Pediatric Imaging Fellowship Program
Note: Program is closed to applicants at this time.
Program Director: Sandra W. Gorges, M.D.
Associate Professor of Radiology
Additional Pediatric Radiology Faculty: Rebecca Stein-Wexler, M.D.
All pediatric radiology faculty are currently CAQ certified.
Number of fellowship positions: 1 per year
Duration of fellowship: 1 year
This ACGME-accredited fellowship will include:
The pediatric radiology fellow shall complete 12 months of clinical pediatric radiology rotations (minus vacation and meeting time). The pediatric radiology practice at UC Davis is an integrated practice, including plain film interpretation, fluoroscopy, ultrasonography, computed tomography, and magnetic resonance imaging. Neuroimaging is included within this. Pediatric sedation for imaging procedures is also integrated into the daily schedule. Thus, daily rotations will include review and discussion of cases in all these modalities. Nuclear imaging and interventional radiology are associated with the pediatric radiology service, but not performed by the pediatric radiologists. The pediatric radiology fellow will actively participate in the performance, review and discussion of these cases either (1) on an afternoon rotation, or (2) by being freed from the pediatric radiology service to go to perform these cases.
A sample daily schedule would be:
7:30 a.m. – arrive for preview of morning cases. Discuss morning fluoroscopy protocols with the technologist and attending. Review chart and paperwork for any morning sedation cases.
8:00 a.m. to noon – Morning review, discussion and dictation of cases. These include morning neonatal intensive care (NICU), pediatric intensive care (PICU films), and inpatient studies, ER cross sectional imaging from the previous night, any inpatient or outpatient studies performed after-hours.
Perform pediatric fluoroscopy cases.
Evaluate patients, write orders, and monitor cases (with radiology nursing) for pediatric sedation.
Monitor imaging procedures being performed under anesthesia (typically MRI).
Go over cases with clinicians, including NICU rounds, PICU rounds, and ward rounds.
Noon to 1 p.m. – attend noon conference (or other subspecialty conference, see below)
1 p.m. to 3:30 p.m. – Five choices are available during this time slot, based upon the day and the case load:
(1) perform/review interventional case(s)
(2) perform/review nuclear imaging cases (including PET/CT)
(3) go with one attending pediatric radiololgist to review and discuss cases at Shriner’s Hospital of Northern California
(4) one entire afternoon per week will be given for research, should the fellow show interest.
(5) dictate morning cases and review teaching file.
3:30 p.m. to 5:30 p.m. – Review, discussion and dictation of afternoon pediatric cases.
Trainee duty hours will fall within the published requirements.
There are a number of didactic and multi-disciplinary conferences available for the pediatric radiology fellow. These include, but are not limited to:
Daily radiology resident noon conference – including physics lectures which discuss dose reduction in pediatrics, and which include approximately 12 – 18 pediatric lectures. Pediatric cases will also be periodically discussed in journal club and in interesting case review conferences held monthly as part of the noon conference schedule.
Weekly conferences – including pediatric oncologic radiology, Shriner’s pediatric orthopedic radiology, and pediatric grand rounds.
Biweekly conferences – pediatric case review conference
Monthly conferences – including pediatric tumor board, pediatric pulmonary radiology, and perinatology conference.
1. The pediatric fellow will also receive one-on-one teaching from the pediatric radiology attendings on the material appropriate for this subspecialty training (less common diagnoses, subtle variations of normal and abnormal, growth and development, skeletal dysplasias, sedation issues, etc.)
2. The pediatric radiology fellowship will overlap but differ from the pediatric radiology training for the diagnostic radiology residents. The major differences will include: (1) intensiveness of training for a twelve month period, with the fellow being an integral part of the pediatric radiology service. The fellow will develop his/her autonomy over the course of the year, including his/her clinical knowledge base, development of discussing cases with pediatric subspecialists and pediatricians, and giving rounds and conferences, (2) an increased level of responsibility for the fellow compared with the residents, including call responsibilities, (3) a focus on not only the basics of pediatric radiology, but the clinical material needed for subspecialty training (normal and abnormal development, less common pediatric pathology and diagnoses, dysplasias, etc.)
The pediatric radiology fellow’s clinical responsibility will increase over the year based on his/her ability. The pediatric fellow’s call responsibility will also gradually increase over the year, based on his/her level of competence. Initial call will be with a pediatric radiology attending, and then with attending back up. Pediatric radiology call responsibilities will be 7 days including 2 weekend days per month. The fellow will also be required to provide coverage in the emergency department during occasional evening shifts as directed per the department chair.
