ACVR Residency Training Program Application Form: Institution Name
Oregon State University
This document is to act as a guide for institutions desiring ACVR accreditation of their residency training program. It should be used in concert with the requirements set out in the ACVR
Essentials of Residency Training document and it follows the headings of that document. It is intended to streamline the application process and help define what information the RSEC needs to evaluate the program. All terms used in this application have same definitions as defined in the Essentials.
II. Objectives:
The residency program is designed to provide high-quality, in-depth clinical training in the areas of veterinary diagnostic imaging which will allow the resident to develop knowledge and clinical proficiency in the field and adequately prepare them to pass the examinations for ACVR diplomate status. The program will provide a comprehensive understanding of diagnostic radiology, ultrasonography, computed tomography and magnetic resonance tomography as well as knowledge of the general principles and applications of nuclear medicine. The principles of radiation safety and biology and radiotherapy will be emphasized. Residents will rotate through radiology, ultrasound, CT/MRI/Nuclear Medicine. Additional rotations will occur both remotely and at VDIC in Portland, Oregon to provide additional experience in small animal radiology. The focus of the residency will be on small animals and equine patients; however experience will also be gained with food animals and exotic species. Learning activities scheduled on a daily basis include imaging rounds. Learning activities on a weekly to bi-weekly basis include, resident seminar series and known case conference; and on a monthly basis include journal club. The resident is expected to complete a clinical research project during the second year.
III. Training period:
What is the total length of the training program in months? 48 months
If this is a 4 year program, during what year will the resident be eligible to take the ACVR Preliminary Exam? If the resident is not eligible to take the exam during the beginning of the 3rd
Beginning of 3rd year
What is the total duration of supervised clinical training in the program? 38.5 months What are the responsibilities of the resident in the remaining non-clinical portion of the program?
The off clinic time is for scientific research, completion of Master of Science degree, preparation for board examination and vacation.
IV. Direction and Supervision: Program Director:
Who is the Director of Residency training? Sarah Nemanic, DVM, MS, PhD, DACVR What percentage of this individual’s time is committed to clinical service and teaching of residents? 50%
Faculty:
Please list the faculty member of the program accepting PRIMARY responsibility for training in each of the following core areas:
Roentgen diagnosis:
Faculty: John Feleciano, DVM, DACVR Percentage clinical service: 12.5% Diagnostic ultrasound:
Faculty: Susanne Stieger-Vanegas, DVM, PhD, DECVDI Percentage clinical service: 50%
Computed Tomography
Faculty: Sarah Nemanic, DVM, MS, PhD, DACVR Percentage clinical service: 50%
Magnetic Resonance Imaging:
Faculty: Sarah Nemanic, DVM, MS, PhD, DACVR Percentage clinical service: 50%
Nuclear Medicine:
Faculty: Susanne Stieger-Vanegas, DVM, PhD, DECVDI Percentage clinical service: 50%
List the names and percentage clinical commitment of additional imaging faculty in the program, and their area(s) of instructional responsibility. For each imaging faculty in the program please provide a one page CV documenting their expertise in the area(s) of assigned responsibility.
