Education and Training
The Case Western Reserve University/University Hospitals Cleveland Medical Center Diagnostic Radiology Residency Program is four years in length. Our curriculum is designed to offer comprehensive training in all radiology subspecialty divisions and help residents achieve their professional career goals, including pathways to pursue certifications and acquire additional expertise.
All rotations are completed at either University Hospitals Cleveland Medical Center or Louis Stokes Cleveland VA Medical Center located less than one mile away from UH Cleveland Medical Center. A diverse patient mix at these institutions provides residents with exposure to a variety of radiological pathologies and procedures.
Radiology Subspecialties
The academic year is divided into 13 four-week rotations. Residents rotate through all diagnostic radiology subspecialties/board exam areas during the course of their residency, including:
- Abdominal Imaging (Gastroenterology/Genitourinary)
- Breast/Mammography
- Cardiac Imaging
- Emergency Imaging
- Musculoskeletal Imaging
- Neuroradiology
- Nuclear Medicine
- Oncologic Imaging
- Pediatric Imaging
- Thoracic Imaging
- Ultrasound
- Vascular and Interventional
Understanding Call Responsibilities
Our call experience prepares residents to function independently while also providing an appropriate level of attending support. There is always a 24-hour in-house attending with additional sub-specialty attending backup overnight. An ultrasound technologist is present during all hours to allow the on-call residents to concentrate on exam interpretation. The call experience is rich and diverse including all modalities in the UH Cleveland Medical Center Adult and Pediatric Level 1 Trauma Center.
| Training Level | Diagnostic Call | IR Home Call |
|---|---|---|
| R1 | No diagnostic call | 1 week |
| R2 | Approximately 10 weeks | 2 weeks |
| R3 | Approximately 5.5 weeks | 1 week |
| R4 | Approximately 9 days | No IR call |
Diagnostic Call
- R1 Year
-
We prioritize building a strong foundation in radiology, with an emphasis on pathologies commonly encountered while on call. Our goal is to help residents transition smoothly into the workflow of residency and feel prepared when diagnostic call begins in the R2 year. Residents have access to a robust collection of educational resources, including RadPrimer, CaseStacks, and Medality, complemented by a lecture curriculum developed by faculty and senior residents that focuses on high-yield emergency radiology cases. This curriculum is continually refined based on resident feedback and has been a key factor in helping residents feel confident and prepared for call responsibilities.
During the second half of the R1 year, residents also participate in one to two weeks of "buddy call," serving as an additional junior resident on call during weeknight (5–9 p.m.) or weekend (8 a.m.–8 p.m.) shifts. These experiences provide exposure to call responsibilities in a lower-stress environment with additional support and have consistently received positive feedback from residents as a valuable bridge to independent call.
- R2 Year
-
Residents begin taking in-house diagnostic call during the R2 year. Call is structured in seven-day blocks, with 10 total weeks of call annually: five weeks as the swing resident (Saturday–Sunday, 8 a.m.–8 p.m.; Monday–Friday, 5 p.m.–1 a.m.) and five weeks as the overnight resident (Saturday–Sunday, 8 p.m.–8 a.m.; Monday–Friday, 9 p.m.–8 a.m.).
On weekends, residents work alongside a senior (R3/R4) resident, and on weeknights there is overlap with the co-resident on call as well as senior resident backup. Emergency radiology attendings provide remote overnight coverage and are readily available by phone or chat from 7 p.m.–5 a.m. to answer questions. Although they primarily overread emergency department studies, they are also a valuable resource for inpatient imaging questions. The junior call experience consists primarily of radiographs and CT examinations.
- R3 Year
-
The R3 year marks the transition to senior call responsibilities, which focus primarily on ultrasound and MRI interpretation, while also providing support to junior residents as needed. Senior residents cover daytime weekend shifts (7 a.m.–7 p.m.) or evening/night shifts (weekends 7 p.m.–5 a.m.; weekdays 5 p.m.–5 a.m.).
