2020-2021 M3/M4 Course Syllabi
Radiology
COURSE NUMBER:
21 01 31
TITLE:
Interventional Radiology -ICE
This elective exposes the student to the broad range of diagnostic and interventional procedures performed by Interventional Radiology. Students will be active members of the clinical team that includes pre-procedural care, participation of select vascular and non-vascular procedures, and post-procedural care. Students will gain an understanding of patient selection, various therapeutic options, and the potential complications of interventional radiology procedures.
PREREQUISITES:
26920371 (FAMILY MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP), 26931472 (ACTING INTERNSHP-INT MEDICINE), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26980373 (SURGERY CORE CLKSP)

Completion of all third year clinical rotations, including general surgery. (Sub-Internship/Acting Internship) prior to IR rotation is highly preferred/recommended.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
DIRECTOR:
Seetharam Chadalavada, MD
ram.chadalavada@uc.edu
(513) 558-6180
MSB, E680
ADMINISTRATIVE SUPPORT PERSON:
Tosha Feldkamp
feldkatc@ucmail.uc.edu
5135586098
MSB, E688A
SITE(S):
UCMC - University of Cincinnati Medical Center
MAX ENROLL:
2 
ROTATIONS:
Rotation Dates Max
1 07/06/2020 - 07/31/2020 2
2 08/03/2020 - 08/28/2020 2
3 08/31/2020 - 09/25/2020 2
4 09/28/2020 - 10/23/2020 2
5 10/26/2020 - 11/20/2020 2
6 11/23/2020 - 12/18/2020 0
7 01/04/2021 - 01/29/2021 2
8 02/01/2021 - 02/26/2021 2
9 03/01/2021 - 03/26/2021 2
10 03/29/2021 - 04/23/2021 2
11 04/26/2021 - 05/21/2021 2

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
6:30a-6:30p, Monday-Friday
REPORT 1ST DAY:
You will receive email instructions on where to report the first day. However if you have not received an email one week prior to rotation start, please contact the coordinator.

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Clinical Experience - Inpatient (Nights)
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Journal Club
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
  • Ward Rounds
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
25% Attending Physician
20% Senior Resident
20% Junior Resident
10% Other Allied Health Professional(s)
25% Fellow Physician
FEEDBACK:
Elective director
ASSESSMENT:
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
Recommended texts:
    Image-Guided Interventions, Mauro et al, 2013
    The Practice of Interventional Radiology, Valji, 2012
    Interventional Radiology: A Survival Guide, Kessel et al, 2017
    Patient Care in Vascular and Interventional Radiology (Second Edition), by Waybill and Brown
    Handbook of Interventional Radiology Procedures, by Krishna Kandarpa
    Interventional Radiology (RadsCases), by Hector Ferral and Jonathan Lorenz
    Vascular and Interventional Radiology: The Requisites, by John A. Kaufman
Knowledge/Skills:
1.    Understand patient selection and therapeutic options within Interventional Radiology, including factors that determine if an interventional procedure is necessary and safe
2.    Be knowledgeable of the pre-procedural evaluation and post-procedural management of Interventional Radiology patients
3.    Identify potential complications of Interventional Radiology procedures
4.    Be familiar with current research projects in process and scholarly opportunities within Interventional Radiology
5.    Work with Interventional Radiology physicians, fellows, residents, technologists, and nurses to gain a better understanding of the team approach to interventional therapies.
At the end of the elective, the student should be able to:
6.    Discuss the risks, benefits, indications, and contraindications of IR procedures.
7.    Know the roles of fluoroscopy, ultrasound, and CT for IR procedures.
8.    Discuss dosing and reversal of moderate sedation.
9.    Discuss the drugs used in IR procedures including analgesics, anti-anxiety agents, vasodilator drugs, thrombolytic agents, and antibiotics.
10.    Know the basics of iodinated contrast, including alternatives to standard agents.
11.    Outline arterial and venous anatomy, including collateral routes, particularly in the visceral, peripheral, and renal circulation.
12.    Recognize common vascular normal variants.
13.    Define basic biliary anatomy.
14.    Discuss pathophysiology of biliary and genitourinary obstruction, peripheral vascular disease, venous thromboembolic disease, and abscesses.
15.    Understand and apply physics concepts that will allow for minimization of radiation dose to both patient and operator in the IR suite.
16.    Perform a directed history and physical (H&P) examination.
17.    Concisely document the H&P in the form of a consultation.
18.    Before performing interventional procedures, counsel patients and obtain informed consent (e.g., explain conduct and purpose for procedure, explain risks, benefits and alternatives, solicit and answer patient questions).
19.    Recommends appropriate procedures for common clinical conditions and scenarios, such as long-term venous access, fluid collection drainage, diagnostic venography and arteriography, and dialysis access interventions.
20.    Write the necessary pre- and post-procedure orders pertaining to each procedure.
21.    Premedicate patients with contrast allergy.
22.    Document (via Epic) the Operative Note. A standardized template is available for this purpose.
23.    Dictate an IR procedure report for each case that the student has participated in.
24.    Diligent follow up and rounding on patients who have undergone IR procedures and management of any post-operative complications.
Main Course Topics :
•    Learn how various imaging modalities are used to guide interventional procedures and know the indication for when each modality (e.g., ultrasonography, fluoroscopy, computed tomography) is used
•    Indications and contraindications for common interventional procedures, including but not limited to: venous access procedures, fluid aspiration and drainage, tube placement (e.g., gastrostomy), lower extremity arteriography, renal angiography, embolization, and more
•    Arterial and venous anatomy important to Interventional Radiology
•    Pre-procedural and post-procedural patient care
Procedures:
•    Demonstrate technical competence in the performance of basic vascular access procedures
•    Act as first or second assistants during procedures    

At the end of the elective, the student should successfully perform the procedures below with faculty supervision commensurate with experience and individual competence.
•    Image-guided drainage of fluid (paracentesis or thoracentesis)
•    Ultrasound guidance to obtain vascular access to veins and arteries.
•    Basic drainage technique (e.g., large abscess).
•    Basic ultrasound- and CT-guided technique for organ biopsy (e.g., random liver or kidney).
•    Basic guidewire exchange techniques.
•    Administer local anesthesia.
•    Appropriate suture technique.
•    Participation in at least one ½ day outpatient IR clinic

SAMPLE WEEK

Monday:
6:00AM 7:00AM Pre-rounds
7:00AM 7:30AM IR Board Rounds
7:30AM 6:00PM Cases/Procedures
Tuesday:
6:00AM 7:00AM Pre-rounds
7:00AM 7:30AM IR Board Rounds
7:30AM 6:00PM Cases/Procedures
Wednesday:
6:00AM 7:00AM Pre-rounds
7:00AM 8:00AM IR Teaching Conference
8:00AM 8:30AM IR Board Rounds
8:30AM 6:00PM Cases/Procedures
Thursday:
6:00AM 7:00AM Pre-rounds
7:00AM 8:00AM Hepatobiliary (Multi-disciplinary) Conference
8:00AM 12:00PM Cases/Procedures or Outpatient IR clinic (coordinated with Elective director/coordinator)
12:00PM 6:00PM Cases/Procedures
Friday:
6:00AM 7:00AM Pre-rounds
7:00AM 8:00AM Elective conference
8:00AM 8:30AM IR Board Rounds
8:30AM 6:00PM Cases/Procedures
SCHEDULE NOTE:

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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