Engaging Medical Students and Residents to Choose Pediatric Radiology

drsouthardThis post was contributed by Richard N. Southard, MD, Vice Chairman of Clinical Operations, Director of CT and Cardiac Imaging, Co-Director of the 3-D Innovation Lab at Phoenix Children’s Hospital

To address the on-going physician shortage in Medicine in general, radiology specifically, and my chosen subspecialty of pediatric radiology especially, I need insight about the young adults, medical students and residents whom we are trying to recruit.

These medical students and residents are late Generation Y/Millennials (born 1981-1994), and early Generation Z (born 1995-2012). This technologically savvy generation grew up with computers, and despite being able to instantaneously “connect” via social media, they still seek out and value being with friends and experiences. They also value social equality, want to make a positive impact in a supportive workplace and desire a stable future.

In an article discussing the factors influencing subspecialty choice among residents, Arnold, et al [2009], questioned radiology trainees about their motivations and perceptions of the subspecialty fields when selecting radiology fellowships. Leading factors for the residents were areas of strong personal interest, advanced multi-modality imaging, intellectual challenge, marketability and enjoyable resident rotations. Financial compensation was relatively unimportant.

I completed a pediatric internship and residency before going into radiology. The aspects of pediatric medicine which appeal to me are working with kids, interacting with families, making a positive impact on pediatric care, and the challenges of a multitude of diseases. Pediatric radiology today still has a wonderful blend of patient and family interaction; general to subspecialized clinician interaction; advanced imaging modalities such as ultrasound, MRI, CT, and Nuclear Medicine; and cutting edge hardware and software technologies such as elastography, musculoskeletal ultrasound and interventions, the latest MRI techniques, dual-energy Spectral CT, 3-D modelling and volumetrics, molecular imaging and PET/SPECT/CT. My daily work involves supportive colleagues, an incredible breadth and depth of technology and a large number of disease processes to consider. Pediatric radiology affords me the ability to be a subspecialist and a generalist at the same time, and it is never boring.

Many residents select their subspecialties prior to their 3rd and 4th years, and rotating residents at children’s hospitals typically are in the later stages of training, leaving us at a disadvantage in recruiting bright residents into pediatric radiology fellowships. How to address this problem?

There is need to engage medical students and residents through earlier elective rotations, radiology lectures in medical school or clubs, developing active department research opportunities for medical students and residents and social media such as daily cases on Instagram. One could attract pediatric residents who already show a strong interest in pediatric care into radiology by showing them a welcoming patient-friendly work environment that maintains personal interactions, and our role as an active care team member positively impacting children’s health. The radiology profession is technologically advanced and intellectually challenging, and the multiple imaging modalities are becoming more advanced.

Given the shortage of, and great need for, pediatric fellowship trained radiologists in both private practice and academic settings, these skills remain highly marketable. Compensation and benefits, and flexible work environments, remain good for radiologists.  The role we imagers play in the diagnosis and delivery of health care is both meaningful and rewarding. In my opinion, radiology is the perfect job for today’s medical students and residents to consider.

  • How are you engaging medical students to pursue a career in pediatric radiology, or another subspecialty?
  • Have you been leveraging the new resource, RadInfo 4 Kids, in your practice?

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TMIST Helps Expand Participation in Clinical Trials

Etta Pisano 16May17_0002 headshotThis post was contributed by Etta Pisano, MD, FACR, principal investigator of the Tomosynthesis Mammographic Imaging Screening Trial (TMIST).

Criticisms of some large clinical trials include that the research was confined to large academic centers and that patient populations lacked sufficient representation from underserved communities.

The Tomosynthesis Mammographic Imaging Screening Trial (TMIST) is taking steps to avoid such pitfalls. I recently explained to ACR-RBMA Practice Leaders Forum attendees how their practice or department can benefit by take part in TMIST. The response was fantastic!

It appears many freestanding or outpatient imaging facility leaders have rarely been approached to take part in a large study. That is a shame.

