The relationship of clinical and academic productivity in a university hospital radiology department

The Effect of the COVID-19 Pandemic on Academic Research Gender Disparities in Radiology

RATIONALE AND OBJECTIVES

Gender disparities have long existed in radiology. The COVID-19 pandemic disrupted research activities worldwide and have impacted gender disparities across medical specialties. This study investigates the effect of the COVID-19 pandemic on gender disparities in radiology academic authorship.

MATERIALS AND METHODS

A retrospective observational study was conducted using data from 110 843 global and 23 977 US radiology articles. The gender of authors was determined using an automated gender inference tool. Descriptive statistics were applied to explore authorship changes overall globally, in the US as well as across countries and states.

RESULTS

Female first-authorship increased globally from 16.9% to 17.6% (p < 0.001), and in the US, from 19.0% to 19.6% (p = 0.19) in the peri-COVID period. The combined female percentage increased from 19.7% to 20.0% globally (p = 0.021), and from 20.2% to 21.1% in the US (p = 0.006). Country-level analysis revealed significant increases in female authorship in Colombia, Denmark, Egypt, France, India, and Japan, while New Zealand demonstrated a decrease in female authorship. In the US, Florida, Indiana, Louisiana, Massachusetts, and Ohio experienced increases in female authorship, whereas South Carolina demonstrated a decrease in female authorship.

CONCLUSION

In contrast with other medical fields, the study demonstrates that radiology experienced a slight increase in female authorship in radiology research globally and in the US during the COVID period. While the pandemic may have influenced these findings, further research is needed to establish regional causal relationships and identify best practices for promoting gender equity in radiology research.

A "global village": promoting research and careers in the pediatric radiology community through diversity

There is a severe shortage of pediatric radiologists in the USA and across the globe due to multiple factors. These severe shortages, along with increased clinical demand, growing research costs and limited funding sources place pediatric radiologists, particularly those in academic departments, under increasing time pressure, affecting their ability to maintain research productivity. In this paper, we model a new concept that should help boost the research efforts within the pediatric radiology community, while diversifying the academic workforce through the involvement of international medical graduates (IMGs). We describe the mutual advantages this concept could have on academic pediatric radiology departments and IMGs alike, as well as pose some of the unique challenges that could impact this concept and effective strategies to ensure success.

Research output of radiologists in Australia and New Zealand: Strengths, weaknesses and future directions

INTRODUCTION

Clinical radiology is a popular career. However, academic radiology in Australia and New Zealand (ANZ) has not traditionally been a strength of the specialty which has a focus on clinical medicine and has been influenced by corporatisation of the specialty. The aim of this study was to review the source(s) of radiologist-led research in Australia and New Zealand, to identify areas of relative deficiency and propose plans to improve research output.

METHODS

A manual search was performed of all manuscripts in seven popular ANZ journals, where the corresponding or senior author was a radiologist. Publications between January 2017 and April 2022 were included.

RESULTS

There were 285 manuscripts from ANZ radiologists during the study period. This equates to 10.7 manuscripts per 100 radiologists based on RANZCR census data. Radiologists in Northern Territory, Victoria, Western Australia, South Australia and the Australian Capital Territory all produced manuscripts above the corrected mean incidence rate of 10.7 manuscripts per 100 radiologists. However, locations including Tasmania, New South Wales, New Zealand and Queensland were below the mean. The majority of manuscripts arose from public teaching hospitals with accredited trainees (86%), and there were a higher proportion of manuscripts published by female radiologists (11.5 compared to 10.4 per 100 radiologists).

CONCLUSION

Radiologists in ANZ are academically active; however, interventions aimed at increasing output could be targeted at certain locations and/or areas within a busy private sector. Time, culture, infrastructure and research support are vital, but personal motivation is also extremely important.

Correlation of Scholarly Activity and Departmental Clinical Productivity in a Surgical Subspecialty

INTRODUCTION

Promotion within academic surgery involves demonstrated excellence in administrative, clinical, and scholarly activities. The present study analyzes the relationship between scholarly and clinical productivity in the field of reconstructive microsurgery.

METHODS

This is a retrospective cohort study of microsurgery fellowship directors (MFDs). Data on clinical productivity were obtained from the American Society for Reconstructive Microsurgery and scholarly productivity from Scopus. Outcomes were department annual free flap volume, number of publications, and h-index. Descriptive statistics were calculated, and nonparametric tests were used to compare continuous variables.

RESULTS

Thirty-nine MFDs were included in this study. All were plastic surgery residency trained and 38% trained under the independent training pathway. Most underwent formal fellowship training in reconstructive microsurgery (89%). The top three microsurgery fellowships trained 37% of all MFDs. Twenty-five percent of MFDs trained at the institution where they ultimately became program director. Twenty percent of MFDs had an additional degree (4 MS, 2 PhD, and 1 MBA). The median number of annual free flaps performed per institution was 175 (interquartile range [IQR] 122). The median h-index was 17 (IQR 13) resulting from 48 (IQR 99) publications. There was a correlation between department annual free flap volume and h-index (r = 0.333, P = 0.038).

CONCLUSIONS

There is a correlation between academic productivity of MFDs and the clinical productivity of their department. This study provides a benchmark for aspiring reconstructive microsurgeons.

Trends in Academic Productivity Among Radiologists During the COVID-19 Pandemic

PURPOSE

There is a scarcity of literature examining changes in radiologist research productivity during the COVID-19 pandemic. The current study aimed to investigate changes in academic productivity as measured by publication volume before and during the COVID-19 pandemic.

METHODS

This single-center, retrospective cohort study included the publication data of 216 researchers consisting of associate professors, assistant professors, and professors of radiology. Wilcoxon's signed-rank test was used to identify changes in publication volume between the 1-year-long defined prepandemic period (publications between May 1, 2019, and April 30, 2020) and COVID-19 pandemic period (May 1, 2020, to April 30, 2021).

RESULTS

There was a significantly increased mean annual volume of publications in the pandemic period (5.98, SD = 7.28) compared with the prepandemic period (4.98, SD = 5.53) (z = -2.819, P = .005). Subset analysis demonstrated a similar (17.4%) increase in publication volume for male researchers when comparing the mean annual prepandemic publications (5.10, SD = 5.79) compared with the pandemic period (5.99, SD = 7.60) (z = -2.369, P = .018). No statistically significant changes were found in similar analyses with the female subset.

