Best fellowship for PP?

[EPV213]

Torn between Body MRI or MSK for fellowship? Any advice? My program allows 6 month mini fellowships during fourth year, will do that for the specialty I end up not picking. Any insight will be appreciated.

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[jazzman84]

I’m an MSK rad in PP, so definitely biased. In general I would recommend specializing in a specific system, not a modality.

You could probably hammer body MRI for a chunk of 4th year and be pretty solid.

 

[maxxor]

Unless you mean body mri as a shorthand for abdominal imaging…

I would do msk fellowship. 6 months of msk would get you comfortable with most but not all joints.

Body mri is a dying fellowship (meaning the old generalist mri training). If it’s actually abdominal, I still think 6 months of that makes more sense.

Also biased because that’s what I did (6 months abdominal, dual DR/NM residency, msk fellowship)

 

[guytakingboards]

Mammo will get you a job anywhere.

Between MSK and body MRI, I doubt there's a ton of difference in general marketability. There's no right or wrong answer here.

The big question is do you want to be the go-to body person or go-to MSK person?

The body person covers the high end GI/GU tumor boards, rectal cancer staging, prostates, etc.... Gets all the questions about designing/managing said MR protocols. Interacts more often with colorectal surgeons, urology, OB-GYN.

The MSK person obviously covers ortho onc, rheumatology, etc conferences. Gets all the MSK protocol questions. Interacts more with ortho, rheum, PM&R and pain.

Unless its a super tiny group, the body person ain't gonna be the go-to for MSK and vise versa. It all depends on what you want your primary niche to be. In most small to mid-size groups you'll do a little of both.

 

[EPV213]

Yeah fellowship is body/abdominal imaging focused on MRI (big name tertiary center, ~8 months MRI, 2 months CT, 1 month elective).

My perception is that body MRI tends to be more challenging and thus requires more training, as opposed to CT predominant training so makes sense to get extra training in that. There seems to be plenty of demand for body people in PP, so I don't get why you refer to it as a "dying fellowship".

 

[maxxor]

Yeah fellowship is body/abdominal imaging focused on MRI (big name tertiary center, ~8 months MRI, 2 months CT, 1 month elective).

My perception is that body MRI tends to be more challenging and thus requires more training, as opposed to CT predominant training so makes sense to get extra training in that. There seems to be plenty of demand for body people in PP, so I don't get why you refer to it as a "dying fellowship".

There existed an old fellowship called “body mri” where you did neuro, abdominal, and msk.

It was a fellowship in a modality, not an organ system. That’s why I clarified if it was abdominal or “body”.

While Hopkins (for example) has such a fellowship, it is generally thought better to do an organ system focused fellowship rather than a modality one.

 

[EPV213]

There existed an old fellowship called “body mri” where you did neuro, abdominal, and msk.

It was a fellowship in a modality, not an organ system. That’s why I clarified if it was abdominal or “body”.

While Hopkins (for example) has such a fellowship, it is generally thought better to do an organ system focused fellowship rather than a modality one.

Gotcha sorry misread your post. Ok makes sense

 

[guytakingboards]

Yeah fellowship is body/abdominal imaging focused on MRI (big name tertiary center, ~8 months MRI, 2 months CT, 1 month elective).

My perception is that body MRI tends to be more challenging and thus requires more training, as opposed to CT predominant training so makes sense to get extra training in that. There seems to be plenty of demand for body people in PP, so I don't get why you refer to it as a "dying fellowship".

At the residency level of training, I wouldn't be surprised if you got a better exposure to MSK cross-sectional than body MRI. MSK cross-sectional is higher volume at almost every shop. You may find body MR more challenging because you see it less.

At the end of a full year fellowship, you should expect to be good in either field. In MSK that may mean comfort in MR of all the small joints, ease in reading multi-post op shoulders and being able to stick an arthrogram needle in the midfoot. In body MR, that may mean comfort reading post-treatment GYN cancer MR's (and maybe doing lung biopsies).

Again, it just goes back to what you want to be your primary niche.

Side note, I'm neuro trained and get a lot of satisfaction for being a go-to person for neuro. Had a very experienced body rad ask me a question on their CT chest for H&N cancer staging the other day and after a 2sec look said with 100% confidence it was a benign finding. I do hundreds of LP/myelos a year and enjoy nailing the tough LP/myelo cases that others have failed. Having a niche and being good at it is really satisfying. Just decide what your niche will be.

 

[jazzman84]

There existed an old fellowship called “body mri” where you did neuro, abdominal, and msk.

It was a fellowship in a modality, not an organ system. That’s why I clarified if it was abdominal or “body”.

While Hopkins (for example) has such a fellowship, it is generally thought better to do an organ system focused fellowship rather than a modality one.

Yes I assumed that was what he was referring to. OP, it sounds like you just need to figure out which type of pathology you find more interesting.

 

[EPV213]

Decided on abdominal MRI fellowship thanks for the advice everyone

 

[2brads]

Breast, if possible. Not much difference in desirability between MSK and body.