Diagnostic Radiology Programs Research Articles

Adjectives in the Summary Paragraph of the MSPE: Are They Telling Us Something?

Rationale and ObjectivesMany US medical schools do not provide a summative, comparative assessment of students (class rank), instead utilizing descriptive adjectives in the summary paragraph of the Medical Student Performance Evaluation (MSPE). The objective of this study was to determine whether those adjectives correlate with student performance. Materials and MethodsApplications from all US allopathic medical schools received by a single diagnostic radiology program in the 2023-24 cycle were reviewed. The final adjectives from schools that rank students were coded as positive, negative, or neutral. For students from non-ranking schools, descriptive adjectives from the MSPE summary paragraphs were extracted and categorized based on the final adjective coding schema along with a library of commonly used positive adjectives. The frequency of adjectives was correlated with applicant academic and demographic factors using multivariable logistic regression. ResultsApplications from 97% (147/151) of US allopathic medical schools were received. 60.5% (89/147) of schools rank their students with 27.9% (41/147) using a final adjective coded to performance tier. Of the 58 non-ranking schools, 56.9% (33/58) used descriptive adjectives in the MSPE’s summary paragraph. There was no association with academic performance metrics and either generally positive adjectives or coded descriptive adjectives. There was a greater association with positive descriptive adjectives for non-white applicants (p=0.011) and generally positive adjectives for higher ranked schools (p=0.004). ConclusionUndefined descriptive adjectives in the MSPE’s summary paragraph, when benchmarked to final adjectives, do not correlate with academic performance, and may instead be used for student advocacy by medical school deans.

Analysis of National Resident Matching Program for Radiology Fellowships: Factors Affecting Program Fill Rates

PurposeThe National Resident Matching Program (NRMP) is used by an increasing number of diagnostic radiology (DR) residents applying to subspecialty fellowships. Data characterizing match outcomes on the basis of program characteristics are limited. The aim of this study was to determine if fellowship or residency size, location, or perceived reputation was related with a program filling its quota. MethodsUsing public NRMP data from 2004 to 2022, DR residency, breast imaging (BI), musculoskeletal imaging (MSK), interventional radiology (IR), and neuroradiology (NR) fellowship programs were characterized by geography, DR and fellowship quota, applicants per position (A/P), and reputation as determined by being an Aunt Minnie best DR program semifinalist, Doximity 2021-2022 top 25 program, or U.S. News & World Report top 20 hospital. The DR program’s reputation was substituted for fellowships at the same institution. A program was considered filled if it met its quota. ResultsThe 2022 A/P ratios were 1.02 for IR, 0.83 for BI, 0.75 for MSK, and 0.88 for NR. IR was excluded from additional analysis because its A/P was >1. The combined BI, MSK, and NR fellowships filled 78% of positions (529 of 679) and 56% of programs (132 of 234). Factors associated with higher program filling included Doximity top 25 program, Aunt Minnie semifinalist, and U.S. News & World Report top 20 hospital affiliation (P < .001 for all); DR residency quota greater than 9, and fellowship quota of three or more (P < .01). The Ohio Valley (Ohio, western Pennsylvania, West Virginia, and Kentucky) filled the lowest, at 39% of programs (P = .06). ConclusionsLarger fellowship programs with higher perceived reputations and larger underlying DR residency programs were significantly more likely to fill their NRMP quota.

International Medical Graduates in Radiology Residencies: Demographics, Performance, and Visa Issues

The number of international medical graduates (IMG) in radiology residencies has varied from year to year even as the number of candidates continues to grow. It is unclear from which countries the IMGs are arriving and what visas are being used to accommodate them. We sent a survey to 195 program directors (PD) in diagnostic radiology (DR) inquiring about the number and nationality of IMG residents in their program, their attitudes about IMG candidates, the performance of their IMG trainees, and the visas that are offered. We received responses from 121 of 195 (62.1%) DR programs (121/149=81.2% of actionable emails). 80/121 (66.1%) had at least one IMG in their DR residency program and the countries of origin included India (36), Iran (30), Saudi Arabia (24), Egypt (16), Canada (14), Brazil (14), and Pakistan (9), as the most common. While most programs (76/104, 73.1%) offered J1 visas, 23/99 (23.2%) provided H-1B visas to trainees. IMG DR residents overall performed as well as American graduates, with an equal number of PDs saying IMGs performed better and worse than American graduates. PDs' issues with IMGs centered on visas: (1) expense, (2) lack of familiarity, (3) Educational Commission for Foreign Medical Graduates regulations, and (4) time commitment in submitting paperwork. Most radiology IMG residents originate from India and Middle Eastern countries. Once enrolled, IMG residents perform similarly to US graduates. However, adding IMG candidates to the training program requires overcoming bureaucratic and monetary hurdles around visas. Most DR international medical graduate residents are from India or the Middle East. Although their performance is the same as American graduates in general, PDs note the monetary and bureaucratic hassles accompanying their recruitment.