DISCUSSION

Significant increases in radiologist publication volume were found during the COVID-19 pandemic compared with the year before. Changes may reflect an overall increase in academic productivity in response to clinical and imaging volume ramp down.

A Metrics-Based Research Salary Award System and Its 9-Year Impact on Publication Productivity

RATIONALE AND OBJECTIVES

Although metrics-based systems may incentivize academic output, no prior studies have evaluated the impact on publication metrics in academic radiology. This study presents a metrics-based system of awarding research protected time, and retrospectively evaluates its 9-year impact on publication productivity and impact factor.

MATERIALS AND METHODS

Based on a metrics-based algorithm to award department funded Research Protected Time (RPT), metrics pre-RPT (2003-2009) and during the RPT period (2010-2018) from an academic radiology department were retrospectively analyzed to test the hypothesis that the RPT program resulted in higher publication productivity and journal impact factor at the departmental level and for faculty members receiving the award. Comparison was made between (1) pre-RPT and RPT periods and (2) during the RPT period, between RPT and non-RPT faculty members, for annual publication productivity normalized to faculty count (Student's t test) and median impact factor (Wilcoxon rank sum test).

RESULTS

For the evaluation period of 2003-2018, 724 unique publications were identified: 15% (107/724) pre-RPT period and 85% (617/724) RPT period. Normalized annual publication productivity was higher during the RPT period compared to the Pre-RPT period (1.2 vs. 0.3, p = 0.002), and within the RPT period, higher among faculty who received RPT vs. non-RPT faculty (3.5 vs. 0.4, p = 0.002). Median impact factor was higher during the RPT period compared to pre-RPT period (2.843 vs. 2.322, p = 0.044), and within the RPT period, higher in RPT vs. non-RPT faculty (3.016 vs. 2.346, p < 0.001).

CONCLUSION

The implementation of a metrics-based system of funded, research protected time, was associated with increased publication productivity and increased impact factor.

Which Contributes to Clinical Performance: Academic Output or Person–Environment Fit?

Background

The measures put in place by health authorities to ensure the professionalism of doctors are important. Hospitals in China have included academic outputs in the promotion criteria to incentive medical clinicians to engage in scientific research so that to improve job performance (JP). However, such practice disproportionally focuses on academic outputs but ignores the force of needs fulfilled brought by intrinsic incentive. This study aims to discuss the realistic problem regarding the promotion mechanism and the potential drivers to clinical JP.

Methods

This study was based on multi-source data collection on clinical performance from electric medical record (EMR), person-environment (P–E) fit from the survey, and academic output from personnel files of ward clinicians (n = 244) of general public hospitals who sought for career progression in Shanghai in 2020. Independent-Sample t-test and chi-square test were used for comparison of two sample means or constituent ratio between promoted and not promoted clinicians. Linear multilevel regression was conducted to examine the relationship between clinical performance and academic outputs and P–E fit.

Results

Clinicians who were promoted were more productive in producing academic outputs than those who were not (t = −5.075, p < 0.001). However, there was no difference in clinical performance between the two groups (t = −1.728 to 0.167, p > 0.05). The regression showed that academic outputs were not related to clinical performance, while higher P–E fit was associated with the improvement of various clinical performances.

Conclusion

This study shows that P–E fit plays a more important role in facilitating clinical performance than academic performance and highlights the importance of intrinsic motivation of clinicians in achieving clinical performance.

Clinician-Scientists: Can They Survive in the Modern Era?

Clinician-scientists are commonly characterized as health care professionals who are proficient in both research and clinical practice. Their dual expertise positions them to play a vital role in translating research outcomes to clinical practice. However, economic changes in the past few decades are threatening their very survival. The purposes of this article are to review some of the economic forces that pose the greatest risks to clinician-scientists in the modern era and to glean lessons from the business world in overcoming these challenges. Health care consolidation and decreasing reimbursements are putting increasing financial pressure on academic institutions, leaving them more inclined to cut back on departmental research support. Innovative companies commit a certain percentage of their revenue to research and discovery. Academic institutions should similarly view their research budget as research and discovery that will sustain the future growth of radiology. They should quantify and define expectations for academic productivity, focus on return on investment, and bolster the infrastructure to foster commercial partnerships that can provide additional revenue to support the research mission. Success in academics does not occur by accident. It requires more than individual talent and hard work. It also requires institutional leaders who are committed to developing future academic leaders and supporting innovation.

Comparing the productivity of teaching and non-teaching workflow models in an academic abdominal imaging division

PURPOSE

To evaluate the productivity difference between teaching and non-teaching workflow models in an abdominal imaging division in an academic radiology department.

METHODS AND MATERIALS

RVU data were compiled for six faculty members from the abdominal imaging division over a six-month period. Modalities included ultrasound and CT of the abdomen and pelvis. The relative RVU productivity for faculty members by workflow was compared individually and the composite data for the workflow models were compared. The relative RVU productivity for each faculty member was compared individually and in aggregate to study the effect of the workflow models on RVUs using factorial ANOVA. Turnaround times (TAT) were compared for each attending under both models. TAT data were analyzed using paired t-tests with Bonferroni corrections for multiple comparisons.

RESULTS

Daily RVU data from 387 instances were analyzed. Daily RVUs for faculty members ranged from 23.5 ± 2.3 (mean ± standard error) to 46.2 ± 2.4 with non-teaching and from 29.8 ± 2.2 to 54.4 ± 2.7 with teaching workflow, respectively. There was a significant main effect of the workflow model on RVU productivity (p < 0.05). A significant increase of 27.8% in RVUs was noted with teaching workflow (42.8 ± 0.9) relative to non-teaching workflow (33.5 ± 1.7; p < 0.05). Teaching workflow resulted in significantly higher view-final and complete-final TATs (593 ± 112 min, mean ± SE and 841 ± 96 min, mean ± SE, respectively) compared to the non-teaching workflow (385 ± 124 min).

CONCLUSION

Teaching workflow improves abdominal imaging productivity with an increase in report turnaround times.

Health research capacity of professional and technical personnel in a first-class tertiary hospital in northwest China: multilevel repeated measurement, 2013-2017, a pilot study

Objectives

To explore the health research capacity (HRC) and factors associated with professional and technical personnel (PTP) in a first-class tertiary hospital in northwest China.

