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Breast Imaging Fellowship (UHN, WCH & MSH)

Supervisor: Dr. Supriya Kulkarni

The combined department of Breast Imaging at Mount Sinai Hospital, Princess Margaret Hospital and Women's College Hospital offers a very comprehensive and integrated multimodality one-year Breast Imaging fellowship.  We offer world class experience with a very large number of clinical cases, diverse and rare pathology, leading-edge technology and a comprehensive research and teaching program.  As a result of our large practice and state of the art technology, we are able to offer our fellows in-depth exposure to all aspects of screening, diagnostic, interventional and academic breast imaging experiences.  Our graduates have come to us from varied continents and have been successful in continuing in either academic or community practices of their choice in different parts of the world.

Fellowship:

There are currently 2 funded clinical breast fellowships. The fellowship lasts 12 months with time evenly split across all 3 sites and modalities. 80% of the fellowship is clinical and 20% is dedicated to research.  The fellowships are recognized and listed on the Society of Breast Imaging (North America). Our training program reflects the Breast Imaging Fellowship Curriculum published (2013) by the education committees of ACR and SBI.

The breast imaging division is staffed by 10 fellowship trained dedicated breast radiologists with avid interest in clinical as well as breast imaging research.

Mammography & Ultrasound:

As the breast imaging fellow, you will have exposure to a high volume of diagnostic breast imaging, such as digital screening & diagnostic mammograms, digital breast tomosynthesis, diagnostic ultrasounds including opportunities to explore elastography and contrast enhanced spectral mammography (CESM). The total number of screening/diagnostic mammograms performed across the three Breast Imaging Centers is over 200 per day. Each site performs an average of 15 – 20 diagnostic ultrasounds per day. All 3 of our centers are authorized center for provincial average risk and high risk screening program through the Ontario Breast Screening Program, Cancer Care Ontario.

Breast MRI:

Breast MRI is performed at multiple sites on state-of-the-art 1.5 & 3T breast MRI with post processing software capabilities for kinetic analysis and rendered MIP assessment.  We are also a busy accredited center for the highly acclaimed provincial high risk screening program which allows exposure to reporting and work up of high risk screening MRI. We perform approximately 60-80 MRI per week.

Intervention:

Opportunities for interventional procedures include: stereotactic and ultrasound guided core biopsies (both 14G core and vacuum assisted), stereotactic and ultrasound guided pre-operative and diagnostic needle localizations, ultrasound guided diagnostic and therapeutic needle aspirations ,galactography, MRI guided vacuum assisted biopsy and localization procedures, as well as multimodality guided (stereotactic, US and MRI) marker/clip deployment. There are approximately 3-5 MRI guided interventions per week.

GRDC:

Trainees will have the opportunity to work in our one of a kind Gattuso Rapid Diagnostic Clinic which provides consultations, complete work up, same day pathology and clinical consultation for complex cases within the Greater Toronto Area. All examinations are obtained and reviewed with the latest state-of-the-art technology. 

Equipment:

We have a fleet of digital mammography machines Tomosynthesis capability( Hologic & GE), 3 stereotactic core biopsy units (two upright and one prone), state of the art ultrasound machines (Toshiba and Supersonic ultrasound machines (the latter of which has shear wave elastography capabilities) and multiple 1.5 T &  3T Siemens MRI magnets.

Teaching:

There are  several multidisciplinary breast imaging rounds occurring regularly with fellows involved in direct review of current cases, presentations of new techniques and advances in the field of breast imaging. We work very closely with the breast surgeons, pathologists and oncologists and also provide elective rotations into breast pathology, surgery and genetics. Subsidized/free registration opportunities for locally arranged CME and workshops through the year will be available including our annual hands on Digital Breast Tomosynthesis workshop. In turn fellows have teaching commitments to Medical Students, Breast Imaging Resident and oncology fellows.

Research:

20 % dedicated research time; fellows are expected to produce a minimum of one manuscript during the fellowship. Presentation of research work at international scientific conferences is financially supported and encouraged. There are numerous opportunities for fellows to develop or continue research within the Breast Imaging Division.  We offer on-site clinical research facilities with many dedicated research staff.  Additionally, interdisciplinary work is also encouraged with several projects performed in collaboration with the Breast Surgery and Breast Pathology divisions.

Holidays:

Two work weeks (10days) per 6 month block of your fellowship.  (Total 4 work weeks for 12 months)

Conference leave:

One week upon approval.

(Expense [$2000 CAD] paid if presenting an original paper that has not been presented elsewhere)