For each of the specialty colleges listed below please list at least two Diplomates of these colleges who can be expected to regularly interact with radiology residents:
ACVIM
Associate Professor, Internal medicine (small animal and cardiology) Jana Gordon, DVM, DACVIM
Assistant Professor, Internal medicine (small animal) Craig Ruaux, DVM, DACVIM
Assistant Professor, Internal medicine (small animal) Chris Cebra, VMD, DACVIM
Professor, Internal medicine (large animal) Erica McKenzie, DVM, DACVIM
Associate Professor, Internal medicine (large animal) John Schlipf, DVM, DACVIM
Associate Professor, Internal medicine (large animal) Stuart Helfand, DVM, DACVIM
Professor, Oncology
Shay Bracha, DVM, DACVIM Assistant Professor
David Sisson, DVM, DACVIM Professor, Cardiology
Kate Scollan, DVM, DACVIM Assistant professor, Cardiology ACVS
Wendy Baltzer, DVM, DACVS
Assistant professor, Surgery (small animal, neurology exams and neurosurgery) Milan Milovancev, DVM, DACVS
Assistant professor, Surgery (small animal) Jennifer Warnock, DVM, DACVS
Assistant professor, Surgery (small animal, neurology exams and neurosurgery) Stacy Semevolos, DVM, DACVS
Associate professor, Surgery (large animal) Jill Parker , DVM, DACVS
Associate professor, Surgery (large animal) Katja Duesterdieck-Zellmer, DVM, DACVS Associate professor, Surgery (large animal) Michael Huber, DVM, DACVS
Associate professor, Surgery (large animal) ACVP
Susan Tornquist, DVM, DACVP Professor, Pathology (clinical) Elena Gorman, DVM, DACVP
Associate Professor, Pathology (clinical)
Christiane Löhr, Dr. med. vet., PhD, DACVP
Associate Professor, Pathology (Gross- and histopathology) Rob Bildfell, DVM, DACVP
V. Affiliation agreement:
If all of the training will not be accomplished on-site, please attach a copy of the affiliations agreement(s). Include the scope of the training and amount of time the resident will be away from the home institution.
VI. Facilities:
Small animal
• Computed radiography in 2 designated radiography rooms
• Mobile C-arm (2) for use in surgery suites and interventional cardiac studies • Advanced ultrasound system including 3D capability and 6 transducers
• 1 smaller mobile unit (Mylab) designated for small animal emergency service use • 64-slice multi-detector row computed tomography with Vitrea work station Additional resident training in small animal radiology will be performed with VDIC either remotely via telemedicine or on site in Clackamas Oregon. VDIC is located approximately 80 mile north of Oregon State University. VDIC is a private practice teleradiology service for digital and film radiographs. At this location, there are
approximately 3 ACVR board certified radiologists on-site and 20 located off-site. We will utilize the report writing and oversight system that they developed to fulfill the requirements of their alternative radiology residency program through ACVR. Specifically, the resident would gain training by writing radiology reports on
telemedicine and referral radiographs that would be evaluated by one of the on-site or remotely located board certified radiologist within 2-3 hours. During the 1 week blocks at VDIC, the resident would receive training by multiple ACVR certified radiologists at VDIC; however, they would at all times be under the direct supervision of John Feleciano, DVM, DACVR. The resident would spend approximately 1 of every 8 weeks at VDIC for a total of 6 months of the 48 month training period. In addition to film reading at VDIC, the resident will participate in one known case conference per week spent at VDIC. Our goal is to provide additional training in small animal radiology and to increase the number of ACVR diplomats who actively participate in the training of the resident.
• Nuclear imaging (IS2 gamma camera) with PC based Mirage software • 1 Tesla MRI unit
• Medical Grade monitor computer work stations with Merge eFilm DICOM viewer software
• PACS image storing system in house and off-site • Web-based off-site image access
Large animal
• Computed radiography in 1 designated large animal radiography room including a high output ceiling-mounted x-ray tube with linked Bucky. This is being changed in 2014 to DR with 2 Cannon wireless DR plates.
• Portable digital radiography developer system
• Two portable x-ray units and one high-output mobile unit • Mobile C-arm for use in surgery suite
• Advanced ultrasound system with 2 transducers
• 1 smaller mobile unit (Mylab) designated for large animal use
• 64-slice mulit-detector row computed tomography with equine table and Vitrea workstation
• 1 Tesla MRI unit – only available for large animals < 250lb
• Nuclear imaging (IS2 gamma camera) with PC based Mirage software • Medical Grade monitor computer work stations with Merge eFilm DICOM
viewer software
• PACS image storing system in house and off-site, • Web-based off-site image access
VII. Clinical resources:
Indicate the approximate number of patients seen annually by the home institution? 16,160
What is the annual imaging caseload? 5,244
Small animals (canine, feline) 74.3% Large animals (equine and food animals) 25.5%
Exotic animals 0.2%
What is the approximate annual imaging caseload of the program in:
Small Animal Radiology:2420
Small Animal Radiology- VDIC: 75,000 Large Animal Radiology: 730
Abdominal Ultrasound:900 Computed Tomography:860 Nuclear Medicine:5
Magnetic Resonance Imaging:125
Other (specify): Fluoro 25, Musculoskeletal Ultrasound 250
VIII. Training content:
What percentage of imaging reports are typically available within 48 hours after the examination is conducted in typewritten or electronic form? 100%
If your answer is less than 75% please explain how reports are generated and how long it takes for the report to be available for review in typewritten form.