Methods

We collected the repeated measurement data from a first-class tertiary hospital in northwest China between 2013 and 2017. HRC of PTP was assessed by a comprehensive evaluation system and measured by research capacity score (RCS). The participants were divided into research group (RCS >0) and comparison group (RCS = 0); participants of the comparison group were selected by two-stage stratified random sampling. Multilevel model for repeated measures was used to investigate the potential factors associated with HRC.

Results

A total of 924 PTP were included (308 in the research group and 616 in the comparison group). This study found consistent growth in RCS and associated 95% CIs for the hospital during 2013 and 2017. The linear multilevel model showed PTP with a doctorate degree had higher RCS than those with a master’s degree (β, 1.74; P <0.001), bachelor’s degree (β, 2.02; P <0.001) and others without a degree (β, 2.32; P <0.001). Furthermore, the PTP with intermediate (β, 0.13; P = 0.015), vice-high (β, 0.27; P = 0.001) and senior (β, 0.63; P <0.001) professional titles had higher RCS than those with junior positions. Compared with PTP in the administration, those in paediatrics had higher RCS (β, 0.28; P = 0.047) though similar to PTP in other departments. PTP with an administrative position had a higher RCS than those in non-administrative positions (β, 0.26; P <0.001). The RCS increased with the research fund (β, 0.15; P <0.001). However, no associations were found between RCS and sex, age, ethnic, graduate school or technical type.

Conclusions

HRC with associated variation of PTP for the hospital in northwest China increasingly improved and degree, professional title, administrative position, and research fund were related to HRC of PTP. Multi-central prospective studies are needed to clarify the potential relationship of related factors and HRC of PTP.

Setting the Standards: Examining Research Productivity Among Academic Urologists in the USA and Canada in 2019

BACKGROUND

Research productivity among academic urologists is strongly encouraged, but little data are available on productivity metrics within the field.

OBJECTIVE

To provide the first comprehensive survey of research productivity among academic urologists in the USA and Canada.

DESIGN, SETTING, AND PARTICIPANTS

Using the Accreditation Council for Graduate Medical Education, the Canadian Resident Matching Service, and individual program websites, all active accredited urology faculties were identified. For each individual, we collected data on American Urological Association section, title, gender, fellowship training, Scopus H-index, and citations. Comprehensive searches were completed during March-May 2019.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Descriptive statistics for demographic comparisons were performed using analysis of variance for continuous variables and chi-square test for categorical variables. Multivariable logistic regressions were used to identify the predictors of H-index greater than the median.

RESULTS AND LIMITATIONS

A total of 2214 academic urology faculties (2015 in USA and 199 in Canada) were identified. The median and mean H-indices for the entire cohort of physicians were 11 and 16.1, respectively. On multivariable analysis, physicians in the North Central and Western Sections (vs mid-Atlantic), who were fellowship trained (vs no fellowship training), and of higher academic rank (professor and associate professor vs clinical instructor) were more likely to have H-index values greater than the median. Additionally, female physicians (vs male) were more likely to have H-index values less than the median.

CONCLUSIONS

This study represents the first comprehensive assessment of research productivity metrics among academic urologists. These represent key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to their peers.

PATIENT SUMMARY

In this study, we provide the first comprehensive assessment of research productivity among academic urologists in the USA and Canada. Our results help provide key benchmarks for trainees considering careers in academics and for practicing physicians gauging their own productivity in relation to peers.

Factors That Predict Institutional Adoption of Professional Physical Therapist Education Programs

BACKGROUND

Between 1995 and 2015, the number of accredited physical therapist education programs in the United States rose from 127 to 224. Colleges and universities have been known to develop new programs in an effort to generate revenues through student tuition.

OBJECTIVE

In the present study, sources of institutional revenue and expenditures were used as predictors for the adoption of physical therapist education programs.

DESIGN

Yearly data from the Integrated Postsecondary Education Data System for 1731 higher education institutions were combined with dates from the Commission on Accreditation in Physical Therapy Education for physical therapist education program accreditation from 1995 to 2015.

METHODS

A retrospective event history analysis of yearly institutional data was used to calculate the hazard of an institution adopting a physical therapist education program on the basis of institutional revenues and expenditures.

RESULTS

Private institutions were 62% less likely to adopt a physical therapist education program when they experienced a 1% increase in total revenue per full-time-equivalent student. Conversely, a given private institution was 2.71 times more likely to adopt a physical therapist education program for every 1% increase in total expenditures per full-time-equivalent student. Both public and private institutions experienced an increased chance of adopting an entry-level (professional) physical therapist education program when instructional expenditures rose. They were also more than twice as likely to adopt physical therapist education programs when they experienced a 1% increase in the number of students.

LIMITATIONS

Causation between professional physical therapist education program adoption and the variables studied cannot be determined through observational analysis alone.

CONCLUSIONS

The more revenue a private institution generated, the less likely it was to add a program in the search for further revenues. As expenses rose, the chance of adoption trended upward beyond increases in institutional revenues for both public and private not-for-profit institutions.

Radiology Education in the 21st Century: Threats and Opportunities

Over the past 25 years, radiology has seen tremendous growth in interpretive demands, including increasing imaging volumes and shorter turnaround times, as well as increased noninterpretive demands often targeting value-adding opportunities. These mounting pressures have led to increased burnout among radiologists nationwide and, in the academic setting, have begun to threaten the core educational mission. Despite these threats, radiology has also proven itself over the years to be a leader when it comes to innovation, and as such, no other field is better suited to confront these challenges with innovative solutions. This article explores the impact these workload trends have had on radiology education and educators, as well as opportunities to confront these challenges.

An audit of research productivity in clinical biochemistry revisited

Objective

To investigate recent (2011–2015) research productivity in clinical biochemistry and compare it with a previous audit (1994–1998).

Design

A retrospective audit of peer-reviewed academic papers published in Medline listed journals.

Setting

UK chemical pathology/clinical biochemistry laboratories and other clinical scientific staff working in departments of pathology.

Participants

Medically qualified chemical pathologists and clinical scientists.

Main outcome measures

Publications were identified from electronic databases for individuals and sites. Analyses were conducted for individuals, sites and regional educational groups.

