Cornell University Hospital for Animals

 

Veterinary Diagnostic Imaging


Residency Program

The American College of Veterinary Radiology (ACVR) accredits Cornell’s residency program in Veterinary Imaging. This 3-year program generally enrolls new candidates each July and provides specialty training in general radiology, fluoroscopy, ultrasonography, nuclear medicine, computed tomography, and magnetic resonance imaging in small, exotic/wildlife, and large animals, and radioiodine treatment of hyperthyroidism in cats. Successful completion of the program qualifies candidates to take the ACVR board-certification examination, and prepares candidates for academic or specialty practice. Preference is given to candidates with a history of interest in academic practice.

Potential Applicants

Applications are managed through the Veterinary Internship and Residency Matching Program unless otherwise specified. Applicants must have a D.V.M. or equivalent degree, and at least one-year post graduation clinical experience: completion of an internship is encouraged. Applicants must be proficient in English (both written & spoken). Foreign applicants are eligible and encouraged to apply. For successful international candidates, the College provides assistance with obtaining a visa.

The application includes a letter of intent, transcript, and three letters of recommendation. An interview is not required except under special circumstances. Phone or Skype interviews initiated by candidates are discouraged. Imaging Faculty might contact applicants who have met the criteria for ranking. Applicants may visit the facilities to learn more about the program: visitation dates are limited and must be scheduled through Rosemary Adessa. Only about a half of the successful candidates visit our program prior to acceptance. Candidates that have questions about the program also may email the residency program director, Dr. Peter V. Scrivani. Applicants attending the annual ACVR Scientific Meeting also are encouraged to speak with any of the Imaging Faculty attending the meeting.

When preparing an application, the letter of intent should discuss the applicant’s motivation for seeking a residency in veterinary diagnostic imaging, how completing such a program would help achieve their specific career goals, and why this particular program would help meet those goals. Residents also should discuss what skills and talents they will bring to the program. Letters of recommendation should be written by individuals who are qualified to comment on clinical, cognitive, and communication skills of the applicant. Each referee does not have to comment on all 3 aspects, but the group of referees should cover all 3 aspects. It is recommended that at least one letter is from a board-certified veterinary radiologist. Ideally, current supervisors should be asked to write letters. Letters from peers, friends, or supervisors from long ago do not carry much weight.

The number of applicants (as with most residencies) exceeds the number of available positions. Furthermore, only a percentage of the qualified applicants are ranked. Those candidates who are successful tend to be self-motivated, independent, accepting of new experiences and perspectives, and efficient at time management. Successful candidates also tend to have a high GPA/rank, a strong rotating internship or equivalent work experience, a thoughtful and interesting letter of intent, English proficiency, exceptional letters of recommendation, and a documented ability or willingness to work well with people, large animals, and small animals. Other qualifications (eg, publications, research experience, and teaching experience) are helpful when ranking individuals who have made the final cut.

Facilities

Radiography:
Companion Animal Hospital
Radiography:
Equine & Farm Animal Hospital

* Pausch overhead tube/65kw generator
* Summit Specialist
* AGFA DXG – Multi-plate CR
* Canon 14x17 CW Wireless Imaging Cesium Flat Panel Detector Mark Acquisition Device – Wildlife Health Center
* Dentex Image 70
* Dental – Sirona (2 units)
* Carestream CS7600 Digital Dental System

* Pausch overhead tube/80kw generator
* MinXray HF 80 – portable unit
* Siemens Mobilett Plus – portable unit
* Siemens Mobilett XP Hybrid – portable unit
* Siemens Mobilett – portable unit
* MinXray TR80 – portable unit
* AGFA DXG Multi-plate CR
* Canon 11x14 CW Wireless Imaging Cesium Flat Panel Detector Mark Acquisition Device
Fluoroscopy Ultrasonography
* Philips Easy Diagnost – Radiology/Fluoroscopy with Digital spot films and vascular software
* Hologic Insight FD Mini C-arm
* Ziehm Vision RFD C-arm
* Philips EPIQ 5
* Philips IU22
Computed Tomography Magnetic Resonance Imaging
• 16-Slice Toshiba Aquilion LB
• Universal Medical Large Animal Table
• 1.5 T Toshiba Vantage Atlas
• Equine Gurney
Nuclear Medicine Information Technology
* MIE Equine Scanner HR/Scintron VI-VME * Carestream Vue PACS and VueMotion
* UVIS
* ImageNow

 


Program Statistics


On average, the total number of annual imaging examinations is approximately 9000. On average, each resident generates approximately 2000 written reports each year. Preliminary reports typically are completed within 1 day and then reviewed by a board-certified radiologist.
    • Number of residents currently enrolled in the program = 4
    • Number of residents that completed the program and are board certified = 13/14 (93%)
    • Number of residents that passed the qualifying (written) examination on the first attempt = 13/16 (81%)
    • Number of residents that passed the certifying (oral) examination on the first attempt = 8/14 (57%)
   • Number of residents that passed the entire examination on the first attempt = 8/14 (57%)


Pie Chart - Caseload by Modality and by Species

Continuation in the program will be based on an acceptable level of performance by the resident.

