Radiology Resident Experience in a Community-Based Residency Program

RATIONALE AND OBJECTIVES: The authors performed this study to examine the educational experience of radiology residents by evaluating exposure to total number and variety of examinations. They examined this exposure in relation to current concepts of resident education regarding exposure to difference radiologic examinations, preparation for private practice, and 4th-year resident experience. MATERIALS AND METHODS: The number of examinations performed by radiology residents and the number classified as general versus cross-sectional radiology were analyzed by calculating the average number of studies performed per academic year during the past 6 years. RESULTS: In general, there was in increase in the total number of examinations performed per resident during the past 6 years. There was no statistically significant difference in the experience with general versus cross-sectional radiologic examinations. The data support the contention that 4th-year residents perform fewer examinations. CONCLUSION: Experience with all radiologic examinations is increasing as the overall utilization of radiology services increases. Fourth-year residents read fewer images; further studies are necessary to determine whether this finding reflects a planned decrease in workload or an increase in the complexity of the workload. It may be necessary to establish a minimum number and mixture of examinations to prepare residents for private practice.     

Radiology on the air. A continuing medical education experiment.

RATIONALE AND OBJECTIVES. The purpose of Radiology on the Air was to assess the technical and educational feasibility of providing radiologic continuing medical education via a fully interactive live telecommunications network. METHODS. Thirty-nine radiologic conferences were broadcast over the communications network of the Microelectronics Center of North Carolina (MCNC). Category 1 credit for the Physicians Recognition Award of the American Medical Association was available to participants who returned a completed program evaluation sheet by mail. RESULTS. Three participating academic institutions regularly offered the programming to a total of 684 participants, of whom 129 viewed programs at distant sites. Despite adequate-to-excellent technical quality and positive feedback concerning educational content, no continuing medical education (CME) credits were issued by the parent institution. CONCLUSIONS. The Radiology on the Air experiment suggests that a live telecommunications network is a capable vehicle for providing CME in radiology.     

On-call services provided by radiology residents in a university hospital environment.

OBJECTIVE: To better understand the consultative role of the radiology resident after hours. METHODS: Data were collected prospectively from Mar. 15, 1999, to Jan. 5, 2001, during on-call coverage hours at our university hospital. Urgent radiologic examinations for which the on-call resident rendered a preliminary interpretation were included in our analysis, with the following entered into a database: patient demographics, consultative time and weekday, imaging modality, consulting clinical service and indication for each study. RESULTS: A total of 1784 studies were performed on 1451 patients; most were requested by the emergency department (844 cases [47.3%]). The mean number of radiographic studies performed was 20.1 (standard error of the mean [SEM] 1.1) per weekday (n = 44) and 49.4 (SEM 1.8) per weekend day or holiday (n = 18). There were 1227 (68.8%) computed tomographic (CT), 338 (18.9%) ultrasonographic, 98 (5.5%) plain radiograph, 63 (3.5%) nuclear medicine, 21 (1.2%) interventional, 20 (1.1%) fluoroscopic and 17 (1.0%) magnetic resonance imaging examinations. The 3 most common studies were CT of the head in 692 cases, CT of the abdomen in 230 and venous Doppler ultrasonography in 158. CONCLUSIONS: Radiology residents are performing a diverse and increasing number of emergent diagnostic examinations after hours. It is therefore important that radiology departments are aware of these consultative needs to best ensure that appropriate resident skills are developed to meet these demands.     