Prevalence of Diversity Statements and Disability Inclusion Among Radiology Residency Program Websites

IntroductionRadiology has widely acknowledged the need to improve inclusion of racial, ethnic, gender, and sexual minorities, with recent discourse also underscoring the importance of disability diversity and inclusion efforts. Yet studies have shown a paucity of diversity among radiology residents, despite increasing efforts to foster diversity and inclusion. Thus, the purpose of this study is to assess radiology residency program websites’ diversity statements for inclusion of race and ethnicity, gender, sexual orientation, and disability as commonly underrepresented groups. MethodsA cross-sectional, observational study of websites of all diagnostic radiology programs in the Electronic Residency Application Service directory was conducted. Program websites that met inclusion criteria were audited for presence of a diversity statement; if the statement was specific to the residency program, radiology department, or institution; and if it was presented or linked on the program or department website. All statements were evaluated for the inclusion of four diversity categories: race or ethnicity, gender, sexual orientation, and disability. ResultsOne hundred ninety-two radiology residencies were identified using Electronic Residency Application Service. Programs with missing or malfunctioning hyperlinks (n = 33) or required logins (n = 1) were excluded. One hundred fifty-eight websites met inclusion criteria for analysis. Two-thirds (n = 103; 65.1%) had a diversity statement within their residency, department, or institution, with only 28 (18%) having residency program–specific statements and 22 (14%) having department-specific statements. Of the websites with diversity statements, inclusion of gender diversity was most frequent (43.0%), followed by race or ethnicity (39.9%), sexual orientation (32.9%), and disability (25.3%). Race or ethnicity was most included in institution-level diversity statements. ConclusionsLess than 20% of radiology residency websites include a diversity statement, and disability is the least-included category among the diversity statements. As radiology continues to lead diversity and inclusion efforts in health care, a more comprehensive approach with equitable representation of different groups, including those with disabilities, would foster a broader sense of belonging. This comprehensive approach can help to overcome systemic barriers and bridge gaps in disability representation.

A National Survey of Canadian Diagnostic Radiology Program Directors on the Transition to Competence by Design in Diagnostic Radiology Post-Graduate Medical Education.

A National Survey of Canadian Diagnostic Radiology Program Directors on the Transition to Competence by Design in Diagnostic Radiology Post-Graduate Medical Education.

Accelerated Fellowships Applicable Across all Subspecialty Areas of Diagnostic Radiology as a Catalyst for Academic Recruitment

To build a sustainable faculty development program based on potential acceleration of all subspecialty fellowships types into the PGY 5 year. Single center experience in programmatic change to enhance faculty recruitment. Diagnostic Radiology (DR) residents apply to subspecialty fellowships per SCARD Fellowship Embargo Guidelines. Based on projected faculty hiring needs, internal candidates are vetted and agree to enter an accelerated fellowship. The commitment is two years: the PGY5 senior year schedule prioritizes rotations in the subspecialty area while fulfilling requirements of all DR graduates, including call. Accelerated fellows (AF) participate in junior faculty development and concentrated mentoring. A subsequent instructor faculty year within our department is required to ensure professional maturity and provides financial remuneration greater than PGY 6 fellowships. From July 1, 2018, to June 30, 2022, 34 trainees have graduated from our DR program, and 32 have gone through the process of securing fellowships. Over this interval, our DR program has matched 7-9 residents per year. Up to four early specialization positions consisting of 2 Early Specialization in Interventional Radiology (ESIR), and 2 Early Specialization in Nuclear Medicine (ESNM), per year, are available. Over four years of the program, 8 residents participated in standard early specialization opportunities: 5 ESIR, and 3 ESNM. These 8 residents were excluded from consideration for AFs. Two additional residents declined fellowships, leaving 22 seeking standard fellowships for PGY 6 year. Six (26%) of those were approached as potential AFs; 3 (50%) agreed to and completed the 24-month process. 2 of 3 (67%) continue to serve on faculty after the required instructor year. The novel concept of early specialization outside of ESIR and ESNM presents an opportunity to tailor the PGY 5 DR year to increase recruitment to academic faculty positions.

