Vascular and Interventional Radiology
Fellowship Director: Divya Sridhar, M.D.
Vascular & Interventional Radiology
Department of Radiology
NYU Langone Medical Center
HE-221, 560 First Ave
New York, NY 10016
Office: (212) 263-5898
Fax: (212) 263-7914
The Vascular and Interventional Radiology (VIR) fellowship at the NYU Langone Medical Center is a one-year training program. Three ACGME-approved fellows are accepted annually. The training is clinically oriented, with the workday being a combination of routinely scheduled cases supplemented by add-on urgent and emergency studies.
The training philosophy is one of graded responsibility. The fellows are given responsibilities commensurate with their level of training, experience, and interest; they are considered attending physicians-in-training. Fellows have the primary clinical responsibility to assess all patients and answer patient questions prior to procedures (alone or with the attending physician); review all pertinent medical records, laboratory and imaging studies; assist in and/or perform the procedures; manage patients in the post-procedure and long-term post-procedural period. Prior to each procedure, the case is thoroughly discussed with the attending physician to ensure that it is appropriate, no contraindications exist, and informed medical consent has been obtained. The fellow initiates procedure planning including guidance techniques and instrumentation. Each procedure is performed by one fellow and one attending physician, ensuring a preceptor-like arrangement where trainees' progress can be closely monitored with instruction on a one-to-one basis. After having gained the necessary level of competence and expertise, the fellow's role shifts from assistant to primary operator, assisted and guided by the attending physician staff.
Post-procedural care and patient follow-up are strongly emphasized. Hospital rounds are made at least once daily, seeing patients who have undergone procedures earlier on the same day and patients who are being followed on an ongoing basis. This includes patients primarily admitted to the VIR Service as well as medical and surgical patients who have undergone interventional procedures. Patients seen in initial clinic consultation and those having longitudinal follow-up outpatient care are also seen by the attending staff and the fellow in the Vascular and Interventional Radiology clinic.
Clinical experience is gained in three hospitals: Tisch Hospital (NYU's teaching hospital), Bellevue Hospital (the flagship institution of the New York City Health and Hospitals Corporation), and the Manhattan Campus of the New York Harbor Healthcare System's Veterans Affairs Medical Center. The latter two institutions serve as the regional referral centers for chronic liver diseases. Two fellows are assigned to Tisch Hospital and the third is assigned to Bellevue and the Manhattan VA Hospitals. This rotation changes on a weekly basis. At each site, the fellow is the first to be called for after-hour emergency vascular or interventional procedures. Attending physician consultation and backup are provided at all times. A one-month rotation elective is dedicated to non-invasive imaging (CTA, MRI/MRA). The Tisch Hospital VIR service is supported by physician extenders including a nurse practitioner, physician assistant, and a registered radiology assistant.
Didactic and interactive instructions are carried out on an ongoing basis. In addition to discussing studies as they are performed, daily fellow case review sessions are conducted. Biweekly VIR conferences are held among the attending and fellow physician and physician extender staff. Radiologic morbidity/mortality conferences are conducted monthly. Weekly combined service conferences are held each week with the Division of Vascular Surgery, Pulmonary Oncology, and other regular held conferences are held with the GI Malignancy Group (medical and radiation oncology, surgical oncology, interventional radiology). A monthly multidisciplinary conference is held in conjunction with Transplant Surgery, Hepatology, Hepatobiliary Surgery, Oncology, and Pathology. Fellows are encouraged to attend the radiology department's two daily noon conferences and weekly CT/MRI conferences, which includes a full series of didactic lectures encompassing vascular and interventional radiology.
Fellows gain experience with the entire spectrum of Vascular and Interventional Radiology, especially Interventional Oncology, including image-guided biopsies, tumor embolization and thermal ablation (radiofrequency, cryo- and microwave ablation). A broad experience in dealing with oncologic cases is obtained by working closely with the Department of Surgery and the Division of Medical Oncology. Experiences include biliary and genitourinary (GU) drainage procedures, and embolization/chemoembolization techniques. These patients are followed closely throughout their entire hospital and outpatient course.
A very active service exists in trans-jugular portosystemic shunt (TIPS), balloon retrograde trans-venous obliteration of varices (BRTO), percutaneous biliary interventions (including drainage, stenting, stone extraction), uterine artery embolization (UAE), and inferior vena cava filter placement and retrieval. Venous interventions performed include thrombolysis, angioplasty, stenting, and placement of chest ports and tunneled catheters. Vertebroplasty and kyphoplasty are also performed in our section. In conjunction with the Section of Interventional Neuroradiology, the fellows also have the opportunity to train in carotid artery stenting.
A close working relationship exists with the Department of Urology, and the VIR section performs percutaneous nephrostomies, stenting, stone removal, cyst and abscess drainage, and renal biopsies. A very active Tuberous Sclerosis Center affords a great case load of renal angiomyolipoma (AML) embolization and management. The VIR attending physicians (including the fellows) frequently function as the "primary care" providers for patients with indwelling biliary or GU catheters.
All fellows are entitled and encouraged to attend one major national meeting. They are encouraged to conduct research for publication and presentation at national and international meetings. Academic time can be set aside to further such research endeavors for the interested fellow. In addition, there are many conferences on Vascular and Interventional Radiology in the immediate area that are easily accessible, including the monthly New York Angio Club meeting. A monthly journal club is also held, for teaching fellows skills in critical appraisal of the medical literature.
The major strength of NYU's fellowship program is the comprehensive experience and preparation for the training fellows, with no fragmentation of procedures to other services, from biopsies to TIPS creation. Each of the three fellowship program institutions offers a unique case load and experience, with the training fellow securing a wealth of experience for the confidence and readiness of the first year of practice.
The Vascular & Interventional Radiology fellowship participates in the NRMP matching program.
View the Schedule of dates for the Radiology Fellowship Match on the NRMP website.