Radiology Residency Programs Research Articles

Branding Your Radiology Residency and Fellowship Programs in the COVID-19 Era.

The ongoing coronavirus disease 2019 pandemic has led to unprecedented changes in the practice of radiology and radiology education. In addition to the rapid adoption of remote teaching of and learning by trainees, the residency recruitment process will be going virtual. Both programs and applicants will face challenges as they attempt to create an optimal virtual experience for applicants to explore open residency and fellowship positions. In addition to providing informative institutional and departmental websites, programs will need to find ways to capture their uniqueness and stand out from their counterparts across the country.

Parental Leave and Neuroradiology Fellowships.

A uniform policy on parental leave in radiology training programs is lacking. Although previous publications have addressed the status of parental leave policy among radiology residency programs, the state of parental leave in radiology fellowships has not been addressed to date. Our aim was to determine the state of parental leave policies in American neuroradiology fellowship programs. An Internet survey was sent to the directors of neuroradiology fellowship programs listed on the Accreditation Council for Graduate Medical Education Web site (n = 87) in January 2020. The questionnaire assessed the policies of the fellowship programs and Program Directors' attitudes toward maternal and paternal leave. Four reminders were sent during the 3 weeks before closing data collection. The response rate was 76% (66/87). Ninety-four percent (62/66) of program directors claimed to have a maternal leave policy, of which 51/62 (82%) were written and 53/62 (85%) were paid. Additionally, 77% (51/66) had a policy for paternal leave, of which 80% (41/51) were written and 76% (39/51) were paid. The average length of paid leave was 6.7 ± 3.25 weeks for new mothers and 2.9 ± 2 weeks for new fathers. Unpaid leave was mostly based on the Family and Medical Leave Act. Fellows were responsible for making up call duties during the parental leave in 47% of the programs. Radiation exposure was restricted in 89% of the programs during pregnancy. Policies addressed breast feeding and untraditional parenthood in just 41% of the responding programs. Most program directors supported the development of a unified national policy on maternal (83%) and paternal (79%) leave. Most neuroradiology fellowship programs have explicit maternal and paternal leave policies that grant paid leave to trainees. Some also offer unpaid leave, mostly through Family and Medical Leave Act guidelines. A uniform policy derived from the Accreditation Council for Graduate Medical Education and/or American Board of Radiology would be useful and overwhelmingly accepted.

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

Changes in Hospital Outpatient Quality Reporting Program Brain CT Efficiency Performance, 2013 to 2018

Inefficient imaging practices merit renewed attention in preparation for full implementation of the Appropriate Use Criteria Program. This study's purpose is to quantify changes in outpatient brain CT imaging efficiency from 2013 to 2018, including changes in relative efficiency by hospital category. Imaging efficiency data were obtained from the Medicare Hospital Compare website. Summary statistics were calculated for rates of unnecessarily combined brain and sinus CT scans from 2013 to 2018. Relative performance was compared by hospital Medicare payment structure, type of ownership, and affiliation with a radiology residency program. The predictive value of these hospital characteristics on brain CT efficiency was determined using linear regression analysis. From 2013 to 2018, the mean frequency of unnecessarily combined brain and sinus CT scans decreased by 1.82% (95% confidence interval, 1.74%-1.90%). Proprietary and physician-owned hospitals exhibited a higher mean frequency of combined scans than other hospitals in 2013 (P < .001), and government-owned hospitals exhibited a lower mean frequency of combined scans than other hospitals in 2018 (P < .001). Radiology residency-affiliated hospitals exhibited no significant difference in 2013 but exhibited a higher mean frequency in 2018 (difference: 0.45%; 95% confidence interval, 0.29%-0.61%). Critical access hospital status and nonaffiliation with a radiology residency program were the strongest predictors of brain CT efficiency in the regression model. Recent changes in hospitals' relative brain CT efficiency suggest category-specific differences in responsiveness to quality improvement efforts and may foreshadow similar trends under forthcoming initiatives.