3. The fellow will spend about half of one or two afternoon(s)/week at Shriner’s Hospital of Northern California. This is a pediatric subspecialty hospital including pediatric orthopedics, pediatric rehabilitation medicine, and pediatric burn medicine and surgery. The fellow will be given graded responsibility in film interpretation and review, dictation, and in giving conferences at this hospital. Plain films, ultrasonography and fluoroscopy are performed at this hospital. There are also outside cross-sectional cases that are brought in for review by radiology.
4. At the University of California, Davis we are actively involved in research and in clinical implementation of low-dose pediatric procedures. The pediatric radiologists, the radiology department physicists, will provide instruction on performance of these procedures. In addition, the fellow will participate with the technologists in performance of low-dose procedures to see the clinical implementation of what they have learned.
5. Training in the various subspecialties will be provided as follows:
Approximately 50 pediatric nuclear medicine studies are performed at UCD per month. The pediatric radiology fellow will spend part of one or two afternoons/week in the interpretation, review and dictation of these studies. The exams will be performed in the nuclear medicine section. If other cases of interest are being done outside of this time frame, the fellow will be freed from other clinical responsibilities so they can participate in the case.
Magnetic Resonance Imaging
The pediatric radiologists perform pediatric magnetic resonance imaging as part of the integrated pediatric radiology imaging service. This includes body imaging, musculoskeletal imaging, and neuroimaging. Studies are protocoled, monitored, and reviewed by the pediatric radiology service.
The majority of pediatric diagnostic neuroimaging is performed by the pediatric radiology service. The neuroimaging section also performs some diagnostic studies as a part of shared imaging services, but the fellow will receive ample instruction in pediatric neuroimaging, as nearly 6000 pediatric diagnostic neuroimaging cases (CT and MRI) are performed here each year.
Pediatric neurointerventional cases will be performed in the section of Neuroimaging. The pediatric radiology fellow will participate in these cases with the interventional neuroradiologist.
Pediatric angiography and interventional radiology
About 25 pediatric interventional procedures are performed each month at UCD. These are performed in the interventional radiology section. The pediatric radiology fellow will participate in the preparation, performance and interpretation of these exams, as well as in post-procedure care. About 1 – 2 afternoons/week will be spent in interventional radiology, and the fellow will be freed from pediatric radiology to participate in any other interesting pediatric interventional cases that may occur.
Pediatric diagnostic ultrasonography is performed on a daily basis within the section of pediatric radiology. The fellow will receive instruction from the pediatric radiologists and the ultrasonography technologists in the optimal performance of these exams. Ultrasonography studies include but are not limited to cranial, hip, abdomen, musculoskeletal, genitourinary, chest (diaphragm, etc) and vascular sonography. Interventional sonography cases (biopsies, drainages) will be performed in conjunction with the adult sonography attending(s).
Research and Teaching:
Research in pediatric radiology will be encouraged. If interested in research, the fellow will be given ½ day each week for research, and can be given more time based upon the project and his/her interest.
The pediatric radiology fellow will have the opportunity to teach medical students. Opportunities include one-on-one instruction at readouts, and preparing and giving conferences (multidisciplinary and/or didactic). The fellow will be expected to give two one-hour noon conferences to the radiology residents as part of their fellowship training.
Vacation and Conference Time:
20 vacation days per year
4 educational days per year (elective with Director's approval)
12 sick days per year
Competitive salary and benefits
Completion of four-year residency in the United States or Canada.
California Medical License before starting fellowship. Please visit the California Medical Board Web site or contact them directly for more information: http://www.medbd.ca.gov/ or (916) 263-2344.
Requirement for Acceptance of International Medical Graduates at UC Davis for Postgraduate Training.
How to apply
To apply, please submitt the following materials to the fellowship coordinator at the address below.
A letter of recommendation from the director of your radiology residency program mailed from the Dean's office directly to our program.
Two additional letters of recommendation from physicians of your choice addressed to the fellowship director.
A letter from the dean of your medical school addressed to the fellowship director.
Medical school transcripts and USMLE scores (optional).
Current photo (to ensure we have the correct applicant with the correct file during rank period).
If you have questions or would like to submit your application materials, please contact:
Phone: (916) 703-2273
Fax: (916) 703-2274
UC Davis Health System
Department of Radiology
4860 Y Street Suite 3100
Sacramento, CA 95817