Transitions: The Seismic Shift From Trainee to Attending

The following post was written by guest blogger Matt Hawkins, MD, assistant professor of pediatric vascular/interventional radiology at Emory University School of Medicine.

Training is complete. Congratulations. Finally – we’re finished.  (At least that’s what we’re taught.)  But nothing could be further from the truth. We are simply just beginning. And we have a long way to go. Yet, we’ve come so far…right?

The transition from trainee to attending is exhilarating and intimidating.  Just when we all thought the world might slow down a bit, it just starts to whiz by even faster. New names, new faces, new parking lots, new phone numbers, new paging systems, new cafeterias, imaging protocols, and post-procedure order sets. And even though we knew there would be increased expectations and responsibility, it is something that cannot be understood until it smacks you in the face.

While new streets, hallways, stairwells, and underground tunnels turn us in circles, we are trying to teach fellows and residents the fundamentals of our profession. And oh yeah, we are also enrolling our children in school, finding our own PCPs, reorganizing our finances, supporting our spouse through one of life’s most gargantuan transitions, and spending hours on end looking at Google Maps as we try to wind our way to grocery stores, post offices, and … ummm … hospitals.

Has anyone else experienced this? We are not alone. We’ll keep our heads up and our shoulders lowered. It is a rite of passage, I guess. And every attending that has ever lived will look back at their transition, crack a timid smile, and acknowledge that the shift from trainee to attending is something no one wants to do more than once. But that’s the best part. We don’t have to. We’ll become more patient, more reasonable, and simply better. We were trained to do this. And remember, we’re all in this together.

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Your Role in Advocacy

Advocacy is an important part of any business or profession, including radiology. So much of what we do is influenced by decisions made by Congress and state legislators. Research has demonstrated the effectiveness of advocacy. The political process gives everyone an opportunity to advocate for their interests. When advocacy activity is geared toward specific legislation or a particular legislator, rules regulating lobbying become important.

In radiology, there are several organizations that maintain lobbying activity. Since lobbying does not directly generate revenue, smaller organizations are limited in their ability to support lobbying activities. The American College of Radiology (ACR) and its government relations department are widely recognized by other societies, industry and Congress as one of the most effective and influential groups in advocating for the interests of our members.

The late Harvey Neiman developed the College’s current government relations department based on his commitment to creating the premier lobbying group for radiologists. A behind-the-scenes look into how our government relations team worked with RADPAC, policymakers and our members to influence the passage of the SGR patch bill, recently appeared in the ACR Bulletin. It is definitely worth a read.

Our lobbyists are supported by several programs. RADPAC is our political action committee which helps us contribute to the campaigns of legislators who recognize the value of radiology and the expertise of the ACR. RADPAC now consistently ranks in the upper five for medical specialties. However, PACs for other interests are much more successful such as the trial lawyers.

When our lobbying team needs your grassroots support to contact your legislators about pending legislation, we send out “Calls to Action” via email. The Radiology Advocacy Network (RAN) is a team of state-based physician advocates dedicated to optimizing the response to calls to action. We now have physician volunteers in 45 states. The Resident and Fellow Section does a great job of mobilizing its resident advocates. The RAN has improved the rate of response from less than 5 percent to consistently more than 14 percent.

We all have a role in advocating for radiology and our patients. To learn more how you can help, see my article in this month’s Journal of the American College of Radiology (JACR®).

Howard B. Fleishon, MD, MMM, FACR