Diagnostic Radiology Residency Program Director Workforce in the United States: A Descriptive Analysis

To investigate and describe the demographics, academic background, and scholarly activity of Diagnostic Radiology (DR) residency program directors in the United States. A list of all DR residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and corresponding program directors (PD) was obtained from ACGME website. Information about each PD was obtained from publicly available sources including program websites, Healthgrades and Doximity. Demographic and academic data including age, sex, educational background, subspecialty, tenure, interval between residency completion and appointment as PD, terms served, additional degrees, academic rank, prior leadership positions and metrics of scholarly activity were recorded. Nonparametric statistics including Mann-Whitney U and Kruskal-Wallis tests were applied to compare differences between groups. Results are considered statistically significant at p < 0.05. A total of 197 PDs were included in the study of which 139 (70.6%) were male. Average age of PDs was 47.56 years (SD 8.29, median 45, range 35-77). There was no significant difference in median age of male vs female PDs (45 vs 44.5, p = 0.655). Majority of PDs attended American medical schools (181/197, 91.9%), and 16/197 attended international medical schools. Nine PDs received DO degrees (9/197, 4.6%). Academic rank was available for 137 PDs, of which 4 (2.9%) were instructors, 63 (46.0%) were assistant professors, 47 (34.3%) were associate professors and 23 (16.8%) were professors. Fellowship information was available for 183 PDs, of which the most common subspecialties were neuroradiology (24.5%), musculoskeletal radiology (15.8%), abdominal radiology (10.3%), and interventional radiology (9.8%). Female PDs had a significantly higher median publications (13.5 vs 6.0, p = 0.003), median citations (133 vs 37, p = 0.19) and median h-index compared to male PDs (6 ± 3, p = 0.005). Radiology PDs are mostly males who graduated from US allopathic medical schools. Female PDs had significantly higher scholarly metrics compared to male PDs. Twenty three percent PDs were appointed in the last 1 year.

Radiology Education Amid COVID-19 Pandemic and Possible Solutions.

Along with the rest of the world, the United States is inundated by the COVID-19 pandemic. The medical services in the country have been severely affected. The pandemic poses extraordinary challenges to academic institutions including radiology residency and fellowship programs. Herein, we delineate major difficulties faced by our radiology training program and mitigating countermeasures. The primary objective is to discuss the changes in our radiology training programs due to COVID-19 to allow for continued radiology education.

Non-interventional Radiology Fellowship Programs: What Is Out There?

ObjectiveTo determine the spectrum of non-interventional radiology fellowship programs in institutions that offer both a radiology residency program and one or more non-interventional radiology fellowship programs. MethodsInstitutions offering both radiology residency and non-interventional radiology fellowship programs were identified using publicly available websites. The non-interventional radiology fellowship programs were categorized into “traditional” (neuroradiology, breast imaging, abdominal imaging, musculoskeletal imaging, thoracic imaging, pediatric radiology, and nuclear medicine) and “nontraditional” fellowship programs. The nontraditional programs were stratified into four categories: a) Combinations of traditional fellowships; b) Focused nontraditional fellowships; c) Combinations of traditional and focused nontraditional fellowships (excluding traditional-traditional combinations); and d) Mandatory two-year fellowships. The distributions of the different types of traditional and nontraditional fellowship programs were evaluated. Results555 fellowship programs were identified in 113 institutions that offered both radiology residency and non-interventional radiology fellowship programs. 73.33% (407/555) of the programs were traditional fellowships, and 26.66% (148/555) were nontraditional fellowships. The 148 nontraditional fellowship programs were comprised of 41 different types of programs, 23 types of which were unique to and offered exclusively at specific institutions. 38.08% of the traditional fellowship programs were Accreditation Council for Graduate Medical Education (ACGME) accredited, while only 16.21% (24/148) of the nontraditional fellowship programs were ACGME-accredited. ConclusionsThe nontraditional non-interventional radiology fellowship programs are formed by a heterogeneous group of programs, some of which are offered exclusively at a single institution. Awareness of the types of existing programs would help radiology residents in making a more informed decision regarding their fellowship training.