Results of and comments on the 2000 survey of the American Association of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVES: The American Association of Academic Chief Residents in Radiology (A3CR2) annually surveys radiology residency programs on issues related to training. The objective is to highlight national similarities, differences, and trends to help programs establish standards and improve residency training. MATERIALS AND METHODS: Questionnaires were mailed to 180 accredited diagnostic radiology residency training programs in the United States. The survey covered the usual general topics and more specific topics considered every 4 years; for 2000 the latter were on-call issues and the chief residency year. RESULTS: Completed surveys were returned from 63 programs (35%). Important findings included increased caseload and call commitments, especially for smaller programs. Resident salaries appear to have increased more than the consumer price index. Nonemergent after-hour coverage and teleradiology are now a large part of the resident work practice. Women continue to be underrepresented, with a trend downward. Chief residents are more involved in organizing preparation for board examinations and have greater office facilities and more administrative duties. CONCLUSION: This survey provided useful insights. All levels of residency face increased workloads. On-call hours have not changed, but the work has intensified and the use of teleradiology has increased. Many programs have adopted a "night-float" system, and nonemergent after-hours coverage should be considered in any program evaluation. Continued vigilance and sustained efforts are required to ensure that radiology is considered as a specialty by both men and women. With increased demands on attending physicians' time, chief residents may need to take on more administrative responsibilities.     

Occupational necessity and educational invention: resident teaching of radiologic technologists

RATIONALE AND OBJECTIVE: Radiology faces a severe and growing shortage of radiologic technologists. One way of redressing this problem is to improve the quality of education provided to radiologic technology students. Yet growing clinical demands increasingly erode faculty time for teaching. This study examined whether radiology residents could provide equivalent instruction in radiologic technology at lower cost, and whether such experience could enhance residents' interest in teaching as part of their careers. MATERIALS AND METHODS: Course evaluation forms completed by the students in a required radiologic pathology course were reviewed, and student-reported faculty and resident performances in teaching were compared. Residents also were surveyed for their reactions to the experience of teaching this course. RESULTS: Ninety percent of students (27 of 30) either agreed or strongly agreed that the course was well taught by radiology faculty members, and 97% (29 of 30) either agreed or strongly agreed that the course was well taught by radiology residents. The total direct cost of instruction by radiology residents was 73% lower than the cost of instruction by faculty. Residents who participated in teaching found the experience worthwhile, and they described a wide variety of personal and educational benefits. CONCLUSION: Involving radiology residents in teaching can help redress the growing shortage of radiologic technologists, relieve some of the pressure on faculty time, and contribute to the professional development of the next generation of radiologists.     

Are NBME examination scores useful in selecting radiology residency candidates?

RATIONALE AND OBJECTIVES: The quality of the graduates of radiology residency programs is powerfully affected by the quality of the candidates admitted to them, making the evaluation and ranking of residency applicants one of the most important tasks of radiology education. In the applicant evaluation process, evaluators frequently take into account applicants' scores on the National Board of Medical Examiners (NBME) examination, operating on the implicit assumption that these scores help predict future performance as residents. The purpose of this study was to test that assumption. MATERIALS AND METHODS: Using a data set consisting of information about 99 residents admitted over a period of 10 residency class years, the authors compared scores for parts I and II of the NBME examination with later results on the American Board of Radiology (ABR) written and oral examinations. Logistic regression was used to model differences in resident performance on the NBME and ABR examinations and to determine whether variance in ABR results could be predicted by variance in NBME examination scores. RESULTS: The authors were unable to demonstrate any statistically significant value of NBME examination scores in predicting eventual performance on the ABR written and oral examinations. CONCLUSION: The authors' attempt to validate the widespread practice of using NBME examination scores to evaluate and rank applicants to radiology residency programs demonstrated no discernible value for these scores in predicting the success of residents on the ABR examinations.     

