Junior faculty satisfaction in a large academic radiology department

RATIONALE AND OBJECTIVES: Retention of academic faculty is a pressing issue for many radiology departments. The departure of junior faculty members to private practice may be driven in part by economics; however, the choice may be influenced by many other elements of faculty satisfaction. The purpose of this study was to evaluate how satisfied junior (assistant professors and instructors) and senior (associate professors and professors) faculty in an academic radiology department are with respect to their work and to determine which factors most affected the decision to stay in academics. MATERIALS AND METHODS: We conducted a survey of junior and senior faculty in the department of radiology. Questions included attitudes regarding work, home, and family issues. Among the 27 junior faculty (73%) who responded to the survey, 14 were instructors and 13 were assistant professors. Among the 11 senior faculty (21%) who responded to the survey, 3 were associate professors and 8 were professors. RESULTS: Academic radiology faculty are very happy with work and derive enjoyment and fulfillment from their work. The working week excluding call (average 52 hours) and including call (average 61 hours) was not regarded as too long. The average academic faculty works 72% clinical time (range 15% to 100%) and gets 0.96 day a week of professional development. Fifty-nine percent are funded at an average of 0.91 day a week. Forty-one percent are on tenure track, and of the remainder, 40% expressed a desire for tenure track. Fifty-five percent of faculty have mentors and 57% receive adequate mentoring. When it comes to teaching, 50% have enough time to teach juniors. Of the remainder, all but one cited high clinical workload as an impediment to teaching juniors. Forty-one percent of faculty reported not getting enough academic time. Fifty-nine percent felt pressure to publish and 34% felt pressure to obtain external funding. Seventy-six percent surveyed felt it has become more difficult to publish. The main reasons cited were increasing clinical workload (34%), higher standards required (25%), lack of academic time (25%), and institutional review board constraints (16%). Twenty-eight percent of faculty work on research projects during weekends, 25% during professional development time, and 21% on weekday evenings. However, 63% said they had too little time to spend at home, with family, or on hobbies. The main reasons cited were demands on time caused by clinical work (45%), research (42%), and teaching (24%). Fifty-three percent said that their work regularly causes conflicts at home. CONCLUSIONS: The main reasons to stay in academics were the opportunity for teaching (68%), working with expert colleagues (58%), to pursue research (55%), and an interesting mix of cases (47%). Disincentives to stay in academics included insufficient financial remuneration (82%), the high clinical workload (45%), academic center "politics," and the lack of academic time (42%).     

Twenty-four-hour emergency department coverage by attending radiologists

It has been 5 years since we implemented extended attending radiology coverage at the Ohio State Medical Center. This change in our practice has raised several issues including which cases we should report, the effect on resident education, the impact on our circadian rhythm, and scheduling complexity. As a result of this initiative, the quality of care we provide has improved because of a dramatic decrease in report turn-around time and better consultation with our referring physicians.     

Enhancing research in academic radiology departments: Recommendations of the 2003 Consensus Conference

Opportunities for funded radiologic research are greater than ever, and the amount of federal funding coming to academic radiology departments is increasing. Even so, many medical school-based radiology departments have little or no research funding. Accordingly, a consensus panel was convened to discuss ways to enhance research productivity and broaden the base of research strength in as many academic radiology departments as possible. The consensus panel included radiologists who have leadership roles in some of the most well-funded research departments, radiologists who direct other funded research programs, and radiologists with related expertise. The goals of the consensus panel were to identify the attributes associated with successful research programs and to develop an action plan for radiology research on the basis of these characteristics.     

After-hours coverage: Problems and solutions

Among the problems facing many radiology groups today is how to cover after-hours studies, because the demand is increasing while the number of available radiologists is still relatively low. There are a number of possible solutions, each of which has its own pros and cons, and no solution is right for every group. Recently, there have been a number of companies whose sole business is providing outside teleradiology coverage of after-hours radiology studies, sometimes referred to as “nighthawk” services. This article describes one group’s decision-making process in choosing to hire a nighttime teleradiology provider as well as its subsequent experiences and ideas for future solutions.     

