Academic Radiology Departments Research Articles

Women in leadership matters: Achieving diversity in radiology residency recruitment

Rationale and objectivesTo assess whether academic radiology departments and residency programs with efforts toward supporting and augmenting Diversity, Equity, and Inclusion (DEI) are associated with a higher proportion of residents from diverse backgrounds. Materials and methodsProgram Directors within the Radiology Residency Education Research Alliance were surveyed to gather information about program characteristics, incorporation of diversity in resident recruitment, the sponsoring department's commitment to efforts at expanding diversity, and a summary of their current and past residents, staff and faculty members (academic years 2020 and 2023) with respect to a list of diversity characteristics. ResultsSurvey response rate was 51 %. Sixty-three percent (15/24) of participating programs have departmental committees dedicated to DEI work; 46 % (11/24) of programs' departments have a Vice Chair for DEI. Sixty percent (15/24) of programs use their social media accounts to advertise their DEI programming efforts. Ninety-six percent (23/24) of programs participating in the survey use diversity factors to select candidates for their program. Women Leadership was associated with above-median diversity of residents and faculty. ConclusionThis study of radiology residency programs encourages a more prominent role for women in leadership positions within academic radiology departments to drive diversity and inclusion efforts.

Academic radiology department subspeciality organization & fellowship offerings: A hodgepodge

IntroductionAs opportunities for radiologists to subspecialize have increased, many avenues to organize Radiology department subspecialties exist. This study seeks to determine how academic U.S. Radiology departments structure themselves with respect to subspecialty divisions/sections, as there are no current standards for how Radiology departments are subdivided. Additionally, the extent of Radiology fellowships offered are assessed. The websites of academic U.S. Radiology departments, a highly influential source of information, were analyzed to perform this study. Materials & methodsRadiology department websites of all allopathic U.S. medical schools (n = 148) were assessed for the following: presence/absence of Radiology department subdivisions, division/section labels, number of divisions/sections, division/section titles, presence/absence of Radiology fellowships, number of fellowships, and fellowships titles. Results114/148 (77 %) medical schools had Radiology department websites. According to their respective websites, 66/114 (58 %) academic Radiology departments had subspecialty divisions/sections, whereas 48/114 (42 %) had no divisions/sections listed. Of the departments that had divisions/sections, the median number of divisions/sections per department was nine, and ranged from two to 14. Fellowships were offered at 82/114 (72 %) academic Radiology departments that had websites, and the median number was six, ranging from one to 13. ConclusionThere is marked heterogeneity of departmental organization across Radiology departments nationwide, likely due to the lack of current standards for how Radiology departments are subdivided into divisions/sections. Of the 77 % of medical schools that have Radiology department websites, only 58 % of departments listed divisions/sections, and 72 % posted fellowship offerings.

A Novel Design-Thinking, Hospital Innovation Core Certificate Curriculum for Radiologists and Trainees: Creation, Implementation, and Multiyear Results

Innovation is a crucial skill for physicians and researchers, yet traditional medical education does not provide instruction or experience to cultivate an innovative mindset. This study evaluates the effectiveness of a novel course implemented in an academic radiology department training program over a 5-year period designed to educate future radiologists on the fundamentals of medical innovation. A pre- and post-course survey and examination were administered to residents who participated in the innovation course (MESH Core) from 2018 to 2022. Respondents were first evaluated on their subjectivecomfort level, understanding, and beliefs on innovation-related topics using a 5-point Likert-scale survey. Respondents were also administered a 21-question multiple-choice exam to test their objective knowledge of innovation-related topics. Thirty-eight residents participated in the survey (response rate 95%). Resident understanding, comfort and belief regarding innovation-related topics improved significantly (P<.0001) on all nine Likert-scale questions after the course. After the course, a significant majority of residents either agreed or strongly agreed that technological innovation should be a core competency for the residency curriculum, and that a workshop to prototype their ideas would be beneficial. Performance on the course exam showed significant improvement (48% vs 86%, P<.0001). The overall course experience was rated 5 out of 5 by all participants. MESH Core demonstrates long-term success in educating future radiologists on the basic concepts of medical technological innovation. Years later, residents used the knowledge and experience gained from MESH Core to successfully pursue their own inventions and innovative projects. This innovation model may serve as an approach for other institutions to implement training in this domain.