Results of the 2004 survey of the American Association of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVE: Every year, the American Association of Academic Chief Residents in Radiology (A3CR2) conducts a survey of the chief residents in accredited radiology programs in the United States and Canada. The purpose of the survey is to evaluate current residents' opinions regarding a number of different issues pertaining to their educational experience, work responsibilities, and benefits. This information is useful in monitoring patterns of change in resident attitudes toward their experiences within their residency training programs. MATERIALS AND METHODS: Online surveys were made available to the chief residents from 193 training programs in North America. For the most part, the questions were presented in a multiple-choice format, with additional space for elaboration or comments provided for many of the items. Some questions are repeated annually, addressing general topics such as salary and hospital size. However, new questions are incorporated each year. In particular, this year's survey included questions pertaining to Armed Forces Institute of Pathology course funding, and advanced cardiac life support (ACLS) /basic life support certification and changes in duty work hour and call requirements in the face of changing ACGME (Accreditation Council for Graduate Medical Education) regulations. RESULTS: The results of the survey were then tabulated, and responses to several of the repeated questions were compared with those from prior surveys dating back to 1996. This year's response rate was 55%, with 106 unique responses received. This represents an improvement since last year's survey, when the response rate was 41%. In some cases, more than one response was generated by a given residency program, in which case the questionnaire that was more thoroughly completed was used for statistical analysis. Responses were received from chief residents in 37 states and in Canada. The largest number of respondents was from New York, and 80% percent of respondents were from programs affiliated with a university. Forty-two percent were incoming chief residents with less than 3 months' experience, whereas 58% were outgoing chief residents with less than 9 months remaining in their tenure. CONCLUSION: The majority of respondents report that changes made by their respective programs as the result of new ACGME maximum duty hour standards have been viewed favorably by radiology residents. Many training programs have moved toward a night float based call system in order to maintain compliance. Nearly all programs have overnight in-house radiology resident coverage, but there has been a slight decline in the percentage of programs that provide in-house attending coverage at night. The majority of residents, however, have access to attendings after-hours by pager. Finally, resident salaries and benefits continue to increase, as has been the trend over the past several years.     

The chief residency in radiology. Results of a survey of A3CR2 members

Detailed questionnaires were sent to the 192 members of the American Association of Academic Chief Residents in Radiology (A3CR2) to learn about the logistics of chief resident selection, the responsibilities of the chief resident, the attitudes and perceptions of the chief resident about his or her position, and suggestions for improving the chief residency. Completed questionnaires were returned by 149 (78%) chief residents from 111 different residency programs. The results show that radiology residents have a greater voice in selecting their chief residents than in the past. The number and types of responsibilities given to the chief resident at different institutions vary considerably. Although only 62% of respondents felt that being chief resident was worth their time and effort, 88% would accept the position again. The most commonly voiced suggestion was for greater input from the chief resident during the formulation of policies that affect the residents. Based on these results and a review of previous reports about the chief residency in other specialties, several proposals are offered for increasing the effectiveness of the radiology chief residency.     

Beyond business as usual: Radiology residency educational response to the COVID-2019 pandemic

The COVID-19 pandemic has disrupted standard hospital operations and diagnostic radiology resident education at academic medical centers across the country. Deferment of elective surgeries and procedures coupled with a shift of resources toward increased inpatient clinical needs for the care of COVID-19 patients has resulted in substantially decreased imaging examinations at many institutions. Additionally, both infection control and risk mitigation measures have resulted in minimal on-site staffing of both trainees and staff radiologists at many institutions. As a result, residents have been placed in nonstandard learning environments, including working from home, engaging in a virtual curriculum, and participating in training sessions in preparation for potential reassignment to other patient care settings. Typically, for residents to gain the necessary knowledge, skills, and experience to practice independently upon graduation, radiology training programs must provide an optimal balance between resident education and clinical obligations. We describe our experience adapting to the challenges in educational interruptions and clinical work reassignments of 41 interventional and diagnostic radiology residents at a large academic center. We highlight opportunities for collaboration and teamwork in creatively adjusting and planning for the short and long-term impact of the pandemic on resident education. This experience shows how the residency educational paradigm was shifted during a pandemic and can serve as a template to address future disruptions.     

