Clinical training

At Mayo Clinic, the 12-month academic year for your clinical training in the Abdominal/Body Radiology Fellowship program is divided into 13 four-week blocks. While we do expect fellows to spend a large majority of their time in abdominal MRI, abdominal CT, and US, the fellowship program does allow some opportunity for elective time (up to two of the 13 blocks) to be spent within the abdominal radiology subspecialty (GI fluoroscopy, additional abdominal MRI, CT, and US) and/or outside of the abdominal radiology subspecialty (cardiothoracic imaging and nuclear medicine [e.g., oncologic PET]).

An example of a one-year curriculum with a range of possible blocks is shown below. 

Abdominopelvic MRI

As a fellow, you are responsible for all aspects of the abdominal MRI exams, including protocols, monitoring of exam, interpretation, dictation, reporting, and consulting as a subspecialist with referring services and recommending additional studies as appropriate. Attendings are always available (two attendings assigned per day Monday through Friday). Your training includes:

• Hepatobiliary and pancreatic MRI: Comprehensive contrast-enhanced MRI including:
  • LI-RADS guidelines for hepatocellular carcinoma (HCC) diagnosis and treatment response
  • Pre- and post-liver transplant evaluation
  • Diffusion-weighted imaging
  • MR elastography
  • MR fat and iron quantification of the liver
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Secretin stimulation dynamic MR pancreatography
  • Comprehensive oncologic imaging
• Gastrointestinal (GI) tract MRI: MR enterography, MRI staging of rectal cancer and perianal fistulas, and dynamic MR defecating proctography and pelvic floor imaging.
• Gynecologic MRI: Comprehensive MRI of the uterus, ovary, and vagina covering cancer staging, deep pelvic endometriosis, pelvic congestion syndrome, and uterine artery embolization for fibroids.
• Genitourinary MRI: Multiparametric MRI of the prostate at 3.0T utilizing PI-RADS version 2.1 and DynaCAD v5.0, MR urography, and comprehensive MRI of the kidney, adrenal gland, urethra, penis, scrotum, and supporting retroperitoneum. MRI-based artificial intelligence/machine learning total kidney and liver volume (AI TKV/TLV) for polycystic kidney and liver disease evaluation.
• Abdominal MR angiography (MRA) and venography (MRV): Contrast-enhanced and noncontrast-enhanced MRA/MRV of the aortoiliac, mesenteric, renal, and pelvic arteries and veins.
• Oncologic PET/MRI: Oncologic PET/MRI including F18 FDG PET/MRI for staging and restaging hepatobiliary, pancreatic, GYN, and rectal and anal malignant neoplasms, and F18 PMSA PET/MRI for the evaluation of patients with high-risk prostate cancer as well as recurrent prostate cancer.

Abdominopelvic CT

Our CT service is the workhorse of abdominal and pelvic imaging and imaging protocols range from the routine to complex multiphasic with dual-energy scanning. Interpretation of exams includes patients in the emergency room, inpatient, and outpatient settings. The disease entities being imaged are wide-ranging from straight-forward classic emergent diagnoses to complex oncologic staging for multidisciplinary management and pre and post-organ transplant (liver, kidney, pancreas) evaluation. CT imaging protocols include enterography, colonography, urography, cystography, vascular CT angiography, and venography (e.g., acute GI bleed CTA, pre- and post-transplant CT angiography, deep inferior epigastric perforator [DIEP] CTA). It also allows for experience with state-of-the-art dual-energy CT technology, radiation dose reduction, and contrast volume dose reduction techniques.

