Abdominal Imaging Fellowship


Biatta Sholosh, MD
Abdominal Imaging Fellowship Program Director
UPMC Abdominal fellowship is committed to adhere to the SCARD guidelines for the 2022-23 recruitment season. Currently, applications are accepted from August 1st, 2020 and interviews may begin from November 1st, 2020 . Please note that internal, international, military candidates and spouses are excluded from the embargo timeline. All fellowship interviews will be virtual.

Please refer to the SAR website and SCARD policies for updated information.

OVERVIEW

The University of Pittsburgh Department of Radiology is one of the nation’s largest and most productive academic radiology departments with approximately 150 clinical faculty performing nearly 2 million procedures annually. Since it was established in 1992, the abdominal imaging fellowship at the University of Pittsburgh Medical Center (UPMC) is a 1 year, non ACGME program designed to train radiologists in all aspects of abdominal imaging to acquire the skills, knowledge, and expertise necessary to multimodality image interpretation and performing interventional procedures. The fellows rotate all year in week-long blocks primarily at our main teaching campus, Presbyterian Hospital, an 800-bed facility, in ultrasound, CT-MRI, abdominal interventional service, and at Shadyside hospital, a 520-bed tertiary care hospital which comprises all of the above modalities with an emphasis on oncologic, genitourinary, and digestive disorders. Fellows will also spend time at the nearby Magee Women’s Hospital focusing on benign and malignant gynecological imaging including female pelvic MRI, receive approximately 4 weeks of academic or elective time and occasionally rotate at the outpatient center, South Hills Imaging in Bethel Park, PA. Five fellows are accepted into the program every year. Fellows completing the program will be well positioned for either a private practice or an academic career.

COVID-19 UPDATES

The University of Pittsburgh Medical Center takes precautions to maintain a safe work environment for all trainees, faculty, staff, and patients. The hospital center follows all state and local guidelines for dealing with Covid-19. Everyone entering all UPMC facilities have to undergo mandatory temperature checks, screening questions and currently, there is a Pennsylvania state mandatory mask wearing policy in all public spaces, including while in the hospital facilities. All of the abdominal imaging fellows and division faculty are issued complete home workstations allowing the division to provide diagnostic services remotely to maintain flexibility in staffing coverage. We have added “remote” rotations for fellows and faculty when possible that allows work from home with the capability of Microsoft Teams and screen sharing for readouts. N95 masks are provided, and required for certain procedures, for example, thoracentesis. The hospital system has ample access to personal protective equipment.

EDUCATIONAL PROGRAM

Training the next generation of expert abdominal radiologists is not just a goal of the program, but the passion and a critical mission of the abdominal imaging division. The faculty are highly supportive of the abdominal imaging fellows and are dedicated to teaching through a formal curriculum and daily instruction at readouts. The abdominal imaging faculty and fellows have received numerous awards voted on by the radiology residents in recognition of their dedication to teaching. Fellows work directly alongside faculty As a large tertiary care center and one of the largest transplant centers in the country, the trainees benefit from a high volume of difficult and interesting cases that prepare radiologists to triage and work up all types of pathologies. One of the unique educational benefits is having access to gross pathology photographs integrated into the radiology PACS system allowing for constant radiology-pathology correlation. We also have access to endoscopic reports with endoluminal images, EUS images, and access to uploaded imaging studies from “outside hospital”. Access to electronic medical records to gather additional relevant history, lab and pathology reports is easy; the medical records update automatically when the imaging study is opened.

A. Learning Objects

    • The abdominal imaging fellow will develop clinical expertise in the diagnosis and treatment of all diseases of the abdomen and pelvis with special emphasis on the following areas: hepatobiliary diseases, oncology, trauma, organ transplantation, pre- and post-operative evaluations, diverse vascular Doppler studies as well as other areas of abdominal and pelvic disease that may be subject to imaging evaluation.
    • Learn the latest advances and protocols in abdominal imaging with emphasis on a practical approach and problem solving to avoid common pitfalls.
    • Become expert at nonvascular image-guided interventions of the neck, chest, abdomen, and pelvis.
    • Show progressive knowledge and have graded responsibility in interpretation and performance of studies, though these are done under the supervision of faculty radiologists within the division of abdominal imaging.
    • Develop the ability to teach radiology residents and medical students both informally and through participation in resident case conferences and medical student lectures.
    • Understand how to implement research activities in an academically active department.

