Results of the 2019 Survey of the American Alliance of Academic Chief Residents in Radiology

Five Years of the Musculoskeletal Radiology Fellowship Match: Trends and Perspectives

RATIONALE AND OBJECTIVES

The 2023 Match marks 5 years since the Musculoskeletal (MSK) Radiology Fellowship Match first took place in June 2019. The objective of this study is to analyze trends in the MSK Match over its 5-year course.

MATERIALS AND METHODS

Data from the National Resident Matching Program were evaluated for the number of applicants, medical school type of matched applicants, number of programs, and number of positions. Programs were grouped according to geographic region, program size, and ACGME accreditation status. These data were plotted to look for trends over time and by program characteristics.

RESULTS

There has been little variation in the number of eligible programs registering for the Match (range 80-83). The number of available positions has had a wider variation (range 204-218), and the number of applicants preferring MSK has varied from 156 to 178. The gap between positions and applicants has resulted in a percentage of positions filled that has ranged from 70.9% to 82.4%. Program size is positively correlated with Match rates, with 100% of programs with five or more positions filling ≥ 50% in 4 out of 5 years.

CONCLUSION

The variable numbers of fellowship positions and applicants have resulted in variable success of the Match by all metrics. Maintaining or increasing the number of applicants is the most critical factor for ongoing Match success.

Results of the 2020 Survey of the American Alliance of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVES

An annual survey of chief residents in accredited North American radiology programs is conducted by the American Alliance of Academic Chief Residents in Radiology (A³CR²). The purpose of this study is to summarize the 2020 A³CR² chief resident survey.

MATERIALS AND METHODS

An online survey was distributed to chief residents from 194 Accreditation Council on Graduate Medical Education-accredited radiology residencies. Questions were designed to gather information about residency program practices, benefits, fellowship or advanced interventional radiology (IR) training choices, and the integration of IR training. Subsets of questions focused on the perception of corporatization, non-physician providers (NPPs), and artificial intelligence (AI) in radiology and their relationship to the radiology job market.

RESULTS

174 individual responses from 94 programs were provided, yielding a 48 % program response rate. Extended emergency department coverage has steadily decreased over the last 5 years (2016-2020), however only 52 % of programs have independent overnight call (without attending coverage). Regarding the impact of new integrated IR residencies on training, 42 % indicated there was no appreciable impact on their DR or IR training, while 20 % indicated DR training for IR residents suffered and 19 % indicated IR training for DR residents suffered. Corporatization in radiology was perceived as the biggest potential threat to the future job market.

CONCLUSIONS

Integration of IR residency did not detrimentally affect DR or IR training in most programs. Radiology resident perception of corporatization, NPPs, and AI may help residency programs shape educational content.

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

PURPOSE

In academic radiology departments, attendings and resident are increasingly working together overnight for Emergency Department (ED) radiology coverage. The purpose of this study was to quantify reporting turnaround time for overnight cases read by residents and for overnight shifts with residents on duty.

METHODS

A retrospective study was performed at a hospital system where one overnight attending covers two hospitals with a 2nd/3rd year overnight resident, and a second overnight attending covers two other hospitals 80% of the time independently and 20% of the time with a fourth-year resident. In the first analysis, the median difference in turnaround time, from the time when the case was completed by the technologist to the time the attending finalized it, between cases read independently by attendings and cases pre-dictated by residents was calculated. In the second analysis, the median difference in turnaround time for all cases performed at the second two hospitals was compared on nights when an attending was on duty alone versus nights when a fourth-year resident was also on duty, regardless of if the resident had pre-dictated the case.

RESULTS

For computed tomography (CT), radiographs (XR), and ultrasound (US), there was a significant delay in turnaround time for cases pre-dictated by residents compared to cases read independently by attendings, ranging between 11 and 49 min depending on resident seniority and modality (p ≤ 0.001). For all cases on nights with a 4th year resident working, overall median report turnaround time decreased by 7 min (p < 0.001).

CONCLUSION

Resident pre-dictation causes delay in the finalization of individual CT, US, and XR reports; however, overall, working with residents results in a significant decrease in report turnaround time supporting the belief that overnight resident education does not delay patient care.

