Clerkship Overview

The Clerkship provides a general understanding of the spectrum of diagnostic imaging and diagnostic and therapeutic image-guided interventional techniques.The student will understand the role of Radiology in medical care, and will appreciate the patient's perspective of undergoing medical imaging or intervention.

• Spectrum of imaging modalities: Exposure to the many different imaging modalities that fall under the rubric of "Radiology".
• Image-guided intervention: Exposure to the broad spectrum of minimally invasive diagnostic and therapeutic procedures offered by Interventional Radiology, and the role of IR in direct patient care.
• Radiologists as the “consultant’s consultant: Emphasize the breadth of medical knowledge necessary for imaging performance and interpretation and the value of sub-specialization in Radiology.
• Imaging as information: Understand the fundamental role and value of imaging to provide timely, accurate, and actionable diagnostic information regarding a patient’s medical condition, based on or tailored to specific clinical questions.
• The radiology team: The spectrum of caregivers involved in the diagnostic and therapeutic imaging arena, including physicians, technologists, nurses, physicists, computer scientists, administrators, and administrative assistants.
• Imaging information systems (PACS – Picture Archiving and Communication System and RIS – Radiology Information System): Provide practical knowledge and experience for navigating these imaging information systems.

Radiology Utilization

Provide general education regarding the indications and appropriateness of imaging studies for common clinical problems and an understanding of the appropriate sequencing of exams and the limitations of diagnostic imaging tests.

• Value of diagnostic imaging in the evaluation of common clinical problems.
• Appropriateness of specific imaging examinations based on clinical questions.
• Appropriate sequencing of imaging examinations.
• Pitfalls of inappropriate exam choice.
• Importance of timely imaging and interpretation relative to the clinical presentation –stat vs. urgent vs. elective…logistic vs. medical urgency.
• Cost of various imaging studies and an initial exposure to the concepts of cost-effectiveness as they relate to radiology.
• Limitations of commonly used diagnostic tests.
• Basic Test Concepts. Overview of sensitivity, specificity, accuracy, and predictive value, and how the results of a diagnostic test affect the clinical probability of disease and the differential diagnosis.

Image Interpretation

Provide introductory education on imaging techniques and a general approach to the interpretation of diagnostic studies. The complexity of imaging interpretation and the value of training and experience are emphasized.

• Basic study identification and viewing: The appearance of imaging studies using different diagnostic modalities, their physical basis, and how the diagnostic information is displayed (Projectional vs. cross-sectional, dynamic vs. static, gray-scale appearance).
• Basic study interpretation: Approach to evaluation of a diagnostic image and the development of search patterns.
• Basic normal anatomy and pathology as depicted on common studies (radiography, fluoroscopy, CT, ultrasound, MRI) and in various organ systems (head/neck, chest, abdomen, musculoskeletal).
• Begin to develop the skills that will allow evaluation of basic imaging studies in an independent fashion, as is often required during clinical clerkships, internship, and residency.

Teaching Methods

• Clinical Rotations: Rotation on the various clinical services is the lynchpin of the educational experience. During the first week the students will spend one day each on four different clinical services. During the second week they will spend one day in the Radiology Department at the Cincinnati Children’s Hospital, and then two days on a specific service of their choice.
• Didactic Lectures: A didactic lecture series specifically for medical students, provided by the radiology faculty and residents, is a standard part of each day’s curriculum.
• Textbook: The Basics and Fundamentals of Imaging by William E. Erkonen and Wilbur L. Smith.