Diagnostic Radiology

A message from the Program Director

Thank you for visiting Norwalk Hospital. We are pleased that our Diagnostic Radiology Residency Program is of interest to you, and we appreciate this opportunity to meet you, introduce you to our residents and faculty, and show you our hospital and department.

Our program has many unusual features. We are proud of our tradition of excellence in education and our reputation for outstanding clinical training.

We understand that the residency application and interview process is stressful, but we hope that your visit with us will be relaxing, informative, and even fun.

Please find out as much about us as you can. I will try to tell you what I think is most important, but also make a point of talking to our residents, especially between interviews and during lunch. They are honest and can help you figure out whether Norwalk Hospital would be a good choice for you.

If you think of any questions after you leave, please feel free to contact Anila Dalipi, our program coordinator, or any of our residents or graduates.

Sincerely,

Evan S. Wasserman, MD
Undergrad: Washington University in St. Louis, MO
Medical School: Albert Einstein College of Medicine
Internship: Massachusetts General Hospital, MA
Residency: Massachusetts General Hospital, MA
Fellowship: MSK/MRI—Massachusetts General Hospital, MA; Breast & Body Imaging—Memorial Sloan Kettering, NY

Overview

Norwalk Hospital’s residency in Diagnostic Radiology provides a clinically intense but highly supportive environment for resident training, which is essential to our educational philosophy and approach to teaching. The program consists of 10 radiology residents, three alternating with two in each of the four years. The teaching faculty is composed of 14 fellowship-trained radiologists.

The formal didactic education of our residents is extensive. In brief, the morning and noon lectures from our attending radiologists are excellent, with education further strengthened by several invited guest lecturers from neighboring institutions regularly lecturing each month. Residents are involved in preparing the weekly tumor board, an invaluable learning experience and great preparation for fellowship. We sponsor our residents to attend AIRP to learn radiologic-pathologic correlation. In addition to the board preparation provided by our faculty, our residents also attend multiple radiology board review courses and physics courses.

In the absence of fellows, residents gain a primary role in image interpretation, patient management, decision-making and performance of procedures. This front-line position enables our residents to acquire substantial clinical skills, and our graduates are eagerly sought for fellowships and attending positions in both academic and private practice settings. Our residents have been accepted for fellowship training programs at world-class academic medical centers, and have gone on to pursue successful careers in both academic institutions and private practice.

Curriculum

The first two weeks of training are purely didactic, consisting entirely of lectures in basics of radiology, radiation protection, and handling of emergency situations (particularly contrast reactions). The next six weeks are spent in abbreviated two-week rotations in ultrasound, computed tomography, and fluoroscopy. The remainder of the clinical rotations are in four-week blocks incorporating the usual subspecialties of diagnostic radiology. Many rotations are modality-based rather than organ-system based, which we feel reflects the way radiology is actually practiced.

Yale New Haven Hospital and NewYork-Presbyterian Morgan Stanley Children’s Hospital rotations, outpatient center rotations (advanced women’s imaging), and a one-month American Institute for Radiologic Pathology rotation are scheduled during the first, second, third, and first half of fourth year.

In their third and fourth years, residents have elective blocks, which can be used for additional  clinical  rotations  or  research.  It  should  be  noted  that  clinical  rotations  are  selected and arranged in order to facilitate and enhance each resident’s training and education; they are not based on merely fulfilling necessities of clinical coverage.

After  passing  the  CORE board  exam,  residents  may  elect  to  perform  one  or  more  mini-fellowships.

There are two learning conferences daily, usually a morning lecture and midday case conference. Most conferences are given by Norwalk Hospital’s faculty, but we also incorporate  guest  lecturers,  all  luminaries  in  their  fields,  including topics such as Pediatrics, Cardiac, Chest, GU, Ultrasound, MSK, and GI. The majority of lectures and teaching cases are stored on the hospital shared drive which are easily available for residents to review. A course in radiation physics and radiation biology is offered twice a week throughout the first year.