Learning from errors: Implementation of a resident-oriented radiology morbidity and mortality conference as an educational tool

PurposeOur diagnostic radiology (DR) program lacked a formalized, structured process for residents to learn from errors. Prior DR residency Accreditation Council for Graduate Medical Education (ACGME) survey results additionally demonstrated opportunity for improvement in resident evaluation, resources, and patient safety/teamwork. Our project's purpose was to implement and evaluate a new resident-oriented radiology morbidity and mortality (M&M) conference to enhance resident education. MethodsAll DR residents (n = 48) were surveyed regarding a new didactic M&M consisting of quarterly resident-led and faculty-moderated M&Ms. Cases for potential review were collected and stored in a REDCap database via an anonymous survey, from which resident-selected faculty curators would select 4–6 for presentation. Residents presented these cases and the group discussed applicable improvements. An anonymous survey of residents followed each conference. Relevant questions from ACGME survey data were extracted from the two years preceding the didactic M&M and the pilot year. ResultsBefore implementation, 86% of responding residents (n = 29; 60% of resident complement) supported the program, 90% expressed willingness to share their own mistakes, and 79% preferred faculty involvement. Respondents favored careful selection of faculty to promote education. At one year, 100% of respondents (n = 17; 35% of resident complement) approved of adding the didactic M&M and endorsed program continuance. All respondents expressed a willingness to share their own mistakes. There was also coincident improvement in ACGME survey data in the domains of evaluation, resources, and patient safety/teamwork. ConclusionWe designed and implemented a resident-oriented M&M conference that resulted in increased resident confidence and impacted ACGME survey results in evaluation, resources, and patient safety/teamwork. PrecisImplementation of a structured, resident-oriented radiology M&M conference can increase resident confidence and impact ACGME survey results in the domains of evaluation, resources, and patient safety/teamwork.

Gender of Department Chair and Paid Parental Leave Benefits in Academic Radiology Residency Programs

Residency training often overlaps with prime childbearing years, yet variability in availability and duration of parental leave in residency can complicate the decision to become parents. Gender disparities in attitudes towards parenthood in residency is well recognized, with females generally reporting more concerns surrounding prolonged training, hindrance of future career plans, and negative perception from peers. However, gender of the department chair has not yet been examined as a factor influencing parental leave policies for residents in Radiology. The gender of the department chair and parental leave policies for residents in 209 ACGME accredited diagnostic radiology programs across the United States were procured from their websites. These programs were stratified into 6 geographical regions to identify regional differences. Chi-squared analyses were used to compare availability of paid parental benefits with the gender of department chairs. Seventy-seven percent of diagnostic radiology program department chairs were male. 34 of 49 programs (69%) with female department chairs advertised paid parental benefits, compared to 61 of 160 programs (38%) chaired by males (P < 0.001). When stratified by region, this gender difference remained statistically significant in the mid-Atlantic and New England. Female gender of the department chair was associated with the increased availability of paid parental leave benefits for residents, yet females hold fewer academic leadership positions than males. Future discussions regarding parental leave policies for residents will have to consider the unique challenges in residency such as length of training and burden on coresidents.

Analyzing the Administrative Burden of Competency Based Medical Education.

Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen's University Diagnostic Radiology program. Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process. The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block. This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education.

Abstract No. 114 Assessing the current state of the chief interventional radiology residents across all interventional radiology and diagnostic radiology programs

