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Radiology - Diagnostic


At A Glance

Program Type: Military Medical Center

Location: San Antonio, TX

Accredited: Accreditation Council for Graduate Medical Education (ACGME)

Program Length: 4 years

Required Pre-Requisite Training: Medical School graduation, PGY1 internship completion. All applicants must be active duty members of the U.S. Military.

Categorical Year in Specialty Required: No

Total Approved Complement: 40

Dedicated Research Year Offered: No

Medical Student Rotation Availability: 3rd and 4th Year

Additional Degree Concurrent with Training (e.g. MPH): No

Our Residents in Action

Program Description

The San Antonio Uniformed Services Health Education Consortium radiology residency is a four-year program training up to 40 total residents. Each year group is made up of 8-10 residents. Residents rotate monthly through various imaging services including emergency imaging, neuroradiology, thoracic imaging, abdominal imaging, musculoskeletal imaging, pediatric imaging, ultrasound, interventional radiology, mammography, nuclear medicine, electives, and research. Residents spend the majority of their clinical time at Brooke Army Medical Center on Fort Sam Houston and at Wilford Hall Ambulatory Surgical Center on Lackland Air Force Base. During their first and third years, residents experience month-long rotations at Texas Children’s Hospital in Houston, Texas. As a top tier tertiary pediatrics referral center, TCH exposes trainees to diverse, complex, and rare pediatric imaging diagnoses. During their second year, resident rotate through San Antonio’s University of Texas Health Science Center abdominal imaging section. This rotation serves as an introduction to transplant imaging.

The SAUSHEC radiology department is comprised of approximately 45 attending radiologists, the majority of which have completed subspecialty fellowship training. Graduate medical education is a top priority at SAUSHEC with 7-8 hours of protected lecture time per week. Teaching methods include formal faculty-led didactics/case-based learning, resident-led conferences, and one-on-one apprenticeship training at the workstation.

BAMC is the Department of Defense’s only Level 1 Trauma Center that serves the greater San Antonio area. During their emergency room rotations and on-call shifts, residents interpret a high volume of trauma imaging in addition to nontraumatic emergency imaging. As compared to all other military treatment facilities, BAMC has the highest volume and greatest complexity of cases. SAUSHEC radiology generates approximately 340,000 imaging studies annually. Additionally, BAMC serves as a teleradiology hub for small clinics and remote sites not staffed by radiologists.

Mission, Vision and Aims

Mission

To develop competent, board-eligible, military Diagnostic Radiologists prepared to serve the military community in a spectrum of stateside and foreign environments to provide expert care for the general and military-specific needs of our warrior population but also their dependents and retirees.

Vision

SAUSHEC Radiology will lead the DOD as the premier training site for competent, top-tier diagnostic radiologists.

Aims

Training within SAUSHEC Radiology includes but is not limited to the following aims:

  • To provide the most rigorous clinical training to residents as the military’s largest and busiest radiology residency, garnering the most complex patients in the DOD.
  • To ensure residents are expertly trained in all aspects of trauma imaging at the DODs only Level 1 Trauma center, and to produce deployment-ready radiologists for the 24/7 ops of deployment where mass casualties are frequently encountered.
  • To foster a culture of scholarship and learning, emphasizing the importance of lifelong learning.
  • To recruit the next generation of radiology residents through engaging rotations, mentorship, research collaboration, and other medical student/intern outreach efforts.

Curriculum and Schedules

There are one-hour faculty-led noon lectures on Monday, Wednesday, and Friday. There is a two-hour block of faculty-led lectures on Tuesday from 8 – 10 a.m. There are one-hour resident-led lectures on Tuesday morning from 7 – 8 a.m. and on Thursday at noon. Resident-led lectures include chief resident forums, Core Radiology review series, journal clubs, morbidity & mortality conferences, and interesting case conferences. The first-year residents have an additional hour of physic lectures every week. In total, there are 7-8 hours of protected lecture time every week. 

The radiology curriculum is supplemented with an annual two-week block of non-interpretive skills lectures including research principles, wellness, professionalism, military concepts, and quality improvement/patient safety.

Radiology residents complete a total of 13 4-week radiology rotations each year. The five rotation sites, rotation abbreviations, and elective/vacation comments are listed below the radiology residency block diagram. 

