students during the daily reading sessions. They also work with the residents on the Neuroradiology rotations to acquire interesting cases for the weekly case conference in which they are the primary presenter. One staff member is also present at each conference to aid in the discussions.

Endovascular Neurosurgery staff are actively involved in research and the neuroradiology fellow is strongly encouraged but not required, to participate in basic and/or clinical research during the two years. Each trainee will be given one half day per week to pursue research efforts. They will also be strongly encouraged to present research in national meetings and to prepare manuscripts for publication during these two years.

Each trainee is evaluated by each neuroradiology staff member on a monthly basis and all forms are forwarded to the neuroradiology program director for review. Combined six-month evaluations are submitted to the Graduate Medical Office at CCF and are reviewed with the trainee on a semi-annual basis. When specific problems arise, they are addressed as needed.

Interventional Radiology Fellowship

Our ACGME-accredited fellowship is one year in length and is composed of three fellows. Our Section of Interventional Radiology consists of 10 full-time staff interventional radiologists, two to three fellows, 15 nurses, 16 technologists, two to three rotating radiology residents and five advanced practice nurses, one of whom specializes in pediatric care. Over 9,500 vascular and interventional procedures are performed annually.

We provide training in all aspects of vascular and interventional radiology. Rotations in endovascular surgery, noninvasive vascular imaging lab, image guide biopsy and drainage, diagnostic neuroradiology and pain management are available. There are a total of seven angiographic suites, all digital. Two of our rooms have DynaCT. Every room has ultrasound available. We interpret 5 to 10 MR and/or CT angiograms per day. The fellows are expected to be actively involved in approximately five procedures per day. Particular emphasis will be placed on the more advanced procedures that may be beyond the level of training of the rotating radiology residents (such as TIPS, percutaneous angioplasties, stent placements, stricture dilatations, biliary and genitourinary interventions, chemoembolization, selective internal radiation therapy, RFA, vascular malformation treatment, uterine fibroid embolization, etc.) The fellow will generate the formal report for each procedure and will visit and examine the patient both before and after the procedure. The Section does have admitting privileges and a busy IR clinic. The fellows will participate in either their own research projects or in an on-going research project. We have full-time research coordinators.

A core curriculum of dedicated interventional radiology conferences are provided by our staff over the course of the year. We have quarterly journal club dinner meetings. In order to apply, please send curriculum vitae, and three letters of recommendation. Use of the universal application form is strongly encouraged. These documents may be submitted by mail, fax or e-mail attachment. Applicants are expected to have completed an accredited residency program in diagnostic radiology prior to starting the fellowship. We do participate in the NRMP Match and our Match number is 11253511.

Musculoskeletal Imaging Fellowship
  • The Musculoskeletal Imaging Fellowship at Cleveland Clinic is 1 year in length beginning July 1st and ending June 30th.
  • There are 4 positions each year: 2 ACGME positions (accredited) and 2 clinical positions (non-accredited).
  • The Cleveland Clinic Imaging Institute archives 2 million exams or procedures per year. The MSK section reads or performs over 170,000 procedures per year which include high volume services in sports medicine, orthopedic oncology, and rheumatology.
  • Fellows will spend time at the Main Campus as well as the Sports Health Center (a satellite facility).
  • Fellows will be exposed to daily didactic and clinical conferences including Journal Club, MSK Tumor Conference, MSK Interesting Case Conference, MSK US Conference, Rheumatology Conference, MSK Infectious Disease Conference, Fellow Teaching Conference and Resident Teaching Conference.
  • Fellows will receive MSK US training along with Primary Care Sports Medicine fellows in an integrated curriculum.
  • Fellows will have access to resources from the MSK Radiology Research Lab.

Clinical responsibilities:

  • Interpreting MSK radiographs, MRI, CT, US, and Bone Mineral Density scans.
  • Performing fluoroscopic and US guided joint injections and aspirations.
  • Performing CT and US guided bone and soft tissue biopsies including RF ablations
  • Protocoling and monitoring cross-sectional imaging studies
  • Supervising residents (32 residents) and medical students
  • Attending all clinical conferences (1 per day)
  • Preparing for and presenting at assigned clinical conferences (4 per month)

Non-clinical responsibilities:

  • Presenting didactic conferences for medical students and residents (2 per year)
  • Performing at least 1 research project over the course of the year that will be submitted to a national meeting for oral presentation and culminate in a manuscript that will be submitted for publication.
  • Performing at least 1 quality improvement project over the course of the year.
  • Participating in CME conferences hosted by the section.

Benefits:

  • Salary paid at the level of PGY6*
  • Medical Insurance
  • Malpractice insurance
  • 1 academic day per week for ACGME fellows or 1 clinical day in the CCF Regional Practice for clinical fellows*
  • 3 weeks of vacation time
  • 1 week meeting time (If presenting, meeting expenses will be reimbursed)
  • 2 weeks of elective rotations one of which must be in Neuroradiology for exposure to spine MRI.