The presence and role of chief resident(s) vary across medical specialties and from institution to institution. The most recent American Alliance of Academic Chief Residents in Radiology (A3CR2) survey found that the responsibility of Diagnostic Radiology chief residents involved scheduling, resident education and curriculum development, residency recruitment and even hospital committee service. With the new interventional radiology residency programs coexisting within many academic radiology departments, the presence and role of a dedicated interventional radiology (IR) chief resident (IRCR) is not presently known. The purpose of this study is to survey active integrated and independent interventional radiology programs to categorize the presence and role for a dedicated IRCR. IRB exemption was granted for this study. A survey invitation to program directors and their coordinators was distributed via email through the Association of Program Directors in Interventional Radiology (APDIR) membership roster. The web-based survey consisted of 21 questions including program demographics, the presence of a dedicated IRCR(s) and additional questions clarifying the tasks that the IRCR is assigned, where present. Of a total of 89 IR integrated programs, 34 programs (38%) responded to the survey. 28 reporting programs have an early specialization in IR (ESIR) track (82%). 13 respondents were from the Northeast, 7 from the Southeast, 7 from the Midwest, 6 from the Southwest, and 1 from the Northwest. 30 (88%) of respondents were from an academic/university setting. 24 (70%) programs reported having a separate, dedicated IRCR with 11 programs (32%) having more than one IRCR. The IRCR was a PGY 4 or greater in all but one program. Two of the programs with PGY 4 chiefs also had another chief in the PGY 5 or 6 year. Tasks the IRCR(s) were involved in included scheduling (79%), organization of research and QI projects (37%), resident recruitment (75%), grievance resolution (45%), social event coordination (33%), and running trainee meetings and program review (29%). Slightly more than half (54%) of IRCRs receive additional financial compensation for their role. The role of the IRCR has been established at a majority of reporting IR/diagnostic radiology programs, with most resident(s) being tasked with clinical scheduling, resident recruitment and educational programming/organization. This snapshot serves as a baseline for the presence and organizational role of a dedicated IRCR, which can be used as a means of comparison as the training programs, and role of the chief resident evolve.

Overnight radiology resident discrepancies at a large pediatric hospital: categorization by year of training, program, imaging modality, and report type.

Overnight radiology resident discrepancies have been described in multiple studies; however, study of resident discrepancies specific to pediatric radiology is limited. To examine radiology resident discrepancies as they pertain to a large pediatric hospital system. A total of 21,560 preliminary reports issued by 39 residents over a one-year period were scored as agreement, minor discrepancy, or major discrepancy by faculty members using a modification of the 2009 RADPEER scoring system. Residents were trainees of three different diagnostic radiology programs: large university-based, medium-sized community-based, or small community-based. Discrepancy rates were evaluated based on resident postgraduate year, program, and imaging modality. The effect of a general pediatric radiology report versus pediatric neuroradiology report of a CT scan was also tested. CT was the only modality in which there were comparable numbers of studies scored by both general pediatric radiologists and neuroradiologists. The rate of major resident to faculty assessment discrepancies was 1.01%, and the rate of minor resident to faculty assessment discrepancies was 4.47%. Major discrepancy rates by postgraduate years 3-5 were 1.08%, 0.75%, and 1.59%, respectively. Major discrepancy rates were highest for MR (11.22%), followed by CT (1.82%), radiographs (0.91%), and ultrasound (0.56%). There was no significant difference in discrepancy rate between residency programs and general pediatric radiology report of a CT versus pediatric neuroradiology report of a CT. Radiology discrepancy rates for residents issuing preliminary reports at a large children's hospital system are similar to those reported for adult procedures.

Delivering CaRMS Transparency: Applicant Review and Selection Process of a Single-Center Diagnostic Radiology Residency Training Program.

To report the current application review and selection process in our Canadian diagnostic radiology program at the University of Ottawa for both Canadian and international medical graduates. Submitted applications fulfilling institutional requirements were selected for a detailed file review after preliminary screening. A diverse group of file reviewers and interviewers was selected. Interviews were offered based on file review score sheet outcomes. Each interviewer generated a postinterview rank list. Applicants were reviewed and discussed from highest to lowest rank based on a preliminary compiled rank list generated from the average of the postinterview rank lists. Group discussion and a consensus model were used to create a final applicant rank list. We outlined our systematic, consistent selection process which aligns with current best practices. This description may inform other programs wishing to adopt or optimize strategies to improve candidate assessments and selection processes.

“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.

COVID-19 and the Radiology Match: A Residency Program's Survival Guide to the Virtual Interview Season

COVID-19 and the Radiology Match: A Residency Program's Survival Guide to the Virtual Interview Season

Competency-Based Medical Education in Radiology: A Survey of Medical Student Perceptions.