Radiology residency rotation schedule per year.
1st Year 3nd Year 3rd Year 4th Year
  • Interventional Radiology
  • Nuclear Medicine
  • Chest (2 blocks)
  • Ultrasound (3 blocks)
  • Neuroradiology (2 blocks)
  • Body
  • Musculoskeletal Imaging (2 blocks)
  • Pediatric Radiology
  • Interventional Radiology
  • Research
  • Breast Imaging
  • Pediatric Imaging (2 blocks)
  • Chest
  • Ultrasound
  • Musculoskeletal Imaging
  • Body (2 blocks)
  • Neuroradiology
  • Nuclear Medicine (2 blocks
  • Interventional Radiology
  • Cardiac
  • Chest
  • Ultrasound
  • Musculoskeletal Imaging (2 blocks)
  • Body
  • Neuroradiology (2 blocks)
  • Breast Imaging
  • Nuclear Medicine
  • Pediatric Imaging
  • American Institute of Radiologic Pathology Course
  • Interventional Radiology
  • Pediatric Imaging
  • Emergency Medicine Imaging
  • Chest
  • Ultrasound
  • Musculoskeletal Imaging
  • Body
  • Neuroradiology
  • Nuclear Medicine
  • Breast Imaging (2 blocks)
  • Elective (2 blocks)

Residents are given two elective months in their 4th year. They may choose any of the core rotations as an elective month. They may also design a unique radiology-centered elective rotation or perform radiology-relevant research. Examples of resident-designed electives include radiology economics, Artificial Intelligence, and Computed Tomography (CT) dosimetry research.

On-call residents are supervised by in-house faculty radiologists 24/7/365. First year residents begin taking 4-hour buddy-call shifts in the winter of their first year as an introduction to the on-call experience. In the spring, they begin taking full call shifts including overnight shifts, swing shifts, and weekend day call shifts. Call weeks are comprised of seven 10-hour overnight or swing shifts. Weekend day call shifts are comprised of two 10-hour shifts. Holiday call shifts are 11 hours long. Residents take between 40-60 call shifts annually, most in their second year. After a week of overnight call, residents are granted one comp day plus two weekend days to recover.

The BAMC level 1 trauma experience simulates battlefield injuries and prepares residents for deployments. The most military-relevant traumatic mechanisms of injury include ballistic trauma and high velocity motor vehicle collision trauma. Radiology residents work closely with trauma surgeons to provide preliminary interpretations at the Computed Tomography (CT) scanner. The close working relationship between radiology and the trauma service helps to foster a rich teaching environment.

The musculoskeletal imaging service prepares residents to interpret complex sports-related orthopedic injuries as well as follow-up postoperative imaging. This skill set is military-relevant as these injury patterns are commonly encountered during operational military training, particularly among basic trainees.   

During the noninterpretive skills lecture series, residents join experienced active duty and retired military radiologists for round table discussions. Topics include professional development, radiology in the deployed setting, and hospital leadership. 

The American Institute of Radiologic Pathology is a mandatory 4-week virtual or in-person course that provides pathologic correlates to imaging findings. The in-person course takes place in Silver Spring, Maryland.

First year residents participate in an on-call radiology simulation at the workstation to gauge preparedness to begin taking call. Each resident is given 4 hours to interpret a list of 50 cases consisting of commonly encountered emergency room diagnoses.

Residents on the interventional radiology rotation participate in surprisingly realistic image-guided interventional simulations that develop relevant procedural skills, particularly endovascular procedures.   

The leadership curriculum is embedded in the noninterpretive skills block of lectures and includes the following topics: communication skills, conflict resolution, professionalism, leader development courses (USU), round table discussions, emotional intelligence, and organizational change.

Scholarly and Professional Development Opportunities

The SAUSHEC radiology department prioritizes scholarly activities and fosters an environment of scientific curiosity. Residents are expected to complete one research project during their residency with the goal of publication. The government incentivizes scholarly activities by funding travel for first authors/presenters to attend conferences. Residents are entitled to one government-sponsored conference per year if their work is accepted. The SAUSHEC radiology department associate program director for research promotes research by helping residents navigate the process. Residents are granted administrative time, elective time, and dedicated research time to develop new research projects, or they may choose to join an ongoing project. 