Visa Opportunities for International Medical Graduates Applying for U.S. Academic Radiology Department Faculty Positions: A National Survey.

BACKGROUND. International medical graduates (IMGs) are a source of physicians who could help alleviate radiologist workforce shortages in the United States. However, IMGs may face barriers in obtaining appropriate visas (e.g., H-1B or O-1 visas) to allow faculty employment. OBJECTIVE. The purpose of this study was to assess the policies and experiences of U.S. academic radiology departments in offering visas to IMGs applying for faculty positions. METHODS. A web-based survey on policies and experiences in offering visas to IMG faculty candidates was distributed to chairs of U.S. radiology departments with a diagnostic radiology training program recognized by the National Resident Matching Program. Individual survey questions were optional. The initial survey and subsequent reminders were sent from October 7, 2022, through November 7, 2022. RESULTS. The survey response rate was 81% (143/177). A total of 24% (28/115), 38% (44/115), 17% (20/115), and 20% (23/115) of departments offered H-1B visas to IMG faculty frequently, sometimes, rarely, and never, respectively; 3% (3/113), 27% (31/113), 22% (25/113), and 48% (54/113) of departments offered O-1 visas frequently, sometimes, rarely, and never, respectively. However, 41% (46/113) and 5% (6/113) of departments had default policies of offering H-1B and O-1 visas for IMG faculty candidates, respectively. The most common reasons given for why departments did not offer visas included, for both H-1B and O-1 visas, the time-consuming process, lack of reliability of candidates' starting time, and the expense of the visa application; for O-1 visas, the reasons given also included lack of expertise. A total of 15% (16/108) of departments set their own visa policies, 75% (81/108) followed institutional policies, and 10% (11/108) followed policies set by other entities (e.g., state government). CONCLUSION. Although to at least some extent most U.S. academic radiology departments offer H-1B and O-1 visas for IMGs seeking faculty positions, use of such visas typically is not the departments' default policy. A variety of barriers contributed to visas not being offered. The departments' visa policies were primarily determined at the institutional level. CLINICAL IMPACT. The identified barriers faced by U.S. academic radiology departments in offering visas to IMG faculty candidates impact the role of IMGs in helping to address radiologist workforce shortages.

Strategies for successful integration of work from home faculty in an academic radiology department

Academic radiology departments have added increasing numbers of entirely remote “work-from-home” or hybrid faculty. This change has presented both an opportunity to recruit and retain faculty as well as a set of challenges to maintaining the full academic mission and educational environment. In this article we describe our experience with creating a remote faculty position and the key elements that we believe made it successful. Guiding principles for the department and faculty member accepting such a position are proposed and discussed.

Implementation of Medical Students as Radiology Reading Room Coordinators

ObjectiveEffort has been made to minimize the burden of non-interpretive tasks (NITs), in particular by hiring and training non-radiologist support staff as reading room coordinators (RRCs). Our medical center recruited and trained senior medical students from our affiliated school of medicine to work alongside on-call radiology residents as RRCs. MethodsA 12-month Malpractice Carrier monetary grant was acquired to fund medical students at with the aim to reduce malpractice risk. After the first year, residents were surveyed regarding the impact of the RRCs on perceived on-call efficiency and morale. Furthermore, report turnaround times (TAT) on call shifts that were and were not accompanied by a RRC were compared. Results89 % of residents strongly agreed that the RRC improved workflow efficiency, decreased distractions, and felt less stressed during the call shift when the RRC was on duty. 78 % strongly agreed to be more likely to contact a referring clinician when the RRC was able to help coordinate. The mean TAT in the presence of a RRC was 36.8 min, and the mean TAT in the absence of a RRC was 36.9 min DiscussionAfter hiring medical students to assist on-call radiology residents with noninterpretive tasks, residents reported subjective indicators of program success, but average report turnaround time was unaffected. Nevertheless, we predict that this type of program will continue to grow among academic radiology departments, though additional research is required to evaluate national trends and impacts on radiologist productivity and well-being.