A survey evaluating the beliefs of radiology residency program directors regarding incorporation of numeric standards into accreditation standards

RATIONALE AND OBJECTIVES: Numeric standards do not exist for the evaluation and comparison of radiology resident education. The Accreditation Council for Graduate Medical Education has recently proposed the evaluation and assessment of residents by using numeric values for films read in various radiology modalities. The purpose of this study was to evaluate radiology residency program directors' perceived need for numeric standards for radiology residency programs. MATERIALS AND METHODS: Program directors were surveyed via a three-part questionnaire. Initial contact was made by e-mail, with follow-up by telephone if necessary. The survey questions were: (1) Do you feel that a need exists for a set of numerical standards for the number of films read by radiology residents in each of the various subspecialties? (2) Specify the needs that you see. (3) What are the barriers and disadvantages to acquiring such data? RESULTS: Survey responses were received from 44 of 192 radiology residency programs (23% response rate). Overall, 34 (77%) of 44 program directors were against implementation of the Accreditation Council for Graduate Medical Education proposal, whereas 8 (18%) of 44 program directors were in favor of the proposal and 2 (5%) of 44 were undecided. A variety of reasons, both for and against the proposal, were provided by program directors. CONCLUSION: Among the program directors responding to the survey, there was strong opposition to implementation of mandatory standards for specific numbers of radiologic examinations by residents as the basis for program accreditation.     

Evaluation of clinical experience in a radiology residency program with quantitative profiling: rationale,methods, and application

RATIONALE AND OBJECTIVES: The author developed a technique for residency program evaluation, called "quantitative profiling," that is based on computer retrieval of radiologic reports. The hypothesis was that it would provide insights into the contributions of residents to clinical service, measures of resident experience and productivity for program evaluation, and benchmarks for comparison. MATERIALS AND METHODS: The radiology residency program of a major teaching hospital was studied retrospectively from 1989 to 1997. The number of radiologic reports signed by individual residents and faculty members was retrieved. The clinical experience of the 1993-1997 cohort of residents was described according to subspecialty area and modality. RESULTS: Residents signed 46.5% of all reports, with a mean total of 14,445 reports +/- 1,292 per resident during the entire residency. The distribution of examinations was as follows: thoracic, 42.1%; musculoskeletal, 26.1%; abdominal, 13.4%; sonography, 8.7%; neuroradiology, 4.3%; nuclear, 2.4%; breast, 1.6%; and vascular, 1.4%. The most frequently reported results were for one-view chest radiography. CONCLUSION: Quantitative profiling can help track the range and progress of resident experience, help determine the deployment of residents, and provide empirical data upon which decisions to modify residency programs may be based.     

Self-subsidization of educational expenses by senior radiology residents

RATIONALE AND OBJECTIVES: The purpose of this study is to document the degree of self-subsidization of educational expenses by senior radiology residents. MATERIALS AND METHODS: Questionnaires were distributed to all radiology residents (n = 176) attending the New Jersey Medical School board review course held twice in 2006. Respondents (n = 175) documented the number and source of financial support for review courses they had or would attend, including the AFIP course in radiologic pathology. They also listed the amount of additional financial allowances paid to them by their programs and cited the funding source for the radiology board examinations. RESULTS: Average AFIP expenditure, including tuition, room, board, and travel, equaled 3,969 dollars +/- 45 dollars, of which 46% was paid by the residents themselves. The respondents attended, on average, two review courses costing 4,116 dollars +/- 149 dollars, bearing 77% of the costs. The average additional allowance paid to residents was 1,938 dollars +/- 156 dollars. Total board expenditures of 3,120 dollars, including fees and travel, were borne entirely by the residents. Total out-of-pocket expenses for these activities was 7,928 dollars +/- 165 dollars, which amounted to 16% of senior residents' average annual salary (49,746 dollars). CONCLUSION: The desire by both programs and trainees for success on the radiology board examination has stimulated the growth of review courses. The enduring popularity of the AFIP course has made this activity an essential rotation for most radiology residency programs. Each of these off-site opportunities incurs significant financial obligations to residents, and when added to the cost of the board exams, equals 16% of their average annual salary. Thus radiology residents are subsidizing their education to a considerable degree relative to their salaries. This study reveals that senior radiology residents significantly subsidize their education and bear the burden of hidden costs associated with their training.     