Performance Expectations: On Clinics

The first week of the program is dedicated to hospital orientation. The next month is dedicated working with the technicians to learn how to use the imaging equipment. Additionally, the resident must attend and successfully pass Cornell’s Radiation Safety class. For the remainder of the program, the resident is expected to provide imaging services in the Cornell University Hospital for Animals under the supervision of the Imaging Faculty. Imaging services includes performing special procedures, interpreting of all types of imaging studies, and performing interventional procedures (eg, fine-needle and core biopsies, radioiodine treatment). Residents also may participate in outpatient examinations or consultations. Residents are assigned to clinics for a minimum of 30 months and a maximum of 32 months during the 3-year program. The faculty, who will take into account the needs of hospital and the resident, determines the amount of time on clinics that is above the minimum.

Residents are expected to show continuous improved proficiency in producing and interpreting medical images as well as communicating results accurately and efficiently (both orally and written). When assigned to clinics, residents should be accessible, prepared to perform imaging examinations, provide oral interpretations to students and clinicians, and conduct rounds with the veterinary students. Appropriate floor management involves supervision of image quality, facilitating that procedures are performed and interpreted accurately and timely, and being aware of what is occurring presently and what needs to be accomplished that day. Excellent client and peer communication skills and the ability to work collaboratively as part of a clinical team are essential. At least 90% of all preliminary written reports should be completed within 24-hours of image acquisition. These reports are finalized by the faculty or resident after case review with the chief-of-service: residents are expected to increasingly finalize reports as they progress through the program. Residents must review reports finalized by the faculty member to acknowledge any change made to their preliminary report or observe the style of reporting of that faculty. Residents also are expected to follow-up on cases, which include pursuing results of laboratory tests, observing in the operating room, or attending the necropsy examination.

Annual resident evaluation is performed, usually in January. At that time, third-year residents who meet the criteria of the imaging faculty may be assigned as chief-of-service for some weeks. When assigned as chief-of-service, residents are expected to take a leadership role in floor management. The faculty reserves the right to revoke these privileges when the resident does not continue to meet the faculty criteria of acceptable performance.

Performance Expectations: Off Clinics

During the 3 years, residents are assigned off-clinics for a minimum of 4 months and a maximum of 6 months. The minimum amount of time is set aside to learn echocardiography (2 weeks), study for the qualifying examination (6 weeks) and vacation (6 weeks). For vacation, the resident is allowed 2 weeks (10 work days) per year, which may not be used during the last month of the program. Additionally, off-clinic time may not be taken during the first six months of the program without permission of the imaging faculty. Except for vacation, the resident is expected to work full time while off-clinics: off-clinic duty assignment provides dedicated time for board-examination preparation, teaching preparation, attending conferences, and completing research projects (some of these tasks also will be performed after hours, weekends, or during clinics).

Residents are expected to attend morning rounds when off-clinics (the only exceptions are vacation, externships, attending approved conferences/lecturers/seminars, and the 4 weeks prior to the qualifying (written) examination). Residents may be assigned to emergency call while off-clinics. In general, as a minimum, the resident is not scheduled for emergency during the 4 weeks prior to the qualifying examination. Residents typically have 6 weeks off-clinics prior to the qualifying examination, which may or may not be 6 continuous weeks.

The resident is expected to rotate through cardiology for two weeks to learn echocardiography. The resident must arrange this rotation with the Cardiology Service at Cornell or as an externship with a qualified person such as a board-certified cardiologist. Whereas the focus of this program is on diagnostic imaging, residents are expected to learn imaging-guided fine-needle aspiration and tissue-core biopsy. Additionally, residents are expected to participate in cardiovascular catheterizations when available. The resident might use some of the off-clinic time to perform an externship, such as to learn interventional radiography. The Imaging Section usually does not fund externships. The resident also is expected to review all on-line teaching resources and teaching files.

Performance Expectations: Emergency


Residents are expected to be able to use all of the imaging equipment within the section necessary to perform emergency procedures. On-call duty is shared fairly among the residents. Residents provide primary consultation, but have an assigned Faculty member for support. When scheduled on emergency, the resident must be available in person, and by phone. The resident is expected to respond to all calls in less than 30 minutes (including having access to a computer for remote consultation or to arrive at the hospital for procedures).

Whereas a faculty member is always assigned to provide backup support to the resident on emergency, the expectation of the emergency-rotation experience is for the resident to develop and demonstrate independence on the clinic floor. Demonstrating independence includes BOTH successfully performing examinations without faculty support and requesting faculty help when appropriate. If the emergency service requests faculty support, the resident will call the backup faculty. If there is any controversy about a case, then the resident is expected to call the backup faculty for advice on how to deal with the situation.

