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Vascular and Interventional Radiology Fellowship

A one year fellowship (2-year fellowship will be considered, with a significant dedicated research component).

The Department of Medical Imaging at Western University is pleased to offer a one-year fellowship in vascular and interventional radiology at the combined campuses of London Health Sciences Centre (LHSC), including Victoria Hospital (VH) and University Hospital (UH) and St. Joseph's Health Care (SJHC).  The fellowship includes exposure to all aspects of vascular and non-vascular interventional radiology, along with non-invasive vascular imaging.  It will also incorporate an integrated experience of teaching, research and clinical care.

LHSC is composed of two main sites: Victoria Hospital and University Hospital.  Victoria Hospital is a level 1trauma centre and attached to the London Regional Cancer Centre, the main oncology referral centre for Southwestern Ontario.  It is also a large regional vascular centre and contains an attached pediatric hospital.  University Hospital has an active hepatobiliary/transplant service, which is one of two such services in Ontario.  Both hospitals are also dialysis centres. SJHC is largely an ambulatory centre with a large urology stone management practice.  This hospital provides exposure to uterine fibroid embolization, ports, varicocele embolization amongst other general procedures.  All of these services, along with other clinical services contribute to a rich exposure to a varied patient population in both adult and pediatric interventional radiology.

The particular strengths of IR at Western University include:

Objectives

General IR

  • Patient care (including inpatient rounds and outpatient IR clinics)
  • Awareness of occupational hazards and radiation safety (including principles of ALARA)
  • Learning the team approach and collaboration in IR

Diagnostic Vascular IR

  • Conventional angiography of aorta, visceral branches, upper and lower extremities
  • Interpretation of non-invasive vascular imaging, including doppler/duplex ultrasound, CTA and MRA

Vascular Interventions

  • Treatment of ischemia of peripheral and visceral arteries (angioplasty, stent/stent/graft placement, thrombolysis)
  • Treatment of peripheral or visceral aneurysm via endovascular techniques
  • Embolotherapy (vascular malformations, chemoembolization for liver malignancies, portal vein embolization, uterine fibroid embolization, varicocele embolization, various oncologic embolizations, trauma, etc)
  • TIPS
  • Venous interventions (large volume of venous access-dialysis permcaths, ports, Hickman lines, PICC’s, fistuloplasties, IVC filter insertions/removals, transjugular liver biopsies

Non-Vascular Interventions

  • Percutaneous tumour ablation (renal, liver and other) with radiofrequency, microwave and cryoablation techniques
  • Vertebroplasty and spine intervention (facet, selective nerve root block)
  • Abscess drainage and fluid collection management
  • Biliary and renal interventions
  • Percutaneous gastrostomy and gastrojejunostomy feeding tube placement
  • Colonic stenting
  • Image-guided biopsies with CT, ultrasound or fluoroscopy

Fellowship and Academic Responsibilities

Teaching

  • IR fellows will provide resident teaching rounds whenever appropriate (usually one hour teaching rounds are held weekly for radiology residents)
  • They will also be involved directly with resident teaching and supervision for radiology residents on IR rotation for teaching basic interventional techniques
  • This resident teaching should positively impact residency training and should not have any negative impact on resident training in IR as the fellows responsibilities are separate and different from the radiology residents
  • IR fellows are required to attend and participate in multidisciplinary conferences
  • IR is an active participant in several biweekly multidisciplinary tumour boards (neuroendocrine, HCC and hepatopancreatobiliary rounds, for example) and in weekly combined vascular surgery/IR rounds
  • The fellow will present and participate in quarterly city-wide IR rounds of mortality and morbidity rounds or interesting cases

Research

  • Fellows are expected to complete one research project with the expectation to submit a manuscript ready for publication prior to the end of fellowship
  • They can also participate in other ongoing clinical projects at LHSC in radiology, in collaboration with other specialties, or in collaboration with the world-renowned imaging scientists at Robarts and Lawson Research Institutes

On-Call Responsibilities

  • Fellows will provide on call IR services with attending physician back-up supervision for a call frequency of one in three to one in four.  Call will be provided across the two hospitals by the fellows. Whenever the fellow is called regarding a consultation, they must discuss the case with the IR attending physician.

Schedule

  • Procedures are scheduled at all three sites at 8:00 am and continue to approximately 17:00.  Fellows may be required to come earlier for inpatient rounds and “board talk” to discuss the day’s caseload or stay late to finish the workload or round on inpatients.

Vacation/Conferences

  • IR fellows will receive four weeks of vacation, along with an additional week during the Christmas/New Year’s holidays
  • If the fellow is presenting at a major conference, the fellow may attend and the time will not count towards vacation
  • The fellow is also eligible for funding if presenting a research project from Western

Fellowship Evaluation

  • IR fellows are evaluated daily by the IR attending physicians
  • The fellow will be evaluated monthly by the site supervisors and will meet quarterly with the IR fellowship director to review the fellow’s procedure logbook and evaluations
  • Formal evaluations include face-to-face feedback and a CANMEDS based evaluation

For further details and information, please contact the Fellowship Program Coordinator, Ms. Kellie Griffin