Effectiveness of resident-prepared conferences in teaching imaging utilization guidelines to radiology residents

RATIONALE AND OBJECTIVES: The authors evaluated the effectiveness of a resident-prepared conference series for teaching imaging utilization guidelines to radiology residents. MATERIALS AND METHODS: Brown University radiology residents (n = 17) gave 61 presentations on imaging utilization to their colleagues during 16 1-hour conferences. The residents were later examined on the topics presented and surveyed about their familiarity with the American College of Radiology appropriateness criteria, their exposure to issues of cost-effectiveness, and their degree of confidence in providing imaging consultation. The same examination and survey were administered to control residents from the University of Wisconsin (n = 14) and the Oregon Health Sciences University (n = 14). Scores were compared by using linear regression and Wilcoxon rank sum tests. RESULTS: Controlling for years in radiology residency, residents at Brown scored on average 16.0% (standard error = 2.2%) higher than residents at the other universities (P < .001). Controlling for institution, 3rd- and 4th-year residents scored on average 7.4% (standard error = 2.1%) higher than 1st- and 2nd-year residents (P = .001). Brown residents expressed more familiarity with American College of Radiology appropriateness criteria and appeared to have more exposure to cost-effectiveness issues in conferences than residents at Wisconsin or Oregon Health Sciences University (P < .005). Residents from the three universities did not differ in their level of confidence in providing imaging consultation. CONCLUSION: Resident-prepared conferences are an effective means of teaching imaging utilization guidelines to residents, but they do not affect the residents' perception of their ability to provide imaging consultation.     

Diagnostic radiology resident compliance with recommended health guidelines: effect of resident work environment

RATIONALE AND OBJECTIVES: To determine diagnostic radiology resident compliance with recommended health guidelines for physical activity, body weight, diet, related health indicators, and the effects of the resident work environment on compliance. MATERIALS AND METHODS: A request was electronically mailed to members of the Association of Program Directors in Radiology and the Association of Program Coordinators in Radiology in May 2007 and again in June 2007, asking members to forward to their radiology residents an invitation to complete an online health survey. Frequency counts and Fisher's exact test, respectively, were used to summarize results and to determine statistically significant relationships between survey variables. RESULTS: A total of 811 radiology residents completed the survey, representing 18% of 4,412 diagnostic radiology residents. Five hundred forty-five (67.2%) of 811 were male and 264 (32.6%) female. Two hundred ten (25.9%) were first-year, 239 (29.5%) second-year, 201 (24.8%) third-year, and 161 (19.9%) fourth-year residents. Three hundred two (37.2%) engaged in recommended guidelines for physical activity and < or =465 (57.3%) complied with each of multiple federal dietary guidelines (excluding alcohol intake). Up to 329 (40.6%) residents did not know whether they were in compliance with various dietary guidelines. A total of 426 (52.5%) residents reported working > or =60 hours/week, which significantly correlated with less physical activity (P = .013). CONCLUSION: A substantial number of residents are out of compliance with federal guidelines for physical activity and diet and are not knowledgeable about their personal dietary intake. Long work hours are related to a lack of physical activity. Radiology programs may be able to influence resident health practices by modifying work hours and the working environment, encouraging healthy dietary intake and physical activity, and instituting campaigns to inform residents and faculty about health guidelines and available wellness programs.     

The “night stalker” effect: Are quality improvements with a dedicated night call rotation sustained?

