Results of the 2001 survey of the American Association of Academic Chief Residents in Radiology

Rewinding the Clock: Preparing the Next Generation of Radiology Residents for Oral Boards

The replacement of the ABR in-person oral examination with the DR certifying examination affected approximately 15,000 radiologists, spanning from 2013 to 2027. This decision was motivated by better aligning with the timing of other American Board of Medical Specialty (ABMS) members, more closely reflecting real-world practice of radiology and narrowing training geared towards the trainee's subspecialty preference. However, in retrospect, this change may have subtracted from the quality and value of diagnostic radiology training as a whole with the de-emphasis on competence in general radiology, communication skills, and cognitive reasoning. In this paper, the authors lay out a blueprint necessary in order to rewind the clock of how diagnostic radiology programs can prepare their trainees for the new DR oral examination. Such a change will require substantial redactions affecting all designations, including radiology faculty, education teams, departmental leadership, academic institutions, ACGME, and ABR. The authors believe that implementing these modifications will not only effectively equip radiology candidates for the new DR oral examination but will also augment the significance of radiologists as indispensable members of multidisciplinary teams. The authors also outline the challenges that could emerge from these changes and speculate on the anticipated role of AI in future oral board examinations.

Does the Oral "Mock Board" Examination Still Have a Role as a Training Tool?

RATIONALE AND OBJECTIVES

The American Board of Radiology has adopted a new standardized board examination and the traditional oral examination has been abandoned. Although many programs have changed their educational efforts to reflect the new test format, some faculty members and residents have expressed a desire to keep an oral examination as a component of education and evaluation in radiology residency programs.

MATERIALS AND METHODS

An oral comprehensive examination including all the appropriate subspecialties was administered to each second year and third year resident in our training program by faculty members. Both the resident examinees and faculty examiners were surveyed after the examination to gauge the perceived value of the experience.

RESULTS

Residents were divided in their perceptions of the fairness and utility of an oral examination as a tool to aid in board preparation and as an assessment of their knowledge and communication skill. Faculty members were universal in their endorsement of the oral examination and suggested continued use of the technique.

CONCLUSIONS

Residents and faculty members have differing perceptions of an oral examination delivered during training to assess knowledge and communication skill. The value of an oral examination in providing actionable feedback to trainees and the possibility of detecting struggling residents made it useful in our training program, and it thus it has been implemented for future years. Whether resident performance measured by this technique is predictive of success on American Board of Radiology examinations remains unclear.

Mock radiology oral examination

RATIONALE AND OBJECTIVE

To organize and implement a mock oral examination for radiology residents in an attempt to prepare them for the American Board of Radiology Oral Examination.

MATERIALS AND METHODS

A mock oral examination was administered to junior and senior radiology residents by radiology faculty. All participants completed postexamination surveys.

RESULTS

The mock oral examination process not only provided practice for preboard residents, but also determined areas of deficiency in their fund of knowledge and presenting skills. Additionally, it provided faculty members with areas of curricular weakness.

CONCLUSION

Administration of a mock oral examination reaps multiple benefits, which far exceed the task of its implementation.

What is the impact of commercial test preparation courses on medical examination performance?

BACKGROUND

Commercial test preparation courses are part of the fabric of U.S. medical education. They are also big business with 2,000 sales for 1 firm listed at nearly $250 million. This article systematically reviews and evaluates research published in peer-reviewed journals and in the "grey literature" that addresses the impact of commercial test preparation courses on standardized, undergraduate medical examinations.

SUMMARY

Thirteen computerized English language databases were searched using 29 search terms and search concepts from their onset to October 1, 2002. Also manually searched was medical education conference proceedings and publications after the end date; and medical education journal editors were contacted about articles accepted for publication, but not yet in print, that were deemed pertinent to this review. Studies that met three criteria were selected: (a) a commercial test preparation course or service was an educational intervention, (b) the outcome variable was one of several standardized medical examinations, and (c) results are published in a peer-reviewed journal or another outlet that insures scholarly scrutiny. The criteria were applied and data extracted by consensus of 2 reviewers. The search identified 11 empirical studies, of which 10 (8 journal articles, 2 unpublished reports) are included in this review. Qualitative data synthesis and tabular presentation of research methods and outcomes are used.

CONCLUSION

The articles and unpublished reports reveal that current research lacks control and rigor; the incremental validity of the commercial courses on medical examination performance, if any, is extremely small; and evidence in support of the courses is weak or nonexistent; almost no details are given about the form and conduct of the commercial test preparation courses; studies are confined to courses in preparation for the Medical College Admission Test, the former National Board of Medical Examiners Part 1, and the United States Medical Licensing Examination Step 1, not tests of clinical science; and that cost-benefit analyses of the test preparation courses have not been done. It is concluded that the utility and value of commercial test preparation courses in medicine have not been demonstrated, and that evaluation apprehension in the medical profession and aggressive marketing practices are most likely responsible for commercial course prosperity.

Radiology residency eCurriculum developed in-house: evaluation of benefits and weaknesses

RATIONALE AND OBJECTIVES

The purpose of this study was to evaluate residents' use of a radiology curriculum CD-ROM designed to provide ready access to the department's curricula, study materials, and Internet resources.

MATERIALS AND METHODS

A survey questionnaire eliciting feedback about the usability and value of the CD-ROM, as well as suggestions for future modifications in its content, was distributed to radiology residents (n = 26) in the authors' training program. Twenty-three (88%) of the residents responded to the survey.

RESULTS

Eighteen (78%) of the 23 respondents reported having used the CD-ROM at least once, and 22 (96%) considered the CD-ROM an asset to the residency program. Fourteen (61%) identified the centralization of important information as the greatest benefit of the CD-ROM. Nonetheless, a majority continued to rely on more traditional methods of obtaining information essential to their work and studies. Twelve (52%) of the 23 residents reported that daily use of the material stored on the CD-ROM would be encouraged by placing it on a departmental intranet, while seven (30%) preferred the addition of dedicated computers and the provision of study space in the department.

CONCLUSION

The CD-ROM has not been fully integrated into the residency program. The greatest obstacle to its use is the lack of computer resources in the department.

Factors that influence radiologists' career choices

RATIONALE AND OBJECTIVES

The authors performed this study to examine the factors, particularly the modifiable factors, that influence the career choices of radiologists immediately after graduation from residency and later.

MATERIALS AND METHODS

A survey was sent to 119 radiologists who had graduated from a large academic training program between 1981 and 2000. The graduates were asked to classify their first job and any subsequent jobs in academic radiology or private practice and to identify the reasons for their initial job choices and any job changes. A nested cohort study was performed to evaluate the effect of research experience on career choice.

RESULTS

Seventy-nine (66%) graduates responded to the survey. Forty-three (54%) of the respondents had chosen academic positions as their first jobs. Those who had published during their residency were 26.4 times more likely to choose an academic position as a first job. Twenty-four graduates had since left their academic jobs for private practice. Although the discrepancy in financial rewards between academic radiology and private practice was the main reason for the job switch in 71% of these cases, 33% of the respondents cited difficulty with research as a reason. In addition, only 25% of current academic radiologists were satisfied with their research activities.

CONCLUSION

An exodus from academic radiology to private practice is evident among graduates from this large academic residency program, with greater financial reward being the primary motivation. However, a positive research experience during residency could persuade more graduates to choose and to continue in an academic career.