The most exciting aspect of Radiology as a field is that it is constantly evolving and, as a result, residency training must keep pace. Despite being at the forefront of medical technology, most residencies continue to conform to an apprenticeship model of medical training. At Stanford, we are increasing simulation and deliberate practice based resident learning to complement the traditional apprenticeship model. Ultimately, we envision airline pilot training: centered on controlled, pre-selected, and directed cases. This year we have dedicated more didactic hours to simulation-based training than ever. We have continued exploring ways of augmenting our day-to-day learning in different sections: musculoskeletal imaging has a checklist of diagnoses and joints that are expected to be discussed over the course of a rotation; breast imaging has an enriched screening dataset with pathology-proven diagnoses; thoracic imaging has developed a month-long curriculum of cases that are viewed by residents and discussed as if they are de novo cases and tracked over the course of the month to ensure broad and representative exposure. In addition, we are fortunate to be able to experience a large (and growing) number and variety of de novo cases, given the growing practices associated with our residency, which include community- and county-hospital practices, quaternary care, and now population-based health. These are just a few examples of how we are moving toward a more deliberate residency training experience.

Residents from the various clinical sites meet together weekly for a five-hour block conference at Stanford, with lunch provided by the department. The sections have been working on a revised curriculum to maximize the benefit of this type of exposure. This format has the added benefit of bringing our residents together on a regular basis outside of the clinical environment and to date has been a very popular. We have continued the peer learning component of the conferences, which has remained a favorite. Examples of simulation-based training include partnership with the Stanford Center for Immersive and Simulation-based Learning to practice contrast reactions in the CT or MRI environment or radioactive spills. Ultrasound club gives residents the opportunity to learn how to scan with experienced technologists using each other as models. Breast imaging and interventional radiology perform biopsy and vascular access practice.

During the first three years of residency, trainees rotate through all clinical subspecialties of radiology including pediatrics, emergency radiology, genitourinary, gastrointestinal, chest, musculoskeletal, interventional/angiography, neuroradiology, cardiovascular, mammography, ultrasound, abdominal CT, and MRI. Residents spend the majority of time at Stanford Hospital and associated outpatient clinics, with additional rotations at the VA Palo Alto Health Care System and Lucile Packard Children’s Hospital. Our residents also rotate to the Santa Clara Valley Medical Center for rotations in mammography and emergency radiology. All residents have the opportunity to take a four-week subsidized elective at the Registry of Radiologic Pathology at the American Institute for Radiologic Pathology (AIRP) in Washington DC, which has been virtual in the COVID era.

We have continued to improve the core radiology clinical training experience in order to expand the ability of our fourth-year residents to experience early clinical subspecialization of their choice, including nontraditional pathways. Some residents have chosen to pursue early subspecialization in a single field such as neuroradiology or interventional radiology. Some have chosen to use this time to enhance several aspects of their clinical exposure, while others have included research endeavors, biodesign, leadership, and quality “mini” fellowships during their fourth year. We are proud to be able to allow a lot of flexibility in support of residents who wish to tailor their clinical experience.

This year we look forward to continued recruitment into the Interventional Radiology residency. In addition, have recently been approved by ACGME to expand our Early Subspecialization in IR (ESIR) pathway to up to 3 DR residents. This option is designed for our diagnostic radiology residents who start undecided or wish to consider the possibility of training in a different location in their last year of IR training. Almost all of our ESIR residents have chosen to stay at Stanford for their independent IR year.

Dedicated research time is available to residents over the course of the four years. Residents are encouraged to participate in a wide range of departmental research efforts, including Molecular Imaging Program, Canary Center, and Radiological Sciences Laboratory, and the Center for Artificial Intelligence in Medicine & Imaging among others. Many of our research minded residents successfully compete for competitive grants, both internal and external. A larger range of departmental research opportunities may be found here. Residents regularly travel to and present at major national radiology meetings and publish their work in peer-reviewed journals with faculty and financial support from the Department.