Adoption of the 16-month American Board of Radiology pathway to dual board certifications in nuclear radiology and/or nuclear medicine for diagnostic radiology residents

10-year update to the combined 16-month nuclear medicine and diagnostic radiology residency: The NuRad pathway

BACKGROUND

The decline in nuclear medicine (NM) residencies in the United States has led to a shortage of NM physicians. To help address this, a 16-month NM pathway for diagnostic radiology (DR) residents was developed in 2010. At the University of Arkansas for Medical Sciences, we matched our first resident into the NuRad (NM + DR) pathway in 2013. Despite our success, we remain one of only five programs in the United States that offers a combined training pathway through the National Resident Matching Program.

OBJECTIVES

Review our 10-year experience with the NuRad pathway at UAMS and highlight the key components and significance of the 16-month NM pathway.

METHODS

Retrospective review of NRMP applicants to the DR and NuRad pathway from 2013 and 2023 at UAMS. Literature and website review of the educational structure of the 16-month NM pathway.

RESULTS

We have seen significant increase in the number of applicants to the NuRad pathway at UAMS over the last 10 years with 184 applicants for 1 position in 2023, up from 18 applicants in 2013. Furthermore, we have seen an increase in the USMLE step scores for applicants during this time.

CONCLUSIONS

There is a growing need for NM trained physicians in the United States. Over the last 10 years, we have seen increasing interest in the NM 16-month pathway as a part of DR residency. A wider implementation of this combined training pathway is needed, if we are to realize its full potential.

The integrated nuclear medicine and radiology residency program in the Netherlands: strengths and potential areas for improvement according to nuclear medicine physicians and radiologists

PURPOSE

To evaluate the Dutch integrated nuclear medicine and radiology residency program from the perspective of nuclear medicine physicians and radiologists.

METHODS

A survey was distributed among nuclear medicine physicians and radiologists in hospitals that participate in the Dutch integrated nuclear medicine and radiology training program.

RESULTS

A total of 139 completed questionnaires were included. Nuclear medicine physicians (n = 36) assigned a mean score of 5.7 ± 2.0, and radiologists (n = 103) assigned a mean score of 6.5 ± 2.8 (on a 1-10 scale) to the success of the integrated training program in their hospital. On multiple regression, female gender of the survey participant (B = 2.22, P = 0.034), musculoskeletal radiology as subspecialty of the survey participant (B = 3.36, P = 0.032), and the survey participant's expectancy of resident's ability to handle workload after completion of residency were significantly associated with perceived success of the integrated training program (B = 1.16, P = 0.023). Perceived strengths of the integrated training program included broadening of expertise, a better preparation of future imaging specialists for hybrid imaging, increased efficiency in training residents, and increased efficiency in multidisciplinary meetings. Perceived weaknesses of the integrated training program included reduced exposure to nuclear medicine, less time for research and innovation, and concerns about its international recognition.

CONCLUSION

This study provided insights into the experiences of nuclear medicine physicians and radiologists with the Dutch integrated nuclear medicine and radiology residency program, which may be helpful to improve the program and similar residency programs in other countries.

The Current State of Nuclear Medicine and Nuclear Radiology: Workforce Trends, Training Pathways, and Training Program Websites

BACKGROUND

Nuclear medicine (NM) is a multidisciplinary field. Its overlap with nuclear radiology (NR) creates unique training considerations, opportunities, and challenges. Various factors impact the workforce, training needs, and training pathways. This state of flux may be perplexing to prospective NM/NR trainees.

PURPOSE

To evaluate the state of NM/NR training by assessing the (1) workforce trends and job prospects for NM/NR trainees, (2) NM and NR training pathways, and (3) applicant-accessible online presence of training programs.

METHODS

Workforce trends were analyzed using data collected from the 2017 American College of Radiology Commission on Human Resources Workforce Survey. Information regarding the training pathways leading to board certification(s) for NM and NR physicians were obtained through the American Board of Nuclear Medicine, the American Board of Radiology (ABR), and the Society of Nuclear Medicine and Medical Imaging. Each Accreditation Council for Graduate Medical Education-accredited NM residency or NR fellowship training program's website was reviewed for 20 content items to assess its comprehensiveness for those seeking information regarding eligibility, applications, training curriculum, and program characteristics.

