For more information on student medical education, contact Barbara Dimmit at
(513) 584-0647 or
barbara.dimmitt@healthall.com

Education

Third-Year Medical Student Clerkship

Radiology is a dynamic specialty encompassing diagnostic imaging as well as diagnostic and therapeutic image-guided intervention. Imaging techniques are rapidly evolving with an ever-expanding role in patient care.

All medical students, whether they will pursue a career in Radiology or another specialty, need to be familiar with the imaging and image-guided interventions available for patient care.

The two-week, third-year clerkship is designed to provide students with their first structured exposure to radiology.

The general goals of the clerkship and some more specific curricular goals are as follows:

Clerkship Overview
Provide a general understanding of the spectrum of diagnostic imaging and diagnostic and therapeutic image-guided interventional techniques. Understand the role of Radiology in medical care, and appreciate the patient's perspective of undergoing medical imaging or intervention.

- Spectrum of imaging modalities: Exposure to the many different imaging modalities that fall under the rubric of "Radiology".

- Image-guided intervention: Exposure to the board spectrum of minimally invasive diagnostic and therapeutic procedures offered by Interventional Radiology, and the role of IR in direct patient care.

- Radiologists as the “consultant’s consultant”: Emphasize the breadth of medical knowledge necessary for imaging performance and interpretation, and the value of sub-specialization in Radiology.

- Imaging as information: Understand the fundamental role and value of imaging – to provide timely, accurate, and actionable diagnostic information regarding a patient’s medical condition, based on a tailored to specific clinical questions.

- The radiology team: The spectrum of caregivers involved in the diagnostic and therapeutic imaging arena, including physicians, technologists, nurses, physicists, computer scientists, administrators, and secretaries.

- Imaging information systems (PACS – Picture Archiving and Communication System; and the RIS – Radiology Information System): Provide practical knowledge and experience for navigating these imaging information systems.

Radiology Utilization
Provide general education regarding the indications and appropriateness of imaging studies for common clinical problems, and an understanding of the appropriate sequencing of exams and the limitations of diagnostic imaging tests.

- Value of diagnostic imaging in the evaluation of common clinical problems.

- Appropriateness of specific imaging examinations based on clinical questions.

- Appropriate sequencing of imaging examinations.

- Pitfalls of inappropriate exam choice.

- Importance of timely imaging and interpretation relative to the clinical presentation –stat vs. urgent vs. elective…Logistic vs. medical urgency.

- Cost of various imaging studies and an initial exposure to the concepts of cost-effectiveness as they relate to radiology.

- Limitations of commonly used diagnostic tests.

- Basic Test Concepts. Overview of sensitivity, specificity, accuracy, and predictive value, and how the results of a diagnostic test affect the clinical probability of disease and the differential diagnosis.

Image Interpretation
Provide introductory education on imaging techniques and a general approach to the interpretation of diagnostic studies. The complexity of imaging interpretation and the value of training and experience, are emphasized.

- Basic study identification and viewing: The appearance of imaging studies using different diagnostic modalities, their physical basis, and how is the diagnostic information displayed (Projectional vs. cross-sectional, dynamic vs. static, gray-scale appearance).

- Basic study interpretation: Approach to evaluation of a diagnostic image and the development of search patterns.

- Basic normal anatomy and pathology as depicted on common studies (radiography, fluoroscopy, CT, ultrasound, MRI) and in various organ systems (head/neck, chest, abdomen, musculoskeletal).

- Begin to develop the skills that will allow evaluation of basic imaging studies in an independent fashion, as is often required during clinical clerkships, internship, and residency.

Teaching Methods
Clinical Rotations: Rotation on the various clinical services is the lynchpin of the educational experience. During the first week the students will spend one day each on four different clinical services. During the second week they will spend one day in the Radiology Department at the Cincinnati Children’s Hospital, and then three days on a specific service of their choice. Students are integrated into the daily work with the residents and faculty as much as possible. This provides exposure to radiology as it is practiced in “real life”. One evening during the rotation each student will “shadow” the on-call radiology resident for several hours to learn what “off-hour” service entails.

Didactic Lectures: A didactic lecture series specifically for medical students, provided by the radiology faculty and residents, is a standard part of each day’s curriculum. The famous “T meeting” occurs from noon to 1 pm each day – a department wide didactic or case interpretation session that covers the full gamut of radiologic topics. Elective radiology subspecialty conferences occur on several mornings (Thursday – Bone Conference, Friday – Body MRI Conference). Finally, there are a number of multidisciplinary conferences that interested students may elect to attend. Examples include a Neuro-Vascular Conference, weekly meeting of the Pancreatic Disease Center and the Hepatobiliary Center, Solid Tumor Board, and a weekly Breast Imaging conference.

Textbooks: Each student is provided with two textbooks for study during the rotation. The first is “Primary-Care Radiology”, a concise textbook that gives an overview of imaging from an organ system perspective. The second optional text is Goodman’s revision of the famous basic chest radiology primer written initially by Dr. Felson, Dr. Harold Spitz, and Dr. Aaron Weinstein. This text provides a more detailed, but still remarkably intuitive, approach to interpretation of chest radiography.

The Education Center: Self Learning Assets
The Aaron Weinstein Radiology Education Center was opened in the winter of 2001. The lab contains seven state of the art computers with access to the UCCOM and Health Alliance networks as well as the World Wide Web. The center has full audiovisual capability. A Medical Student Teaching File (film-based) is available for self-study. This is constantly being updated and serves to augment the student's exposure to imaging through self study. Immediately adjacent to the center is the Leslie M. Ringel Memorial Library, which houses a vast assortment of radiology texts and journals, as well as a variety of digital educational tools such as CDs.