University of Virginia Health System

PEDIATRIC RADIOLOGY 1 RESIDENT ROTATION

Teaches Med. Students 8:00 a.m. : M, T, W, F

Dictates Rollerscope

Covers Fluoro , US , CT

Prepares and gives Wed. 8:45 Peds. Conference

Prepares and gives KCRC Conf.: Th 9:00 a.m.

Prepares and gives Friday 2:00 Heme Oncology Conference

PEDIATRIC RADIOLOGY 2 RESIDENT ROTATION –

JUNIOR RESIDENT

Medical Student teaching 8:00 : M, T, W, F

Dictates rollerscope: M - F

Fluoro

SENIOR RESIDENT

1. Peds films on PACS
2. US
3. CT

iGives Wed 8:45 Peds. Conference

hOn Thursday gives 9:00 KCRC Conf.

iPrepares and gives Friday 2:00 Heme Oncology Conference

I. PURPOSE AND GOALS:

At the end of the pediatric radiology rotation, the resident should:

Be familiar with the care and handling of pediatric patients and their families. There are many specialized skills and techniques involved in the approach to pediatric patients while in the x-ray department. This is especially true of the newborn and the young infant. Many of these techniques have to do with positioning, immobilization, and infant temperature maintenance. You will be expected to both understand and properly carry out these techniques. In addition, utmost care must be taken that the patient’s parents thoroughly understand all procedures to be carried out on their child.

Be capable of acting as a consultant to the pediatricians and pediatric surgeons. We function as consultants on this service and close contact with the clinical services is maintained at all times. No examination is performed on any child without proper clinical information.

Be capable of performing numerous radiologic procedures on infants and children including: gastrointestinal fluoroscopy; intravenous pyelography and voiding cystourethrography; airway fluoroscopy and radiography; neonatal ultrasonography, including head and body; other examinations such as CT and MRI as they pertain to the pediatric patient.

Have acquired a fund of knowledge about pediatric radiology. This will require reading on your own, studying the teaching file, working with the ACR learning file, in addition to performing the daily work schedule.

II. DUTIES AND RESPONSIBILITIES:

1. Act as the primary consultant in pediatric radiology.
   
   As the primary consultant for pediatric radiology you should be available at all times for consultation. If you leave the department during the day, you should let the page operator know where to reach you.
2. You are responsible for organizing the Wednesday morning pediatric ward conference. Please bring interesting cases each morning for the medical students and pediatricians.

The conference schedule is as follows:

a. Pediatric medical students 8:00

b. General Ward Conference Wednesday 8:45 .

c. Neonatal Intensive Care 10:30, Monday - Friday.

d. Pediatric Intensive Care Unit 11:00, Monday – Friday as needed.

e. KCRC Conf: Thursday 9:00 in Ped. Reading Room

f. Pediatric Heme/Onc Conf: Friday 2:00 in Ped. Reading Rm.

It is the responsibility of the pediatric housestaff to provide the patient list. Immediately following the morning conference, all films should be dictated. All interesting cases should be entered in the case book and the diagnosis and interesting x-ray findings listed.

Films from the NICU and the PICU should be available by 10:00 a.m.

1. Fluoroscopy and other procedures begin immediately following conference. Prior to that time, you should check with Fluoroscopy scheduling for the day’s fluoro list. Please evaluate each request; if proper clinical information is not available, check with the physician who requests the study. Usually the pediatric housestaff or attending will have spoken to one of us before ordering the test. Try to formulate your own plan for each study. We will discuss each case before you begin. The procedure should then be discussed fully with the parents. The parents may accompany the child during the examination. All studies should be checked by the attending prior to dictation. Your goal in performing the various procedures should always be to achieve maximum radiographic information with minimum morbidity and radiation dose to the patient. Keep a log of your cases and fluoro time.
2. Ultrasound - See schedule and manual (Ultrasound Scanning: Principles and Protocols by Tempkin)
3. CT - See schedule and manual
4. Reading routine films - Routine out patient films will be placed on the rollerscope by the film room personnel. Please formulate your impression of each case, after which time the cases should be presented to the pediatric radiology attending. As soon as a group of outpatient radiographs is dictated, they should be taken down by the film room and additional films for the day put up in their place. Please see that the film room clears all films from the rollerscope each afternoon with the exception of the current in-house patient films.
5. Kluge Children's Rehabilitation Center (KCRC) - KCRC films are sent over and put up in the Pediatric Reading Room for the resident to read.
6. KCRC Ward Conference is Thursday 9:00 a.m. in Ped. Reading Room (After Pediatric Grand Rounds). The list is available by Wednesday afternoon.
7. Teaching file and 1:00 p.m. conference - You will be responsible for placing pediatric radiology cases in the teaching file. Current, interesting cases should always be shown to your fellow residents. It is very important for you to participate in educating your fellow residents. All interesting cases should be entered in the case book.

III. READING AND STUDY:

1. In depth reading and study will be necessary in order to gain a firm foundation in pediatric radiology during your brief rotation.
2. Current cases should be researched at once.
3. You should attempt to review all of the pediatric portion of the teaching file. Pediatric cases are designed by red tape on the green jackets and a white tape on the red jackets.
4. Reading List.
5. ACR LASER DISC PEDIATRIC TEACHING FILE
6. Web site - Introduction to Pediatric Radiology

IV. TEACHING:

1. Much of the teaching will be done using current daily cases.

2. Any free time in the afternoon should be spent in the library/teaching file/ website.

3. We will give a series of conferences and lectures each year.

V. FRIENDLY MINI BOARDS:

An oral exam may be given in the middle of the rotation.

SUBJECT: Optional friendly pediatric mini boards for the Radiology Resident on the Pediatric Rotation.

When - last Friday of the rotation. Suggested reading: Fundamentals of Pediatric Radiology by: Lane F. Donnelly, M.D.