Career Trajectory Factors Affecting Gender Diversity in Academic Radiology Department Chairs: Results of a Survey of SCARD Members.

Career Trajectory Factors Affecting Gender Diversity in Academic Radiology Department Chairs: Results of a Survey of SCARD Members.

Grassroots Approach to Forming a Diversity, Equity, and Inclusion Committee in an Academic Radiology Department

Radiology is among the medical specialties that have made the fewest gains in closing the gap in underrepresented minorities and women. Diversity, equity, and inclusion (DEI) initiatives are important for promoting healthy learning environments for trainees, health equity for patients, and equitable career development opportunities for employees, all of which contribute to innovation in today's competitive health care environment. DEI committees can self-organize or form from institutional directives. These committees can implement impactful projects in multiple domains in education, recruitment and retention, department culture, and health equity research. This article describes the formation of a grassroots DEI committee, key initiatives and strategies, and structures for accountability. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.

Systematic Review of Radiology Residency Artificial Intelligence Curricula: Preparing Future Radiologists for the Artificial Intelligence Era

ObjectiveAlthough educating radiology trainees about artificial intelligence (AI) has become increasingly emphasized, the types of AI educational curricula are not well understood. We performed a systematic review of original studies describing curricula used to teach AI concepts and practical applications for radiology residents and fellows. Materials and methodsWe performed a PubMed search for original studies published as of July 22, 2022, describing AI curricula geared toward radiology residents or fellows. Studies meeting inclusion criteria were evaluated for curricula design, implementation details, and outcomes. Descriptive statistics were used to summarize these curricula. ResultsFive studies were included describing an AI curriculum, all geared toward radiology residents. All five curricula were led by radiologists, mostly by individual academic radiology departments (4; 80%) with one led by the ACR Resident and Fellow Section. Curricula design included didactic sessions (5; 100%), assigned readings (4; 80%), hands-on learning (3; 60%), and journal clubs (3; 60%); only one had individualized learning plans. All four studies that evaluated the impact of the curricula on participants’ knowledge or attitudes showed positive effects. DiscussionAmid increasing recognition of the importance of AI education for radiologists-in-training, several AI curricula for radiology residents have been implemented. Although curricula designs varied and it is unclear if one type is superior, they have had a positive impact on residents’ knowledge and attitudes toward AI. As AI becomes increasingly adopted in radiology, these curricula serve as models for other departments and programs to develop AI educational initiatives to prepare the next generation of radiologists for the AI era.

Work From Home in Academic Radiology Departments: Advantages, Disadvantages and Strategies for the Future.

To achieve necessary social distancing during the Covid-19 pandemic, working from home was introduced at most if not all academic radiology departments. Although initially thought to be a temporary adaptation, the popularity of working from home among faculty has made it likely that it will remain a component of radiology departments for the long term. This paper will review the potential advantages and disadvantages of working from home for an academic radiology department and suggest strategies to try to preserve the advantages and minimize the disadvantages.

Institutional Strategies to Maintain and Grow Imaging Research During the COVID-19 Pandemic.

Understanding imaging research experiences, challenges, and strategies for academic radiology departments during and after COVID-19 is critical to prepare for future disruptive events. We summarize key insights and programmatic initiatives at major academic hospitals across the world, based on literature review and meetings of the Radiological Society of North America Vice Chairs of Research (RSNA VCR) group. Through expert discussion and case studies, we provide suggested guidelines to maintain and grow radiology research in the postpandemic era.

