Diagnostic radiology resident perspectives on fellowship training and career interest in emergency radiology

Purpose

(1) Evaluate radiology resident perception of emergency radiology (ER). (2) Identify potential barriers to pursuing fellowship training or a career in ER among radiology residents.

Materials and methods

A 9-question digital survey was designed using Qualtrics Experience Management software (Qualtrics Inc., Provo, UT) and distributed to all US radiology residents via a multi-pronged distribution approach.

Results

Four hundred fifty-one residents responded out of an estimated national total of 4432 residents (10.2%). Gender proportion was nationally representative (female?=?24.5%; p?=?0.57), with a slight R1 predominance (p?=?0.034). Of the residents, 88.8% were aware that an ER subspecialty exists, 82.0% were aware that ER fellowships exist, but only 51.7% were aware that the American Society of Emergency Radiology (ASER) exists. Nearly a quarter reported no ER division or ER resident rotation. Residents in a program without an ER division or rotation were nearly twice as likely to be unaware of the existence of ER subspecialty, ER fellowships, and ASER compared to others (p?=?0.017). The presence of an ER division and rotation significantly increases the knowledge of ASER (65.5% vs. 40.7%, p?<?0.001) and increases residents’ ratings of their ER training (p?<?0.001). The following factors were ranked as the most important for fellowship choice: (1) personal interest, (2) intellectually stimulating, and (3) work hours. When asked if ER had an appealing work schedule, the mean response was 56 out of 100 (0?=?disagree, 100?=?agree).

Conclusion

US radiology residents with the greatest exposure to ER during residency are more familiar with ER training, ER career opportunities, and ASER and had a more favorable perception of the field. Subspecialty leaders should focus on ER’s inherent intellectual appeal and reframe its nontraditional schedule as positive (flexible).

     

Creating and enhancing radiology student interest groups

Student interest groups are an important forum in which medical students learn about and develop interest in different medical specialties. To attract top students to radiology and promote understanding and appreciation of radiology among future physicians, it is important that radiology educators help to develop and sustain such groups at their institutions. This article reviews key considerations in creating and enhancing a radiology student interest group.     

The effect of radiology electives on career choice at McMaster University

Recruitment ot radiology is said to be affected by the extent to which radiologists participate in medical student teaching. At McMaster University, where radiologists make major contributions to the medical school curriculum, students appear to show little interest in radiology as a career. The characteristics, attitudes and career choices of students at McMaster who undertook elective periods in radiology between 1973 and 1976 were examined. Though students rated the elective experience very highly, none intended to become a radiologist. Half of the group wished to take up family practice, the proportion in the school as a whole being similar. This is consistent with policies of student selection and education at McMaster. Most of those choosing family practice did not change their career choice between entry to and exit from the school. Involvement of radiologists in the curriculum had no detectable positive influence on career choice.     

Problem-based learning and medical student radiology teaching

The present study describes some practical advantages and disadvantages of problem-based learning (PBL), and makes suggestions to improve PBL radiology teaching of medical students.     

Application of the case method in medical student radiology education

RATIONALE AND OBJECTIVES: Our goal is to design, implement, and evaluate a rich educational activity to engage medical students in learning the importance of providing clinical histories when ordering radiological examinations. We adapted the format of the case method commonly used in business schools. MATERIALS AND METHODS: In the setting of a 1-week required radiology course offered during the third year of medical school, we created an unknown case assignment consisting of two chest radiographs and a concise history for three- to four-person study teams. Unknown to students, each team received the same images, but different patient histories. After turning in their written analyses, students had a classroom opportunity to discuss their conclusions. A written evaluation of the entire experience using both Likert items and unstructured response items was conducted at the end of each session. RESULTS: The evaluation was conducted during a 17-month period, and 141 evaluations were received from students. The response rate was 100%. Most teams met several times and worked on the assignment for 2 or 3 hours. Students agreed that the learning experience was worthwhile (95%), content was appropriate (93%), and the activity should be continued for subsequent classes (94%). Unstructured responses indicated that students learned the importance of clinical histories in the interpretation of radiological studies. CONCLUSION: An educational activity based on the case method was well received by students and met its educational objectives. Activities of this type have potential for widespread application in radiology education.     

A medical student perspective on self-referral and overutilization in radiology: application of the four core principles of medical ethics

There is contention within the medical community surrounding imaging self-referral, in which providers refer patients to imaging facilities from which they receive financial returns. Controversy surrounds the assertion that self-referral leads to overutilization, or the application of imaging resources and services in situations in which patients are unlikely to benefit. Proponents of self-referral claim that the practice provides increased convenience, timelier diagnosis, more expeditious treatment, and decreased cost, while opponents believe that the practice results in the inappropriate ordering of unnecessary imaging studies. Given the importance of this subject and the magnitude of its potential economic impact, it is important to restore objectivity. The 4 core principles of medical ethics--autonomy, nonmaleficence, beneficence, and justice--represent a useful and well-established paradigm. This review article addresses the question of whether self-referral upholds these 4 principles and thus whether it is an ethical practice.     

The value of good medical student teaching: increasing the number of radiology residency applicants

RATIONALE AND OBJECTIVES: The authors attempted to define the value of good medical student teaching to the profession of radiology by examining the effect of radiology course improvements on the number of 4th-year students applying to radiology residencies. MATERIALS AND METHODS: Course evaluation and residency application data were obtained from six consecutive classes of 4th-year medical students at the study institution, and these data were compared with national data. RESULTS: Between 1995 and 2000, the number of 4th-year U.S. medical students applying to radiology increased 1.6 times. At the study institution, that number increased 4.5 times, a statistically significant difference (P = .020, chi2 test). Student survey data indicate that this increase reflects a general increase in the quality of radiology teaching in the study institution and specific changes in a required 2nd-year medical school course. CONCLUSION: These results strongly suggest that good medical student teaching pays important dividends, not only to the departments that provide it but also to the profession of radiology as a whole. Exposing students to good radiology teaching early in their medical school careers is especially important. Radiology departments that provide outstanding medical student education should be studied to help develop a model of educational best practices.