<p>Postgraduate musculoskeletal fellowship training in the United States: current trends and future direction

OBJECTIVE: To document current postgraduate musculoskeletal training program (accredited and unaccredited) curricula and approaches to education. DESIGN AND PATIENTS: Questionnaires were sent to all musculoskeletal training programs. Responses regarding radiology residency and fellowship program sizes, types of imaging and invasive procedures included, and other program parameters were solicited. Features of accredited and unaccredited programs were compared. Teaching approaches, including the use of web-based or distance learning were evaluated. RESULTS: Twenty-nine (73%) of 40 musculoskeletal programs responded to the questionnaire. Twenty-eight percent of programs were accredited and 72% unaccredited. Radiology residencies were also present at all responding institutions (the majority had a class size of 4-8/year). Residency programs in related specialties included pathology 96%, orthopedics and rheumatology 90%, oncology 83% and pain management 69%. The majority (93-100%) provided training in radiography, MRI and CT. Spine MRI was included in 69% of programs, ultrasonography in 62% and positron emission tomography in 24%. Arthrography and diagnostic and therapeutic injections (100%) were included in all programs. Other invasive procedures, including spine and radiofrequency ablation, were offered less frequently. Teaching approaches included conferences (100%), journal clubs (62%), multidisciplinary conferences (45-90%), web-based learning (30%) and distance learning (7%). Forty-one percent of programs offered off-site rotations. CONCLUSIONS: The majority of musculoskeletal training programs prepared trainees for private or academic practice. There are inconsistencies that could be improved to better prepare trainees for careers in musculoskeletal imaging.     

Status of and trends in nuclear medicine in the United States

Nuclear medicine in the United States has grown because of advances in technology, including hybrid imaging, the introduction of new radiopharmaceuticals for diagnosis and therapy, and the development of molecular imaging based on the tracer principle, which is not based on radioisotopes. Continued growth of the field will require cost-effectiveness data and evidence that nuclear medicine procedures affect patients' outcomes. Nuclear medicine physicians and radiologists will need more training in anatomic and molecular imaging. New educational models are being developed to ensure that future physicians will be adequately prepared.     

中美环境辐射监测系统比较

目的旨在通过对中美环境放射性监测系统的比较，以期对各自的发展或类似系统的发展起到一定的参考作用。方法通过对中国国家放射性污染监测系统（NRCMS）和美国环境辐射监测系统（ERAMS）、环境测量研究所（EML）全球放射性监测网在样品采集、放射性核素分析以及数据发布等方面的比较，给出各系统的异同点。结果NRCMS和ERAMS在职责、目的、监测对象等方面有很大的相似性，差异主要存在于监测的规模和大小上。EML全球监测网在地表空气放射性核素监测方面是全球最大、最全面和最有成效的。结论与EML全球监测网相比较，NRCMS和ERAMS存在更大的相似性，差异较小。     

Standards of practice in interventional neuroradiology

The growing importance of INR has resulted in the need to define and promote professional standards of clinical practice. Several professional organizations have published guidelines recently for the neurointerventional treatment of cerebrovascular diseases, including technical and personal recommendations, but detailed definitions of technical and organizational conditions needed for the safe and effective performance of such treatments are lacking. To fill this gap ESNR, ESMINT and the UEMS Division for Neuroradiology established a working group, to develop a consensus paper on “Standards of Practice in Interventional Neuroradiology”. This document is the result of the Consensus Working Group and has following review gained approval by the Executive Boards of ESNR and ESMINT and by the members of the UEMS Division for Neuroradiology in 2017.

     

United States Medical Licensing Examination Step 1 and 2 Scores Predict Neuroradiology Fellowship Success

PurposeMany neuroradiology programs use United States Medical Licensing Examination (USMLE) scores to assess fellowship candidates. The authors hypothesized that because they are taken several years before fellowship, USMLE scores would correlate poorly with success in fellowship training as measured by faculty evaluations.MethodsUSMLE scores from 10 years of neuroradiology fellows (n = 73) were compared with their cumulative mean E*Value scores from their fellowship years and their best-to-worst rankings within their fellowship years. If available, subspecialty certification scores were also factored as an outcome. Linear correlation and regression analyses were performed adjusting for gender, medical school site, and practice setting after fellowship.ResultsUSMLE Step 1, 2, and 3 scores were available for 69, 64, and 56 fellows, respectively. Fellowship E*Value scores and rankings showed statistically significant (P < .05) correlations with all USMLE scores, but most strongly for Step 1 scores and E*Value grade (r = 0.443) and rank (r = 0.370). The mean USMLE Step 1 score of the top-ranked fellows (234.5) was significantly higher than that of the bottom-ranked fellows (217.7). The correlations of E*Value score and rank with USMLE Step 1 and 2 scores remained after adjusting for gender and American versus foreign medical school, but the medical school site attended also was an independent predictor of fellowship evaluations. Subspecialty certification scores did not show correlations but were underpowered (n = 28).ConclusionsUSMLE Step 1 and 2 scores correlated significantly with success in neuroradiology fellowship, measured by faculty assessments of the six core competencies. Using the scores as a means of assessing candidates for positions is justified.     

Mission, staffing, and budget data of flight programs in the United States

INTRODUCTION: Manage care and other health care reform initiatives have forced all hospitals to evaluate their work processes. In this era of cost containment, many flight programs are examining the structure of their programs to determined whether they are functioning in an efficient, cost-effective fashion. METHODS: A survey was sent to the chief flight nurse of 240 flight programs in the United States. RESULTS: Eighty-five programs (35.4%) responded. Data were collected on demographics, management structure, mission information, staffing issues, and budgets. Results in each program varied widely. CONCLUSION: Benchmark data are available against which programs can compare themselves. Such comparisons may allow the discovery of opportunities to enhance program efficiency and cost-effectiveness.     

Molecular imaging programs in the United States: results of a national survey

RATIONALE AND OBJECTIVES: We sought to identify and describe the characteristics of molecular imaging (MI) programs in the United States and to determine the factors considered critical for their future. MATERIALS AND METHODS: In a cross-sectional study, a validated survey was sent to members of the Society of Chairmen in Academic Radiology Departments (SCARD) in the United States, and 26 variables were studied. RESULTS: The response rate was 40.3%; 67.9% of the departments surveyed have an MI program. The main focus of 47.4% of departments is oncology. The number of radiologists working for the department was the only variable found to be significantly positively correlated with (1) number of researchers in the MI program, (2) number of MI modalities available, (3) total number of grants, and (4) having ongoing MI clinical trials. These four variables plus the number of federal grants and the space used by MI programs were independent of the geographical region, hospital size (number of beds), and department size (number of radiological examinations per year). All the MI programs received grants during 2005. Only 16.1% have no alliances with industry. Among all the departments, 82% identified staff training and recruitment as the keys for success; 78.57% considered oncology the most important future application of MI and cancer management the hospital service most affected by MI. CONCLUSION: MI programs are starting to be more widespread throughout the United States, and the trend is for more academic radiology departments to become engaged in MI activities; their development is independent of department characteristics. Radiology departments strongly agreed about the key components for success of MI initiatives and the areas that will be most affected by MI applications.     

Cerebral angioplasty practice at major medical centers in the United States

Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. Received: 27 November 1998/Accepted: 13 May 1999