Lessons learned during the COVID-19 pandemic: a single institution radiology chief resident experience

Coronavirus Disease 2019 (COVID-19) has posed incredible new challenges for radiology residency programs, including resident training under tenuous and uncertain conditions, barriers to communication, deployment-induced anxiety, and social isolation. Chief residents and program leadership play a critical role in guiding radiology residents through these unprecedented times. Best practices and creative approaches experienced in a single institution's residency program located in New York City are shared in an effort to encourage other programs struggling with similar obstacles to prioritize resident education and wellness.

COVID-19 Impact on Well-Being and Education in Radiology Residencies: A Survey of the Association of Program Directors in Radiology

Rationale and ObjectivesThe COVID-19 pandemic has forced rapid evolution of the healthcare environment. Efforts to mitigate the spread of the virus through social distancing and shelter-at-home edicts have unintended consequences upon clinical and educational missions and mental well-being of radiology departments. We sought to understand the impact of the COVID-19 pandemic on radiology residencies with respect to the educational mission and perceptions of impact on well-being.Materials and MethodsThis study was IRB exempt. An anonymous 22 question survey regarding the impact of COVID-19 pandemic on educational and clinical missions of residencies, its perceived impact upon morale of radiologists and trainees and a query of innovative solutions devised in response, was emailed to the Association of Program Directors in Radiology membership. Survey data were collected using SurveyMonkey (San Mateo, California).ResultsRespondents felt the COVID-19 pandemic has negatively impacted their residency programs. Regarding the educational mission impact, 70.1% (75/107) report moderate/marked negative impact and 2.8% (3/107) that educational activities have ceased. Regarding the pandemic's impact on resident morale, 44.8% (48/107) perceive moderate/marked negative effect; perceived resident morale in programs with redeployment is significantly worse with 57.1% (12/21) reporting moderate/marked decrease. Respondents overwhelmingly report adequate resident access to mental health resources during the acute phase of the pandemic (88.8%, 95/107). Regarding morale of program directors, 61% (65/106) report either mild or marked decreased morale. Program innovations reported by program directors were catalogued and shared.ConclusionThe COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the United States.

Impact of COVID-19 on Canadian Radiology Residency Training Programs.

Purpose:The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19.Methods:A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark.Results:We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations.Conclusion:The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs.

The Relationship Between ACR Diagnostic Radiology In-Training Examination Scores and ABR Core Examination Outcome and Performance: A Multi-Institutional Study.

We analyzed multi-institutional data to understand the relationship of ACR Diagnostic Radiology In-Training Examination (DXIT) scores to ABR Core examination performance. We collected DXIT rank scores and ABR Core examination outcomes and scores for anonymized residents from 12 different diagnostic radiology residency programs taking the ABR Core examination between 2013 and 2019. DXIT scores were grouped into quintiles based on rank score for residency year 1 (R1), residency year 2 (R2), and residency year 3 (R3) residents. Core outcome was scored as fail when conditionally passed or failed. Core performance was grouped using SD from the mean and measured by the percent of residents with scores below the mean. Differences between DXIT score quintiles for Core outcome and Core performance were statistically evaluated. DXIT and Core outcome data were available for 446 residents. The Core examination failure rate for the lowest quintile R1, R2, and R3 DXIT scores was 20.3%, 34.2%, and 38.0%, respectively. Core performance improved with higher R3 DXIT quintiles. Only 2 of 229 residents with R3 DXIT score ≥ 50th percentile failed the Core examination, with both failing residents having R2 DXIT scores in the lowest quintile. DXIT scores are useful evaluation metrics to identify a subgroup of residents at significantly higher risk for Core examination failure and another subgroup of residents at significantly lower risk for Core examination failure, with increasing predictive power with advancing residency year. These scores enable identification of approximately one-half of R3 residents whose risk of Core examination failure is negligible.