While we thank — and are proud of — all the large institutions taking part in TMIST (and we want more to take part), we are also seeking a mix of facility types to demonstrate that trial results are applicable across care settings.

pisano at podium wide

ACR-RBMA Practice Leaders Forum

TMIST participation can also empower your practice to offer the latest care to underserved populations and expand minority and rural resident participation in clinical trials.

Sites receive $500 for the recruitment of each woman to the study and the submission of the data on the first round of screening, plus $150 for data submitted after each additional TMIST-required screening mammogram.

What makes TMIST different from most other federally funded trials is that for uninsured women recruited to the study who qualify for charity care at a participating facility, the site also receives $138 for each TMIST screening mammogram (on top of the $500 and $150 mentioned above).

pisano at podium tight

This is a new and rare opportunity — one that I am proud to say TMIST can offer to practices.

TMIST seeks to identify groups of women in which tomosynthesis may outpace digital mammography at reducing advanced cancer development. TMIST would also create the world’s largest bio-repository to tailor future risk-based screening policy.

I encourage you to get involved in shaping the future of breast cancer screening by participating in TMIST. Decision makers rarely update policy without such a randomized, controlled trial.

Now is the time to get involved.

Email TMIST@acr.org — we will answer your questions and walk you through how to get started.

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The Missing Link

reduced turkey neck and 8 bit

This post was contributed by Bruce J. Hillman, MD, FACR, Professor of Radiology and Medical Imaging and Public Health Sciences, the University of Virginia and founding editor of the Journal of the American College of Radiology (JACR)

Having spent the past sixteen years helping found the JACR and overseeing its development – not to mention eight additional years as editor-in-chief of two other radiology journals – I feel qualified to speak to the joys and occasional miseries of a career in medical journalism. On the plus side, there is no such thing as a journalistic emergency. Journal editors sleep soundly and without interruption. I like that I am the first person to know new things. I learn from the manuscripts submitted to the Journal about important advances and the creative ponderings of some of the best radiology has to offer. I would enjoy this aspect of being an editor even more if I weren’t ethically bound not to tell a soul about what I know. Finally, guiding JACR gave me an expansive, monthly pulpit from which to expound on the issues of the day.

Of course, no job is perfect. Even editing a medical journal has its downsides. Most of these are petty and not worth mentioning. One thing that does chronically bother me, however, is how little recognition our specialty grants to successful researchers, even those whose research and writings expand the horizons of our specialty. Over the roughly twenty-five years I’ve been involved in American College of Radiology (ACR) leadership, member surveys have consistently shown that what members value most is the ACR’s successes in government relations and economics. Members tend to rank research in the lowest third, and occasionally at the very bottom, in their appreciation of the various College activities.

What survey respondents overlook is that no matter how persuasive our arguments to government regulatory and reimbursement agencies, without supportive research our efforts would be doomed from the outset. Consider the answers to the following rhetorical questions:

  • Would there be reimbursement for PET imaging in cancer without the National Oncologic PET Registry (NOPR)?
  • CT lung cancer screening, if not for the National Lung Screening Trial (NLST)?
  • CT colonography without the National CT Colonography Trial?
  • How many exams, worth how much in billings, did just these few exemplary research studies add to our practices?
  • Who designed and led these research efforts? And again, these are just a few of the many researchers whose accomplishments have contributed to the vibrancy of our specialty.

Like a shark, radiology must keep swimming (i.e. innovating) or we will cease to exist. So say “thank you” to your friendly neighborhood researcher. While ACR’s research provides no guarantee that we will be the beneficiaries of that research down the line, it is a certainty that without ACR research developing new opportunities for improved patient care, radiology will stagnate. To stay ahead of both our human and robotic competition, we must continue to progress. By better understanding the critical role research plays in furthering our economics and government relations agenda and offering their moral and financial support, ACR members help assure the continued success of our specialty.

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