Implementing competency-based medical education in diagnostic radiology residencies will change the paradigm of learning and assessment for residents. The objective of this study is to evaluate medical student perceptions of competency-based medical education in diagnostic radiology programs and how this may affect their decision to pursue a career in diagnostic radiology. First-, second-, and third-year medical students at a Canadian university were invited to complete a 14-question survey containing a mix of multiple choice, yes/no, Likert scale, and open-ended questions. This aimed to collect information on students' understanding and perceptions of competency-based medical education and how the transition to competency-based medical education would factor into their decision to enter a career in diagnostic radiology. The survey was distributed to 300 medical students and received 63 responses (21%). Thirty-seven percent of students had an interest in pursuing diagnostic radiology that ranged from interested to committed and 46% reported an understanding of competency-based medical education and its learning approach. The implementation of competency-based medical education in diagnostic radiology programs was reported to be a positive factor by 70% of students and almost all reported that breaking down residency into measurable milestones and required case exposure was beneficial. This study demonstrates that medical students perceive competency-based medical education to be a beneficial change to diagnostic radiology residency programs. The changes accompanying the transition to competency-based medical education were favored by students and factored into their residency decision-making.

Abstract No. 459 Interventional radiology/diagnostic radiology residency applicant preferences in the National Resident Matching Program

Investigators have evaluated diagnostic radiology (DR) residency applicant preferences; however, extensive study of interventional radiology (IR)/DR applicant preferences has not been performed. The purpose of this study is to evaluate factors determining where IR/DR applicants match. We hypothesize that IR/DR applicants rank IR/DR higher than DR programs rather than by strength of training institution. 628 IR/DR applicants at a single academic center for the 2017-2019 Match seasons were invited to participate in an anonymous web-based survey (Qualtrics; UT) assessing their ranking preferences with Likert scales (n = 83, 13% response rate; 72% M, 28% F, age 29 (25-36) years). 75% matched to IR/DR, and 25% matched to DR. Data are reported as mean (range) or mean ± standard deviation. Statistical analyses including t-test and Mann-Whitney U tests were performed in Prism (GraphPad; CA) with P <0.05 considered statistically significant. Applicants did not have a significantly higher score for ranking IR/DR over DR programs (3.7 ± 1.2) when compared to ranking by academic reputation of IR (3.9 ± 0.8) or academic reputation of DR (3.7 ± 0.9) at an institution. Preferences for ranking IR/DR over DR programs were significantly higher than preferences due to a program’s number of IR/DR residency spots (2.7 ± 1.3) and significantly lower than program location (4.2 ± 0.9) or perceived happiness of current residents (4.1 ± 0.9). Applicants who matched IR/DR had a higher score for ranking IR/DR programs over DR programs compared to applicants who matched DR (P <0.01). More applicants who matched IR/DR (55%) versus DR (8%) felt that training would be stronger after completing an IR/DR versus a DR residency with Early Specialization in IR (ESIR) (P <0.01). IR/DR applicants value location and trainee happiness above all else; however, applicants who matched IR/DR preferentially ranked IR/DR programs over DR programs. This study may help to guide future IR/DR applicants and program directors in how to best allocate limited recruitment resources. The study’s main limitation is that responses are self-reported, which may lead to selection bias; however, the results may help clarify an evolving process.

Gender Differences Among Academic Pediatric Radiology Faculty in the United States and Canada

It is currently unknown whether efforts in recent years to create equal opportunities for female faculty in academic medicine have succeeded. We looked at faculty members in academic pediatric radiology departments across the United States and Canada to assess for evidence of gender disparities and differences in academic performance between males and females. The analysis included diagnostic radiology programs across the United States and Canada, as specified by the American Medical Association's Fellowship and Residency Electronic Interactive Database (FREIDA Online) and the Canadian Resident Matching Service website. The Scopus database was used to retrieve the H-index, number of publications, and number of citations for each faculty member. We examined the distribution of male and female faculty members across geographical regions, academic ranks, and leadership roles. Academic performance was also compared. Across all regions and academic ranks, disparities exist between the number of male and female faculty members. The greatest disparity was found amongst the professor rank, where more than 70% of positions were occupied by males. Female professors were found to demonstrate similar levels of academic performance compared to their male counterparts, although this parity was not observed amongst assistant and associate professors. Women occupied almost half (46.6%) of the total academic pediatric radiology workforce, despite having been previously shown to make up only 21% of radiologists. However, gender disparities currently exist among academic pediatric radiology faculty, with a significantly higher percentage of men in pediatric radiology faculty positions. Women, however, currently occupy a greater percentage of leadership positions compared to men, even though the majority of senior academic ranks are held by men.