Senior residents also perform emergent fluoroscopic studies and procedures, such as lumbar punctures and joint aspirations, when clinically indicated.
- R4 Year
-
Diagnostic call responsibilities are intentionally limited during the R4 year to allow dedicated board preparation time for the R3 class. R4 residents typically cover only one week and one weekend of senior call during the year.
IR Call
You will take 1 week of IR home call during your R1 year, 2 weeks during your R2 year and 1 week your R3 year. This consists of holding the IR pager and fielding consults. We are fortunate to have a very strong and collegial IR department, thanks to both our IR attendings and integrated IR residents. This is exemplified by the ‘checklist’ system created by one of our IR residents, which highlights the pertinent clinical and lab data to collect for commonly encountered emergent IR consults (ie GI bleed, septic shock requiring drain placement, etc.). After gathering history from the consultant, you will then contact the on-call IR attending to formally staff the consult, at which time you will finalize whether you need to come in-house for a procedure.
There will likely be minor changes to the DR/IR call formats from year to year since we try to incorporate resident feedback as frequently as possible to optimize the experience. Therefore, more details regarding both DR and IR call will be provided throughout your educational curriculum at UH.
Here are some examples of how the call curriculum and diversity of cases at UH have prepared graduates for fellowship and beyond:
| Day | 8 – 9 a.m. | 12 – 1 p.m. |
|---|---|---|
| Monday | Peer-peer lecture/guest lecture | Breast or Chest/Cardiac |
| Tuesday | IR lecture (7:15 a.m.), Neuroradiology (8 a.m.) | Grand Rounds or Oral Boards Prep |
| Wednesday | Peer-peer lecture/guest lecture | Body |
| Thursday | Physics | Musculoskeletal |
| Friday | Peer-peer lecture/guest lecture/wellness | Pediatrics or Nuclear Medicine |
Peer-to-Peer Lecture Series: This volunteer-led lecture series is hosted by senior residents and focuses on high-yield topics for call and board preparation. Sessions occasionally take the form of Jeopardy-style case conferences, where resident teams work through cases and present their findings. The series has received positive feedback and supports our ongoing efforts to prepare residents for oral boards. It also serves as an opportunity for resident-led town halls, during which chief residents gather feedback and discuss ways to enhance both the educational and wellness aspects of the residency experience.
Guest Lectures: Guest lecturers bring a wide range of perspectives to the program, from leaders in healthcare and business to accomplished program alumni. Recent speakers have included professionals discussing leadership development, career planning, and strategies for evaluating post-graduation employment opportunities.
Physics: Our physics curriculum is led by dedicated medical physicists and is primarily geared toward R1 and R2 residents. The program provides a strong foundation in imaging physics, helping residents build the knowledge necessary for clinical practice and future board preparation.
Oral Boards Preparation: This recently introduced series allows residents to practice cases in a format that mirrors the oral board examination in a supportive, low-stress environment. Sessions are held biweekly and are led by faculty members or senior residents.
Grand Rounds: Held every other week, Grand Rounds features distinguished speakers from radiology and related fields. Topics range from groundbreaking clinical trials and emerging technologies to innovative subspecialty applications, exposing residents to diverse perspectives and advances across the specialty.
Wellness: Dedicated wellness time provides residents with opportunities to connect with colleagues, recharge, and maintain balance outside of the hospital.
R1 Boot Camp: Despite its name, R1 Boot Camp is designed to make the transition into radiology residency as smooth as possible. During the first month of training, residents participate in daily sessions (typically 8–9 a.m.) led by senior residents and faculty. Topics cover essential workflow fundamentals, including PACS, Fluency dictation software, communication of critical findings, and rotation-specific tips and expectations. The curriculum is continually refined based on resident feedback and focuses on providing practical, immediately applicable knowledge to help new residents succeed from day one.