Results

Clinical scientific staff numbers fell by 3.9% and medical staff by 17.4% from 1998 to 2015. Publication rates declined as publication count centiles rose between 1998 and 2015 (e.g. n = 5; 67th→84th centile; p < 0.001). A reduction in productivity was seen in medically qualified staff but less from clinical scientists. Regional staffing was 77 ± 37 (range 30–150) with university hospital laboratory staff accounting for 58 ± 19% (range 30–92%). Medically qualified staff comprised 20 ± 4% of staff with lowest numbers in some London regions. Publication rates varied widely with a median of 155 papers per region (range 98–1035) and 2.82 (1.21–8.62) papers/individual. The skew was attenuated, increasing the publication rate to 6.0 ± 2.73 papers (range 2.29–11.76)/individual after correction for the number of university hospital sites per region and was not related to numbers of trainees. High publication rates were associated with the presence of one highly research-active individual. Their activity correlated over their careers from recruitment to today (r²= 0.45; p = 0.05). The productivity rates of recent cohorts of trainees are inferior to previous cohorts.

Conclusions

Research remains a minority interest in clinical biochemistry. A small and decreasing proportion of individuals publish 90% of the work. A reduction was seen in clinical scientist and especially medical research productivity. No correlation of training activity with research productivity was seen implying weak links with translational medicine.

Radiologists' Variation of Time to Read Across Different Procedure Types

The workload of US radiologists has increased over the past two decades as measured through total annual relative value units (RVUs). This increase in RVUs generated suggests that radiologists' productivity has increased. However, true productivity (output unit per input unit; RVU per time) is at large unknown since actual time required to interpret and report a case is rarely recorded. In this study, we analyzed how the time to read a case varies between radiologists over a set of different procedure types by retrospectively extracting reading times from PACS usage logs. Specifically, we tested two hypotheses that; i) relative variation in time to read per procedure type increases as the median time to read a procedure type increases, and ii) relative rankings in terms of median reading speed for individual radiologists are consistent across different procedure types. The results that, i) a correlation of -0.25 between the coefficient of variation and median time to read and ii) that only 12 out of 46 radiologists had consistent rankings in terms of time to read across different procedure types, show both hypotheses to be without support. The results show that workload distribution will not follow any general rule for a radiologist across all procedures or a general rule for a specific procedure across many readers. Rather the findings suggest that improved overall practice efficiency can be achieved only by taking into account radiologists' individual productivity per procedure type when distributing unread cases.

Baseline Survey of the Neuroradiology Work Environment in the United States with Reported Trends in Clinical Work, Nonclinical Work, Perceptions of Trainees, and Burnout Metrics

BACKGROUND AND PURPOSE

Neuroradiologists have faced continuously increasing clinical workloads. Our aim was to establish and report a baseline survey of the current neuroradiology work environment in the United States and of experiential changes in recent years.

MATERIALS AND METHODS

A voluntary survey was sent to practicing and out-of-training members of the American Society of Neuroradiology in the United States. Selected measures included workday volume and length, burnout symptoms, participation in academic and practice-building duties; effects on perceived interpretation quality, communication of abnormal results, and consideration of early retirement or career changes, among others.

RESULTS

Four hundred thirty-two respondents across a broad range of experience reported the following: 52.8% (224/424) with teaching responsibilities; 93% (399/430) with workdays extending at least 1 hour past expected, in 45% (193/430) frequently or always; 71.9% (309/430) reading more cases per hour compared to previous years; 79.5% (341/429) sometimes-to-always interpreting cases faster than comfortable for optimal interpretation; and 67.8% (292/431) sometimes or more often with inadequate time to discuss abnormal results. Burnout symptoms ranged between 49% and 75% (211/428 to 322/428) across 4 indices. For academic activities of teaching, mentoring, and research/publications, a mean of 94.3% reported cut-backs during the past few years. For practice-building activities, 92% reported cut-backs, 51.6% (222/429) considered early retirement, and 38.8% (167/429) considered changing careers.

CONCLUSIONS

Increasing clinical demands have coincided with destructive effects in the work environment and the ability and desire of neuroradiologists in the United States to perform academic or practice-building duties with a substantial incidence of burnout symptoms. While this survey does not prove causation, the trends and the correlations should be concerning to the leaders of radiology and warrant further monitoring.

Characteristics and trends in publication of scientific papers presented at the European Congress of Radiology: a comparison between 2000 and 2010

OBJECTIVE

To determine journal publication rates of scientific papers presented orally at the European Congress of Radiology (ECR) 2010, with comparison of country data to ECR 2000.

METHODS

All oral presentations from ECR 2010 were evaluated for publication between 2010 and 2014 using the MEDLINE database. Countries, collaborations, subspecialties, modalities and study design were ranked by publication percentage. Chi-square tests were used to compare publication percentages for each category of variables. Hazard ratios (HR) were calculated for each country relative to the host nation, Austria. ECR 2010 country statistics were compared with analogous data from ECR 2000.

RESULTS

In total, 360/840 abstracts were subsequently published (43 %). The author's country of origin (p = 0.02), subspecialty (p = 0.02) and study design (p = 0.001) were significantly associated with subsequent publication. Switzerland, the Netherlands, France and Germany were among the top six countries by publication percentage in 2000 and 2010. In 2010, Switzerland had the highest publication rate (62 %) and HR in comparison to Austria (HR 2.62 [1.31-5.25], p = 0.01). Three Asian nations increased relative publication rates over the 10-year period.

CONCLUSION

Several European nations consistently convert relatively high percentages of oral abstracts at ECR into publications, and the influence of Asian countries is increasing.

MAIN MESSAGES

• Certain European nations consistently publish high percentages of orally presented abstracts at ECR. • The influence of several Asian countries on ECR is increasing. • Country, subspecialty and study design are significantly associated with journal publication. • Authors collaborating internationally have the highest publication rates and mean impact factors. • Among all modalities, PET-CT, MRI and CT have the highest publication percentages.

