Radiologists spend a lot of years in medical school and in residency, but they still aren’t getting enough medical ethics training, according to a recent analysis published in the American Journal of Roentgenology.

The authors surveyed more than 400 radiologists and radiology trainees in late 2016 about the American College of Radiology (ACR) Code of Ethics and the American Medical Association (AMA) Code of Medical Ethics. Overall, more than 77 percent of respondents said they had never read the AMA Code of Medical Ethics, while more than 67 percent said they had never read the ACR Code of Ethics.

The authors also reached out to the ACR and found that the college’s Code of Ethics was only downloaded 723 times from June 2015 to May 2016, which was right after a recent update to the document.

“On the basis of our survey, we concluded that changes in medical ethics training and education in radiology residencies are required to promote ethical behavior in radiology practice,” wrote lead author David M. Yousem, MD, MBA, of Johns Hopkins Medicine in Baltimore, and colleagues.

Yousem et al. suggested that the Accreditation Council for Graduate Medical Education should require a business principles requirement, for example. They also suggested the ACR solicit experts in this area to provide an online program for trainees to turn to for education.

The authors added that the imaging industry’s various academic journals should “add medical ethics-oriented articles for the edification of their readership.”