A Framework for Developing Health Equity Initiatives in Radiology

PurposeIn recent years, radiology departments have increasingly recognized the extent of health care disparities related to imaging and image-guided interventions. The goal of this article is to provide a framework for developing a health equity initiative in radiology and to articulate key defining factors. MethodsThis article leverages the experience of three academic radiology departments and explores key principles that emerged when observing the experiences of these departments that have begun to engage in health equity–focused work. ResultsA four-component framework is described for a health equity initiative in radiology consisting of (1) environmental scan and blueprint, (2) design and implementation, (3) initiative evaluation, and (4) community engagement. Key facilitators include a comprehensive environmental scan, early stakeholder engagement and consensus building, implementation science design thinking, and multitiered community engagement. ConclusionsAll radiology organizations should strive to develop, pilot, and evaluate novel initiatives that promote equitable access to high-quality imaging services. Establishing systems for high-quality data collection is critical to success. An implementation science approach provides a robust framework for developing and testing novel health equity initiatives in radiology. Community engagement is critical at all stages of the health equity initiative time line.

Challenges and Solutions for Establishing Robust Diversity, Equity, and Inclusion Efforts in US Academic Radiation Oncology Departments

Challenges and Solutions for Establishing Robust Diversity, Equity, and Inclusion Efforts in US Academic Radiation Oncology Departments

Resident pre-dictation of ED case delay signoff of those reports, but overall, residents improve report turnaround time.

In academic radiology departments, attendings and resident are increasingly working together overnight for Emergency Department (ED) radiology coverage. The purpose of this study was to quantify reporting turnaround time for overnight cases read by residents and for overnight shifts with residents on duty. A retrospective study was performed at a hospital system where one overnight attending covers two hospitals with a 2nd/3rd year overnight resident, and a second overnight attending covers two other hospitals 80% of the time independently and 20% of the time with a fourth-year resident. In the first analysis, the median difference in turnaround time, from the time when the case was completed by the technologist to the time the attending finalized it, between cases read independently by attendings and cases pre-dictated by residents was calculated. In the second analysis, the median difference in turnaround time for all cases performed at the second two hospitals was compared on nights when an attending was on duty alone versus nights when a fourth-year resident was also on duty, regardless of if the resident had pre-dictated the case. For computed tomography (CT), radiographs (XR), and ultrasound (US), there was a significant delay in turnaround time for cases pre-dictated by residents compared to cases read independently by attendings, ranging between 11 and 49 min depending on resident seniority and modality (p ≤ 0.001). For all cases on nights with a 4th year resident working, overall median report turnaround time decreased by 7 min (p < 0.001). Resident pre-dictation causes delay in the finalization of individual CT, US, and XR reports; however, overall, working with residents results in a significant decrease in report turnaround time supporting the belief that overnight resident education does not delay patient care.

Assessment of a Large-Scale Peer Learning Program's Value by Manual Review of Case Submissions.

Prior studies used submission numbers or report addendum rates to measure peer learning programs' (PLP) impact. We assessed the educational value of a PLP by manually reviewing cases submitted to identify factors correlating with meaningful learning opportunities (MLOs). This institutional review board-exempted, retrospective study was performed in a large academic radiology department generating >800,000 reports annually. A PLP facilitating radiologist-to-radiologist feedback was implemented May 1, 2017, with subsequent pay-for-performance initiatives encouraging increasing submissions, >18,000 by 2019. Two radiologists blinded to submitter and receiver identity categorized 336 randomly selected submissions as a MLO, not meaningful, or equivocal, resolving disagreements in consensus review. Primary outcome was proportion of MLOs. Secondary outcomes included percent engagement by subspecialty clinical division and comparing MLO and report addendum rates via Fisher's exact tests. We assessed association between peer learning category, pay-for-performance interventions, and subspecialty division with MLOs using logistic regression. Of 336 PLP submissions, 65.2% (219 of 336) were categorized as meaningful, 27.4% (92 of 336) not meaningful, and 7.4% (25 of 336) equivocal, with substantial reviewer agreement (86.0% [289 of 336], κ= 0.71, 95% confidence interval 0.64-0.78). MLO rate (65.2% [219 of 336]) was five times higher than addendum rate (12.9% [43 of 333]) for the cohort. MLO proportion (adjusted odds ratios 0.05-1.09) and percent engagement (0.5%-3.6%) varied between subspecialty divisions, some submitting significantly fewer MLOs (P < .01). MLO proportion did not vary between peer learning categories. Educational value of a large-scale PLP, estimated through manual review of case submissions, is likely a more accurate measure of program impact. Incentives to enhance PLP use did not diminish the program's educational value.