Embedding research culture and productivity in hospital physiotherapy departments: challenges and opportunities

Few studies have investigated research culture in the Australian hospital system. Although physiotherapists working in tertiary hospital departments conduct and publish research, a conflict between service delivery and research productivity remains. Few departments record research achievements, which limits the accuracy of investigating factors associated with research productivity within allied health. The conduct and translation of research within acute physiotherapy and allied health departments is imperative to improve patient health outcomes, optimise health service efficiency and cost-effectiveness and to improve staff and patient satisfaction and staff retention. Allied health departments should institute a research register and consider implementing other strategies to improve research culture and productivity, such as dedicating equivalent full-time staff to research, supporting staff with joint clinical and academic appointments, ensuring a research register is available and used and having events available for the dissemination of research. Future research should focus on improving research productivity within acute allied health departments to provide Level 1 and 2 evidence of service effectiveness and cost-effectiveness to optimise health care delivery and to maximise the benefit of allied health staff to Australia's healthcare system.

Canadian Association of Radiologists Annual Scientific Meetings: How Many Abstracts Go on to Publication?

PURPOSE

To determine the percentage of abstracts presented at the Canadian Association of Radiologists (CAR) annual scientific meetings that go on to publication.

METHODS

Records of previous CAR meetings from the years 2005-2011 were obtained. An Internet search was performed to determine which abstracts went on to publication. Abstracts were assessed according to exhibit category (Resident Award Papers), educational institution, publishing journal, and time to publication.

RESULTS

Of the 402 abstracts presented, 112 (28%) were published. Overall, an average of 37% of Radiologists-In-Training Presentations, 34% of Scientific Exhibits, and 20% of Educational Exhibits went on to publication. The University of British Columbia and University of Ottawa published the largest number of abstracts (66 and 62, respectively) from the years 2005-2011. The University of Montreal had the largest percentage of abstracts published (42%). The range of publishing journals was wide, but the top publisher was the Canadian Association of Radiologists Journal (27%). Eighty-three percent of abstracts were published within 3 years of being presented.

CONCLUSION

In total, 28% of all the abstracts presented at the CAR conferences between 2005 and 2011 were published. Further exploration into the reasons and barriers for abstracts not being published may be a next step in future research.

Physiotherapy departments in Australian tertiary hospitals regularly participate in and disseminate research results despite a lack of allocated staff: a prospective cross-sectional survey

OBJECTIVES

To establish the level of research activity in physiotherapy departments of Australian tertiary hospitals.

DESIGN

Prospective cross-sectional survey.

PARTICIPANTS

Physiotherapy managers from 37 principal referral hospitals and specialist women's and children's hospitals as identified from the Australian Institute of Health and Welfare (2011).

MAIN OUTCOME MEASURES

A purpose-designed predominantly open-response questionnaire investigating site demographics, research activity and research support was developed, piloted and administered.

RESULTS

Thirty-seven surveys were completed (54% response rate). Median [IQR] respondent equivalent full-time staffing was 23.8 (19-39). Respondents represented a median [IQR] 6.5 (3-20) publication output in the past 2 years. Twelve respondents (32%) reported that staff had completed a doctorate in the past 5 years and 49% of respondents reported no staff had completed higher degrees. A total of 71 grants had been received and 73% of respondents indicated they had no allocated staffing for research activity. The most common indicators of research culture were organization-led research dissemination events and research training (i.e. manager attending research events and celebrating research achievements).

CONCLUSIONS

This is the first study to report on research activity in hospital-based Australian physiotherapy departments. Few sites allocate staff to conduct or support research. Despite this, physiotherapy departments regularly publish and present research results. Future studies could investigate how hospital-based physiotherapy departments can optimize research culture and output.

Developments and innovations in resident and fellowship education: review article

BACKGROUND

Medical trainee education has drastically changed over the past 30 years significantly since the inception of the Accreditation Council for Graduate Medical Education (ACGME) in 1981. With an emphasis on patient safety, regulations and oversight from the ACGME have drastically changed the way many programs function with respect to trainee responsibilities, duty hours, and resident supervision.

QUESTIONS/PURPOSES

The purpose of this review is to summarize significant changes and innovations implemented by the ACGME and their proposed effects on trainee education. While there is an emphasis on musculoskeletal radiology fellowship training, the majority of the regulations and guidelines are applicable to all training programs.

METHODS

Articles, commentaries, and policies focusing on ACGME requirements were reviewed, with a focus on musculoskeletal radiology.

RESULTS

Changes in ACGME policies have resulted in significant structural modifications in how training programs are designed, specifically with respect to curriculum standardization, measuring outcomes of trainee performance, and integration of residents and fellows into hospital-based quality improvement and patient safety initiatives.

CONCLUSION

With an eye to continued training program advancement and improvement, the goal of universal oversight and standardization in medical training remains to produce forward-thinking physicians with an emphasis on lifelong learning, patient care, and quality improvement.

Academic productivity and its relationship to physician salaries in the University of California Healthcare System

OBJECTIVES

To evaluate whether physicians with higher academic productivity, as measured by the number of publications in Scopus and the Scopus Hirsch index (h-index), earn higher salaries.

METHODS

This was a cross-sectional study. Participants were ophthalmologists, otolaryngologists, neurosurgeons, and neurologists classified as "top earners" (>$100,000 annually) within the University of California (UC) healthcare system in 2008. Bibliometric searches on Scopus were conducted to retrieve the total number of publications and Hirsch indices (h-index), a measure of academic productivity. The association between the number of publications and h-index on physicians' total compensation was determined with multivariate regression models after controlling for the four specialties (ophthalmology, otolaryngology, neurosurgery, and neurology), the five institutions (UC San Francisco, UC Los Angeles, UC San Diego, UC Irvine, and UC Davis), and academic rank (assistant professor, associate professor, and professor).

RESULTS

The UC healthcare system departments reported 433 faculty physicians among the four specialties, with 71.6% (n = 310) earning more than $100,000 in 2008 and classifying as top earners. After controlling for the specialty, institution, and ranking, there was a significant association between the number of publications on salary (P < 0.000001). Scopus number of publications and h-index were correlated (P < 0.001). Scopus h-index was of borderline significance in predicting physician salary (P = 0.12). Physicians with higher Scopus publications had higher total salaries across all four specialties. Every 10 publications were associated with a 2.40% increase in total salary after controlling for specialty, institution, rank, and chair.

CONCLUSIONS

Ophthalmologists, otolaryngologists, neurosurgeons, and neurologists in the UC healthcare system who are more academically productive receive greater remuneration.