Interdisciplinary conferences with other departments are also held regularly,  usually on a monthly basis. As a Memorial Sloan Kettering cancer treatment site, we currently have joint conferences with pulmonary medicine, hepatobiliary and gastrointestinal surgery, gyn-oncology, heme-oncology, neurosurgery, breast oncology, and gastroenterology. Residents prepare and present cases for these interdisciplinary conferences on a weekly or monthly basis.

Research and Investigation

We feel residents should be encouraged, but not forced, to participate in research during residency training.  We are aware that four years is a relatively short time to become a competent clinical radiologist and to receive board certification. Almost all of our  graduates go on to their desired fellowship positions, and for some, that may be a more appropriate time to become seriously involved in research.  However,  it does seem that at least some involvement in investigation makes one a more critical reader and a more well-rounded physician. Accordingly, we try to encourage scholarly pursuits, but recognize that some individuals have greater interest and abilities in certain areas than others.  We require only that each resident prepare at least one paper suitable for publication during their four years of training. Most residents do more than this and some have prepared and published numerous projects.

Time is made available for research and investigation during electives and during research rotations at Norwalk Hospital and at Yale New Haven Hospital. Norwalk Hospital pays travel expenses for residents attending conferences for purposes of presenting a paper or exhibit.

We have an  Interdisciplinary  Research  Committee—which oversees and coordinates projects involving various departments, a departmental research advisor, and a hospital-wide research coordinator, biostatistician, and other support staff as needed.

On-Call Support

Residents begin taking call after 12 months of training, and after passing an oral and practical examination in required skills. 

CT scans performed after 10:00 p.m. are interpreted by attendings via teleradiology. Residents provide preliminary interpretations of scans performed before 10:00 p.m., but if clinical volume is high, or if the resident should be involved with some other clinical activity, studies are interpreted by teleradiology.  Residents cannot become  “backed up” or fall behind. This system allows residents to develop critical clinical skills to become an independent radiologist without excessive stress or exhaustion.

Two radiology attendings are always on call, one for general and one for interventional radiology. The on-call radiology attendings are happily and readily available for immediate consultation if the on-call resident requires assistance or has questions. Furthermore, because of the provided hospital housing, remote access to the PACS imaging network, and the close network we have as a radiology residency, senior residents are readily available for assistance and advice.

Housing and Benefits

Hospital Housing

In addition to a competitive salary, Norwalk Hospital provides highly subsidized housing. Residents receive an apartment in one of two buildings on the hospital campus, directly across the street from the hospital itself, at a very low cost. Hospital housing serves important functions, which relate indirectly to education. Because the apartments are on the hospital campus, residents who choose to live there have no commuting expense or excessive commuting time. With a great salary, residents can live comfortably for their four or five years of training at Norwalk Hospital. They are not forced to moonlight, borrow to make ends meet, or have to choose between beginning to pay back their student loans.

Because most of the residents live in hospital housing, it is common for junior residents to call upon senior residents to help out in some situations. This has proven most valuable in resident-to-resident teaching. House staff and fellows from other departments also live in the hospital-housing complex, which has consequently emerged as a social center for house staff and their families.
For the few that choose to live off-campus, Norwalk Hospital provides an additional monthly housing stipend of $370 per month.

Outpatient Center

The Diagnostic Radiology Department of Norwalk Hospital consists of the facilities at Norwalk Hospital itself and at Norwalk Radiology and Mammography Center, an outpatient facility. The Department, together with the outpatient facility, performs over 120,000 examinations each year, employing state-of-the-art equipment in all areas. Training at these two different facilities (inpatient and outpatient) enables residents to experience contrasting types of patients and diseases. This combination serves to broaden the resident’s clinical experience and practical skills.

