Frequently Asked Questions

Frequently Asked Questions


Q1. How many MSK MRIs the fellow will be able to dictate on an average day and what is the percentage of oncology cases approximately?

A1. It depends on each day because you have some days with procedures and other days without any procedures. If you have no procedure at all and are spending all day dictating, you can expect to dictate 20 to 30 MRI’s on a very busy day. In reality, you will be also reading other modalities including CT and Ultrasounds, so typically you will be reading a combination of those. Our Fellowship structure is such that you read all modalities every day, just like being an attending, but primarily focusing on MRI. 

The percentage of oncology cases will also depend on each day. However, we do have a large number of orthopedic oncology cases, thanks to referral and close connection with Orthopedic oncologist Dr. Fazel Khan. Typically, if you read 20 MRIs, then I would say 10 to 20 % of those (again variable on each day) can be oncologic imaging.

Q2. How frequent are the tumor boards?

A2. Twice a month, 1st and 3rd Tuesday morning at 7:00 am, we have a soft tissue sarcoma board with orthopedic oncologist Dr. Fazel Khan, other oncology/general surgeons, as well as radiation oncologists and pathologists. The conference is about 1 hour in length, we discuss 5 to 10 cases (variable), and MSK Fellow will be presenting radiological aspects of each case. Often, these are the cases MSK Fellow actually biopsied with IR attending already, or cases to be biopsied in the near future. 

Also, there is a monthly (every 4th Wednesday) orthopedic grand round which is actually an orthopedic tumor board attended by Orthopedic attendings, residents and fellows, MSK Radiology attendings and fellow, and a pathology attending and fellow. Typically, three cases discussed per conference. The orthopedic resident presents clinical aspects, MSK fellow presents radiology aspects, and pathology resident presents histopathological slides. This conference lasts about an hour as well.


Q3. How many procedures in an average day the fellow will be able to perform and what does the schedule look like? 

A3. Given there is only one MSK fellow, initially time priority is given to MSK procedures, particularly those with IR attendings such as CT-guided bone biopsy, bone marrow biopsy, US-guided soft tissue tumor biopsy, fluoro-guided kyphoplasty, etc. You might typically do one or two heavy IR procedures like those mentioned above per day. For example, kyphoplasty takes at least 2 hours from start to finish, and it will take more if one includes pre-procedure preparation and post-procedure care. On the other hand, more light MSK procedures (with MSK attendings) like arthrogram injection, joint aspiration, or joint steroid injection, you might be doing up to 5 to 6 of those per day. 

When those procedures are done, then MSK fellow will return to the reading room and dictate studies, mainly MRI, but also other modalities. Although MSK Fellow is expected to dictate as many MRIs as possible, in reality, it is not practically possible to dictate every single MRI because of procedures and we do have Radiology residents rotating to MSK so they will also be dictating studies. Together, we generally manage to dictate everything in a timely manner. 


Q4. Is there any elective time or optional training available?

A5. One-half day per week is allocated as an optional/elective time for MSK Fellow to suit their specific clinical and research interest with the approval of the MSK fellowship program director. For example, the past fellows have done the following activities using this half-day session. Prospective fellows are welcome to discuss potential options with the program director at the time of the interview as well as after the fellowship has begun.

  • Pain management procedures with the anesthesiology department
  • Didactic teaching of advanced MRI protocol applications and scanning with MRI physicist
  • Radiological research leading to publication and conference presentation
  • Focused clinical training such as dedicated MSK ultrasound scanning
  • Focused MSK interventional procedure training with IR attending (e.g. kyphoplasty)
     

Q5. Are there any elective time or optional training available?

A5. One half day per week is allocated as an optional/elective time for MSK Fellow to suite their specific clinical and research interest with the approval of MSK fellowship program director. For example, the past fellows have done following activities using this half-day session. Prospective fellows are welcome to discuss potential options with the program director at the time of interview as well as after fellowship has begun. 

  • Pain management procedures with anesthesiology department 
  • Didactic teaching of advanced MRI protocol applications and scanning with MRI physicist 
  • Radiological research leading to publication and conference presentation 
  • Focused clinical training such as dedicated MSK ultrasound scanning 
  • Focused MSK interventional procedure training with IR attending (e.g. kyphoplasty)