PGY4 Pediatric Radiology

Supervisor:                           Dr. Nicole Hughes, Janeway

The assessment tools utilized during the rotations include global faculty ratings including the ITER rotation evaluation sheet. An examination assessing knowledge obtained as per the listing curricula at each stage of training will be given on the last day. The examination will assess the acquisition of knowledge throughout the rotation. A pass mark is 70%. The inability to pass the exam will render the rotation incomplete, and the rotation will be completed at a later date. 360 degree evaluations by the pediatric technologists will also be included in the ITER evaluation sheet. This will also include nursing staff.  A print out of the complete required modules from the online curriculum will be required.

Completion of Daily Encounter Cards (ITERs) are required for each day of this rotation.  These cards are located in the residents' reporting area of the Janeway.

Duties and Responsibilities

Report emergency films daily early a.m.

Fluoroscopy list 2 days per week minimum.

Ultrasound approximately 2 days per week minimum.  The resident should be capable of scanning independently and obtaining diagnostic images.  The resident should provide an image of a normal appendix scanned personally by the end of the rotation.  The resident is responsible for reporting the majority of ultrasounds on scheduled ultrasound days.  At least one morning per week (minimum) hands-on scanning.

CT approximately 2 days per week. The resident will review all CT requisitions and decide on protocols with the staff person. The resident will supervise and subsequently report all a.m. CT’s on scheduled days.

MRI – the resident will review and report the majority of pediatric MRI’s performed during the rotation.

Report non-emergent/ICU general radiology as time permits.

The resident will be responsible for the same rounds and teaching file responsibilities as in the PGY2 rotation.

Completion of online curriculum.


Required Reading List

  1. As per PGY2 rotation
  2. Appropriate sections on pediatric and obstetrical ultrasound – Rumack and Wilson
  3. Appropriate sections in CT book – Lee, Sagal and Stanley
  4. Pediatric Body CT – Daneman
  5. Pediatric Neuroimaging – Barkovich
  6. MRI in Pediatric Neuroradiology – Walpert, Barnes
  7. Imaging of the Pediatric Head, Neck and Spine – Castillo Mukherji
  8. Pediatric Sonography – Siegel
  9. Other departmental reference texts



 Please read the corresponding RSNA physics module, as outlined in the physics curriculum



  1. Medical Expert
  2. Communicator

Become competent in interpreting plain films and performing basic procedures; namely, barium swallows, UGI’s and follow-throughs, enemas, VCU’s and IVP’s, and fluoroscopy.

Be aware of how to tailor any general procedure to answer the specific clinical concerns, be aware of radiation dosage and individual exposure in pediatrics.

Learn contrast dosage and treatment of reaction in the pediatric population.

Increase knowledge of anatomy and pathology related to organ systems with specific attention to the pediatric population.

Familiarize yourself with ultrasound/CT/MRI examination for pediatric conditions and related protocols.

Complete Pediatric Radiology online curriculum sections for Senior Resident, as well as Upper Airway Inflammation, and Inflammatory Neck Lesions and pediatric brain tumor sections in Barkovich.  Provide print out of completed courses.

The website can be accessed at:

Provide analgesia and sedation to pediatric patients when appropriate (MRI and CT).

Be able to read plain film studies of pediatric patients including the chest and musculoskeletal system.


Establish a therapeutic relationship with patients and communicate well with family.  Provide clear and thorough explanations of diagnosis, investigation and management.

Produce succinct reports that describe findings, most likely diagnosis, and, where appropriate, recommend further investigation or management.

Develop techniques for communication with apprehensive pediatric patients and parents.


  1. Collaborator
  2. Manager

Establish good relationships with peers and other health professionals.  Effectively provide and receive information.  Learn to deal with conflict situations.

The skills of being a collaborator are developed on a day to day basis.  Residents are strongly encouraged to interact with house staff and referring physicians as “first contact” in order to better develop these skills.  In addition, residents will be required to be active participants in inter and intra discipline rounds.

Consult effectively with other physicians and health care professionals.

Contribute effectively to other interdisciplinary team activities.



Learn competence in and make use of computer science/information technology as it pertains to Diagnostic Radiology.

Learn to set realistic priorities and use time effectively in order to optimize professional performance.

Understand the fundamentals of quality assurance.

Utilize resources effectively to balance patient care, learning needs, and outside activities.


  1. Health Advocate
  2. Scholar

Learn to recognize the Radiologist’s role in ensuring appropriate radiological investigation and to act as an advocate for patients in terms of their diagnostic imaging needs.

Understand and communicate the benefits and risks of radiological investigation and treatment, including population screening and the risk of radiation exposure to the pediatric population.

Recognize the burden of illness upon the patients served by Radiology.

Benefits/risks of radiologic investigation.  Consult CAR and ACR appropriateness guidelines.


Demonstrate an understanding and a commitment to the need for continuous learning. 

Develop and implement an ongoing and effective personal learning strategy.

Be able to critically appraise medical information and demonstrate basic knowledge in biostatistics and experimental design with respect to Radiology.

Demonstrate an ability to be an effective teacher of radiology.

Work up cases for the teaching file and identify a potential research project with supervisors.


  1. Professional

Demonstrate integrity, honesty, compassion and respect for diversity.

            Fulfill medical, legal and professional obligations of a Diagnostic Radiologist.

Demonstrate timeliness, reliability and conscientiousness.

Understand the principles of ethics and apply these in critical situations.

Demonstrate an awareness of personal limitations, seeking advice when necessary. 

Accept advice graciously.