Over the last several years, both the inpatient and outpatient departments completed major physical and technological renovations. Both centers are completely digital (film-less), with state-of-the-art equipment, voice recognition transcription, and PACS, RIS, and CAD enhanced systems. The combined centers operate a total of four CT scanners, four MRI scanners, four digital mammography units, multiple digital fluoroscopy suites, three nuclear medicine cameras, PET/CT, and state-of-the-art interventional facilities. We also have multiple Vitrea workstations, which enables us to evaluate both CT and MR images in multiple dimensions, and also create 3-D model reconstructions.

Norwalk Radiology and Mammography Center was designated a National Showcase by GE Healthcare for its “exceptional clinical expertise in breast health, use of the latest technology, and outstanding patient care.” The center was the only facility in Connecticut to receive this prestigious award. Both centers are accredited by the American College of Radiology.

PGY-1 Year

Norwalk Hospital permits many options for the required PGY-1 (internship) year. Any ACGME-accredited approved clinical year is acceptable. Many residents have completed their PGY-1 year in medicine or surgery, while some have completed transitional years.

Vacation and Conference Time

Annually, each resident receives four weeks of vacation and two personal days, in addition to one optional week of continuing medical education. Residents are solely in charge of scheduling their vacation time as they please. We only ask during certain critical months (first-year ultrasound rotation, fluoroscopy rotation, or during the month of June for first and second years) that you do not take a vacation during this time.

Residents are allotted a post-call day after a call shift. In addition, during scheduled calls on a weekday (Monday-Thursdays), residents are excused 2 hours before they are scheduled for their evening call shift in order to help relieve resident burnout.

Traditionally, holiday coverage is covered by the current 2nd-year residents (the eve and day of). In return, each eve/holiday call shift is converted into an “extra” vacation day for use by that resident.

Furthermore, as third-year residents, we are allotted time off to attend two board review courses of your choice that is reimbursed by the department. We are also allotted time off for fellowship and job interviews.

Benefits

Residents’ salaries are competitive and Norwalk Hospital provides highly subsidized housing. Medical, dental, life, and disability insurance are provided for house staff and their families.

All first-year radiology residents receive, from the faculty, a myriad of radiology textbooks deemed important for learning general radiology and passing the CORE exam.

For outside rotations, including the American Institute for Radiologic Pathology and clinical rotations at Yale New Haven Hospital and NewYork-Presbyterian Morgan Stanley Children’s Hospital, Norwalk Hospital and the faculty pay tuition, travel costs, and lodging. There is no expense to the resident.

A physics review and clinical review course for the ABR Core exam is fully reimbursed.

Moonlighting

Third and fourth-year residents are granted permission to moonlight at the outpatient Norwalk Radiology and Mammography Center. This is evenly split between the two residency classes. The radiology faculty covers the cost of obtaining the annual Connecticut Physician License required to moonlight for these residents. Residents are able to opt-out if they choose not to participate.

The moonlighting residents’ responsibilities include providing clinical care should a contrast reaction occur, and providing preliminary reads for the outpatient radiographs, ultrasounds, and CTs performed.

FAQs

See below responses to our most frequently asked questions regarding the Diagnostic Radiology Residency Program at Norwalk Hospital.

Q: What are the most positive features of your program?

A: Among many points:

  • Emphasis on resident education
  • Outstanding fellowship-trained faculty
  • Superior clinical training
  • Outstanding board passage statistics
  • Community, inpatient, outpatient, and university hospital rotations
  • State-of-the-art equipment
  • Outstanding outpatient center
  • State-of-the-art PACS, RIS, voice recognition, EMR
  • Great location
  • Congenial atmosphere
  • Teleradiology coverage on call

Q: What kind of applicant are you looking for?

A: Like most programs, we favor good students from good medical schools. Grades, evaluations, letters of recommendation and USMLE scores are all considered. However, since we are a close-knit and supportive department, we probably put more emphasis on personality than some other programs. We definitely look for the right fit. We do not discriminate against applicants with degrees in Osteopathy, applicants with unconventional backgrounds, or applicants with prior post-graduate training in other fields.

Q: How many candidates do you interview?