B. Instructional/Teaching Activities

    • Advanced didactic and interactive case-based curriculum provided by all the faculty members designed and tailored specifically for the abdominal imaging fellow. The curriculum is called “Spotlight Conferences” and occurs regularly throughout the year. Teaching conferences are virtual, allowing attendees to log in from any location and most are recorded. Click here for a link to a sample annual conference schedule.
    • Journal Club.
    • Regular divisional interesting case conferences where the best cases of the day are presented by the fellows.
    • Fellow oriented conferences on pelvic MRI and abdominal MRI following a topic based curriculum. Fellows each select topics of interest at the start of the year and present succinct PowerPoint presentations based on provided review articles followed by relevant case presentation.
    • Interdepartmental Conferences:
        1. Liver Tumor Board
        2. Pancreas Tumor Board
        3. General Tumor Board
        4. Inflammatory Bowel Disease Multidisciplinary Conference
        5. GU Conference
        6. GI Conference
        7. Parathyroid Conference
        8. Grand Rounds
    • The fellows are under the direct faculty supervision during procedures and interpretation sessions with gradual increased responsibility during the year.
    • Opportunities are given to present case conferences to the radiology residents and medical students.
    • Participate in the peer learning department initiative.
    • Understand how to protocol MRI studies
    • Fellows receive regular formal and informal evaluations and formally evaluate the faculty.
    • Fellows are encouraged to participate in ongoing research projects or develop their own.

FACULTY AND EQUIPMENT

There are 13 faculty and 3 full-time physician assistants and 1 radiology assistant in the division of abdominal imaging. The fellowship utilizes the main academic campuses comprised of UPMC Presbyterian Hospital, Montefiore University Hospital and Shadyside Hospital. All fellows are issued complete 4 monitor workstations allowing flexibility between in-house and a remote working hybrid model. The department is exceptionally well equipped with the latest diagnostic tools. Currently, there are 16 Multidetector CT scanners with CT fluoroscopy capabilities, 13 ultrasound units and 10 high field strength 1.5 and 3.0T magnets. Ultrasound units have been recently upgraded. UPMC is equipped with Phillips PACS with integrated teaching file capabilities. Workstations are ergonomically controlled. Every workstation has access to Vital Images Vitrea and Dynacad. Powerscribe is used for dictation. Many templates are available including for PI-RADS, LI-RADS, TI-RADS, and rectal cancer staging reporting.

MRI

Fellows receive continuous exposure to a high volume of MRI studies throughout the year. State of the art equipment and protocols offer constant learning opportunities. While all types of exams are represented, the department performs a high volume of liver MR studies utilizing MR elastography, new MR fat and iron quantification methods, secretin stimulated MRCP, LI-RADS V2.1 guidelines for HCC diagnosis and pre- and post- transplant liver evaluation. Trainees will understand the uses and differences between hepatobiliary and intravascular contrast agents. The division performs a large number of Multiparametric 3.0 Tesla prostate MRI utilizing Dynacad for segmentation prior to urologist performed MR-TRUS fusion biopsies, female gynecologic pelvic MR, placental imaging, appendix MR, MR enterography, perianal fistula evaluation, pre- and post-treatment staging of rectal cancer, genitourinary imaging, dynamic pelvic floor imaging (defecography), and MR angiography. Fellows are involved in the protocol selection, selecting scanning planes for certain advanced studies and interpretation.

CT

High volume of diverse cases focused on focal and diffuse liver diseases, inflammatory and neoplastic conditions of the pancreas, trauma, CT colonography, oncologic inpatient and outpatient studies, imaging critically ill patients, broad array of gastrointestinal disorders including CT enterography, acute abdominal conditions, CT angiography, and pre- and post-transplant evaluation. The abdominal division interprets most chest CT’s in patients who undergo imaging of the abdomen/pelvis. Dual energy CT exams are performed in our practice.

INTERVENTIONAL PROCEDURES

A large number of solid organ biopsies and drainages are performed daily by the division at all academic sites. The fellow will have dedicated rotations performing routine (paracentesis and thoracentesis) and specialized/complex procedures including all image guided percutaneous biopsies and drainages of the neck, chest, abdomen and pelvis utilizing both ultrasound and CT, including lung, native and transplant renal biopsies, superficial lymph node, parotid and thyroid FNA’s, deep abdominal and pelvic drainages, omental biopsies. The division also performs percutaneous radiofrequency tumor ablation, cryoablation and cholecystostomy tube placement. Other procedures performed include HSG’s, fiducial placement, lap band adjustment, and transvaginal drainages. The week-long rotation on the interventional service at Presbyterian hospital repeats all year so that the trainees progressively build their skill level and experience where they work alongside faculty and highly experienced dedicated physician assistants working up consults, performing procedures, following up and correlating with pathology results. A new IT feature automatically sends all pathology results to the proceduralist for radiology-correlation.

