Association Of Program Directors In Radiology Research Articles

Radiology program director's perspective on a novel hands-on advanced elective

With the advent of the USMLE Step 1 exam moving to a pass/fail status, Radiology Program Directors (PDs) and Associate Program Directors (APDs) need alternative methods of identifying interested and engaged medical students who are applying to their program. Additionally, undergraduate radiology medical education in the United States varies widely from institution to institution with no universal mandatory radiology component. To address these problems, we implemented an advanced fourth year hands-on radiology elective where the students were treated as first year radiology residents (R1s), giving them resident-level access to the Picture Archive and Communication System (PACS) and dictation software, and allowing them to perform entry-level procedures with appropriate supervision. After implementation of the elective, a 5-question online survey was sent to two hundred and ninety-eight PDs and APDs via the Association of Program Directors in Radiology (APDR) listserv, of which seventy-two responses were compiled, yielding a response rate of 24%. The survey focused on how a hands-on medical student elective would help in assessing prospective candidates and predicting R1 performance. Most respondents felt interest in radiology, motivation, and interpersonal skills would be better assessed after such an elective and the vast majority felt hands-on Advanced Elective would be at least slightly predictive of first year resident performance. Based on this information, we believe implementing a hands-on advanced radiology elective would significantly help address the passive nature of traditional radiology electives, providing valuable information to PDs and APDs and giving the best possible radiology experience to our medical students.

Development and Assessment of Early Utilization of the Standardized Letter of Recommendation for Use in the Radiology Residency Match

Letters of recommendation are essential for residency applications. Traditionally, narrative letters have been used. Standardized letters of recommendation (SLOR) have been developed and have benefits to the writer and reader. The goal was to develop an informative, meaningful, and efficient SLOR for the radiology residency Match and to assess its early use. An Association of University Radiologists (AUR) Research and Education Venture Fund Grant was awarded for the development of a SLOR for use in the radiology residency Match. Grant recipients developed the letter and modifications were based on feedback from the Alliance of Medical Student Educators in Radiology (AMSER) SLOR task force and a larger task force including additional AUR and Association of Program Directors in Radiology (APDR) members. AUR and APDR members were surveyed in 2020 to assess the radiology SLOR. The radiology SLOR became available for use in September 2018. It highlights the top six traits or abilities deemed most valued in a resident candidate and guides the writer to develop a concrete narrative. Top perceived benefits of the Radiology SLOR are ease of reading and interpretation. Top perceived drawbacks are an impersonal format and concerns regarding program directors' perceptions of the new SLOR. SLOR utilization increased in the second year of availability. The radiology SLOR was developed and first used in 2018. Its use increased over two years and will likely continue to increase given the perceived benefits and increasing awareness of the SLOR.

“What Program Directors Think” V: Results of the 2019 Spring Survey of the Association of Program Directors in Radiology (APDR)

The Association of Program Directors in Radiology (APDR) surveys its membership annually on hot topics and new developments in radiology residency training. Here we report the results of that annual survey. A web-based survey was posed to the APDR membership in the Fall of 2018. Members were asked 43 questions on program staffing, resident education resources/funding, impact of the integrated-Interventional Radiology residency program on Diagnostic Radiology program resources, resident interest in imaging informatics, Accreditation Council for Graduate Medical Education requirements on resident practice habits data reporting, institutional reliance on residents for clinical coverage, teaching format in the post-oral board era, resident conference attendance, confidentiality of the Match rank list, Early Specialization in Interventional Radiology pathway recruitment and selection, Diagnostic Radiology and Interventional Radiology program relationships, independent resident call, pediatric radiology training, diversity and unconscious bias training, and social media in radiology education. Responses were collected electronically, results were tallied using Qualtrics software, and qualitative responses were tabulated or summarized as comments. There were 86 respondents with a response rate of 31.3%. Survey result highlights include perceived resident interest in imaging informatics with the vast majority of residency programs offering an informatics curriculum; the provision of resident practice habits data by nearly all residency programs despite lack of clarity surrounding this Accreditation Council for Graduate Medical Education requirement; continued use of case-taking in the post-oral boards era; frequent disclosure of the Match rank list to departmental and hospital administration; low penetration of unconscious bias training in academic radiology; and finally, the successful integration of interventional and diagnostic radiology training programs.