You Can't Expect When You're Expecting: The Variable State of Parental Leave in Radiology Residency Programs

In 1919, the International Labor Organization (ILO) fought to establish legislation for the first global workforce standards for protected maternity leave. A century later, the ILO maintains that “the intersection of work with maternity, paternity, and care responsibilities [is] a particular critical focal point for efforts to improve health, equality, and job equality” (1). While in the United States, the Family and Medical Leave Act (FMLA) of 1993 ensures that eligible new parents can take up to 12 weeks of job-protected unpaid leave (2), paid leave policies specific to the birth or adoption of a child into a family often offer more comprehensive support for new parents.

Initial Experience Integrating a Hands-On Innovation Curriculum Into a Radiology Residency Program and Department.

Initial Experience Integrating a Hands-On Innovation Curriculum Into a Radiology Residency Program and Department.

Economic Recession From the COVID-19 Pandemic Signals Recruiting Difficulty Ahead for Radiology Residency Programs

Economic Recession From the COVID-19 Pandemic Signals Recruiting Difficulty Ahead for Radiology Residency Programs

Introducing Summative Progress Testing in Radiology Residency: Little Change in Residents\u2019 Test Results After Transitioning from Formative Progress Testing

IntroductionEducational effects of transitioning from formative to summative progress testing are unclear. Our purpose was to investigate whether such transitioning in radiology residency is associated with a change in progress test results.MethodsWe investigated a national cohort of radiology residents (N > 300) who were semi-annually assessed through a mandatory progress test. Until 2014, this test was purely formative for all residents, but in 2014/2015, it was transitioned (as part of a national radiology residency program revision) to include a summative pass requirement for new residents. In 7 posttransitioning tests in 2015–2019, including summatively and formatively tested residents who followed the revised and pre-transitioning residency program, respectively, we assessed residents’ relative test scores and percentage of residents that reached pass standards.ResultsDue to our educational setting, most posttransitioning tests had no residents in the summative condition in postgraduate year 4–5, nor residents in the formative condition in year 0.5–2. Across the 7 tests, relative test scores in postgraduate year 1–3 of the summative resident group and year 3.5–4.5 of the formative group differed significantly (p < 0.01 and p < 0.05, respectively, Kruskal-Wallis test). However, scores fluctuated without consistent time trends and without consistent differences between both resident groups. Percentage of residents reaching the pass standard did not differ significantly across tests or between groups.DiscussionTransitioning from formative to summative progress testing was associated with overall steady test results of the whole resident group in 4 post-transitioning years. We do not exclude that transitioning may have positive educational effects for resident subgroups.

Radiology Residency Program Management in the COVID Era – Strategy and Reality

The Coronavirus Disease 2019 (COVID-19) is a global pandemic whose impact thus far cannot be overstated. In response to this global pandemic, the Accreditation Council for Graduate Medical Education (ACGME) developed a new framework for its sponsoring Institutions; the ACGME's three stages are Stage 1 “Business as Usual”, Stage 2 “Increased Clinical Demands” and Stage 3 “Pandemic Emergency Status” (1) (Table 1). Radiology residency programs throughout the United States may find themselves in any of these three, with each stage having distinct implication on resident education, clinical care, and research (2).

Radiology Residency Preparedness and Response to the COVID-19 Pandemic

This article provides a guideline for radiology residency programs to prepare and respond to the impact of coronavirus disease 2019, by offering specific examples from three programs, and provides a list of resources for distance learning and maintaining well-being.

Parental Leave Policy in Radiology Residency Programs: Current Status.