* Clinical fellows receive additional salary for clinical day.

Neuroradiology Fellowship

Cleveland Clinic’s Section of Neuroradiology offers three ACGME accredited positions in diagnostic neuroradiology each year. The core rotations include CT, MRI and diagnostic angiography. These rotations include extensive training in myelography, CT angiography, CT/MR perfusion, functional MRI/diffusion tensor imaging, as well as catheter based diagnostic angiography. Additional rotations in spinal biopsy, transcranial doppler ultrasound, and spinal pain management procedures are provided. Fellows receive training under 12 experienced staff members with CAQ's in neuroradiology. Requirements for candidates include completion of a radiology residency and USMLE step three.

Nuclear Medicine Fellowship

Cleveland Clinic’s Imaging Institute is currently accepting applications for one one-year fellowship position in the Department of Nuclear Medicine, to begin July 1st of each year.

This ACGME accredited fellowship is comprehensive, offering trainees extensive clinical experience in all aspects of clinical nuclear medicine. Our department currently performs over 20,000 imaging examinations per year, including nearly 7,000 nuclear cardiology studies. In addition to the imaging studies, we also perform sentinel lymph node localization procedures and administer radionuclide therapies including I-131, Y-90, Sr-89, radioimmunotherapies and radioembolic therapies. We are a state-of-the-art department, equipped with three PET/CT cameras, three SPECT/CT (multi-row-detector) cameras, six dual-headed SPECT cameras and a thyroid uptake probe. We have a fully functional radiopharmacy ("hot lab") staffed by two full time radiopharmacists. Also within our department, we have our own medical cyclotron and two associated laboratory facilities for the production of both commercial and investigational positron-emitting radiopharmaceuticals.

In addition to his/her primary clinical responsibilities, the Nuclear Radiology Fellow will also have academic obligations including case presentations at the biweekly departmental research conference, weekly resident didactic/case conferences and resident board review. The fellow is strongly encouraged to participate in research projects, with protected academic time provided.

Cleveland Clinic’s Department of Nuclear Medicine is staffed by seven full time dedicated nuclear medicine physicians and radiologists, most of whom are fellowship trained. Also included among our staff are three full time staff scientists, including two radiochemists and a medical physicist. The Department of Nuclear Medicine is physically located within Cleveland Clinic’s Heart Center, giving the Fellow the opportunity to also serve as an integral member of a multi-disciplinary clinical team.

Cleveland Clinic offers a competitive fellowship salary and benefits package. In accordance with the Office of Graduate Medical Education, each fellow is permitted three meeting days with appropriate compensation for CME credits. There is some call responsibility, performed by teleradiology with staff physician backup.

All applicants must have completed a United States residency training program in Diagnostic Radiology, and must be board certified or eligible by the American Board of Radiology prior to commencing the fellowship.

Thoracic and Cardiac Imaging Fellowship

Cleveland Clinic’s Thoracic Imaging Fellowship program offers comprehensive training in all aspects of thoracic and cardiac imaging including thoracic CT, MR and plain film as well dedicated time with cardiac CT and MR. Chest intervention and biopsy rotations can be incorporated at the request of the fellow and the time spent in each area can be tailored to the individual’s interests and needs. A portion of each fellow’s schedule is protected for academic and scholarly pursuits such as research projects, preparation of manuscripts for peer-reviewed journals and preparing presentations for national meetings with available mentors to help guide each individual. A unique resource at Cleveland Clinic is the Center for Medical Art and Photography which is available for support in all academic endeavors, something that past fellows have found very useful.

The department consists of 9 fulltime thoracic and 3 fulltime cardiac imagers, all of whom have advanced training in their respective fields. Teaching conferences are held regularly and all staff members are approachable, eager to teach and actively engaged in educational discussions with fellows and residents.  Our volumes include over 150,000 thoracic imaging examinations (including 20,000 CT imaging studies), over 200 interventional procedures, over 2,000 Cardiac MR and over 7,000 Cardiac CTs are performed annually. The vast and complex pathologies encountered at Cleveland Clinic – ranging from ILD to post cardiac and lung transplant patients to unusual infectious diseases is unprecedented. Past fellows have been well trained and well prepared for academic or private practice jobs.

Some of the highlights of our institution include:

  • Cleveland Clinic's Respiratory Institute ranks 3rd in Pulmonology according to U.S. News & World Report's 2013-14 "America's Best Hospitals" rankings.
  • The Miller Family Heart & Vascular Institute at Cleveland Clinic ranks 1st in Cardiology and Heart Surgery according to U.S. News & World Report's 2013-14 "America's Best Hospitals" rankings.
  • Recently, Cleveland Clinic's lung transplant program set the world record for number of lung transplants performed in a single year.