Diagnostic Radiology Residency Home Page

About Lahey and the Department of Diagnostic Radiology

Lahey Clinic Medical Center is a 317-bed combined inpatient and outpatient medical center in Burlington, Massachusetts, a suburb 20 miles northwest of Boston. Lahey Clinic Medical Center, North Shore, is a smaller, satellite facility located in Peabody. Over the past 80 plus years, Lahey has acquired an international reputation as a tertiary care referral center. Currently, more than 450 staff physicians offer diagnostic and treatment skills in all specialties of medicine and surgery. This combined population received over 300,150 radiologic examinations at Lahey facilities in the past year. The Radiology Department became filmless in 2003 with the installation of a Picture Archiving and Communications System (PACS). A voice activated dictation system was installed in 2003.

The Department of Diagnostic Radiology is composed of 33 full time radiologists and 2 part-time radiologists. Radiologists with expertise in computerized tomography, magnetic resonance, nuclear medicine and ultrasound are members of the department. There are five neuroradiologists, four interventionalists, two neurointerventionalists and multiple specialists in all areas of radiology including chest, bone and joint, genitourinary, gastrointestinal and breast radiology. Two physicists are also in our radiology department. All members of the radiology staff are clinically oriented, working side by side with the radiology resident on the various resident rotations. Staff radiology coverage for night call includes one general radiologist, one neuroradiologist and one interventionalist. All three members are available to the radiology resident on-call who will triage cases to the staff radiologist necessary to address the patient's needs. Our neuroradiologists use the PACS system for call coverage.

The 16-member residency in Diagnostic Radiology at Lahey is approved by the Acreditation Council for Graduate Medical Education for four years in training and is designed to lead to certification in diagnostic radiology by the American Board of Radiology. As of July 1, 2005, we have been approved by the ACGME to expand to as many as 20 residents. A year of internship or its equivalent must be completed before beginning the residency program. Internships are offered at Lahey in Medicine or Surgery. Training programs offered by Lahey Clinic include Radiology, Medicine, General Surgery, Colon & Rectal Surgery, Urology Residency, Plastic Surgery Residency as well as Fellowships in Gastroenterology, Pulmonary-Critical Care, Cardiology and Vascular Surgery. There are rotations from Boston-based programs to the Clinic in the areas of ENT, Neurology, Infectious Disease, Hematology/Oncology, Gynecology, Orthopedics, Anesthesia, Pathology and Emergency Medicine.

What You Can Expect

During their training, residents become accomplished in techniques of basic radiography, fluoroscopy, film interpretation, and radiation protection. In addition to the conventional diagnostic procedures, the program encompasses extensive training in chest radiography, nuclear medicine, gastrointestinal radiology and neuroradiology. Up to two months of elective time within the Department of Diagnostic Radiology is offered. Residents are closely supervised with increasing participation and responsibilities as the individual resident develops more skills. Residents are also first to assist in all procedures. With the exception of a fellowship in Interventional Neuroradiology, there are no fellowships within Diagnostic Radiology.

The rotations in Neuroradiology and Interventional Radiology include broad training in general angiographic and interventional procedures of the abdomen, extremities, chest, and brain. There is a Neurointerventional Center offering a Neurointerventional fellowship. Radiology residents will participate in conferences pertaining to neurointerventional radiology and participate in neurointerventional cases on a voluntary basis during rotations on neuroradiology. Opportunity is available to gain expertise in performing and interpreting a multitude of interventional procedures including: arthrography; myelography; venography; percutaneous cholangiography; biopsy and drainage procedures; percutaneous extraction of calculi from the biliary and urinary tracts; vascular embolization; angioplasty; placement of nephrostomy tubes; and TIPS procedures and lymphangiography.