To explore the current status and determine the uniformity of parental leave policies among US radiology residency programs. An electronic survey was developed and sent to 222 radiology residency program directors (PDs) in June 2019 to assess their policies and attitudes toward parental leave. The survey was administered via the Internet Qualtrics Research Suite (Qualtrics, Provo, Utah) format with four reminders sent over the course of 2 months before closing the data collection. In all, 74 PDs responded to the survey. Of those, 88% claimed to have a maternal leave policy (88% explicitly written and 77% paid); 80% had a paternal leave policy (88% explicitly written and 75% paid). The average length of maternal and paternal leaves was 7.4 ± 3.9 and 3.7 ± 3.7 weeks, respectively. Parental leaves were allocated at least every other year in over 70% of programs. Approximately 60% of the PDs required residents to make up call rotations for parental leaves. About 92% of responsive programs adjusted angiography and fluoroscopy rotations for trainees throughout the pregnancy or according to the trainee's request. Policies did not generally address issues of breastfeeding and nontraditional parenthood. The proportion of radiology programs with explicit maternal leave policies remained constant compared with previous surveys during the last two decades. However, there was a dramatic rise in the adoption of paternal leave policies. Overall, there was a lack of national uniformity in radiology residency programs' policies concerning parental leave, leaving open the possibility of national guidance in addressing the issue.

Assessing the Status of Mentorship Programs in Interventional Radiology Residency Training: Results of a 2018 Survey

To assess the prevalence and structure of mentorship programs in interventional radiology (IR) residency programs. A 12-question anonymous survey was distributed via email to all 78 program directors (PDs) of United States IR residency programs. The survey included information about the presence or absence of a formal mentorship program at their institution, how the program functions, potential barriers to implementation, and future plans for mentorship. Twenty-three of 78 integrated IR residency PDs completed the survey (response rate 29.5%). Thirteen of 23 reports that they currently have a formal mentorship program in place and 11 of 13 report no direct departmental support for mentorship. Of those that do not have a mentorship program in place, 5 of 10 report that implementation is underway. These programs report that the absence of a mentorship program is due to a lack of dedicated time and financial support. While 8 of 23 PDs were unaware of the Society of Interventional Radiology Mentor Match program, 6of 23 were registered as mentors through it. Nearly all PDs reported interest in receiving mentoring resources from SIR with the most popular choices being a dedicated mentorship educational course at the SIR annual meeting and regular mentorship articles and practical tips in publications such as IR quarterly. Despite involvement of many IR PDs in mentorship, numerous residency programs lack a formal mentorship program. Of those with a program, most don't receive direct departmental support and those without a program cite lack of time and financial support as barriers to effective implementation.

The Relationship Between US Medical Licensing Examination Step Scores and ABR Core Examination Outcome and Performance: A Multi-institutional Study.

We analyzed multi-institutional data to understand the relationship of US Medical Licensing Examination (USMLE) Step scores to ABR Core examination performance to identify Step score tiers that stratify radiology residents into different Core performance groups. We collected USMLE Step scores and ABR Core examination outcomes and scores for anonymized residents from 13 different diagnostic radiology residency programs taking the ABR Core examination between 2013 and 2019. USMLE scores were grouped into noniles using z scores and then aggregated into three tiers based on similar Core examination pass-or-fail outcomes. Core performance was grouped using standard deviation from the mean and then measured by the percent of residents with scores below the mean. Differences between Step tiers for Core outcome and Core performance were statistically evaluated (P < .05 considered significant). Differences in Step 1 terciles Core failure rates (45.9%, 11.9%, and 3.0%, from lowest to highest Step tiers; n= 416) and below-mean Core performance (83.8%, 54.1%, and 21.1%, respectively; n= 402) were significant. Differences in Step 2 groups Core failure rates (30.0%, 10.6%, and 2.0%, from lowest to highest Step tiers; n= 387) and below-mean Core performance (80.0%, 43.7%, and 14.0%, respectively; n= 380) were significant. Step 2 results modified Core outcome and performance predictions for residents in Step 1 terciles of varying statistical significance. Tiered scoring of USMLE Step results has value in predicting radiology resident performance on the ABR Core examination; effective stratification of radiology resident applicants can be done without reporting numerical Step scores.