Performance Expectations: Morning Rounds

"Morning rounds" are offered every day except when there are scheduling conflicts (e.g., meetings, lectures). With little exception, all Imaging Faculty and residents attend these rounds whether scheduled on or off clinics. On Monday, Tuesday, Wednesday, and Friday, the intent of these rounds is to review the over-night cases, to showcase and discuss select cases from the previous day, and to discuss special procedures to be performed that day. The rounds are directed toward optimizing patient care and resident learning. Residents are expected to professionally present cases focusing on the imaging signs and how that affects patient management. Residents should prepare for rounds by reviewing relevant clinical data (including test results) and pertinent literature. Residents are expected to answer impromptu questions asked by Faculty or other residents. On Thursday, morning rounds are dedicated to resident learning through Known Case Conference or Journal Club.

Performance Expectations: Board Preparation


Meeting specialty board requirements is the responsibility of the individual resident. The section supports individual efforts through Known Case Conference and Journal Club (see below). Residents are expected to engage in self-directed study of the objectives for the qualifying portion of the ACVR examination. Many of these learning issues are reinforced on the clinic floor and during morning rounds. Therefore, residents are expected to be self-motivated, organized, and take charge of their educational experience. Examples of successful behavior include organization of book club to review specific topics, self-initiated literature reviews, and asking Faculty for clarification of complex topics. Residents also are expected to attend College or Hospital seminars when topics are relevant to veterinary imaging: Tumor Board, Pathology Rounds, etc.

Performance Expectations: Known Case Conference (KCC)

As part of board-examination preparation, KCC is offered every other Monday and is attended by all the imaging residents and faculty. In KCC the faculty selects cases that the resident has never seen, and where the diagnosis/outcome has been unequivocally confirmed. These cases are then presented to the residents as unknowns. These conferences may take different forms (e.g., film, digital, PowerPoint Presentation, slides, quizzes) but are designed to test the progress of the resident's pattern recognition and medical decision-making skills. The resident receives immediate feedback from the faculty.

Performance Expectations: Journal Club (JC)

JC is offered every other Monday and is an opportunity for the imaging faculty and residents to review and discuss the medical literature. Articles may be recently published, related to a current topic of interest, or a seminal article previously published. The articles preferentially are selected from the current veterinary literature and must relate to medical imaging. Articles also may be selected from the human literature.

The goals of JC are for the resident to establish a life-long habit of staying current with the medical literature, to review the current literature for board-examination preparation, and to develop the skills necessary to perform critical evaluation of the medical literature. The ability to perform critical evaluation of the medical literature is necessary to:
    • Determine if the manuscript will alter how the resident performs medicine
    • Perform peer review of a manuscript
    • Help design future studies

For JC, the designated person--in consultation with faculty--will assign one or two journal articles the week prior to discussion. All participating members are expected to read the articles and be prepared to discuss the articles. The designated resident will spend up to 20 minutes to discuss the study design and how it generalizes to clinical practice relative to improving patient care—as if performing peer review. The remainder of the hour, the resident will lead a conversation about the topic of the paper.

Performance Expectations: Student Rounds

The intent is for residents to develop skills with small-group teaching. During rounds, each veterinary student on rotation will be asked to interpret unknown cases. Residents are expected to moderate rounds and provide feedback about the case presentation and teach concepts related to the particular rounds topic. Residents also are expected to participate in determining student grades based on this experience.
Performance Expectations: Teaching in the DVM Curriculum
The intent of this opportunity is for the resident to gain didactic teaching experience, especially with larger audiences. The first-year resident is expected to attend all lectures and laboratory sessions in VTMED 5510, which is the basic diagnostic radiology course, and all laboratory sessions in VTMED 5100, which is the basic canine anatomy course. In VETMED 5510, the resident will present one 50-minute lecture. Throughout the program, residents also will be variably expected to participate in additional courses that are taught by the faculty. Additional opportunities for teaching exist, but are not required.

Performance Expectations: Research Project

The intent of performing a research project is to understand how patient care is improved through discovery of new knowledge. In conjunction with a faculty mentor(s), the resident may be expected to:
    • Participate in study design for the project
    • Write a grant for funding
    • Obtain Institutional and Animal Care Use Committee (IACUC) approval
    • Execute data collection and statistical analysis
    • Present abstract at ACVR conference (or other comparable forum)
    • Publish results in peer-reviewed journal

Residents also are encouraged to write a case report, case series or other manuscript, in part, to better understand the peer-review process and the steps necessary to publish a manuscript.

Residents are expected to attend the Department of Clinical Sciences Resident Seminar Series, which covers topics related to study design, statistical analysis, and professional development. Imaging residents also are expected to complete the on-line instructional course for the University’s formal Responsible Conduct of Research.

Additional Expectations

Residents are expected to spend a substantial amount of time performing additional activities such as studying, writing papers, participating in book clubs and reading the medical literature. The radiology faculty may assign other duties or tasks on an as-needed basis. As long as the program is compliant with the requirements of the ACVR and CUHA Residency Oversight Committee, the radiology faculty reserves the right to alter the program at any time without notice.