Educating Medical Students about Radiologists' Contributions to Patient Care

Abstract

I nmanyNorth American medical schools, students take no dedicated radiology courses. In some of these, students still receive instruction from radiologists, who serve as guest instructors in courses offered by other disciplines and multidisciplinary courses. In other schools, radiologists play little or no role in required coursework, and whatever instruction in radiology students receive is provided by physicians in other fields. As a result, many students have little opportunity to learn what radiologists do and, in particular, to gain an understanding of the many ways radiologists contribute to patient care. This is a problem for radiology, the students, and the patients for whom they will care. In thinking about what radiologists contribute to patient care, it is important to distinguish between two fundamentally different categories of contribution: inputs and outputs. The facts that there are more than 30,000 practicing US radiologists and that the average US radiologist performs and interprets more than 15,000 exams per year represent inputs. They tell us that health professionals rely to a great extent on radiology in the care of their patients, but they do not tell us what sort of impact radiologists are actually having on the care of those patients. What really matters most is not the resources being put into radiology but the outputs of radiology in improving care. The most readily apparent contribution radiologists make to the care of patients is found in the area of diagnosis. In many cases, health professionals refer patients for imaging exams with particular diagnostic hypotheses in mind, such as ‘‘right upper quadrant pain—assess for gallstones’’ or ‘‘thunderclap headache—rule out subarachnoid hemorrhage.’’ Under these circumstances, one of the radiologist’s principal missions is to confirm or disconfirm the hypothesis, by determining whether there is evidence of gallstones or subarachnoid hemorrhage. In many cases, such as suspected fracture, the images are completely diagnostic.