New England Women in Radiology (NEWR) Invited Lectureship Series: A Novel Program to Advance the Careers of Junior Female Faculty in Academic Radiology

RATIONALE AND OBJECTIVES

The purpose of this study is to assess the impact of the New England Women in Radiology (NEWR) program, a new program aimed to generate speaking and networking opportunities for junior women radiologists in New England, by providing opportunities to speak at other academic institutions in the region.

MATERIALS AND METHODS

A total of 12 academic radiology departments and 20 faculty members at various New England institutions participated in the program during its first year. An institutional survey was sent to all participating institutions and a faculty survey was sent to all participating faculty to assess their experience with the program. Experience was measured using a Likert scale. A word cloud was used to visualize common themes in free response survey questions.

RESULTS

Hundred percent of participating institutions and 67% of participating faculty responded to the corresponding surveys. Hundred percent of responding faculty indicated that they would participate in the program again. Ninety-two percent of faculty said that they would recommend the program to a colleague. Fifty-eight percent found the networking opportunity valuable; while 83% believed that participation in the NEWR program would help them achieve a promotion. Hundred percent of the participating institutions who completed the survey strongly agreed that 1) the program was easy to administer, 2) participating in the program was valuable to their educational mission, and 3) participating in the program benefited the promotion of junior women faculty in their department.

CONCLUSION

Initial experience with the NEWR program in its first year was positive amongst both faculty and institutional participants. To further help female junior faculty advance their careers in academia, the NEWR program could be adapted to other geographical locations to incorporate a greater number of institutions and faculty.

A Snapshot of Radiology Training During the Early COVID-19 Pandemic

PURPOSE

The COVID-19 pandemic transformed the personal and professional lives of radiology trainees. The purpose of this study was to broadly summarize the impact of COVID-19 on radiology trainees and their training programs via data collected during the early pandemic.

MATERIALS AND METHODS

An online survey was distributed to radiology chief residents in residencies throughout North America with responses collected between March 20th, 2020 and May 15th, 2020, which coincided with the development of initial COVID-19 peaks in North America. A subset of COVID-19 pandemic questions included resident wellness, imaging opinions, residency infrastructure change, and opinions regarding the Core Exam delay.

RESULTS

One hundred forty chief residents from 86 institutions responded to COVID-19-related questions. Nearly all responding programs (99%; 85/86) reported institutional positive cases of COVID-19. Most residents (94%; 132/140) thought laboratory testing provided more value than imaging. Fifty-seven percent of respondents (80/140) would use COVID-19-related terminology when encountering chest CT findings supportive of viral pneumonia in symptomatic patients. There was little reported change in the number of residents on call (no change reported in >80% of programs). Fifty-nine percent of residents (83/140) reported increased stress related to the COVID-19 pandemic. The majority of programs (93%) had fewer residents on service (80/86 responding programs).

CONCLUSIONS

COVID-19 dramatically affected radiology residencies during the early pandemic period. As we enter future phases of the COVID-19 pandemic, careful thought should also be given to rebuilding the radiology resident experience.

Preparing junior radiology residents for overnight call via peer-led, hands-on simulation

PURPOSE

The aim of this study was to assess the perceived value and impact of a hands-on mock call simulation program on resident confidence with interpretation of emergency department overnight call cases.

METHODS

A five-session course was implemented in June of 2018 for rising PGY-3/R2 residents to mimic the experience of overnight call with indirect supervision. Sessions were led by senior residents in the program and consisted of timed, independent interpretation of 15-20 high-yield cases per day which highlighted "do-not miss" critical findings and simulated workflow interruptions including phone calls, consultations, and questions from technologists. IRB-approved, and anonymous pre- and post-course surveys were administered to participants which assessed residents' degree of confidence in interpretation of on-call cases and comparison of the mock call experience with existing preparatory strategies. Survey responses were analyzed using McNemar's test and Mann-Whitney U test.

RESULTS

Our survey response rate was 91% (29/32). After completing the mock call simulation, there was a significant increase in the mean Likert score of resident confidence levels and feelings of preparedness from 4.59 to 7.38 (p < 0.01). The majority of respondents (72.4% [21/29]) felt that the mock call simulation was "extremely useful." One hundred percent of respondents indicated that the mock call simulation should be implemented for the following year.

CONCLUSION

Implementation of a hands-on mock call simulation significantly improves the confidence levels of radiology residents before assuming on-call responsibilities and may serve as an adjunct to existing preparatory strategies.