The USMLE Step 1 Pass/Fail Reporting Proposal: The APDR Position

The National Board of Medical Examiners (NBME) and the United States Medical Licensing Examination (USMLE) has convened a conference of "key stakeholders" on March 11-12, 2019 to consider reporting the results of the USMLE Step 1 as pass/fail. While the original purpose of the USMLE Step 1 was to provide an objective basis for medical licensing, the score is increasingly used in residency applicant screening and selection because it is an objective, nationally recognized metric allowing comparison across medical schools in and outside the United States. Excessive reliance on the Step 1 score in the matching process has led to "Step 1 Culture" that drives medical schools to "teach to the test," increases medical student anxiety, and disadvantages minorities that have been shown to score lower on the USMLE Step 1 examination. The outsize role of the USMLE Step 1 score in resident selection is due to lack of standardization in medical school transcripts, grade inflation, and the lack of class standing in many summative assessments. Furthermore, the numeric score allows initial Electronic Residency Application Service filtering, commonly used by programs to limit the number of residency applications to review. The Association of Program Directors in Radiology (APDR) is concerned that pass/fail reporting of the USMLE Step 1 score would take away an objective measure of medical student's knowledge and the incentive to acquire as much of it as possible. Although the APDR is not in favor of the Step 1 exam being used as a screening tool, in the absence of an equal or better metric for applicant comparison the APDR opposes the change in Step 1 reporting from the numeric score to pass/fail.

The Association of Program Directors in Radiology Well-Being 2019 Survey: Identifying Residency Gaps and Offering Solutions

PurposeThe Well-Being subcommittee of the Association of Program Directors in Radiology (APDR) Common Program Requirements (CPR) Ad Hoc Committee and the APDR Academic Output Task Force jointly conducted a study of APDR members’ current level of understanding and implementation of the 2017 ACGME CPR regarding well-being. MethodsA survey instrument consisting of 10 multiple-choice and open-ended questions was distributed to the 322 active members of the APDR. The survey focused on three main content areas: APDR member knowledge of the 2017 CPR, composition of department well-being curricula, and residency well-being innovations. ResultsIn all, 121 members (37.6%) responded to the survey. Of those, 67% rated their knowledge of requirements as incomplete. Responses also indicated that 74% of departments have not implemented a comprehensive well-being curriculum; 53% of programs do not offer the mandated self-screening tool; 15% of respondents do not offer residents protected time for medical, mental health, and dental appointments; and 42% do not offer their trainees access to an institutional mental health clinic. Survey comments offer numerous individual well-being initiatives from across the membership. ConclusionsThe results of the APDR Well-Being Survey indicate that many programs have substantial work remaining to achieve ACGME compliance. Well-being innovations were included in an effort to share best practices.

Should Radiology Delay the Start of Fellowships? A Survey of the APDR

Several major medical specialties have recently considered delaying the start date of their fellowship training programs to allow for completion of their trainees' residency obligations. Radiology program directors (PDs) have voiced the need for a similar solution, as fellowship start dates at some institutions now occur well before the end of residency training. The objectives of this study are to assess the current state of the radiology fellowship transition and understand its impact on residency programs and clinical services. Survey Monkey (Palo Alto, CA) was used to create a survey consisting of 9 multiple choice and 2 free text questions. The survey was approved by the survey committee of the Association of Program Directors in Radiology (APDR) and distributed via email to all 240 APDR members in November 2018. The survey was closed after 30 days. The response rate was 67% (160/240). Fifty-nine percent of respondents indicated some of their residents are asked to arrive at fellowships before July 1, often several days early for orientation and picture archiving and communication system (PACS) training. Sixteen percent of respondents said their own institutions ask incoming fellows to arrive early. Sixty-four percent of respondents indicated that this causes staffing problems. Seventy-eight percent of respondents supported considering a delay to the start of radiology fellowships. Most APDR members claim that residents are asked to arrive at fellowships early to complete orientation and training before July 1, and most say that this produces staffing problems on services. A significant majority of respondents support a discussion regarding delaying fellowship start dates.