Computerized diagnostic examinations are a mainstay of diagnostic imaging. Currently there are three helical CT scanners at Lahey Clinic Medical Center, Burlington and one scanner at Lahey Clinic Medical Center, North Shore. We have recently installed a state-of-the-art Dual Energy Siemens scanner, which allows for the highest quality cardiac and peripheral vascular imaging available. We also perform diagnostic CT scans on a combined PET/CT unit in Burlington, and we have another dedicated CT unit in Burlington for interventional procedures such as biopsies, drainages and radiofrequency ablations.

Lahey Clinic Medical Center, Burlington was approved as a Level II Trauma Center in 1997. This, in combination with a workload of over 50,000 examinations over the past year ensures all residents have exposure to a wide variety of cases. In addition to routine CT studies including brain, spine, extremities, chest and abdominal cases, we perform state-of-the-art CT angiography (neurovascular, cardiac, and peripheral vascular imaging). A dedicated 3-D imaging laboratory allows for the manipulation of images to better serve our referring clinicians. We have also recently installed similar software at all radiology PACS stations; these have allowed for tremendous hands on training for residents in the use of 3-D post-processing software.

Nuclear Medicine

The Nuclear Medicine Division offers comprehensive diagnostic imaging services performed on a wide range of state-of-the-art imaging equipment.

There are five gamma cameras installed between the Lahey Clinic Medical Center, Burlington and Lahey Clinic Medical Center, North Shore. Four of which have SPECT/CT capabilities to acquire General Nuclear Medicine procedures such as skeletal imaging, renal function studies, GI Bleeding exams, hepatobiliary, parathyroid, thyroid and lung perfusion as well as ventilation studies.

A 64-slice PET/CT scanner at Lahey Clinic Medical Center, Burlington performs F-18 FDG whole body imaging for the diagnosis, staging, and restaging of cancer, and neurological indications such as dementia, Alzheimer's and seizure. PET/CT is also used for radiation treatment planning as well as treatment monitoring.

Diagnostic CT services are performed in the PET/CT suite to provide continuity of care for our oncology patients and referring physicians.

Myocardial Perfusion Imaging with Rubidium-82 has been introduced to the menu of nuclear cardiology services along with SPECT imaging and viability studies.

Lahey Clinic is the first in Massachusetts to offer Breast Specific Gamma Imaging (BSGI) on a dedicated high-resolution gamma camera designed specifically for breast imaging.

Therapy offerings include I-131 for thyroid cancer, Bexxar for Non-Hodgkin's lymphoma and Quadramet for bone palliation.

Ultrasonography at Lahey is performed with real-time scanning techniques, which offer cross-sectional imaging of the thyroid, abdomen, pelvic and extremities as well as guidance for cyst aspiration and biopsy. Color flow Doppler scanning is performed within our ultrasound section, and the Radiology Department is also responsible for the non-invasive vascular laboratory, which includes Doppler examination of the carotid arteries, extremities and abdominal vessels.

MRI scanning is performed with three 1.5 Tesla supraconducting magnets. We performed 27,504 examinations last year, which includes brain, breast, spine, musculoskeletal, abdominal, pelvic, cardiac studies and MRI angiography.

Cardiac Imaging

Lahey Clinic Medical Center offers a state-of-the-art highly integrated non-invasive cardiac imaging service to our patients. We perform exams on high-end equipment such as a 2x64 slice Siemens Definition Dual Source CT scanner and a 64-slice GE VCT scanner for coronary CTA, a 64 slice hybrid GE PET/CT system for cardiac PET examinations and GE TwinSpeed 1.5T HDX magnets.

All imaging takes place in the Radiology Department and is interpreted by radiologists. Twice weekly joint case conferences with the diagnostic and interventional cardiologists are conducted in the Radiology 3-D Lab, which features many different workstations including TeraRecon, Vital Images, Siemens Leonardo and GE ADW 4.2.

In the lab, there is real-time network access to digital echocardiography and cardiac cath images that greatly enhances the ability to correlate the various exam findings and exchange of information about management of cardiac patients. Radiology residents have an opportunity to directly interact with radiology staff engaged in non-invasive cardiac imaging, cardiology staff and fellows.

