Radiologist recruitment and retention: How can we improve?

The die-hards, negotiators and migrants: Portraits of doctors' career pathways through specialisation

INTRODUCTION

Global workforce shortages in medical specialties strain healthcare systems, jeopardising patient outcomes. Enhancing recruitment strategies by supporting professional identity (PI) development may be one way to address this workforce gap-yet little research has explored this topic. The goal of the current study was to explore specialty-specific recruitment through considering PI. As proposed causes of workforce shortages in anatomical pathology (AP) bear similarities to many other specialties, this study uses the field of AP as a model for specialist PI development and asks: (1) why, how and when do doctors choose to pursue AP training and (2) what can be learned from this for recruitment to AP and other specialties?

METHODS

A qualitative research approach was undertaken using narrative inquiry. Interviews with junior doctors interested in AP, AP registrars and AP consultants from Australia and New Zealand were interpreted as stories via 're-storying'. Narrative synthesis of participants' collective stories identified chronological key events (i.e. 'turning points') in choosing AP.

RESULTS

Narrative synthesis resulted in identification of three portraits entering medical specialist training: (1) die-hards, deciding upon initial exposure; (2) negotiators, choosing after comparing specialties; and (3) migrants, seeking to move away from non-pathology specialties. The negotiators and migrants cemented their decision to pursue AP as a postgraduate doctor, whereas the die-hards made this decision during medical school.

CONCLUSIONS

Given the similarities in portrait traits between AP and other specialties across the literature, our results suggest ways to support specialty recruitment using PI development. We propose a medical specialist recruitment framework to support the PI development of doctors with die-hard, negotiator and migrant traits. Use of this framework could enhance current specialty-specific recruitment approaches, particularly in fields challenged by workforce shortages.

Utility of contemporaneous dual read in the setting of emergency teleradiology reporting

PURPOSE

Emergency radiology requires rapid and accurate interpretation of imaging examinations. Missed findings may lead to adverse outcomes. Double reporting may be used to minimize errors. Limited contemporaneous double reporting may be most efficient and cost-effective, but no data exists. This study is intended to examine the benefits of double reading and identify examinations where this would be most useful.

METHODS

In this study, dual reporting was conducted in a parallel reading environment in a teleradiology practice for 3779 radiological procedures performed at two radiology centers in the USA over a period of 4 months. Discrepancies between reads were scored using the ACR peer review scoring system and grouped by modality and body part. Errors were tabulated across the study types, followed by identification of statistically significant differences. The interaction between image number and odds of an error was ascertained.

RESULTS

In 145 instances (3.8%; 95 % CI, 3.2-4.4%), double reporting identified errors, leading to report modification. Study type was significantly related to error frequency (p = 0.0001), with higher than average frequencies of error seen for CT abdomen and pelvis and MRI head or spine, but lower than average for CT head, CT spine, and ultrasound. Image number was positively associated with error odds, but was not independently significant in a joint logistic regression model that included study type.

CONCLUSION

Dual reporting identifies missed findings in about 1 of 25 emergency studies. This benefit varies substantially across study types and limited double reporting, merits further investigation as a cost-effective practice improvement strategy.