The authors assessed whether the addition of a second-year diagnostic radiology resident assigned to cover the night shift at a major urban university hospital has a sustained effect on the number and clinical significance of “missed” radiologic findings. Radiographs interpreted overnight in the emergency department by radiology residents between January 1992 and December 1992 were reviewed daily by emergency radiology attending staff. A list of patients for whom there was a modification in the final radiologic interpretation was given to the emergency department physicians, who reviewed each case, scored the urgency of patient recall, and estimated the likelihood of patient morbidity attributable to the miss. The relative performance of after-hours residents was compared on the five nights per week with the dedicated night resident vs. the two nights per week without the dedicated night resident (control group). Of 22,295 after-hours examinations performed during the study period, 304 (1.36%) misses were recorded, nearly identical to the miss rate for the preceding 6 months. The percentage per examination interpreted (and number) of missed cases stratified by recall score for the control and dedicated night resident groups, respectively, were: (a) immediate, 0.62% (34) and 0.29% (49); (b) within 48 hours, 0.31% (17) and 0.32% (54); (c) no recall, 0.71% (24) and 0.29% (39); (d) finding already recognized by emergency department physicians, 0.44% (24) and 0.23% (39); total, 2.09% (114) and 1.13% (190). The difference in total discordance rates is statistically significant (P < 1 × 10⁻¹⁵). Our previously reported improvement in the quality of after-hours radiographic interpretation due to the addition of a dedicated night shift resident is sustained in a new group of residents. This confirms that the improvement is real and not a manifestation of the measurement methods.     

Global Radiology Training Prevalence Among Radiology Residency Programs

ObjectiveGlobal Radiology aims to enhance access to medical imaging services and education, worldwide. To date, few reports have evaluated Global Radiology Training (GRT) in radiology residency programs. Here, we examined how radiology residency programs perceive and incorporate GRT into their curriculum, and how this information is promoted online.MethodsTwo methods were used to examine the current state of GRT. First, radiology residency program directors (identified via the Association of Program Directors in Radiology) were surveyed on topics including: Electives, institutional partnerships, resident and faculty involvement, inquiry by prospective residents, and barriers to implementation. Second, radiology residency program websites (n = 193) were examined for existing GRT on the programs’ publicly available webpages.ResultsThere were 62 survey responses (response rate of 19%). Thirty-eight percent (24/62) of residency programs offered a Global Radiology elective to their residents within the past academic year and 27% (17/62) of programs have active affiliations with medical institutions outside of the United States. Eighty-four percent of program directors (52/62) received questions from residency applicants regarding opportunities to participate in Global Radiology. Furthermore, only 13% (26/193) of all radiology residency programs listed at least one GRT elective on their webpage.DiscussionGRT in radiology residency is more widely available than previously reported and has been underrepresented on residency program websites. In the present survey, the majority of radiology residency program directors reported that radiology is an important component of Global Health, one-third of whom have already incorporated the subject into their curriculum. However, most common barriers to GRT include, perceived lack of time in the curriculum and lack of faculty interest. The high prevalence of inquiry from residency program applicants about GRT suggests that it may be a notable factor for applicants during the ranking process. Programs build up GRT may choose to share related information seeking to may choose to emphasize work in Global Radiology on their program webpages.     

Comprehensive innovative solution for resident education using the Intranet Journal of Chest Radiology

RATIONALE AND OBJECTIVES: Because of the rapid increase in clinical workload in academic radiology departments, time for teaching rotating residents is getting more and more limited. As a solution to this problem, we introduced the Intranet Journal of Chest Radiology as a comprehensive innovative tool for assisting resident education. MATERIALS AND METHODS: The Intranet Journal of Chest Radiology is constructed using Microsoft FrontPage version 2002 (Microsoft Corp, Redmond, WA) and is hosted in our departmental web server (Beth Israel Deaconess Medical Center, Boston, MA). The home page of the intranet journal provides access to the main features, "Cases of the Month," "Teaching File," "Selected Articles for Residents," "Lecture Series," and "Current Publications." These features provide quick access to the selected radiology articles, the interesting chest cases, and the lecture series and current publication from the chest section. RESULTS: Our intranet journal has been well utilized for 6 months after its introduction. It enhances residents' interest and motivation to work on case collections, to search and read articles, and to generate interest in research. Frequent updating is necessary for the journal to be kept current, relevant, and well-utilized. CONCLUSION: The intranet journal serves as a comprehensive innovative solution for resident education, providing basic educational resources and opportunities of interactive participation by residents.     

