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Core Rotations

Mallinckrodt Institute of Radiology provides services in multiple locations at Washington University Medical Center. Most resident rotations are based at Barnes-Jewish Hospital’s two campuses (north and south), which are connected through a series of indoor walkways and are within easy walking distance of each other. Residents spend time on both campuses, seeing a mix of patients in inpatient and outpatient imaging services.

Body Computed Tomography During their first rotation, residents quickly become familiar with normal cross-sectional anatomy of the chest, abdomen and pelvis, and develop an understanding of pathologies seen on CT. In subsequent rotations, they refine their knowledge of diagnoses frequently found on CT and become proficient with advanced CT protocols.

Body Magnetic Resonance Consistently one of our most popular rotations, this busy clinical service covers all aspects of body MRI and body MRI angiography. Residents experience a high-volume body-MRI practice with a mix of thoracic, abdominal, and pelvic MRI and MRA imaging. PET/MRI exposure is a feature of our program.

Breast Our breast imaging facility is co-located with a breast surgical practice, providing residents the opportunity to train and work alongside attending radiologists and breast surgeons. Residents learn how to interpret diagnostic and screening mammograms (including tomosynthesis), receive training in breast MRI, and perform sonographic and stereotactic breast biopsies and needle localizations.

Cardiac Our cardiac imaging section — one of the largest in the nation — is staffed daily by a cardiac radiologist, and a radiology resident dictates all cases. Residents have access to cath and echo images, and every cardiac CT and MRI is physician monitored. As a result, residents become proficient in protocoling studies and complex post-processing of images.

Chest The cardiothoracic imaging rotation covers the review of chest radiographs for Barnes-Jewish Hospital, which includes its medical, surgical, neurosurgical and cardiothoracic intensive care units. With world-class pulmonary and lung transplant programs, and cardiac and thoracic surgery services, this rotation exposes residents to a wide variety of diagnoses, from routine to rare and complex.

Emergency/Trauma First-year residents rotate through the acclaimed Charles F. Knight Emergency Trauma Center at Barnes-Jewish Hospital (BJH) for hands-on experience. The center is a regional Level 1 trauma center that sees more than 95,000 patients annually. Second-year residents have independent call for both BJH and St. Louis Children’s Hospital, the latter exposing them to a range of standard and emergency pediatric cases. Faculty backup is available to review images from home or come in when needed, and each shift ends with a face-to-face readout with subspecialty attendings.

Gastrointestinal/Genitourinary Residents perform all fluoroscopic exams with subspecialist attending involvement, as well as a wide variety of studies on inpatients and outpatients. The former includes swallow studies, barium esophagrams, small bowel studies, barium enemas, hysterosalpingograms, and retrograde urethrograms. Remote faculty viewing of the fluoro screen in the reading rooms provides opportunities to independently perform GI contrast examinations.

Interventional Working one-on-one with attending radiologists, residents are the primary operators on procedures. Residents gain experience from clinical training and large volume exposure to general body interventional procedures, including percutaneous organ drainage, arterial embolizations, and routine and complex central venous access.

Musculoskeletal In this multimodality rotation, residents interpret radiographs, ultrasounds, CTs and MRIs of patients with a wide range of bone and joint disorders, including orthopedic, neoplastic, metabolic, rheumatologic and infectious abnormalities. In addition, an elective musculoskeletal procedure service provides hands-on instruction for performing image-guided diagnostic and therapeutic interventions for a variety of musculoskeletal conditions. 

Neuroradiology Beginning with the first rotation, residents read all modalities in neuroradiology and participate in daily lectures and case conferences dedicated to neuroradiology. In addition to performing fluoroscopically-guided spinal procedures and diagnostic cerebral angiography, residents have the opportunity to participate in interpretation of advanced imaging techniques, including diffusion tractography, functional MRI and PET/MRI.

Nuclear Medicine While on service residents benefit from a unique volume of cases, particularly in the areas of cardiac and PET, as well as exposure to pediatric nuclear medicine. The busy service handles a full complement of imaging, including PET/CT, SPECT, SPECT-CT and planar imaging.

OB/GYN Ultrasound Senior residents, in collaboration with OB/GYN faculty and house staff, learn obstetric ultrasound for the first, second and third trimesters. Residents spend time at Barnes-Jewish Hospital and Missouri Baptist Hospital.

Pediatric Residents learn pediatric imaging from full-time pediatric radiologists at St. Louis Children’s Hospital. To supplement the daytime experience, residents take radiology call at the hospital during night float and senior call experiences. 

Rad-Path All residents have an opportunity to attend the American Institute for Radiologic Pathology, with Mallinckrodt paying the tuition and providing a stipend to defray costs of travel and lodging. Residents who choose not to go are given a four-week rad-path study period at MIR.

Ultrasound The ultrasound service performs most of the image-guided biopsies and aspirations for Barnes-Jewish Hospital, and nearly every patient who comes through this service is scanned by a resident after the sonographer completes the initial evaluation. Residents learn image interpretation and scanning techniques on this busy, hands-on rotation.

Vascular Ultrasound Senior residents learn vascular imaging of the extremities and carotid arteries in the vascular surgery section’s ultrasound laboratory.

Barnes-Jewish West County Hospital Located in west St. Louis County, this 113-bed facility has a busy inpatient and outpatient radiology service staffed by Mallinckrodt faculty. Residents spend one to two months over their four years of training in this facility, primarily rotating on abdominal imaging, musculoskeletal and cardiothoracic services.

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