Emergency radiology coverage: technical and clinical feasibility of an international teleradiology model

The purpose of the study was to determine the feasibility of international teleradiology, utilizing day–night time differences, for online interpretation of overnight computed tomography (CT) studies. One hundred and two consecutive Emergency Room patients who underwent CT examinations between the hours of 11 pm and 7 am were enrolled. All age groups and study types were included. CT studies were transmitted from the in-hospital PACS system (Kodak, Fremont, Calif.) to a web-based server (Medweb, San Francisco, Calif.). A radiologist in Bangalore, India, working an 8 am to 4 pm day shift, downloaded and reviewed the studies on a desktop PC using a 128-kbps internet connection at 10–20:1 wavelet compression and generated a report. The report was then uploaded to the server, noting the time at upload. Each study report was compared with the official in-house diagnostic report and concordance assessed on a three-point scale. Mean download time was 8.14 s per image. For head CT reports (n=47), the mean turnaround time for a final transcribed report was 39.5 min. For abdomen/pelvis CT reports (n=48) the mean turnaround time was 84.4 min. Out of 106 cases, there was discordance between the clinical diagnostic report and the study report in 20 (19%); however, on subsequent review the teleradiology report was found to be correct in 13 of these. Day–night time differences across the globe can be utilized to provide overnight emergency radiology coverage using web-based teleradiology. Scan download and report upload times are within acceptable limits.     

Research and research training in academic radiology departments. A survey of department chairmen

We surveyed 121 chairmen of academic radiology departments to assess how these departments select and educate their residents and fellows in research. Eighty-six chairmen responded (71%). The majority of their programs select at least some of their trainees for their potential as researchers and nearly all encourage trainees to perform research. The more the selection process focuses on research, the greater the percentage of residents and fellows that participate in research during training. Nonetheless, only about one-third of residents and half of the fellows perform and publish research. Only half the programs offer formal research seminars and few trainees opt for additional research training. These results may relate to the relatively small percentage of faculty performing prospective clinical and laboratory research. These findings are disappointing in the light of previous results suggesting that performing research, publication, and formal research education during training correlate highly with the development of successful research careers. Chairmen could increase the likelihood of trainees choosing research careers and being successful in publishing research by providing early exposure to research experiences and providing formalized research training.     

Emergency pediatric chest radiology

Both traumatic and nontraumatic pediatric emergencies relating to the chest may be encountered in the emergency room, but nontraumatic problems probably are more common. This communication deals with the salient points used to identify and diagnose nontraumatic pediatric emergencies on initial radiographic studies.     

Physician assistants in academic radiology: the harborview experience

We describe a model of how physician assistants can be used in an academic medical center to expand radiologist productivity, and to enhance the departmental academic and educational missions. At Harborview Medical Center, following a training program and graduated responsibility under supervision, physician assistants provide initial interpretation of radiology studies, consultation to referring physicians, and perform less complicated interventional procedures. Acceptance of physician assistants by the radiologists, radiology residents, and referring physicians has been high. Although the impact of physician assistants on departmental clinical productivity is difficult to measure, our data suggest that radiologists are more efficient when physician assistants are assigned to service, both in terms of numbers of studies interpreted, and timeliness of reporting and billing. As a result of the success of our program, we believe that physician assistants can have an important role in radiology practice.     

Motivation and compensation in academic radiology

As radiologists are increasingly faced with the challenges of rising demand for imaging services and staff shortages, the implementation of incentive plans in radiology is gaining importance. A key factor to be considered while developing an incentive plan is the strategic goal of the department. In academic radiology, management should decide whether it will reward research and teaching productivity in addition to clinical productivity. Various models have been suggested for incentive plans based on (1) clinical productivity, (2) multifactor productivity, (3) individual productivity, (4) section productivity, and (5) chair’s discretion. Although fiscal rewards are most common, managers should consider other incentives, such as research time, resources for research, vacation time, and recognition awards, because academic radiologists may be motivated by factors other than financial gains.     

介入放射科医疗风险的防范

简要介绍介入放射医疗风险种类,防范要求和内容。加强医疗风险管理是减少医疗差错、改善患者安全的有效途径。介入放射科风险具有一些独特的特征,其风险管理工作应根据风险的特征进行。     

A cross-site vascular radiology on-call service: the Manchester experience

AIM: A cross-site vascular radiology on-call service was established 5 years ago to cover two vascular centres in Manchester. We aimed to review the service. MATERIALS AND METHODS: A prospective audit of out-of hours referrals and procedures over a three month period (March-May 2003) was undertaken. RESULTS: There were 52 incidents in 49 patients (mean 4 calls per week). Nine involved telephone advice only, the remainder (82%) required a procedure. Angiography was performed on 88% of patients and therapeutic radiological intervention on 50%. 71% of calls occurred at a weekend. 50% of the calls were from vascular surgery and 50% from other sources. The consultant vascular radiologist was present for 93% of procedures. CONCLUSIONS: The workload suggests that a vascular radiology on call service is justified in Manchester. There have been no major problems with its implementation and operation. This is a consultant led service, with very few cases being devolved to a specialist registrar (SpR).     

