During the annual 46th annual American Alliance of Academic Chief Residents in Radiology (A 3 CR 2 ) meeting in New Orleans, chief residents discussed the role of residents within American College of Radiology 3.0 campaign. Our discussion was directed toward the evolving role of fourth-year radiology residents and how we might improve their training to better prepare them to add value as both leaders and radiologists. The ideas resulting from our Problem Solving session were divided into three categories: clinical presence in the wards and subspecialty clinics; visibility to clinicians and patients; and the education of medical students, residents, and advanced practice clinicians to aid in realizing the long-term goals of Imaging 3.0.
Introduction
With the introduction of Imaging 3.0, the American College of Radiology has set an agenda for radiologists to seek out leadership roles and optimize high-value imaging care in our constantly changing health-care system. This journey will include both established radiologists and thousands of newly trained residents and fellows, who will become the future leaders of our profession. Residency training curricula should grow to provide training for the new roles that radiologists would need to adopt in this model. If we plan to add value to the health-care community as radiologists, then we as residents need to practice the methods by which we intend to implement these effects.
The American Alliance of Academic Chief Residents in Radiology (A 3 CR 2 ) is an affinity group with the Association of University Radiologists dedicated to advancing the interests of radiology residents in collaboration with other leaders within academic radiology. Shortly after inception in 1968 by Dr. Malcolm Jones, A 3 CR 2 developed a series of sessions at the annual Association of University Radiologists meeting entitled “Problem Solving,” designed to examine the difficult issues facing residency programs throughout the country. Chief residents select a topic for discussion at the preceding A 3 CR 2 meeting, brainstorm for potential solutions, and discuss the results at a roundtable session with members of the Association of Program Directors in Radiology and the Society of Chairs of Academic Radiology Departments.
This year, our focus was directed toward the evolving role of fourth-year radiology residents and how we might improve their training to better prepare them to add value as both leaders and radiologists. The ideas resulting from our Problem Solving session can be divided into the following three categories: clinical presence in the wards and subspecialty clinics; visibility to clinicians and patients; and the education of medical students, residents, and advanced practice clinicians (APCs). Through reorganization of the fourth-year curriculum, we can begin to implement these ideas in the academic medical environment to ensure optimal educational and clinical outcomes.
Clinical Presence in the Wards and Subspecialty Clinics
One important requisite to establishing the value of the radiologist in the ever-changing health-care climate is face-to-face communication with our colleagues in other specialties, what is termed clinical presence . Clinical presence is important because radiologists are best suited to answer clinical imaging questions, which is done most effectively if we are able to communicate directly and meaningfully with the clinicians. Although this kind of direct communication was once more common, the advent of electronic image storage and distribution (i.e. picture archiving and communication system) has made it easy for clinicians to view radiology studies from clinical care areas, without any face-to-face interaction with a radiologist .
Radiologists have been tackling these challenges since at least the 1980s, with numerous papers discussing the importance of radiology’s participation in patient care. One strategy for improving clinical presence is the embedded reading room. These radiology spaces are located within or adjacent to patient-care areas dedicated to a specific subspecialty; for example, an embedded neuroradiology reading room located within a neurology clinic. The full impact of this strategy has not been extensively studied, but one institution found that embedded reading rooms were associated with much higher rates of face-to-face clinician–radiologist interactions and clinician-initiated interactions . Although the idea of embedded reading rooms may increase our clinical interactions, Rosenkrantz et al found that it could also increase our visibility to patients, with 5% of the integrated reading room consults involving direct image review by the radiologist with the patient . Although radiology residents themselves have no control over reading room location, they may be called upon to support this model of service delivery and will become leaders faced with making these decisions in the future.
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Visibility to Clinicians and Patients
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Education of Medical Students, Residents, and APCs
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Discussion
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Conclusion
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Acknowledgements
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