John P. and Kathryn H. Tampas Green and Gold Professor of Radiology Kristen DeStigter, M.D., was appointed chair of radiology following a national search in spring 2017 after having served as interim chair of radiology since 2014 and vice chair of radiology from 2004 to 2014. An alumnus of Case Western Reserve University School of Medicine, she completed a residency in diagnostic radiology and a body imaging fellowship at University Hospitals of Cleveland, Ohio prior to joining UVM in 2001. She is co-founder and president of Imaging the World, a nonprofit organization that developed and uses a new sustainable model for ultrasound imaging, making basic life-saving diagnosis accessible in the poorest regions of the world, is a fellow in the American College of Radiology (ACR), and serves on the ACR International Outreach Committee and as chair of the International Radiology Education Committee of the Radiological Society of North America (RSNA). She specializes in unique applications of ultrasonography in rural medicine, provision of integrated medical imaging in underserved communities, and medical education in diagnostic radiology. The UVM Larner College of Medicine communications staff sat down with DeStigter recently for an interview.
Why radiology, and what are some of the experiences that led you to where you are now?
Prior to and during medical school I worked as a lab assistant in a parasitology lab. We studied some of the worm infections that are endemic to parts of East Africa. I was certain that my career would be in infectious disease. Then I traveled with a team to do field research and it was a Kenyan radiologist who exposed me to ultrasound and its potential to evaluate myriad diseases and make a huge impact in care. When I got back to medical school, I did an elective in radiology and the passion of the radiologists reinforced my new career direction for me. I have not looked back.
I have been at UVM since 2000. Since then, I served as medical student director for radiology, as director of the radiology residency program, and as vice chair of the department, in charge of operations. The opportunities here for professional growth and leadership have been incredible.
I love radiology because to me it is the perfect intersection of the art and science of medicine. Expert knowledge of anatomy, pathology, physiology, physics and clinical medicine must be integrated to make an accurate diagnosis and then translate the imaging findings into the clinical implications and next steps of care. Every patient is unique. At UVM we use the most sophisticated technology in world to look inside the human body to help solve problems. We see a variety of different diseases in both adults and children, and we play an integral role in the clinical care team. Modern radiology covers all aspects of medicine and there is a great mix of diagnosis and intervention. Our department hosts a top tier residency training program and supports world class team science research activities. I am delighted to be working with so many outstanding individuals both inside and outside of radiology to carry forward the mission of the Larner College of Medicine.
What are your priority areas for the Department of Radiology and what’s happening in those areas?
Given the rapid evolution of healthcare reform, precision medicine, point-of-care delivery optimization, patient engagement and “disruptive” IT and technology, our department must continue to be a national leader in redefining how radiology education is conceived, designed and delivered. The radiology graduate medical education program for our 24 residents and three fellows, now directed by Joshua Nickerson, M.D., is one of the most competitive in the country for its size. We have a reputation for training residents to be competent, excellent radiologists and scholars, and are also known for our leadership development and global health education excellence. It has always been a passion of mine to make sure that our residents are both highly qualified and poised to give back.
In addition, we are working to improve the radiology education for medical students. Many of our radiologists are involved in the newly integrated ultrasound training beginning in the first year and continuing though all four years. In addition, others are working with Jill Jemison, technology services director, to develop core imaging modules featuring up-to-date, leading-edge radiology content that could be integrated into the curriculum through flipped classroom and team-based learning sessions, as well as be integrated into the core clerkships. We have student electives in the radiology department where students can learn about all of the radiology modalities. We also offer medical students global health elective opportunities either between their first and second year or during their fourth year through collaboration between the Larner College of Medicine and Imaging the World. Since 2010, over 50 medical students have participated in the program in Uganda, most resulting in peer-reviewed publications or national presentations. This year, Class of 2018 student Lana Khuong traveled to train nurses to do trauma ultrasound; Class of 2020 student Jenna Morris engaged high school students to learn about good prenatal care, including obstetric ultrasound, and increase interest in fields of medicine; several other students are actively engaged in global health-related research projects in the department.
Lastly, beyond the two courses currently being taught to undergraduate students, we hope to participate in expanding imaging education to other learners.
Leveraging the strengths of the institution, our goal is to grow a strong academic radiology department over the next five years. Collaborating with UVM faculty to integrate imaging science, IT and health services research with core strengths in the neurosciences, cardiovascular disease, genomics and cancer research, we aim to develop novel algorithms of care, fresh best practices and guidelines that can be tailored to the most appropriate, cost-effective and beneficial care for defined populations both in Vermont and on a global basis.
Some of our collaborative global health initiatives have involved other College of Medicine faculty, including Magdalena Naylor, M.D., Ph.D. from psychiatry, Friederike Keating, M.D. from cardiology, Anne Dougherty, M.D., and David Jones, M.D., from obstetrics, gynecology and reproductive sciences, Betsy Sussman, M.D., and Sally Herschorn, M.D., from radiology, Brian Sprague, Ph.D., from surgery, and Abiy Ambaye from pathology and laboratory medicine.
Innovation and Industry partnerships
The department will continue and grow strong industry relationships that help us practice on leading-edge equipment, supporting clinical services and the academic mission. Users of the MRI Center for Biomedical Imaging (research-dedicated MRI) include faculty from psychiatry, neurological sciences, orthopedics and rehabilitation, and of course, radiology. We have special luminary agreements to test equipment and software that give us an opportunity to develop new ways to detect and treat disease and then disseminate that knowledge through technological advancements.
What’s next for the Department of Radiology; what’s on your wish list?
Our department will be getting the first in the country all-digital PET/CT scanner within the next few months. This technology that will be primarily used for cancer evaluation, will offer faster testing and lower radiation doses to patients, and improved diagnostic capabilities and increased diagnostic confidence for radiologists. The technology offers a platform for expanded research with our colleagues in other departments.
My wish list includes putting in a Cyclotron to produce new radiotracers that can be used in neurology, cardiology and especially in oncology. In short, biomarkers can be used to test patient response to potential treatments in order to choose the best drug for their particular tumor. This technique improves outcomes and saves costs.
Radiology is expanding to include the UVM Health Network. We have already integrated radiology services with Central Vermont Medical Center and look forward to working with all of our partners, including in New York, on care delivery optimization in our region. These relationships enhance our ability to be innovative around population health solutions.
Machine learning is a hot topic in radiology. We are beginning collaborations with researchers from UVM to use imaging data in new ways - to develop computer algorithms from the complex patterns in the images that we review every day that can not only make better predictions about diagnosis and treatment, but learn from the outcomes to continuously become better over time. Certainly, the objective is not to replace the radiologist but to make us better at what we do! I look forward to working with an incredible team as we head into the future.