Breast Imaging Center

At Lahey Clinic Medical Center, breast imaging utilizes state-of-the-art diagnostic and screening methods. Residents will have the opportunity to be closely supervised as they learn to interpret the full breadth of imaging studies used in screening and diagnostic breast imaging. Over 33,000 cases of Digital Mammography with Computer-Assisted Detection (CAD) are performed annually. In addition to easily meeting the requirements for screening and diagnostic mammographic interpretation, residents become fluid in the breast ultrasound exam and its use in the diagnostic work up of patients. Breast MRI is state-of-the art on a 1.5 tesla magnet with a dedicated breast coil and is combined with CAD technology to permit further evaluation of breast cancer cases, for extent of disease and for problem solving in diagnostic dilemmas. Residents become adept in the indications and interpretation of Breast MR through a combination of active cases, literature review and Breast MR specific conferences. Our department also includes functional imaging methods including Breast Specific Gamma Imaging, a study sometimes used in diagnostic problem solving. PET/CT technology is also a part of breast cancer work up at Lahey that residents will become familiar with. During the course of their training, residents become adept in Imaging Guided Breast Biopsies with hands on, supervised training in a busy breast interventional service that includes ultrasound, digital mammogram (called Stereotactic Core Needle Biopsy), and MRI guided biopsy work. Residents will participate in the interdepartmental weekly breast conferences, which are an opportunity for the resident to learn the full scope of breast care and treatment of breast cancer.

Additional Learning Opportunities

In addition to the rotations in the different subspecialties within the Department of Diagnostic Radiology at Lahey, residents rotate for three months through the Children's Hospital medical Center in Boston to gain valuable experience in pediatric radiology. A one-month rotation with our cardiologists offers experience in interpreting cardiac angiography and echocardiography. Opportunity to go to the Armed Forces Institute of Pathology during the third year of residency for six weeks also exists, as does a one-month rotation at the Brigham and Women's Hospital for high-risk obstetrical ultrasound.

Teaching conferences are held within the Department of Diagnostic Radiology at Lahey. These consist of didactic lectures by staff radiologists, guest lectures from other radiology departments within the Boston area, and presentations from other Lahey staff. Interdepartmental conferences with various subspecialty groups at the Clinic are held daily. Residents also participate in film reading conferences. During the academic year, the conferences are 50 percent didactic and 50 percent film interpretation conferences.

Residents are also encouraged to participate in writing papers on the vast amount of material witnessed at Lahey. Presentation of this material at national meetings is encouraged and has been done by several of our previous residents. Residents also have the opportunity to attend and present cases at medical and surgical conferences within the Medical Center. Tuition to Boston area physics courses is paid by Lahey's Department of Education. These courses include the physics of diagnostic radiology, biophysics, and the physics of nuclear medicine. In addition, our two physicists offer lectures in physics.

Lahey Clinic Medical Center has a central medical library as well as a radiology library within the Radiology Department. The Francis A. Countway Library of Medicine-which combines the libraries of the Harvard Medical School and Boston Medical Library-is also available for residents' use. Our most fascinating cases are being placed in a PACS teaching file. A complete set of the ACR Teaching File on CD-Rom is available. We have also made an agreement with MedPix to be an outside source of teaching cases. Radiology residents will contribute cases to their file. Individual staff cases are available on CD discs. Each resident is given a laptop computer for their use over the four years, as well as access to computers available throughout the Radiology Department.

Applying to the Diagnostic Radiology Program

You can apply to our program online through the Electronic Residency Application Service (ERAS). Please refer to the Lahey Clinic Residency and Fellowship section for further application information.

Letters of reference should be sent to:

Carl R. Larsen, MD
Program Director Residency Program, Diagnostic Radiology
Lahey Clinic Medical Center
Department of Radiology
41 Mall Road
Burlington, MA 01805

When the application and all letters of reference have been received, an interview may be scheduled with members of our radiology staff. At that time, you will have an opportunity to see our entire department and to speak with our current residents.