Of the preliminary reports generated from the imaging caseload what percentage are initially produced by the resident? 80%
What percentage of resident reports are reviewed by the imaging faculty prior to finalization of the report? 100%
When preliminary resident reports are reviewed and edited by the imaging faculty responsible for training, what percentage of the time are two or more faculty present? 10%
Please complete the table below
Approximate number of cases in the 30 months clinical experience
Small Animal Radiology: 6050
Small Animal Radiology - VDIC 2400
Large Animal Radiology: 1825
Abdominal Ultrasound: 2702
Computed Tomography: 2,145
Nuclear Medicine: 13
Magnetic Resonance Imaging: 312
Elective (any of above) Optional 1 month Required elective (specify): Cardiology 2weeks (16)
Total 15,748
Please indicate the course number and unit assignment residents are required to take to meet the educational objectives for formal instruction as outlined in the Essentials in the following:
Topic Course number Units
Radiobiology: MP 583 RADIATION
BIOLOGY
4
The Physics of:
Diagnostic Radiology: MP 541. DIAGNOSTIC IMAGING PHYSICS
3
Nuclear Medicine: MP 541. DIAGNOSTIC IMAGING PHYSICS 3 Ultrasonography: MP 541. DIAGNOSTIC IMAGING PHYSICS 3 CT: MP 541. DIAGNOSTIC IMAGING PHYSICS 3 MRI: MP 541. DIAGNOSTIC IMAGING PHYSICS 3
If your program does not offer formal courses in any or all of these topics please indicate how these educational objectives for each are met. Use attached sheets if necessary.
IX. Research Environment:
Over the last 5 years, what is the average number of peer reviewed publications, on which the IMAGING faculty listed under Direction and Supervision in IV above, are included as authors? 6
What is the number of publications/submissions expected of a resident completing the program? 1
If this is an established program, what percentage of residents have made formal research presentations at the annual ACVR or equivalent national meeting? N/A
Is an advanced degree a requirement of the training program? Yes, a MS. The graduate degree will be completed concurrent with the 48 month residency training program. X. Educational Environment:
How many lectures or scientific presentations are expected of each resident during the course of their training?
Each resident is expected to present the findings of their research project at the ACVR meeting during their third year of training. Each resident is also required to give 1-2 presentations per year to house officers and faculty on topics relating to diagnostic imaging. Additionally, the residents have to give two lectures on selected diagnostic imaging topics to veterinary students on 4th year clinical rotation. Each resident creates and is the primary moderator for one lab session for the 2nd year veterinary student
curriculum, and they assist the laboratory portion of the 2nd and 3rd year veterinary student curriculum.
XI. Evaluation:
During the program how often is resident performance evaluated in writing? Twice yearly formal evaluations are performed.
House Officer Evaluation
Evaluating Clinician House Officer Evaluated
Evaluation for the period beginning: ending:
Exceptional Excellent Good Average
Needs Improvement (please comment) Unacceptable (please comment) Clinical Skills Patient Care Knowledge Enthusiasm/ Motivation Attitude Interpersonal Skills Overall Evaluation
Observations and comments XII. Teaching File:
What is the nature and scope of the teaching file available to residents?
Clinical images since 2005 are in a digital format and are available through the PACS system and the Veterinary Hospital System. A search function was recently added to the Veterinary Hospital System that allows all digital radiology reports to be searched for keywords in either the findings or interpretation sections of the reports. Interesting, unusual and teaching cases can also be indexed by keywords that can be searched in the Veterinary Hospital System and can be filtered as “teaching files”. These cases are directly linked to the PACS system for web-based image retrieval. A film archive of interesting cases and artifacts is also available on-site. The film archive is sorted by patient ID and log sheets are available. The film archive includes the previous 20 years.
