Exploring Which Medical Schools Cost the Most: An Assessment of Medical School Characteristics Associated With School Tuition

ObjectiveTo assess medical school characteristics associated with school tuition.Materials and MethodsUS medical schools’ tuitions, and various medical school characteristics, were extracted from the Association of American Medical Colleges’ online MSAR database, using in-state tuition when applicable. US News ranking and National Institutes of Health (NIH) award ranking from the Blue Ridge Institute for Medical Research were obtained, when available. Geographic population density was obtained using Governing magazine's online database. Cost of living estimates were obtained from online American Chamber of Commerce Research Association Cost of Living Index. Spearman correlations were determined, and multivariable linear regression was performed.ResultsAmong 148 included medical schools, adjusted average ± standard deviation tuition was $47,612 ± $23,765 (range $12,761-$141,464). Tuition demonstrated positive correlations with regional population density (r = +0.577) and years established (r = +0.265). Among ranked schools, tuition showed negative correlations with US News rank (r = −0.469) and NIH rank (r = −0.336). Average tuition varied by geographic region: Northeast: $49,662, Midwest: $43,560, West: $37,701, and South: $34,270. Among states with at least 3 medical schools, average tuition was highest in MA ($53,520), PA ($53,034), $51,547 (DC), and lowest in TX ($21,002), FL ($30,440), LA ($36,066). At multivariable linear regression, the strongest independent predictor of tuition was US News rank (β = −396.0, P= 0.05).ConclusionsUS medical school tuition is highly variable by over a 10:1 ratio. Tuition is greater in higher ranked, longer established schools, in more densely populated regions. Objective data regarding medical education quality may be warranted to assess whether higher tuition in schools with higher US News and NIH rankings is justified.     

Impact of Early Radiology Research Experiences on Medical Student Perceptions of Radiology and Research

Rationale and objectivesTo promote opportunities for medical students to gain early exposure to radiology and research, our institution has initiated programs which fund summer radiology research projects for rising second-year medical students. This study assesses the impact of these faculty-mentored summer research experiences on medical student perceptions of radiology and research, in terms of both knowledge and interest.Materials and methodsA voluntary, anonymous survey was administered to students both before and after the summer research period. Both the pre-program survey and post-program survey included 7-point Likert-scale questions (1 = strongly disagree; 7 = strongly agree) to evaluate students’ perceptions about research and students’ perceptions about radiology as a specialty. Faculty mentors were sent an analogous post-program survey that included an evaluation of their student's research skills.ResultsThe surveys were completed by 9 of 11 students and 10 of 11 mentors. Students’ perceived knowledge of radiology as a specialty improved (P = 0.02) between the pre-program survey and post-program survey. Similarly, there was an increase in students’ perceived knowledge of research skills (P = 0.02) between the pre-program survey and post-program survey, with student ratings of research skills consistent with those of mentors. High student interest in both radiology and research was maintained over the course of the program.ConclusionOur pilot study suggests that summer research experiences can improve knowledge of radiology and research among medical students. Continued evaluation of this annual program will allow us to enhance the benefit to medical students and thereby bolster interest in academic radiology.     

Chest Radiograph Reporting: Public Preferences and Perceptions

PurposeTo assess public preferences and perceptions regarding negative chest radiograph reports.MethodsUsing Amazon Mechanical Turk (Amazon Inc, Seattle, Washington), paid US English-speaking volunteers completed an 18-question survey. Participants were presented with the same two chest radiograph reports—one each in a freestyle and structured format—but randomized to one of four impression statements commonly used in our community. Participants were asked about content comprehension and confidence in the hypothetical interpreting radiologist.ResultsOver 15 days, 5,155 eligible participants completed the survey (of 6,363 respondents). Most reported prior chest radiography (68.9%) or any imaging (93.8%). Of those who underwent chest radiography, 77.6% reviewed their reports. Participants indicated structured reports were easier to comprehend (P < .001) but no difference in perceived confidence in the radiologist with freestyle versus structured reports (P = .21). No differences in comprehension were noted between different impressions with either freestyle (P = .077) or structured (P = .083) reports. Participants indicated higher confidence in radiologists when structured reports indicated “no acute disease” versus “unremarkable” (P = .049). When impressions stated “no acute disease,” participants indicated they would be more likely to do nothing, versus “negative chest” for which they indicated a higher likelihood of taking some action (P = .013, P = .04). Participant responses were similar for subgroups who previously underwent chest or other imaging and previously reviewed their imaging reports.ConclusionFor negative chest radiographs, structured reports are better comprehended by the public and less likely to prompt unnecessary follow-up. As patients increasingly access their medical records online, radiologist reporting should consider patient needs and behavior.     

Russell Warren,MD: Closing the Sports Medicine Gap

As director of sports medicine at New York City's Hospital for Special Surgery, Russ Warren concentrates on helping the high school athlete.     

Trainee and Faculty Perceptions of Remote PACS Workstations and Next Steps in a Large US Academic Medical Institution

ObjectiveRemote workstations were rapidly deployed in our academic radiology practice in late March 2020 in response to the COVID-19 pandemic. Although well-received by faculty, there were concerns for the impact on resident education.Materials and MethodsSurveys of the radiology trainees and faculty were conducted online seven- and thirteen-months following workstation deployment as a part of a quality improvement project to assess the impact on radiology education and faculty wellness, as well as assess the desired trajectory of remote work in an academic setting.ResultsThe majority of trainees (52%) reported the implementation had negatively impacted resident education, greatest among lower level residents (p < .001). This perception did not change despite interventions and perceived improvement in teleconferencing.Greater than 75% of radiologists with remote workstations reported improved wellness and lower stress levels compared to the onsite radiologists. The majority of all respondents voted to continue or expand remote work following the COVID-19 pandemic in both surveys.ConclusionsOnsite teaching is important for the education of residents, particularly for lower-level residents. However, the adoption of a hybrid model in an academic setting may prove beneficial for faculty wellness and recruitment of the next generation.     

Exploring the research domain of consultant practice: Perceptions and opinions of consultant radiographers

AimThis paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group.Design and methodGrounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom.ResultsResults indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice.Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question.Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload.ConclusionResearch is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain.This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice.