The Radiology Department offers an ACGME-accredited fellowship in Neuroradiology to candidates who have completed an ACGME-accredited residency in Diagnostic Radiology. We participate in the Neuroradiology Fellowship Match administered by the National Residency Match Program (NRMP), and use the universal fellowship application designed by the Association of Program Directors in Radiology.
Typically, interviews begin in late winter/early spring of the candidates 3rd year with the applicant’s program rankings due early that summer. Our program has been certified to accept up to 4 fellows per year. Satisfactory completion of the fellowship fulfills requirements for senior membership in the American Society of Neuroradiology (ASNR) and enables the candidate to sit for the Certificate of Added Qualification (CAQ) in Neuroradiology offered by the American Board of Radiology.
Clinical Training Offered
- Computed tomography (CT)
- Magnetic resonance (MR) imaging
- Endovascular therapy
- Positron emission tomography (PET)
- Head and neck imaging
Organization of Fellowship
The fellowship experience encompasses a broad clinical exposure to all aspects of modern diagnostic and therapeutic Neuroradiology, including angiography, interventional Neuroradiology, myelography, CT, MR, PET, ENT and neurosonography.
The fellowship is largely clinical and procedure-oriented, with a required core of Neuroradiology subjects. Typical rotations include angio (3 months), MRI (4 months), CT (4 months), and research (1 month).
First Year Rotations (Typical)
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Research is encouraged and supported throughout the fellowship. Eighteen of our former fellows are in academic medicine; 3 have won the Dyke Award, and 2 are Rhodes Scholars. Active research projects include:
- Evaluating machine learning based classifiers and conventional statistical models to identify structural MRI relationships distinguishing Alzheimer's disease from mild cognitive impairment.
- Arterial Spin Labeling (ASL) MR perfusion technique development
- Investigating evolving patterns of functinal connectivity in the developing brain using arterial spin labeling (ASL) MRI and computational network analysis
- Examining structural network connectivity determinants of poor developmental otucomes in preterm neonates, applying machine learning framework for potential use as a diagnostic test
- Evaluating cerebrovascular disease and cognitive functioning in diabetic patients
- fMRI and PET studies evaluating placebo response
- Collaborative studies with the School of Biomedical Engineering, Virginia Tech and Department of Neurosurgery evlauating traumatic brain injury in youth and collegiate football athletes
A robust MR physics program, with research into flow measurement, phantom design and innovative pulse sequence development, complements the neuroradiology experience. There is a 7.4T horizontal bore small animal imager/spectrometer on-site in the Department of Biochemistry; this unit is available for new research projects and members of the Neuroradiology section participate in ongoing projects in this program. A 64 slice GE CT and a 3.0 T Siemens MR scanner have been recently installed and are 100% dedicated to research.
Educational Objectives and Philosophy
As a result of this clinical training and didactic conferences, we expect each neuroradiology fellow who finishes training with us to be able to:
- Perform and interpret angiograms, myelograms, CT scans and MRI scans in the most complicated/difficult cases encountered in common clinical practice
- Understand the functional neuroanatomy of the brain and spine
- Have good general knowledge of related neuroimaging techniques, such as SPECT, PET, carotid and cerebral ultrasonography
- Understand the physical principles underlying advanced neuroimaging modalities such as MRI, CT and PET
- Be able to design and modify CT and MR protocols as new techniques are developed
- Have thorough imaging and clinical knowledge of diseases of the head and neck
- Be familiar with scientific data and issues debated in current neuroradiology literature
- Design and complete a research project
- Develop skills and confidence in teaching other physicians about neuroimaging
Facilities, Equipment, and Work Load
The Wake Forest Baptist Medical Center consists of a 4-year medical school and an 850-bed teaching hospital. Serving a population of over 2,000,000 people, it represents the closest academic medical center to patients in western North Carolina, southern Virginia, and western South Carolina.
The neuroradiology case load comprises a well-balanced mixture of congenital, traumatic, degenerative, infectious, and neoplastic diseases. The Medical Center houses a 150 bed children's’ hospital, a rehabilitation facility, and a comprehensive cancer center. The institution’s faculty includes internationally recognized authorities in neurology, neurosurgery, and ENT.
Clinical equipment for neuroradiology is "state of the art". Such equipment includes 11 helical CT scanners, 8 of which are GE LightSpeed with 3-D rendering and CT angiographic capabilities as well as GE's newest Discovery CT750 HD. The medical center houses 6 on-site diagnostic MRI scanners including 2 Siemens 3.0 T units (1 in main MRI facility and other at the Comprehensive Cancer Center) in addition to 4 1.5 T units (2 GE and 2 Siemens). Advanced techniques are available such as MRA, diffusion tensor imaging (DTI), susceptibility weighted imaging (SWI), arterial spin labeled (ASL) perfusion, fMRI (BOLD activation studies), and multivoxel spectroscopy. A Siemens biplane flat panel interventional angiography suite is dedicated for neurointerventional procedures. The PET facitlity has a Siemens cyclotron and a GE Advance scanner that are fully under control of the Department of Radiology.
Advanced techniques are available such as MRA, diffusion imaging, FAIR quantitative cerebral blood flow, fMRI (BOLD activation studies), multivoxel/multinuclear spectroscopy. A Siemens interventional angio suite is also available for exclusive use by neuroradiology. The PET facility has a Siemens cyclotron, and a GE Advance scanner and they are fully under control of the Department of Radiology. A GE 1.5T MR scanner and a GE 16 slice CT scanner are available for research. Two PET/CT scanners are also in place (1 located in the radiology department and 1 for treatment planning located in the Cancer Center).
Approximate yearly workloads in each area are:
- Neuro CT: 33,000 cases
- Neuro MR: 16,000 cases
- Cerebral angiography/Neurointerventional: 550 cases
- Neurointerventional: 150 cases
- Myelography/Discography: 100 cases
- Kyphoplasty, Vertebroplasty: 70 cases
- Neuro PET: 50 cases
Vacation and Benefits
Three weeks of vacation are given each year. Each fellow is also allowed to attend an educational meeting of his/her choice with reasonable expenses paid for by the department. Additional paid meeting time is also allotted if a fellow presents a paper at a national radiology meeting. Salary and fringe benefits are on par with other nationally-recognized fellowships. A book fund is also available ($400 per year).
Joseph A. Maldjian, MD, Section Head
Michael D. Baker, MD
Jonathan H. Burdette, MD
Allen D. Elster, MD
Carol P. Geer, MD
Annette J. Johnson, MD
Christopher T. Whitlow, MD, PhD
Daniel W. Williams, III, MD
Michael E. Zapadka, DO -Fellowship Director
Radiology residents who desire to begin a fellowship immediately following the completion of their residency should apply in the late fall/early winter of their 3rd year of radiology residency. Minimum qualifications for the fellowship include successful completion of a diagnostic radiology residency and board certification by the ABR or equivalent, and the ability to obtain a license to practice medicine in North Carolina. A personal interview is required unless there are exceptional circumstances.
A completed application consists of the following:
- Completed Fellowship Application
- Curriculum vitae
- Personal statement or letter of interest explaining career choices and goals
- Letter of recommendation from radiology residency program director
- Dean's letter from medical school (optional)
- Two additional letters of recommendation
- Photograph (for identification)
Completed applications, letters of recommendation, and supporting documents should be addressed to Michael Zapadka, DO. Requests for application materials and inquiries concerning interview arrangements, the receipt of materials and administrative details of the application process should be addressed to Ms.Hodgin at firstname.lastname@example.org