Radiology trainees' workload continues to focus more on noninvasive imaging services

Over the past two decades, the workload of radiology trainees has focused more and more on noninvasive diagnostic imaging services, according to new research published in the Journal of the American College of Radiology.

“Prior authors have studied the changing workloads of radiology trainees with regard to their noninvasive diagnostic workloads, but shifts in trainees’ invasive procedural workload remain poorly understood,” wrote lead author Andrew Rosenkrantz, MD, of NYU Langone Medical Center in New York City, and colleagues. 

Using the Physician/Supplier Procedure Summary Master Files from 1997 to 2016, the researchers tracked Medicare services performed by radiology trainees that were categorized as invasive procedures, noninvasive diagnostic imaging services or clinical evaluation and management (E&M) services.

Rosenkrantz and colleagues found that, during that time, invasive procedures declined from 34 percent to 14 percent of relative work effort for all Medicare-billed radiology trainee services. Other key points include: 

  • Noninvasive diagnostic imaging services increased from 65 percent to 85 percent of relative work effort, though clinically E&M services remained “uniformly low.”
  • Diagnostic radiology faculty supervised 81 percent of trainee invasive procedures in 1997, compared to 68 percent in 2016.
  • Interventional radiology faculty supervised 19 percent of trainee invasive procedures in 1997, compared to 32 percent in 2016.
  • Trainee noninvasive diagnostic imaging services refocused from radiography to CT and MRI.

“Over the last two decades, a wide variety of new invasive and noninvasive radiological services have been incorporated into clinical practice,” Rosenkrantz and colleagues wrote. “Radiology trainees’ relative workload, however, now seems to be disproportionately focused on the latter.”

There are some contributing factors to this increased focus on noninvasive diagnostic imaging. For instance, advances in radiology allow for diagnoses that were only achievable in an invasive manner to be done noninvasively. Trainees are also learning from subspecialized radiologists who could have their own priorities and biases. In addition, basic invasive procedures are now performed by non-physician providers.

The authors added that trainees benefit from receiving training from both diagnostic radiology and interventional radiology faculty.

“To preserve patient access to important basic invasive imaging-guided procedures, the radiology community must continue to train a robust pipeline of future generalist and other diagnostic radiologists who are skilled and comfortable offering such services,” they wrote.