Neck Imaging Reporting and Data System: More Than Just a Template.

The Neck Imaging Reporting and Data System (NI-RADS) is a guide developed and introduced in 2017 by head and neck radiologists who worked in an academic radiology department. Based on the Breast Imaging Reporting and Data System, the initial goals of NI-RADS were to make posttreatment head and neck cancer imaging dictations more succinct and efficient, guide treating physicians in the next appropriate steps when recurrence was suspected, and encourage institutional and national research. NI-RADS is more than a dictation template, and it is best instituted after a head and neck imaging practice is established. We support the use of NI-RADS once a radiologist understands the nuances of head and neck cancer, including the biology, common subsites involved, essentials of tumor staging, common posttreatment benign imaging appearances, and subtleties of recurrent disease.

Using Onomastics to Inform Diversity Initiatives

In multiracial societies, the diversity of names in the workforce may reflect racial inclusivity. There is scant data on racial representation among Canadian physicians, prompting our analysis of naming diversity. We profiled the race and gender demographics of the names of physicians in Canadian academic radiology departments. Further, we devised a structured classification methodology using a commercial artificial intelligence and naming database to classify 1,727 names according to national origin and gender. The names were retrieved from faculty websites. A Z-test of proportions was used to compare radiologists’ name demographics to demographics from the 2016 Canadian census. In close agreement with much of the literature on gender demographics, 31.99% of names were classified as female. Names that were classified as belonging to Indigenous, Black, Latin American, and Filipino name-bearers were underrepresented. Names classified as belonging to the following groups were overrepresented: South Asian, Chinese, Arab, Southeast Asian, West Asian, and Korean. Names associated with White subjects in the corpus were proportionally represented for full names and overrepresented for given names. Faculty with full names classified as Southeast Asian, Korean, and Chinese often had given names that fell into the White category. The structured methodology showed high inter-rater reliability for race classifications. The racial disparities we observed mirrored those found in surveys of medical students, suggesting that the bottleneck occurs at the level of medical school admissions. Thus, onomastics can provide valuable data to diversity initiatives.

Using an Annual Diversity, Equity and Inclusion Dashboard to Accelerate Change in Academic Radiology Departments

Despite widespread interest in creating a more equitable and inclusive culture, a lack of workforce diversity persists in Radiology, in part due to a lack of universal and longitudinal metrics across institutions. In an attempt to establish benchmarks, a subset of the Society of Chairs of Academic Radiology Departments (SCARD) Diversity, Equity and Inclusion (DEI) Committee volunteered to design a DEI dashboard as a potential tool for academic radiology programs to use to document and track their progress. This freely-available, modular dashboard includes suggested (plus optional department-defined) DEI activities/parameters and suggested assessment criteria across three domains: faculty, residents & fellows, and medical students; it can be completed, in whole or in part, by departmental leaders annually. The suggested metrics and their associated rubrics were derived from the collective experiences of the five working group members, all of whom are chairs of academic radiology departments. The resulting dashboard was unanimously approved by the remaining 14 DEI committee members and endorsed by the SCARD board of directors.

A Case for Academic Teleradiology.

A Case for Academic Teleradiology.

Academic Radiology Departments Should Lead Artificial Intelligence Initiatives

With a track record of innovation and unique access to digital data, radiologists are distinctly positioned to usher in a new medical era of artificial intelligence (AI). In this Perspective piece, we summarize AI initiatives that academic radiology departments should consider related to the traditional pillars of education, research, and clinical excellence, while also introducing a new opportunity for engagement with industry. We provide early successful examples of each as well as suggestions to guide departments towards future success. Our goal is to assist academic radiology leaders in bringing their departments into the AI era and realizing its full potential in our field.