A survey of radiology chairpersons' perceptions of the relative importance of education of medical students, residents, and fellows

OBJECTIVE

The purpose of the study was twofold: to assess radiology chairpersons' perceptions about the value of education of medical students, residents, and fellows with respect to the achievement of department success and to uncover their personal involvement in instructional activities.

MATERIALS AND METHODS

A questionnaire was sent to all American members of the Society of Chairmen in Academic Radiology (SCARD) requesting their opinions about 21 putative responsibilities of their job including student, resident, and fellow education. The survey also asked the respondents to list the size of their trainee complement, both residents and fellows. The data were assessed in toto and after disaggregation by program size as indicated by the number of trainees and by the percentage of fellows versus all trainees.

RESULTS

Sixty-nine of 108 chairpersons responded with contributory responses for a response rate of 63.9%. Resident training was the fourth most frequently affirmatively cited component of their perceptions of a department's success at 86% positive. Slightly more than half indicated that they were personally involved in resident instruction but less than a third participated in student or in fellow training. Disaggregation by the size of the department with respect to the number of trainees revealed that resident teaching as a critical factor decreased in estimation of importance from 100% to 64% (p < 0.001) as programs increased in size. Fellowship training correspondingly increased from 18% to 45% (p = 0.054) from small to large departments.

CONCLUSION

Resident education as a valued activity and as a specific chair function varies inversely with both program size and the percentage of fellows among all trainees.

Enhancing research in academic radiology departments: recommendations of the 2003 Consensus Conference

Opportunities for funded radiologic research are greater than ever, and the amount of federal funding coming to academic radiology departments is increasing. Even so, many medical school-based radiology departments have little or no research funding. Accordingly, a consensus panel was convened to discuss ways to enhance research productivity and broaden the base of research strength in as many academic radiology departments as possible. The consensus panel included radiologists who have leadership roles in some of the most well-funded research departments, radiologists who direct other funded research programs, and radiologists with related expertise. The goals of the consensus panel were to identify the attributes associated with successful research programs and to develop an action plan for radiology research on the basis of these characteristics.

The Academic RVU: A System for Measuring Academic Productivity

Despite the importance of teaching, research, and related activities to the mission of academic medical departments, no useful and widely agreed-on metrics exist with which to assess the value of individual faculty members' contributions in these areas. Taking the concept of the clinical relative value unit (RVU) as a model, the authors describe the development of an academic RVU (aRVU) system that assigns weights to and creates formulas for assessing productivity in publications, teaching, administrative and community service, and research. The resulting aRVU schema was implemented on a Web-based system that incorporates a number of novel tools, including a curriculum vitae manager that automatically maintains and calculates total aRVU scores and breaks out component elements for each individual and for the department as a whole. The benefits and limitations of this system are discussed, as well as the potential advantages in sharing this approach with other radiology departments and other medical disciplines. Wide acceptance and implementation would make the aRVU the appropriate counterpoint to the clinical work RVU in academic medicine.

Junior faculty satisfaction in a large academic radiology department

RATIONALE AND OBJECTIVES

Retention of academic faculty is a pressing issue for many radiology departments. The departure of junior faculty members to private practice may be driven in part by economics; however, the choice may be influenced by many other elements of faculty satisfaction. The purpose of this study was to evaluate how satisfied junior (assistant professors and instructors) and senior (associate professors and professors) faculty in an academic radiology department are with respect to their work and to determine which factors most affected the decision to stay in academics.

MATERIALS AND METHODS

We conducted a survey of junior and senior faculty in the department of radiology. Questions included attitudes regarding work, home, and family issues. Among the 27 junior faculty (73%) who responded to the survey, 14 were instructors and 13 were assistant professors. Among the 11 senior faculty (21%) who responded to the survey, 3 were associate professors and 8 were professors.

RESULTS

Academic radiology faculty are very happy with work and derive enjoyment and fulfillment from their work. The working week excluding call (average 52 hours) and including call (average 61 hours) was not regarded as too long. The average academic faculty works 72% clinical time (range 15% to 100%) and gets 0.96 day a week of professional development. Fifty-nine percent are funded at an average of 0.91 day a week. Forty-one percent are on tenure track, and of the remainder, 40% expressed a desire for tenure track. Fifty-five percent of faculty have mentors and 57% receive adequate mentoring. When it comes to teaching, 50% have enough time to teach juniors. Of the remainder, all but one cited high clinical workload as an impediment to teaching juniors. Forty-one percent of faculty reported not getting enough academic time. Fifty-nine percent felt pressure to publish and 34% felt pressure to obtain external funding. Seventy-six percent surveyed felt it has become more difficult to publish. The main reasons cited were increasing clinical workload (34%), higher standards required (25%), lack of academic time (25%), and institutional review board constraints (16%). Twenty-eight percent of faculty work on research projects during weekends, 25% during professional development time, and 21% on weekday evenings. However, 63% said they had too little time to spend at home, with family, or on hobbies. The main reasons cited were demands on time caused by clinical work (45%), research (42%), and teaching (24%). Fifty-three percent said that their work regularly causes conflicts at home.

CONCLUSIONS

The main reasons to stay in academics were the opportunity for teaching (68%), working with expert colleagues (58%), to pursue research (55%), and an interesting mix of cases (47%). Disincentives to stay in academics included insufficient financial remuneration (82%), the high clinical workload (45%), academic center "politics," and the lack of academic time (42%).

The research productivity of Canadian physicians: how the timing of obtaining a PhD has an influence

PURPOSE

To determine whether the sequence of training to obtain MD and PhD degrees is associated with different career paths for physicians who have their PhD before medical school and those who obtain it after their MD, and to explore the factors that encourage or dissuade Canadian dual-degree physicians in pursuing a research career.

METHOD

In 2003, questionnaires from the University of Alberta, Edmonton, Canada, were sent to all 734 Canadian physicians having MDs and PhDs, identified through the Canadian Medical Directory. Data collected were gender; year and country of MD; sequence of obtaining degrees; portion of time on clinical, research, teaching, and administrative duties; number of publications and currently held grant amounts; and perceived incentives and disincentives to research careers. Two focus groups were held with a subset of physicians to further explore themes.