A: We interview a relatively small percentage of applicants selected through ERAS; 40 to 50 each year is typical. We like candidates to see our hospital, meet the faculty, and especially spend time talking with our current residents. Large groups would make this difficult. During interview days, candidates will be given a tour and may be shown on-campus apartments.

Q: Do you use grade or USMLE score or other cutoffs?

A: No. We consider each candidate as an individual. To do otherwise would be contrary to the philosophy of our program.

Q: What is the deadline for applications?

A: We have no absolute deadline but submission by November 15 is strongly encouraged. 

Q: What becomes of your graduates?

A: Most graduates go on to fellowship training in subspecialties at top institutions. The list includes Yale, Harvard, Johns Hopkins, Columbia, Stanford, UCLA, Brown, Mt. Sinai, Duke, UCSF, Mallinkrodt Institute of Radiology, etc. Our most recent residents have matched at the following programs:

2021

Breast & Body Imaging—Northwell Health, NY

Body Imaging—Thomas Jefferson University, PA

2020

Neuroradiology—Mount Sinai, NY

Breast & Body Imaging—Northwell Health, NY

Neuroradiology—Beth Israel Deaconess Medical Center, MA

2019

Interventional Radiology—Dartmouth Hitchcock Medical Center, NH

Breast & Body Imaging—Northwell Health, NY

2018

University of California, Irvine, CA – Musculoskeletal Radiology

Baylor Medical Center, Houston, TX – Breast Imaging

Northwell Health, NY – Musculoskeletal Radiology

 

2017

University of California, San Francisco – Neuroradiology

 

2016

Yale-New Haven Hospital – Neuroradiology

University of California San Francisco (UCSF) – Body Radiology

2015

Stanford University – Pediatric Radiology

Yale-New Haven Hospital – Neuroradiology

Medical University of South Carolina – Vascular/Interventional Radiology

2014

NYU Langone Medical Center – Neuroradiology

Harvard/Beth Israel Deaconess Medical Center – Neuroradiology

Yale-New Haven Hospital – Nuclear Medicine

 

2013

Duke University Medical Center – Neuroradiology

New York Presbyterian-Weill Cornell Medical Center/Memorial Sloan Kettering Cancer Center – Neuroradiology

2012

University of Maryland Medical Center – Thoracic Radiology

St. Francis Hospital and Medical Center – Body Radiology

University of Southern California – Vascular/Interventional Radiology

2011

University of Maryland – Women’s Imaging

Mt. Sinai Hospital – Neuroradiology

2010

New York-Presbyterian Hospital & Weill Medical College of Cornell University – Musculoskeletal Radiology

University of Southern California – Vascular/Interventional Radiology

 

2009

Yale-New Haven Hospital – Breast Imaging

Massachusetts General Hospital – Musculoskeletal Radiology

 

2008

Yale-New Haven Hospital – Women’s Imaging

Thomas Jefferson University – Neuroradiology

 

2007

Thomas Jefferson University – Body Imaging

Columbia University – Body Imaging

 

2006

Yale-New Haven Hospital – Abdominal Imaging

Yale-New Haven Hospital – Women’s Imaging

 

2005

Columbia University – Neuroradiology

Mallinckrodt Institute of Radiology – Nuclear Medicine

Q: Do you sponsor J-1 and/or H-1 visas?

A: The residency program has accepted J-1 visas. In regard to H-1 visas, we do sponsor those on occasion, but that would be determined with the Residency Program Director at the time of the interview. We prefer that all requirements for the H-1 visa be completed before we sponsor such a visa, i.e., you should plan to take the USMLE Step 3 exam before applying.

Q: Do you accept applications from international medical graduates?

A: Yes. Although the majority of our residents are from U.S. medical schools, we have had several excellent international graduates in our program over the years, and we value diversity. Educational and/or clinical experience in this country strengthens one’s application considerably. There are several requirements prior to consideration for international medical graduates. An ECFMG certificate and an ACGME-accredited clinical year are required (Internal Medicine, Surgery, Pediatrics or Transitional).

