Less than half of imaging studies performed at academic radiology departments involve trainees, according to research published this month in Current Problems in Diagnostic Radiology. Residents and fellows seem to dedicate most of their time to CT and MRI.
Radiology depends on its trainees for structural support and off-hours coverage, first author Neena Kapoor, MD, and colleagues wrote in the journal. In 2011, trainees made up around 15 percent of the entire U.S. radiology workforce, with that number higher in academic settings.
But trainee imaging workload has also been growing, the authors said, in part because imaging modalities themselves have seen higher use in recent decades. Between 1998 and 2010, researchers found trainee case volume rose by 26 percent, and mounting requirements from ACGME did little to alleviate that pressure.
“Not only are radiology departments experiencing higher imaging volumes, but there is also increasing pressure to reduce report turnaround times (RTATs), which may have unintended negative impacts on trainees,” Kapoor, of Brigham and Women’s Hospital and Harvard Medical School, and co-authors wrote. “After the implementation of a one-hour RTAT in one hospital’s emergency department, residents felt that their education was negatively impacted in a significant way and faculty felt that the required RTAT negatively affected their ability to teach.”
The authors said that despite their importance, little information exists about how trainees contribute to radiologic services, especially at larger academic centers. The team conducted a retrospective study of trainee involvement at a tertiary care academic medical center, where, between 2015 and 2016, they tracked the proportion of radiology reports co-signed by trainees.
Kapoor et al. noted the imaging modality, trainee participation and subspecialty of the attending radiologist in all 607,074 reports identified during the study period.
The researchers found roughly 40 percent of reports were co-signed by trainees, with involvement varying greatly across divisions and cardiovascular imaging, nuclear medicine and interventional radiology taking prominence. Among diagnostic modalities, residents and fellows were most involved with CT and MRI, though there was just 15 percent participation in ultrasound studies. Radiography and mammography saw similarly low rates.
“The lower participation of trainees in x-ray imaging is likely due to the overall high volume of radiographs performed at our institution,” Kapoor and co-authors explained. “While trainees only read approximately 30 percent of x-rays, this still amounts to over 66,000 x-rays in an academic year. However, it may still be argued that trainee participation is relatively skewed toward more advanced imaging, such as CT and MRI.”
The authors said that while their data suggests there’s a gap in trainee participation—at least at their hospital—staff need to be careful about balancing their expectations for residents and fellows.
“While it may seem that academic radiology departments should maximize trainee participation, departments must balance variations in imaging volume with trainee educational requirements,” they wrote. “In order to train well-rounded radiologists, the trainee curriculum cannot be based on an institution’s imaging volume alone but also on academic and curricular guidelines, and thus imbalances in trainee participation and imaging volume will invariably exist.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.