Ultrasound (US)

Our diagnostic ultrasound service images a high volume of cases with diverse pathology. It covers comprehensive US evaluation of hepatobiliary, splenic, renal, and urinary tract, gynecologic (including deep pelvic US for dedicated endometriosis evaluation), scrotal/penile, bowel, peritoneum/mesentery, abdominal wall, and vascular conditions including acute pathology, oncology, and transplants. The ultrasound service performs visceral biopsy, liver biopsy, renal biopsy, head, and neck fine-needle aspiration (thyroid, lymph node, and parotid), soft tissue tumor biopsy, some ablation procedures, radiotherapy marker placements, and pseudoaneurysm thrombin therapy, among others. It also allows for experience with state-of-the-art contrast-enhanced US and Doppler US technology.

Elective opportunities

Up to two four-week blocks of elective time can be spent in up to two areas within abdominal radiology (GI fluoroscopy, or additional MRI, CT, or US), and/or outside of abdominal radiology subspecialty.

Conferences

During the Abdominal/Body Radiology Fellowship, you participate in radiology peer review conferences across the Mayo Clinic sites as well as several recurring multidisciplinary conferences that afford close cooperative interaction with outstanding medical, surgical, and pathology colleagues. These include: 

• Monthly Abdominal Radiology Peer Learning Conference across the Mayo Clinic radiology enterprise
• Weekly LRC (Liver Radiology Conference) Conference
• Biweekly Colorectal Cancer Tumor Board
• Biweekly Multi-Specialty Pancreas QA Conference
• Biweekly Endometriosis Conference
• Biweekly Gynecology Conference
• Follow-up abdominal imaging case conference on the last Friday of the four-week rotation

 In addition, you have the opportunity to attend multiple conferences related to Abdominal Radiology.

• Weekly GU Tumor Board and Urology Imaging Conference
• Monthly GI Enteric Conference

Abdominal radiology staff also provide noon conference lectures to the radiology residents weekly. Fellows are welcome to attend these conferences as well.  

Lectures to fellows

Faculty gives lectures to fellows on practical topics related to abdominal/body radiology, which occurs once per each four-week block.

Scholarly activities

All fellows should be engaged in a hypothesis-driven research project, educational exhibit, and/or quality improvement project during their fellowship year, with the goal of presenting the work at the annual Society of Abdominal Radiology (SAR) meeting which takes place in the spring. We certainly recognize that a one-year fellowship is a short period of time to develop and complete a research project or educational exhibit. The abdomen division faculty are fully supportive of assisting in developing scholarly ideas that fellows would like to pursue, but we also maintain a repository of both research and educational projects that are scaffolded for a fellow to build upon and complete in a reasonable period of time. To facilitate this goal, up to 10 days of academic time is granted. In general, a research day can be scheduled during each block of your abdominal MRI/CT rotation. The department will fund the presentation of this research at national or regional radiology meetings.

National conferences

Each fellow is given up to five days of funding for attendance at a national society conference or CME courses. Additional funding may be available for fellows giving a presentation(s) at a conference(s). 

Teaching opportunities

Opportunities are available for you to teach radiology and non-radiology residents and medical students rotating through their chosen areas of study. You also educate non-radiology fellows, radiology residents, and attending staff from other departments through frequent and routine daily interactions. Each fellow is scheduled to give one conference/lecture to radiology residents during the fellowship year.

Call frequency

Overnight call shifts are covered by our radiology residents and fellows will not have overnight responsibilities. Fellows do, however, participate in general radiology shifts on weekend days and short evening calls from Monday through Friday as these responsibilities are important in maintaining the general skills attained in general radiology residency. Weekday "short calls" are from 5:30-9:00 p.m. and will be combined with a half-day afternoon clinical rotation beginning at 1 p.m.

General call is often rated as a valuable part of the fellowship by past fellows who have graduated. Once you are selected for an interview, details related to expected call responsibilities will be provided. Mayo Clinic follows the recommendations of the ACGME.

Mentorship

Attendings, as chosen by the fellow, are assigned to be fellow mentors for the year to help guide fellows academically and to help guide them in career selection, and to discuss work-life balance, or multiple issues. Mentors and attendings help connect fellows with subspecialty radiologists across the country.