We participate in the ERAS program, and paper applications are not accepted. Learn more about the ECFMG-ERAS program.

Q: How many residents per year are accepted?

A: Two alternating with three, resulting in a total of ten residents.

Q: What is your call frequency?

A: Because we are a small residency, call may be more frequent than at some larger programs. Call is front-loaded to give younger residents more experience, and allowing less call for more senior residents studying for their board examinations. We believe that on-call experience is necessary for training but that call need not be exhausting or abusive. Studies after 10 p.m. are read by teleradiology.

Q: What kind of conferences do you have, and how often?

A: We have two conferences a day with our faculty – a morning lecture (usually didactic) and a noon conference during which cases are presented. In addition, we have several regular guest lecturers (some of whom are Board Examiners) who give us monthly conferences on Ultrasound, GI, GU, Cardiac, Chest, and Pediatrics. Inter-departmental tumor boards with the Internal Medicine residents, GI and Pulmonary fellows also occur on a monthly basis. This averages out to approximately 2-3 hours of dedicated resident education per day.

Q: Are there any areas where you feel your education could be improved?

A: Norwalk Hospital has a surprisingly broad spectrum of cases. To round out our educational experience, we spend time at Yale-New Haven Hospital and Columbia University’s Children’s Hospital of New York distributed throughout the residency. Neuroradiology and pediatric radiology are the primary focuses at these institutions, respectively. We work side-by-side with Ivy League faculty, with the same privileges and responsibilities as their residents.

Q: What is the difference between a systems-based and modality-based approach?

A: We have a modality-based education at Norwalk Hospital. What this means is that we learn based on the study modality (CT, MRI, US, etc.) rather than on a body system (GI, GU, cardiac, etc.). This leads to a much more practically oriented education, especially for people interested in a private practice setting.

Q: Do residents have much autonomy?

A: In terms of radiology, everything we review as a resident is over-read by an attending. Regarding procedures, residents can exercise their own discretion as to how involved they get after competency is obtained. As residents become more proficient in procedures, more independence is allowed in performing them (there are no fellows) – to the comfort level of the resident. Regarding residency issues, we decide our own call schedule and vacation times.

Q: What kind of support do you get from your faculty?

A: Our faculty is very supportive. They are responsive to our educational wants and needs, and they tailor their lectures to reflect this. Texts and educational DVDs and CD-ROMs are available in the department library, and can be ordered if felt to be of benefit to resident education. Radiology board preparation is outstanding from our faculty.

Q: What other perks does your program offer?

A: Where to begin?

  • 23 days of vacation (four weeks and three personal days; four if a holiday is worked)/year
  • Five days CME/conference time/year
  • Ability to decide when to take vacation (with only minor restrictions on timing)
  • Ability to decide call schedule (with compromises to other residents, of course)
  • Excellent text package – the faculty provides a set of texts for the new residents. This previously included the entire Requisites and Case Review series, but resident input has altered this to reflect texts more useful for resident education.
  • Stipends provided during Yale rotation months ($400/month), housing at the Columbia pediatric radiology rotation, and one of the most generous stipends among radiology programs for the AFIP conference ($3,500 in addition to tuition).
  • Three review conferences subsidized by the program (up to $1,500 each), plus a physics review course, plus a radiobiology review course.
  • The faculty encourages research; if research is presented at a conference, the program will cover the fees.
  • Location; one hour by train, 45 minutes by car (depending on traffic) to Manhattan; 2.5 hours to Boston. South Norwalk offers a variety of upscale dining and a lively weekend nightlife (young professional scene)

Q: What is the benefit of NOT having radiology fellows at Norwalk Hospital?

A: More advanced and versatile residents.

  • With no fellows in the way, residents gain direct, hands-on training in diagnostic and interventional procedures that are otherwise reserved for fellows in other programs. 
  • The relationship between faculty and residents is close and personal, with attendings working one-on-one with residents throughout each day.  Discussion, suggestions, and example lead each resident to a high level of clinical competence and confidence.