“What program directors think IV”: Results of the 2017 Annual Survey of the Association of Program Directors in Radiology

The Association of Program Directors in Radiology (APDR) regularly surveys its members to gather information regarding a broad range of topics related to radiology residency. The survey results provide insight into the opinions of residency program leadership across the country. This is an observational cross-sectional study using a web-based survey posed to the APDR membership in the fall of 2017. The final survey consisted of 53 items, 48 multiple choice questions and five write-in comments. An invitation to complete the survey was sent to all 319 active APDR members. Deidentified responses were collected electronically, tallied utilizing Qualtrics software, and aggregated for the purposes of analysis and reporting at the 66th annual meeting of the Association of University Radiologists. The response rate was 36%. Over the past 16 years, more PDs have assistant and APDs to administer growing residency programs, but the time allocation for these APDs has come from the PD's protected time. An overwhelming majority of PDs consider independent call beneficial to residents and most think a call assistant is desirable. The vast majority of PDs support a unified fellowship match and allow resident moonlighting. Most fourth year residents are actively or moderately involved in clinical work and teaching. The majority of PDs have lost or expect to lose DR training positions to the new IR/DR programs. In a competitive match, PDs do not rely on residency interviews in their selection process.

“What Program Directors Think” III: Results of the 2014/2015 Annual Surveys of the Association of Program Directors in Radiology (APDR)

The Association of Program Directors in Radiology regularly surveys its members regarding issues of importance to support radiology residency programs and their directors. This is an observational cross-sectional study using two Web-based surveys posed to the Association of Program Directors in Radiology membership in the fall of 2014 (49 items) and the spring of 2015 (46 items) on the subjects of importance to the members, including the Accreditation Council on Graduate Medical Education Milestones, the Non-Interpretative Skills Curriculum, the American Board of Radiology Core Examination, the effect of the new resident testing and program accreditation paradigms on training outcomes, the 2015 Residency Match, the Interventional Radiology/Diagnostic Radiology (IR/DR) Residency, and Program Director (PD)/Program Coordinator resources. Responses were collected electronically, results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 63rd annual meeting of the Association of University Radiologists. The maximal response rate was 33% in the fall of 2014 and 36% in the spring of 2015. PDs believed that the radiology Milestones, now largely implemented, did not affect overall resident evaluation, was not reflective of resident experience, and actually made evaluation of residents more difficult. PDs also felt that although the American Board of Radiology oral examination had been a better test for clinical practice preparedness, their new residents knew at least as much as before. There was little evidence of recall reemergence. The radiology training community saw a drop in residency applicant quality as demonstrated by the United States Medical Licensing Examination scores and clinical rotation grades. Because the new IR/DR Residency positions were to be funded at the expense of the traditional DR positions, the majority of PDs expected a negative effect of the impending IR/DR match on their DR recruitment. PDs were in favor of a unified clinical radiology curriculum similar to the Radiological Society of North America online physics modules.

“What Program Directors Think” II: Results of the 2013 and 2014 Annual Surveys of the Association of Program Directors in Radiology

