What to Expect as a Cardiothoracic Imaging Fellow

A day in the Life

  • Integrated cardiothoracic program - all our attendings read chest CT, cardiac CT, cardiac MRI, CXRs, and perform biopsies
  • Exams are mixed throughout the day
  • Good variety and broad training

Practice Volume

We are a busy practice:

  • Daily CTs range from 50-100
  • Daily CXRs range from 100-200
  • Daily PET/CTs range from 1-3

Cardiac CT/MR volume:

  • 5-20 per day = strong volume of cardiac studies admixed with thoracic CT daily

Biopsies:

  • 1-5 weekly

You will be prepared for academic and private practice volumes following Cardiac & Pulmonary fellowship at UCSF.

Cardiac CT/MR

We read all cardiac CT/MR exams in adults and children

  • No split with cardiology

Broad array of cardiac imaging studies

  • Coronary CTA including FFR
  • Adult CMR
  • Structural
    • Congenital
    • Hypertrophic Cardiomyopathy Center of Excellence
    • Heart failure
    • Electrophysiology applications
  • Pediatric CT/CMR
    • Large congenital cardiac surgery program
  • Valve service including TAVR/TMVR/TPVR
  • Pre-ablation imaging

Biopsies

Our department does all CT guided lung biopsies

  • Excellent opportunity to learn procedural skills including CT FNA, core biopsy, and fiducial placement
  • By the end of fellowship will be confident independent proceduralist, having done 50+
  • Marketable skill for both academics and private practice

Cardiothoracic Imaging Call

Our fellows take 2 types of call 

Chest call

  • Begins in October
  • Rotates equally with rest of chest faculty = one week at a time every 6-8 weeks depending on fellow #
  • Pager backup for overnight resident during the week
  • On weekend, final sign inpatient/ER CTs and CXRs (including studies prelimed by resident)
  • No staying up overnight

General non-ACGME call

  • Call is taken by all non-ACGME fellows
  • Either one evening or weekend day shift per month providing prelim reads of inpatient CTs and ultrasounds across all disciplines (other than neuro)
  • These call shifts are from 5p-11p on a weeknight or 12p-10p on a weekend day
  • No staying up overnight

Schedule

Two main fellow roles at Parnassus (50/50 split)

Biopsy/cardiac: fellow acts in a trainee role

  • Reading cardiac CT/MR with attending
  • Reading thoracic CT with attending
  • Performing CT guided lung biopsies with attending
  • (Plus reads CXRs solo) 

Clinical instructor (CI): fellow acts as a mini attending*

  • Reviewing CTs with residents and final signing
  • (Plus reads CXRs solo) 

Fellows also go to ZSFH (trainee role) and SFVA (CI role)

* There are always another 1-2 chest attendings available to the CI fellow, and this is a great chance for the fellow to build confidence, graded responsibility, and experience interpreting exams.  CI days are popular with our fellows since it helps prepare for transition to attending-hood with plenty of support. 

Other schedule considerations

  • Our chest fellows have 1 protected academic day each week (unique perk – more details later)
  • UCSF non-ACGME radiology fellows receive department laptops, educational funds, meeting days, paid vacation days, parental leave, and access to subsidized housing

Conferences

Weekly

  • TAVR valve conference
  • Pediatric cardiac surgery
  • UCSF tumor board
  • VA tumor board
  • Adult congenital heart disease
  • Pulmonary teaching conference
  • ILD conference

Monthly

  • Amyloid multidisciplinary conference
  • Airways/bronchiectasis conference
  • Cardiology multimodality imaging conference

Academics

Our fellows have one protected academic day every week.

This can be used for many difference activities:    

  • Research projects
  • Creating educational materials/lectures
  • Taking courses
  • Attending clinical conferences
  • Shadowing in bronch suite, echo lab, pathology
  • Flexible and customized for each fellows’ goals/interests.

Outcomes

  • 50/50 academic and private practice jobs
  • Fellow outcome for the last 5 years:
Academic Private Practice
  • Duke
  • Stanford
  • UCSF
  • UCSF
  • UCSF
  • Michigan
  • U Washington
  • ZSFG
  • Airforce
  • Denver
  • International
  • Maryland
  • San Francisco
  • San Francisco
  • San Francisco
  • Washington DC

Work Locations

Cardiothoracic Imaging Fellows will work at all of the following sites:

Cardiothoracic Imaging Fellowship Locations