SAUSHEC residents are expected to participate in quality improvement/patient safety (QIPS) projects. Residents frequently identify processes or systems that could be improved. Once identified, a QIPS project is proposed and developed with the help of the radiology QIPS associate program director and radiology QIPS nurse. Some residents may have the opportunity to participate in a real or simulated Root Cause Analysis. All radiology residents participate in Morbidity & Mortality (M&M) conferences.   

In addition to the noninterpretive skills lectures, residents engage in professional development in tumor boards, risk management meetings, internal radiology department meetings, GME subcommittees, joint conferences, and round table leadership discussions.

Radiology faculty provide ad hoc professional development lessons at the workstation and in the performance of clinical duties.

Participating Sites

  • Brooke Army Medical Center
  • Wilford Hall Ambulatory Surgical Center
  • Texas Children’s Hospital
  • University of Texas Health Science Center at San Antonio
  • Audie L. Murphy VA Medical Center

Applicant Information, Rotation and Interview Opportunities

Rotating medical students and interns spend one month in the Brooke Army Medical Center (BAMC) radiology department shadowing residents and faculty in their choice of four, one-week-long rotations on any of the following imaging services: neuroimaging, cardiothoracic imaging, pediatric imaging, interventional radiology, abdominal imaging, musculoskeletal imaging, ultrasound, or nuclear medicine imaging. Rotators learn basic radiology principles including appropriate ordering practices, basic imaging interpretation, communication of results, and follow-up recommendations. They also learn how radiology fits into the overall practice of medicine. We ask rotators to present a 5–10-minute interesting case PowerPoint in their last week. The typical duty day for medical students begins at 7:45 a.m. and ends at 1 p.m. We provide hands-on dictation opportunities on the cardiothoracic and musculoskeletal services, an opportunity for medical students to actively participate in generating radiology reports. We encourage rotators to seek out faculty or resident mentorship and engage in scholarly activities during their afternoons. Rotators who are applying to radiology residency programs are encouraged to reach out to the Program Director to schedule a face-to-face interview. We look forward to meeting you!

To schedule a rotation, e-mail: usarmy.jbsa.medcom-bamc.mbx.saushec-clerkship@health.mil.

Please meet with the Program Director at the beginning of your rotation to schedule an interview, which usually takes place in the last week of the rotation. Be sure to forward your CV and personal statement to the program coordinator well in advance of your interview, dha.jbsa.brooke-amc.list.saushec-rads@health.mil. On the day of your interview, please be punctual and arrive at the Program Director’s office in your dress uniform. Please be prepared to articulate how you came to the decision to enter the field of radiology. We want to hear your story. 

Residents are eligible to take the Qualifying (Core) Exam after 36 months of radiology residency training. The Core exam is offered twice annually, typically in June and November. To become fully board-certified, program graduates must have passed the Core exam and will take the new Diagnostic Radiology (DR) Oral Exam 6-12 months after graduation. First year residents who started residency in 2023 will be the first class to take this exam in 2028. This exam is will likely be offered biannually.

For more information, please visit the American Board of Radiology (ABR) homepage.

Teaching Opportunities

Residents participate in resident-to-resident teaching during interesting case conferences, morbidity and mortality (M&M) conferences, and core review lecture series. 

Additionally, residents participate in inter-departmental joint conferences.  

Residents participate in medical student and intern teaching at the workstation and during formal lectures. 

Faculty and Mentorship

The SAUSHEC radiology department has a full complement of fellowship-trained faculty members representing all radiology subspecialties including neuroradiologists, musculoskeletal radiologists, pediatric radiologists, breast radiologists, interventional radiologists, body radiologists, cardiothoracic radiologists, and nuclear medicine radiologists. 

Each resident is assigned a faculty mentor. Faculty mentors check in with their mentees periodically to discuss short- and long-term goals (including fellowships), research, and wellness.  

Well-Being

Some of our well-being initiatives include the new resident welcome pickleball party, the resident/faculty Ragnar relay race, protected wellness time, post-call comp time, faculty-led holiday parties, department-wide potluck dinners, dedicated study time leading up to the Core exam, and early release from work (during slow times). The resident-led Wellness committee and Program Director continuously strive to improve resident wellness. 

Contact Us

Radiology Residency Program

Location: Brooke Army Medical Center, Radiology Department

Hours of Operation:

Monday–Friday
7:30 a.m. to 4:30 p.m.

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