The Association of Program Directors in Radiology (APDR) surveys residents' educational experiences, work responsibilities, and benefits to support radiology residency programs and their directors. This is an observational cross-sectional study using three Web-based surveys posed to the APDR membership in the spring of 2013 (March 7-29, 2013; 44 items), the fall of 2013 (October 24 to November 15, 2013; 36 items), and the spring of 2014 (March 3-21, 2014; 49 items) on the American Board of Radiology (ABR) Core examination, organization of Clinical Competency Committees (CCCs), fellowship match, and interventional radiology (IR)-diagnostic radiology (DR) training programs. Responses were collected electronically, results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 60th and 61st annual meetings of the Association of University Radiologists, respectively. The maximal response rate was 35% in the spring 2013, 39% in the fall 2013, and 39% in the spring 2014. With the ABR Core examination, radiology educators increasingly included multiple choice questions in teaching conferences. "Boards frenzy" was alive and well. The number of programs with a CCC was growing, chaired primarily by the Program Director (PD), with the most commonly used tool being the rotation evaluation. In view of "fellowship frenzy" in the third year of residency, only a minority of PDs were against a fellowship match in the National Resident Matching Program (NRMP). The majority of respondents replied that the new IR/DR pathway would negatively affect the DR residency.

Review of outside studies by radiology residents: national survey of chief residents.

The purpose of this study was to establish practice patterns of radiology residents in regards to interpretation and reporting of outside studies for transferred patients. We performed a national survey of radiology residency chief residents, administered by email through the Association of Program Directors in Radiology (APDR). There were 81 chief resident respondents, representing 42.8 % of 187 total Accreditation Council for Graduate Medical Education (ACGME)-approved radiology residency training programs in the USA. In 97.5 % of programs, residents perform interpretations of outside studies. Up to 76.7 % of respondents state that when outside studies are reviewed by residents, an original report is available in less than one quarter of cases. While 55.1 % of respondents state that there is a mechanism for recording their findings and impressions for outside studies, only 32.1 % are aware of a policy requiring documentation. Of the respondents, 42.3 % report they have no means for documenting their findings and impressions on outside studies. Further, 65.4 % state that there is no policy requiring an attending to review and document agreement with their interpretation of outside studies. There is wide institutional variation in both policy and practice regarding reinterpretation of outside studies for patients transferred to academic hospitals. While the majority of radiology residents are providing the service of reinterpreting outside studies, only a minority of residency programs have a policy requiring (1) documentation of their impressions or (2) attending oversight and documentation of discrepant opinions.

What Program Directors Think: Results of the 2011 Annual Survey of the Association of Program Directors in Radiology

The Association of Program Directors in Radiology (APDR) conducts an annual survey to monitor and evaluate issues pertaining to radiology residents' educational experiences, work responsibilities, and benefits. Data are used to identify emerging trends and patterns of change to plan and provide resources that support radiology residency programs and their directors. The APDR Annual Survey Committee selected 59 items for an observational, cross-sectional study using a Web-based survey. Topics of interest included program director satisfaction, resident recruitment, social media, program requirements, curriculum, the new American Board of Radiology exam process, call, and residents-as-teachers programs. All active APDR members (n = 296) were invited to participate in survey between February 20 and March 11,2011. The response rate was 47% (140 of 296). Descriptive results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 59th annual meeting of the Association of University Radiologists. Data generated by the annual survey enable the APDR to accrue data pertaining to residents' real-time educational experiences. In 2011, program directors were satisfied with their jobs but not convinced that competency-based program requirements had positive effect on residency training. Programs plan to use the Radiological Society of North America and American Association of Physicists in Medicine Web-based physics training modules. Most radiology programs do not have residents-as-teachers programs, nor do they plan to initiate them. During recruitment, programs use an applicant's location as a proxy for true interest in the program, and interest in the program is important for granting interviews and final ranking. Qualified international medical graduate applicants have access to radiology training in the United States and Canada. Almost half of radiology programs have in-house reading by attending radiologists with residents on call. Residency programs have been slow to embrace social media.