RESULTS

Number of hires for NM/NR physicians has exceeded the projected number of hires from 2014 to 2017. In the last decade, there has been a greater than 25% decrease in the combined number of traditional NM residencies and NR fellowships (79-58 programs) and a greater than 50% decrease in the combined number of NM and NR trainees (173-82 trainees). In 2017, the ABR redesigned its 16-month pathway leading to specialty certification in diagnostic radiology and subspecialty certification in NR. As of March 24, 2019, there are 36 diagnostic radiology or IR residency programs with 64 trainees participating in this redesigned NR pathway. Of the 93.1% (54/58) of traditional Accreditation Council for Graduate Medical Education-accredited NM and NR training programs having websites in the 2017-2018 academic year, the mean number of online criteria met per program was 7.74 ± 3.2 of 20 (38.7%).

CONCLUSION

Recruitment into the traditional NM/NR training pathways has been steadily declining, but there has been a renewed interest with the redesigned ABR 16-month pathway. There is a paucity of online information available to prospective NM/NR applicants. In this rapidly evolving and unique field, it is important to streamline NM/NR training and bolster the information accessible to potential NM/NR applicants as they weigh career options.

How Does the Current Generation of Medical Students View the Radiology Match?: An Analysis of the AuntMinnie and Student Doctor Network Online Forums

RATIONALE AND OBJECTIVES

The AuntMinnie (AM) and the Student Doctor Network (SDN) online forums are popular resources for medical students applying for residency. The purpose of this study was to describe medical student radiology-related posts on AM and SDN to better understand the medical student perspective on the application and Match process.

MATERIALS AND METHODS

We reviewed all posts made on the AM and SDN online forums over 5 consecutive academic years from July 2012 to July 2017. Each thread was organized into one of six major categories. We quantified forum utilization over the past 5 years by the total number of and the most frequently posted and viewed thread topics.

RESULTS

We reviewed 2683 total threads with 5,723,909 views. Total number of threads posted and viewed fell by 46% and 63%, respectively, from 2013-2014 to 2014-2015, after which they returned near baseline by 2016-2017, along with an increase in interventional radiology-related posts between 2012-2013 (13%) and 2016-2017 (32%) (P < .001). The most common application-related topics were preapplication and program ranking advice (20% of all threads and views). Many posts were related to postinterview communication with residency programs (2% of all threads and views).

CONCLUSIONS

After a drop in 2013-2014, utilization of AM and SDN increased in 2016-2017, along with increased interest in interventional radiology. Addressing the student concerns identified in our study, especially in preparing residency applications, ranking programs, and navigating difficult situations, such as postinterview program communication, may improve the radiology application process for future medical students and their advisors.

A Perspective of the Future of Nuclear Medicine Training and Certification

Nuclear Medicine (NM) has evolved from a medical subspecialty using quite basic tests to one using elaborate methods to image organ physiology and has truly become "Molecular Imaging." Concurrently, there has also been a timely debate about who has to be responsible for keeping pace with all of the components of the developmental cycle-imaging, radiopharmaceuticals, and instrumentation. Since the foundation of the American Board of NM, the practice of NM and the process toward certification have undergone major revisions. At present, the debate is focused on the inevitable future convergence of Radiology and NM. The potential for further cooperation or fusion of the American Board of Radiology and the American Board of NM is likely to bring about a new path for NM and Molecular Imaging training. If the merger is done carefully, respecting the strengths of both partners equally, there is an excellent potential to create a hybrid NM-Radiology specialty that combines Physiology and Molecular Biology with detailed anatomical imaging that sustains the innovation that has been central to NM residency and practice. We introduce a few basic trends in imaging use in the United States. These trends do not predict future use, but highlight the need for an appropriately credentialed practitioner to interpret these examination results and provide value to the health care system.