RESULTS

The response rate was 64%. On the basis of the timing of the PhD relative to the MD, physicians were designated early PhDs (26%), concurrent PhDs (12%), or late PhDs (62%). Late PhDs spent more time in research and less time on clinical practice than the other two groups and spent more time teaching and had published more papers than the early PhDs. Grant amounts were highest for late PhDs. Lack of time and resources were the major disincentives to research, and noteworthy incentives were the opportunity for intellectual challenge and creativity, and previous research experience.

CONCLUSIONS

Physicians who obtain a PhD after an MD have a more research-focused career than those who enter medical school with a PhD.

Impact of Isolated Clinical Performance Feedback on Clinical Productivity of an Academic Surgical Faculty

BACKGROUND

There is increasing financial pressure to maximize clinical productivity for academic physicians. We examined whether clinical performance feedback alone could contribute to improving the clinical productivity of surgeons in an academic department of surgery.

STUDY DESIGN

We implemented a clinical performance feedback program in January 2003. We then compared clinical productivity in terms of relative value units (RVUs) of surgeons for 18 months before and 18 months after this intervention, using each surgeon as his or her own control. Regression was performed with dependent variable ln (monthly RVUs) and independent variables "calendar month," "pre/post" January 2003, and "surgeon." The coefficient on "pre/post" reflected average change in RVUs. We also surveyed faculty on their use of and attitudes toward this feedback.

RESULTS

There was a 58% survey response. Ninety-two percent of responding faculty reported that they viewed and used the performance feedback, and that it affected their practice. Ninety-two percent believed the information accurately reflected their performance, 89% thought that the comparisons were useful, and 79% desired more feedback information, specifically, comparisons with external benchmarks. When RVU data were examined, the coefficient on change pre- and postintervention indicated a 7.4% increase in productivity (p < 0.001), or a 6.0% increase (p=0.003) after exclusion of outliers.

CONCLUSIONS

Performance feedback was associated with a small (6.0%) but significant improvement in productivity in this academic surgical faculty group. Performance feedback can be useful and should be used in conjunction with other management tools for this population.

Impact of Resident Duty-Hour Reform on Faculty Clinical Productivity

OBJECTIVE

Prior data have shown that resident duty-hour reform has not affected faculty work hours; yet the preservation of faculty hours may have been at the expense of productivity. We sought to examine change in clinical productivity.

DESIGN

Anonymous survey and analysis of faculty relative value units (RVU) database.

SETTING

A single, large academic medical center.

PARTICIPANTS

All clinical faculty in the Department of Surgery.

METHODS

An anonymous survey was distributed to surgical faculty 18 months after reform and compared with surveys taken before and after reform. Opinions regarding productivity and working hours were solicited. P values were determined by chi-square or Student t-tests. Relative value unit data, reflecting clinical productivity, were compared before and after reform. Regression was performed with dependent variable "lnRVU" and independent variables "calendar month," "pre/post" July 2003, and "surgeon." The coefficient on "pre/post" reflected average change in RVUs.

RESULTS

A total of 49 of 73 surveys were returned (67% response). Faculty reported an average of 68.0+/-7.0 weekly work hours (p=NS compared with previous survey). In the current survey, 35% felt their overall productivity had fallen due to reform. Among these, 83% felt academic productivity had suffered, 11% were unsure, and 1 person (6%) believed academic productivity was preserved. The majority (82%) reported preserved clinical productivity, 6% reported a decrease, and 12% were unsure. Overall, 60% reported doing work previously done by residents. When RVU data were examined, the coefficient on change pre- and post-reform indicated a 5.7% increase in productivity (p=0.005). However, this effect was driven by 5 surgeons with a greater than 75% increase in productivity, all young faculty, early in practice. Excluding these, there was no significant change (0.6% increase, p=0.77).

CONCLUSIONS

Faculty have preserved work hours and clinical productivity, despite a tendency to take on work previously done by residents. This suggests that academic activities may have suffered.

Factors Associated with Academic Radiology Research Productivity

PURPOSE

To determine factors associated with research productivity among all university radiology departments in the United States.

MATERIALS AND METHODS

As an observational study, this was exempt from institutional review board approval. All 47,299 radiology articles from 1996 through 2003 that were indexed in the National Library of Medicine MEDLINE database were studied. Each article was assigned a "publication impact" score based on the impact factor of its source journal. These citations were then matched, along with National Institutes of Health (NIH) extramural grant, residency, fellowship, faculty, and geographic data, to 109 individual medical school radiology departments. Raw citation count was used to measure research quantity, and aggregate publication impact was used to measure quality. Regression analyses were used to compare the relationship between the study variables and research quality and quantity measures on the departmental and individual faculty level.

RESULTS

Finalized statistical models accounted for 75%-88% of variance in productivity. NIH funding had a significant and positive association with all measures of research productivity (P < .001), with one article associated with 167,980 dollars in funding and one publication impact unit associated with 83,271 dollars in funding. Large resident program sizes (P < .001) and the presence of fellows (P = .007) also had a significant association. Geographic region, salary, and faculty characteristics had no detectable association. Extrapolations based on these results estimated the cost of annual global radiology research at 907 million dollars, with the U.S. component at at least 417 million dollars. NIH funding accounted for 45% of the U.S. component.

CONCLUSION

NIH funding, resident program size, and fellow characteristics are significantly associated with academic research output.

Emerging strategic themes for guiding change in academic radiology departments

Academic radiologists are faced with increasing demands on their time and energy, particularly in the clinical arena, where larger examination volumes and higher service expectations are the norm for most medical centers. These demands are intensified by the continuing shortage of academic radiologists. If academic radiology departments continue to devote most of their resources to the clinical mission at the expense of research and educational missions, then there are potentially serious adverse consequences for long-term viability of the profession of radiology. This dilemma represents a critical strategic problem, not just for academic radiology but also for the entire profession of radiology. In this article, the success and growth of academic radiology during the 20th century are framed as the result of the dogged pursuit of certain key strategic themes. With the concept of paradigm shift, introduced by Kuhn, several new strategic themes are identified that are just emerging from changes in work practices, organizational structure, and mind-sets in radiology departments at academic medical centers. One benefit of this approach is that it facilitates the ability of radiologists to articulate and focus on those strategic themes that will help academic radiology departments to adapt more rapidly and successfully to environmental changes during the 21st century.