Business of Radiology 101: The State of Radiology Business Practice and Health Care Policy Curricula at US Radiology Residency Programs

The aim of this study was to assess the prevalence, content, and perceptions of curricula focused on radiology business practice and health care policy at US radiology residency training programs. The desired survey population was trainees and faculty members of radiology residency programs in the United States. Three anonymous survey instruments were distributed, including an e-mail survey to the membership of the ACR RFS, a paper survey to ACR RFS delegates attending the 2010 AMCLC, and an e-mail survey to the membership of the Association of Program Directors in Radiology (APDR). Response rates for the surveys were 12%, 25%, and 21%, respectively. Members of the APDR and RFS agreed that understanding and competency in business practice and health care policy topics are important to the future careers of residents (total favorable sentiment >86% for APDR members and >96% for RFS members). Most survey respondents' home institutions offer some form of a noninterpretive curriculum (91% of APDR respondents, 74% of RFS respondents), but the breadth of topics addressed and educational time devoted to these curricula were quite variable. Subjective effectiveness of curricula was infrequently rated as very effective by 12% of APDR respondents and 6% of RFS respondents. Despite the perceived importance of radiology business practice and health care policy education, and residency training requirements in competencies related to these subjects that have been in place for more than a decade, curricula addressing these items still seem to be in a stage of acceptance and development. Further commitment to and innovation within these curricula are requisite in educating our future radiologists.

Radiology Residents as Teachers: Current Status of Teaching Skills Training in United States Residency Programs

Radiology residents often teach medical students and other residents. Workshops developed with the goal of improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to determine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States. Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed to determine views on a panel of topics related to resident-teacher training programs. A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Residents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it is important for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by residents. Program directors identified residents as being active contributors to teaching in most programs. Although teaching was viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teaching skills training for radiology trainees.

Problem-Solving Session Results From the 54th Annual Meeting of the Association of University Radiologists

The problem-solving session at the 54th Annual Meeting of the Association of University Radiologists (AUR) was formulated by the American Alliance of Academic Chief Residents in Radiology (A3CR2) steering committee at the 2005 RSNA meeting in Chicago. Two issues were discussed: 1) the impact on vascular interventional radiology training by nonradiology specialties and how radiology training programs must adapt to maintain and expand the specialty and 2) how can radiology programs meet the needs of residents who have differing professional expectations and goals, specifically the diversity of resident interest in private practice versus academic careers? The topics were discussed in two sessions composed of A3CR2 members as well as radiology residents from across the country. Solutions were then discussed in a joint session with the Association of Program Directors in Radiology (APDR) and Association of Program Coordinators in Radiology (APCR) and final conclusions were formulated. Participants included several interventional radiologists.

Proceedings of the 54th Annual Meeting of the Association of University Radiologists

The 54th Annual Meeting of the Association of University Radiologists was held April 5−8, 2006, in Austin, Texas. Registrants numbered 932, which was a slight decrease from the prior year. The meeting, once again, was held in conjunction with the Society of Chairmen of Academic Radiology Departments (SCARD), the Association of Program Directors in Radiology (APDR), the Alliance of Medical Student Educators in Radiology (AMSER), the Association of Program Coordinators in Radiology (APCR), the Radiology Research Alliance (RRA), the Radiology Alliance for Health Services Research (RAHSR), the American Alliance of Academic Chief Residents in Radiology (A3CR2), and the Association of University Radiologists-Europe (AUR-E).

Proposed Program Guidelines for Pregnant Radiology Residents: A project supported by the American Association for Women Radiologists and the Association of Program Directors in Radiology 1

Written institutional policies governing radiation exposure and work responsibilities for pregnant radiology residents are not uniform and often are nonexistent. Standardized program guidelines would allow residents and program directors alike to prepare for a resident pregnancy with objectivity and consistency. The American Association for Women Radiologists (AAWR) launched a task force to revisit guidelines for the protection of pregnant residents from radiation exposure during training. We conducted two surveys of the Association of Program Directors in Radiology (APDR) membership. Survey 1 was designed to learn about existing program and institutional policies and to assess the need for and interest in standardized guidelines that would address radiation exposure and work responsibilities for pregnant radiology residents. Based on those responses, we drafted a set of program guidelines incorporating policies contributed by responding program directors. Our follow-up APDR survey, survey 2, was conducted to determine opinions and acceptance of the drafted program guidelines. Each survey was analyzed by using a proportion of means test. Fifty-five of 156 program director APDR members (35%) responded to survey 1. Only half the respondents had formal written policies at their respective institutions. Review of submitted policies showed widely divergent opinions about appropriate policies for pregnant radiology residents. Most (34/52; 75%) supported the development of standardized guidelines. In survey 2, 38/73 responding APDR members (53%) offered their opinions and comments on our drafted guidelines. Approximately 90% agreement was catalogued on 13 of 18 items (72%); a majority (>60%) agreed on all points, even the most controversial points concerning fluoroscopy. A minority of radiology residency programs have written policies addressing pregnancy during training. With expressed support from a majority of responding program directors, we have developed and present here proposed program guidelines for pregnant radiology residents to serve as a framework for radiology residents and program directors alike.