Radiology Resident Journal Club: Enhancements Add Educational Value

Resident journal clubs are essential to develop skills to critically appraise existing literature. However, most reports of journal clubs focus on logistics of the activity and less on established roles of those involved. Our objective is to report on an innovative journal club from the perspective of key participants. Journal club schedule, assignments, evaluations, and analysis are proffered from our institution. The journal club goals were formulated as: (1) improving resident understanding of research (biostatistical and epidemiologic) methods and statistical concepts, (2) teaching critical appraisal skills, and (3) promoting the use of evidence-based medicine. Each session's format is interactive, consisting of a 10 minute lecture with radiology examples of a research or statistical concept, followed by a journal club style discussion. Crucial to the success of this curriculum has been input and engagement of multiple parties: radiology residents, epidemiologist directors, and subspecialist clinician educator faculty members. A well-thought out and well-run resident journal club offers numerous solutions to radiology residencies. To residency program leadership and to each individual resident annually, resident journal club offers cutting edge medical knowledge, interactive conferences in the formal didactic curriculum, resident training in critical thinking skills and research design, resident training in interpersonal and communication skills, opportunity for residents to be teachers, and expanded resident interprofessional education. It meets Accreditation Council for Graduate Medical Education common program, Residency Review Committee diagnostic radiology program, and American Board of Radiology Milestones requirements.

A National Study of Longitudinal Consistency in ACGME Milestone Ratings by Clinical Competency Committees: Exploring an Aspect of Validity in the Assessment of Residents' Competence.

To investigate whether clinical competency committees (CCCs) were consistent in applying milestone ratings for first-year residents over time or whether ratings increased or decreased. Beginning in December 2013, the Accreditation Council for Graduate Medical Education (ACGME) initiated a phased-in requirement for reporting milestones; emergency medicine (EM), diagnostic radiology (DR), and urology (UR) were among the earliest reporting specialties. The authors analyzed CCC milestone ratings of first-year residents from 2013 to 2016 from all ACGME-accredited EM, DR, and UR programs for which they had data. The number of first-year residents in these programs ranged from 2,838 to 2,928 over this time period. The program-level average milestone rating for each subcompetency was regressed onto the time of observation using a random coefficient multilevel regression model. National average program-level milestone ratings of first-year residents decreased significantly over the observed time period for 32 of the 56 subcompetencies examined. None of the other subcompetencies showed a significant change. National average in-training examination scores for each of the specialties remained essentially unchanged over the time period, suggesting that differences between the cohorts were not likely an explanatory factor. The findings indicate that CCCs tend to become more stringent or maintain consistency in their ratings of beginning residents over time. One explanation for these results is that CCCs may become increasingly comfortable in assigning lower ratings when appropriate. This finding is consistent with an increase in confidence with the milestone rating process and the quality of feedback it provides.

Abstract No. 465 Making a case for more IR residency positions: comparing qualifications of medical students applying to IR/DR residencies to NRMP DR match data

To compare measurable qualifications of medical students applying to diagnostic radiology (DR) and interventional radiology/diagnostic radiology (IR) programs in order to promote and support creation of new IR residency positions. NRMP DR match outcome data (2016) and survey data from medical students applying for the upcoming match were used to compare measurable qualifications of medical students applying to IR residencies with those who match into DR residencies. DR data was based on NRMP data from 652 US allopathic seniors who matched in 2016. A total of 32 medical students completed the survey. Out of the students surveyed, 100% are planning on pursuing careers in IR. The majority of the student respondents were in their match application year (75%) and applying to both IR and DR residencies (100%). Students planned to rank IR programs ahead of DR programs (100%). No students intend to apply to only IR programs or DR programs without early specialization in IR (ESIR). Medical students pursuing IR residencies had better average Step 1 and Step 2 CK scores when compared to those who matched in DR (249 vs. 240 and 251 vs. 247, respectively). The percentage of students who had achieved AOA status was also higher among those applying to IR (31%) when compared to DR (18.4%). There were more research experiences and scholarly activity per applicant in the IR group (3.9 and 5.7) when compared to those who matched in DR (3.1 and 4.9). Both groups had similar work and volunteer experiences. Interestingly, there were more students matched into DR with Ph.D. or graduate degrees (5% and 15.4%) when compared to those applying to IR (3.1% and 9.4%). Medical students pursuing careers in IR perform better than their DR counterparts in several key measurable qualifications. DR residencies should favour starting an IR residency and existing IR residencies should consider expansion in order pursue these high caliber students as they appear driven to seek institutions that will satisfy their ability to train in IR.