ULTRASONOGRAPHY

All of the major facets of ultrasound are included such as Duplex Doppler ultrasound of the abdomen, transplant Doppler, TIPS evaluation, sonography of the abdomen and pelvis with 3-D capability, scrotal ultrasound, and neck ultrasound with lymph node mapping. Advanced techniques include contrast ultrasound with microbubbles and sheer wave ultrasound elastography.

CALL

Weekly call responsibilities are split evenly among the fellows, averaging approximately 1 call per month. After hour call responsibilities include pager call during the week with in-house coverage on weekends where fellows work along-side faculty interpreting cross-sectional studies and assisting performance of the interventional procedures. Returning for after-hours emergent interventional procedures are uncommon.

DIVISION RESEARCH INTERESTS

These are varied and include hepatobiliary diseases, such as MR elastography of the liver, hepatocellular carcinoma, pancreatic and gastrointestinal imaging, transplant imaging, endocrine imaging with focus on thyroid and parathyroid diseases, as well as genitourinary imaging including MR and CT urography. Faculty participate on the ACR LI-RADS steering committee. Participating in new and ongoing projects is highly encouraged. Academic time will be preferentially given to fellows involved in academic projects. Former fellows have presented at RSNA and SAR, received research grants and have published in peer-reviewed academic journals. Faculty of the abdominal imaging division are recognized national experts frequently lecturing at national and international societal meetings and providing academic mentorship to the fellows. The division faculty are academically productive and have authored many textbooks in the field.

BENEFITS

Benefits include a generous amount of academic and vacation time, conference days, CME stipend, department issued lab coats and scrubs, and access to the fellow lounge, books, electronic educational material, pre-recorded noon conferences. Paid moonlighting opportunities during the weekend and evening chest shifts are available and shared among all of the non-ACGME department fellows and faculty from the thoracic imaging division. Maternity and paternity leave policies are department wide.

MESSAGES FROM FELLOW ALUMNI

Chris Gu, MD


Chris Gu, MD
Abdominal Imaging and Intervention Fellow 2017-18
Email: chrisgu7@gmail.com
There are many great abdominal imaging fellowship programs around the country where fellows are exposed to high volume pathology and receive excellent training. The Abdominal Imaging and Intervention fellowship at UPMC is one of them and you can read all about the details that make it as good, if not better, than the rest on this website or by asking anyone during your interview.

What makes this fellowship special is the people you will get to work with every day. Vivian (fellowship coordinator) was my go-to person for everything admin related or otherwise; she even helped me fix a stuck zipper on my winter coat once. Dr. Sholosh cares about the fellows as if they were her own kids; she wants to learn about who you are, how family life is going, and always wants your feedback in making fellowship as educational and enjoyable as possible.

The faculty are experts in abdominal imaging but you would never know it by the way they treated fellows as their peers, each taught with passion and enthusiasm that made you want to absorb everything they said during read-out sessions.

Perhaps the most telling sign of how I felt as a fellow was that I looked forward to coming into work. Not only for the world-class education I received, but to be around such awesome people, many of whom I consider friends and keep in touch with. Oishii? Piada? Tacos? Thinking about the conversations around what to get for lunch still makes me laugh!

The AI reading room is truly a special place and you would be lucky to experience it.



Michael Magnetta, MD, MS


Michael Magnetta, MD, MS
Abdominal Imaging Fellow 2018-19
Assistant Professor,
Feinberg School of Medicine
Email: michael.magnetta@nm.org


How my fellowship at the University of Pittsburgh prepared me for a career in academics

I did both my residency and fellowship at UPMC. Both programs, but especially the fellowship that I completed in Abdominal Imaging prepared me well for a career in academics. The faculty at Pitt are well-connected world class radiologists, researchers, teachers, and mentors. Clinically, I often (daily) find myself repeating important points that were made to me in the reading room by these mentors and imparting the same clinical pearls to my residents and fellows. Even as I have left Pittsburgh and started my academic career at Northwestern, I maintain contacts with faculty at Pitt and have collaborated on a number of projects leading to publications and reviewerships for major radiology journals. While I currently do not do interventional procedures, having extensive experience in this aspect of abdominal imaging has come in handy on numerous occasions in interpretation of images, providing next-step recommendations and in discussion with my interventional colleagues. The fellowship is busy and full of complex challenging cases. The world-class referring faculty in hepatobiliary surgery, interventional GI and transplant respect the abdominal imaging department at Pitt for their expertise and often review cases in the reading room with fellows; I find that this experience really helped me establish myself with a new referral base and in giving tumor board conferences. Overall, the fellowship is well-balanced, well-run, and thought-out with extensive educational opportunities and conferences. At the end of fellowship, I had no doubt that I was ready to practice independently and contribute to an academic department; I was right! I wouldn’t have traded my experience for another; I really value and look back fondly at my time at Pitt! Thank you!