Enhancing Research in Academic Radiology Departments: Recommendations of the 2003 Consensus Conference

Opportunities for funded radiologic research are greater than ever, and the amount of federal funding coming to academic radiology departments is increasing. Even so, many medical school-based radiology departments have little or no research funding. Accordingly, a consensus panel was convened to discuss ways to enhance research productivity and broaden the base of research strength in as many academic radiology departments as possible. The consensus panel included radiologists who have leadership roles in some of the best-funded research departments, radiologists who direct other funded research programs, and radiologists with related expertise. The goals of the consensus panel were to identify the attributes associated with successful research programs and to develop an action plan for radiology research based on these characteristics.

Motivation and compensation in academic radiology

As radiologists are increasingly faced with the challenges of rising demand for imaging services and staff shortages, the implementation of incentive plans in radiology is gaining importance. A key factor to be considered while developing an incentive plan is the strategic goal of the department. In academic radiology, management should decide whether it will reward research and teaching productivity in addition to clinical productivity. Various models have been suggested for incentive plans based on (1) clinical productivity, (2) multifactor productivity, (3) individual productivity, (4) section productivity, and (5) chair's discretion. Although fiscal rewards are most common, managers should consider other incentives, such as research time, resources for research, vacation time, and recognition awards, because academic radiologists may be motivated by factors other than financial gains.

Academic radiology: the reasons to stay or leave

RATIONALE AND OBJECTIVES

To find major reasons why junior academic radiologists leave academia for private practice and to suggest future changes to motivate them to stay.

MATERIALS AND METHODS

2000 surveys were sent to every tenth member of the Radiological Society of North America (RSNA) who completed training within the past decade. Those in academic institutions and those who left within 5 years were asked to respond.

RESULTS

132 radiologists responded. Thirty-two percent of responders were in academic radiology. Of those in academic radiology, 71% plan to stay at the same institution, 7% are planning to move to another academic institution, 17% are considering private practice, and 5% are leaving for private practice. The main reasons to leave were low pay and lack of academic time. Sixty-eight percent of responders already left academia after an average of 3.28 years. Ninety-five percent feel the decision was good, and 65% would not go back. Forty-nine percent experienced more than 100% pay increase, 60% feel they work harder, and 62% feel quality of life is better.

CONCLUSION

Significant changes should be made to motivate junior radiologists to stay in academia. Developing leaders in radiology is a must, and should be a top priority. Academic radiologists should not be expected to read private practice volumes and still have time to produce quality research and teaching. Clinical duties should be limited to 32 hours per week. At least 1 day a week should be protected academic time. Efforts should be made to decrease the discrepancy between incomes. Mentoring is important, allowing a smooth transition for junior faculty members to optimize academic progress and lead to promotion.

The manpower crisis in academic radiology: don’t kill the milk cow for meat

There is a manpower crisis in academic radiology departments. These departments cannot sustain their academic missions from clinical revenues alone. Salaries can' t be competitive with private practice, and the recruitment and retention of faculty members are compromised. The education of medical students, residents, and fellows and the clinical and basic research that sustains the specialty suffers. There is no simple remedy; academic departments need philanthropy from industry and private practice, more support from the government and the schools of medicine, and more efficient clinical practices. The future of our specialty is truly at stake. Academic departments are responsible for the great majority of training and technical innovation in the specialty. If academic departments cannot sustain their academic missions, the specialty of diagnostic radiology will certainly suffer.

From traditional reading rooms to a soft copy environment: radiologist satisfaction survey

Academic radiologists are experiencing increased clinical workloads. New technology such as picture archiving and communication systems (PACS) are often justified on the premise of increased efficiency. The authors believe that efficiency can be influenced by the image interpretation environment, and thus they set out to establish baseline satisfaction levels with this environment. The authors surveyed 90 Indiana University (IU) faculty radiologists, fellows, and residents. Their survey was implemented with a questionnaire sent via e-mail. Questions focused on satisfaction with the current soft-copy reading environments and preferences regarding improvements. Of the 90 radiologists surveyed, 55 (61%) responded. Several key findings emerged: (1) Overall satisfaction with the soft-copy environment is low, with nearly half (46%) of respondents rating themselves as "very dissatisfied" or "dissatisfied." (2) Faculty are least satisfied regarding work space ergonomics, room layout, and amount of work space. Appropriate lighting also emerged as an area with low satisfaction and high importance. (3) Ninety-eight percent of respondents indicated that an "ideal" soft-copy environment would have a positive effect on their efficiency. The dissatisfaction with the current soft-copy interpretation environments used by the IU radiologists indicates that this is an area that requires attention. Furthermore, there may be a direct relationship between radiologist efficiency and satisfaction with the image interpretation environment. Attention should be focused on this environment during a soft-copy technology implementation to ensure that planned efficiency gains are realized.

The impact of a program for systematically recognizing and rewarding academic performance

PURPOSE

To describe an academic performance incentive system (APIS) and faculty perception of it; explore the impacts of incentive level, faculty rank, clinical practice volume, and administrative responsibility on academic productivity; and describe the APIS's use in maintaining congruence between department mission and activities.

METHOD

A list of teaching, research, and academic service activities was developed, which full-time faculty (n = 33) used to report activities. Clinical faculty members received incentive income based on credits earned. APIS initially distributed 1% of practice plan receipts (subsequently increased to 3% and then 5%). Productivity was measured by differences in APIS points achieved. Satisfaction of all faculty participants was measured by survey.

RESULTS

Faculty members (n = 20) who participated throughout averaged 22 credits per month (nine to 42 credits), and quarterly incentive bonuses ranged from 145 US dollars to 6,128 US dollars. Average credits earned per month were 24 for the 1% incentive, 23 for the 3% incentive, and 20 for the 5% incentive. Faculty members with administrative responsibilities were as productive academically as were their non-administrative counterparts. Senior faculty members were as productive as junior faculty. Faculty members who were more productive clinically were more productive academically. Seventy percent of respondents reported they were either very satisfied or somewhat satisfied with the APIS. Seventy-eight percent felt that the APIS accurately reflected their academic productivity. Most respondents (81%) felt that the amount of money allocated to the incentive system was appropriate (15% felt it should be increased and one respondent recommended reduction).

CONCLUSIONS

The APIS system has been well accepted by faculty and allows for data-driven discussion of the department's mission and activities.

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.