A model for faculty mentoring in academic radiology

RATIONALE AND OBJECTIVES: The purpose of this report is to describe the development and implementation of a faculty mentoring program in radiology designed to promote the career development of junior faculty and enhance communication in the department. MATERIALS AND METHODS: The mentoring program was implemented in five stages: organizational readiness, participant recruitment, mentor matching and orientation, implementation, and evaluation. Evaluations were based on Likert scale ratings and qualitative feedback. A retrospective analysis was also conducted of the annual performance reviews of junior faculty in the areas of research, teaching, patient care, and overall performance. RESULTS: An average of 83% (19 of 23) of the junior faculty participated in the pilot phase of the mentoring program. During five rounds of testing, the median rating (1 indicates not important; 10, extremely important) from responding junior faculty was 10 for overall value of individual mentoring meetings; the median rating for the mentors responding was 8.75. Research and academic development were identified as the areas of greatest importance to the faculty. Research and patient care were most improved as assessed by faculty peers during performance reviews. The schedule of semiannual formal mentoring meetings was reported to be optimal. CONCLUSION: The program was implemented to the satisfaction of junior faculty and mentors, and longitudinal performance suggests positive effects. Issues to be contended with include confidentiality and the time needed for mentoring beyond already saturated schedules. Overall, the authors propose that mentoring programs can be an asset to academic radiology departments and a key factor in maintaining their vitality.     

Online radiology appropriateness survey: results and conclusions from an academic internal medicine residency

RATIONALE AND OBJECTIVES: This study was performed to evaluate the ability of medical trainees to choose appropriate diagnostic imaging studies for patients with various clinical indications. MATERIALS AND METHODS: Twelve clinical scenarios were excerpted from the 2000 edition of the American College of Radiology appropriateness criteria and arranged in multiple-choice question format. Summary answers based on the criteria were written. The questionnaire and answer key were placed online and linked; the answer key was viewable only after all 12 answers were submitted by the trainee. An invitation to participate in the online survey was forwarded to medical house staff. RESULTS: Sixty-five (43.3%) of 150 potential respondents completed the survey. The results were tabulated for all respondents and separately for each postgraduate-year class. Fewer than 50% of the respondents correctly answered more than half of the 12 questions. The average number of questions answered correctly by 1st-year residents was 7.02; by 2nd-year residents, 7.5; and by 3rd-year residents, 7.9. CONCLUSION: Medical house staff are not adequately prepared to choose appropriate imaging examinations for specific indications. Improvements in education could prevent inappropriate use of radiology resources. Imaging centers might want to consider developing online catalogs to assist clinicians in choosing appropriate imaging tests.     

Quantification of clinical consultations in academic emergency radiology

RATIONALE AND OBJECTIVES: The purpose of this study is to quantify the impact of clinical consultation on the workload of an academic emergency radiology section. MATERIALS AND METHODS: Data from a 7-day audit (24 h/d) of the number and length of clinical consultations was expressed as the mean number of consultations per 24 hours and consultation minutes per 24 hours. Consultations performed on images acquired from outside institutions were noted. The attending radiologist consultation fraction was defined as the attending consultation minutes per 24 hours divided by the number of minutes of attending coverage per 24 hours. Using annualized work relative value units per full-time employee (wRVU/FTE) over the 7 days, the consultation value unit per full-time employee (CVU/FTE) was defined and calculated as the consultation fraction multiplied by the annual wRVU/FTE. RESULTS: For the attending radiologists, the consultation fraction was 0.13 and the CVU/FTE was 1216. Twenty-two percent of the total consultation minutes were spent on studies performed outside our institution. CONCLUSIONS: Clinical consultation represents a significant portion of the workload in academic emergency radiology. The consultation fraction describes the fraction of the radiologist's time spent in consultation, and the CVU/FTE expresses the workload of clinical consultations in terms of wRVU/FTE, the factor used most commonly to determine the academic radiologist's productivity and staffing.