David T. Fetzer, MD


David T. Fetzer, MD
Abdominal Imaging Fellow 2013-14
Assistant Professor, Abdominal Imaging Division
Medical Director of Ultrasound
Department of Radiology

5323 Harry Hines Blvd, E6-230
Dallas, TX 75390-9316
Office: (214) 648-7738
https://utswmed.org/doctors/david-fetzer/
https://www.utsouthwestern.edu/labs/cactus/
“My abdominal fellowship at UPMC was incredibly robust and well-rounded; I was never board! The faculty were all friendly, collegial, and supportive. During my year I had the opportunity to continue funded research started during my residency, complete now published projects, and attend and present at national meetings. Above all, the fellowship prepared me to be an impactful clinician, striking the perfect balance between autonomy and oversite, so that by the time I started my first job, the transition to being an attending was seamless.”



Lawrence Uradu, MD


Lawrence Uradu, MD
Abdominal Imaging Fellow 2017-18
Associate Chief of the Emergency Medicine and Teleradiology Division, UPMC
Email: uradulc@upmc.edu
Recollections about the UPMC Abdominal Fellowship Program

RECENT ABDOMINAL IMAGING FELLOWSHIP GRADUATES – AND WHERE THEY PRACTICE

  • 2017-2018
      • Lawrence Uradu, MD – University of Pittsburgh Medical Center, Emergency Medicine and Teleradiology division
      • Rohit Dewan, DO – UCLA, Los Angeles, California
      • Amar Mehta, MD – Dupage Medical Group, Illinois
      • Chris GU, MD – Excela Health Westmoreland Hospital, Pennsylvania
      • Becky Hwang, DO – (Combined Women’s and Abdominal Imaging Fellowship) - Excela Health Greensburg, Pennsylvania

  • 2018-2019
      • Louise Aguilera, DO – Allegany General Hospital, 24/7 division
      • Peter Hoy, DO – Memorial Hospital Union County, Marysville, Ohio
      • Michael Magnetta, MD – Northwestern Medical Group, Chicago, Illinois
      • Mark Sparrow, MD – Radiology of Indiana, Indianapolis, Indiana

  • 2019-2020
      • Ashley Kalor, MD – University of Pittsburgh Medical Center, Abdominal imaging division
      • Ted Molnar, MD – University of Pittsburgh Medical Center - Community division
      • Samwiri Mukasa, MD – Kaiser Mid-Atlantic Permanente Medical Group, Silver Spring MD
      • Jonathan McGovern, MD – University of Pittsburgh Medical Center- Community division
      • Justin Nelson, MD – Private practice group in Austin, Minnesota

LIVING IN PITTSBURGH

Pittsburgh is a beautiful city with all the amenities of a large vibrant city but the charm and feel of a small town to suit all types of interests. Pittsburgh is home to the Pittsburgh Steelers, Pirates and Penguins, offers 90 unique neighborhoods, dining and nightlife, art and natural history museums, shopping, children’s activities and museums, scenic parks and lakes, is a business and education hub and offers various surprisingly affordable housing options.


HOW TO APPLY

Click here to download or view the UPMC Fellowship application form. The applicant must be able to secure an unrestricted Pennsylvania medical license and DEA, be a US citizen or have appropriate visas and have completed an ACGME approved radiology residency. The University of Pittsburgh/UPMC is an equal opportunity, affirmative action employer.

Please submit your completed, signed application with the following supporting materials:
    • Curriculum Vitae
    • Official Medical School Transcripts
    • Copy of USMLE/COMLEX scores
    • 3 letters of recommendation (one of which must be from your program director)
    • Personal statement as to why you are interested in this training

To Vivian McBride, the fellowship coordinator:

Mailing Address:
UPMC Presbyterian Shadyside
Radiology Suite 200 E Wing
Division of Abdominal Imaging
200 Lothrop Street
Pittsburgh, PA 15213

Telephone: (412) 647-3550
Fax: (412) 647-7795
E-mail: mcbridevl@upmc.edu

Program Director:
Biatta Sholosh, MD
Assistant Professor
Department of Radiology
Division of Abdominal Imaging

Telephone: (412) 647-3550
E-mail: sholoshb@upmc.edu