Diagnostic radiology residents in the classes of 1999 and 2000: fellowship and employment

OBJECTIVE: Most diagnostic radiology residents undergo fellowship training. Applications for fellowship positions are submitted during the third year of residency. We compared the number of residents undertaking fellowship, accepting jobs, and rescinding accepted fellowship positions to accept jobs. MATERIALS AND METHODS: During the 47th Association of University Radiologists meeting, participants from the American Association of Academic Chief Residents in Radiology completed a questionnaire regarding the intentions of third- and fourth-year residents in their programs. RESULTS: Seventy programs, representing 402 fourth-year and 395 third-year residents, responded. Of fourth-year residents, 322 (80.1%) accepted fellowships and 41 (10.2%) accepted jobs. Of third-year residents, 335 (84.8%) accepted fellowships. Eighty-eight (27.3%) fourth-year residents and 95 third-year residents (28.4%) accepted interventional radiology fellowships, and 104 (32.3%) fourth-year residents and 96 (28.7%) third-year residents accepted body imaging fellowships. Most residents who accepted fellowships did so in the same city in which they completed their residency training. Of fourth-year residents who accepted fellowship positions the year before, 14 (4.3%) withdrew their acceptance to pursue employment. CONCLUSION: Most residents opt for fellowship training in interventional radiology or body imaging. We postulate that the practice of accepting fellowships during the third year of residency may contribute to the percentage of residents who rescind fellowship acceptance to pursue employment. We suggest that consideration be given to changing this practice.     

Does hands-on obstetric US experience improve performance on the radiology oral board examination?

PURPOSE: To investigate whether the inclusion of hands-on obstetric ultrasonography (US) experience as a formal part of radiology residency affects performance on the US section of the oral board examination. MATERIALS AND METHODS: An electronic survey was sent to all radiology residency programs to assess (a) the time assigned to US rotation, (b) the inclusion of obstetrics in US rotation, and (c) the opportunity for hands-on scanning of obstetric patients. Blinded results from the 2002 Diagnostic Radiology Oral Board Examination were provided by the American Board of Radiology. We recorded the overall examination score, US section score, and individual score for all obstetric cases for each resident from programs that responded to the survey. A Student t test and stratified statistical analyses were performed. This study was determined to be exempt from institutional review board approval. Residency directors who consented to participate were informed of pertinent information. RESULTS: Of the 159 programs, 64 (40.3%) responded and 63 (98%) of these had scores available. US section scores were provided for 280 residents, with 869 obstetric case scores. Fifty (79%) of 63 programs provided the opportunity for hands-on obstetric scanning. After adjusting for covariates, there was no significant difference in individual resident performance between residents with hands-on scanning experience and those without hands-on scanning experience (P = .61). When evaluated according to program, there was no significant difference in performance between programs with and those without hands-on training (P = .39). CONCLUSION: Radiology resident performance in obstetric US on the American Board of Radiology Oral Board Examination is similar for programs that provide the opportunity for hands-on obstetric scanning compared with those that do not.     

How well does applicant rank order predict subsequent performance during radiology residency?

RATIONALE AND OBJECTIVES: Residency selection committees expend substantial time and resources on assessing the quality of residency applicants to derive an appropriate rank order for the National Residency Matching Program. The authors determined whether there is a relationship between the rank number or rank percentile of applicants selected for a residency training program and subsequent radiology residency performance. MATERIALS AND METHODS: Records of radiology residents completing their residency between 1991 and 1998 were reviewed. Available rank numbers and rank percentiles for each resident were compared with subsequent performance, as assessed subjectively by 4th-year radiology rotation evaluation forms and retrospective recall of four senior faculty members and objectively by numerical and percentile scores on the written portion of the American Board of Radiology (ABR) examinations. Correlation coefficients were obtained for each comparison. RESULTS: Rank number and rank percentile were not significantly correlated with 4th-year resident rotation evaluations or ABR written examination scores or percentiles. A small correlation existed between rank order and retrospective evaluation of resident performance by the four senior faculty. CONCLUSION: Applicant rank number and rank percentile do not correlate with subsequent radiology residency performance as assessed on rotation evaluation forms or the ABR written examinations.