How is it maintained/updated?
The teaching file is updated by faculty and technologists by adding keywords during image acquisition, report generation and report finalization. The artifact files are maintained by the faculty and technologist. The film archive is maintained by technologists.
XIII. Conferences:
On average how many Known Case Conferences are conducted annually? 36 XIV. Literature resources:
What is the geographic relationship between the nearest medical library and the training program?
What is the geographic relationship between the nearest medical library and the training program?
The McDowell Library is in the building, on-site. All relevant veterinary journals are available online or on-site through the library. Most reference books are available in the radiology reading room, those how are not in the radiology library can be found in the library of the College of Veterinary Medicine. An on-site scan and deliver service for articles not available via online or on-site retrieval is available to the resident.
XV. Appendix:
(a) Provide the pass rate for first time, second time, etc for both the preliminary and certifying exams for your residents for the past 5 years. For example, for all residents finishing your program 5 years ago (Year 5), check the appropriate box. Complete the table for residents finishing 4 years ago (Year 4), 3 years ago (Year 3), etc.
N/A
Year 5 Year 4 Year 3 Year 2 Year 1
Passed preliminary exam 1st time Passed prelim exam 2nd time
Passed prelim after 2nd time Passed certifying exam 1st time Passed certifying exam 2nd time Passed certifying exam after 2nd time Unsuccessful in all attempts
(b) Provide a clinical schedule for your resident(s). This schedule should provide a weekly or monthly outline of the resident’s clinical responsibilities. This may be in the form of a master schedule or duty roster for your entire radiology section if desired.
Clinical training year duties
Month 1 2 3 4
July 1 Rad tech / 3 Radiology 3 Radiology/ 1 VDIC 2 Cardio/2 Board prep 3 Radiology/ 1 VDIC August 3 Radiology/ 1 VDIC 3 Radiology/ 1 VDIC
Board prep Board prep
September Ultrasound Ultrasound Ultrasound CT/MR/NM
October 3 Radiology/ 1 VDIC 3 Radiology/ 1 VDIC 3 Radiology/ 1 VDIC 3 Ultrasound/ 1 VDIC
November Ultrasound Ultrasound Ultrasound CT/MR/NM
December 3 Radiology/ 1 VDIC 3 Off clinics/ 1 VDIC CT/MR/NM 3 Ultrasound/ 1 VDIC January CT/MR/NM CT/MR/NM CT/MR/NM CT/MR/NM February 3 Radiology/ 1 VDIC 3 Radiology/ 1 VDIC 3 Radiology/ 1 VDIC 3 Radiology/ 1 VDIC
March CT/MR/NM Off clinics Off clinics Ultrasound
April Ultrasound Off clinics 3 Off clinics/
1 VDIC
3 Off clinics/ 1 VDIC May 3 Off clinics/
1 VDIC 3 Ultrasound/ 1 VDIC 3 Radiology/ 1 VDIC Ultrasound June 3 Off clinics/
1 VDIC 3 Radiology/ 1 VDIC 3 Ultrasound/ 1 VDIC 3 Radiology/ 1 VDIC
Months with time at VDIC are split with 1 week at VDIC and three weeks in another clinical rotation. For instance 3 Radiology/ 1 VDIC = 3 weeks on Radiology at OSU and 1 week on small animal radiology at VDIC.
Off clinics time will be split between vacation (2 weeks/year) and research.
The first year resident will spend the first week working with the radiology technicians in order to learn the operation of the diagnostic x-ray equipment. After that the resident will work
under the direct supervision of ECVDI or ACVR diplomates. Approximately 1 week of every 8 will be spent working with the radiologists of VDIC. While at VDIC the resident will receive intensive training in small animal radiology via the in-house and telemedicine services provided at VDIC. While there, the resident will be trained by multiple ACVR diplomates, under the supervision of John Feliciano, DVM, DACVR.