2005 APDR Program Notes 1

Kitt Shaffer, MD, PhD, was awarded the Association of Program Directors in Radiology (APDR)/Association of University Radiologists (AUR)/Radiological Society of North America (RSNA)/Society of Chairmen in Academic Radiology Departments (SCARD) Education Research Development grant. Her project is entitled “Investigation of the use of 3D modeling software to enhance teaching of radiologic anatomy.”

Results from the problem-solving sessions at the 52nd Annual Meeting of the Association of University Radiologists 1

The education of competent future radiologists is the main goal of radiology residency programs throughout the country. As the field of radiology expands, this goal becomes complex and more difficult to accomplish. At the 52nd Annual Meeting of the Association of University Radiologists (AUR), the American Alliance of Academic Chief Residents in Radiology (A3CR2) hosted problemsolving sessions to discuss two critical educational dilemmas: 1). Ensuring appropriate resident experiences in clinical areas threatened by turf wars, and 2). Achieving the appropriate balance between direct supervision and residents’ independent work. After discussing these issues with radiology residents from across the country, brief position statements were written and presented to members of the Association of Program Directors in Radiology (APDR) and the Association of Program Coordinators in Radiology (APCR) at a joint session. The main objective of this paper is to present the results of this discussion.

Proceedings of the Annual Meeting of the Association of Program Directors in Radiology: April 2002

The Association of Program Directors in Radiology (APDR) presented 10 sessions, many of which were jointly sponsored by colleagues and other organizations. The first session was a joint symposium sponsored by the APDR and the Association of Program Coordinators in Radiology (APCR). Steven Chan, MD, MBA, MPH, presented Columbia University's overall plan for management and medical informatics as part of curriculum and faculty development. He used “problem cases” and an interactive approach utilized in their training program. The discussions were interactive and lively and improved knowledge and scope of the problems discussed. Dr Charles Resnik also presented a talk on “Fellowship Match Update,” which built understanding of the development of the radiology fellowship match and the process and led to further understanding of the importance of 100% participation.

Proceedings of the 50th Annual Meeting of the Association of University Radiologists

The 50th Annual Meeting of the Association of University Radiologists (AUR) was held in Phoenix, Ariz, on April 17–20, 2002. The meeting was held jointly with the Society of Chairmen of Academic Radiology Departments (SCARD), the Association of Program Directors in Radiology (APDR), the American Association of Academic Chief Residents in Radiology (A3CR2), the Alliance of Medical Student Educators (AMSER), the Radiology Research Alliance (RRA), the Society for Health Services Research in Radiology (SHSRR), the Association of Program Coordinators in Radiology (APCR), and the Association of Administrators in Academic Radiology and Radiation Oncology (AAARRO), and was jointly sponsored by the Radiological Society of North America (RSNA). Over 700 registrants attended this 50th anniversary meeting, a new record attendance for the organization. The meeting theme was “Academic Radiology: Improving Patient Care through Diversity in Education—Research—Management.” The meeting offered scientific, plenary and society-specific sessions, the AUR Research Symposium, the Kodak-AUR Management Course, the RSNA Introduction to Grantsmanship Program, the GE-AUR Radiology Research Academic Fellowship Session, the Phillips-AUR Academic Faculty Development Program, the Kay Vydareny Film Interpretation Competition, the AUR Awards Ceremony and Banquet, and many enjoyable social programs.