Balancing Clinical Service and Education in the Radiology Residency

Rationale and Objectives

Among the various medical disciplines, the radiology residency faces unique challenges when balancing clinical service and education, which have not been explored in the literature.

Materials and Methods

The authors present a summary of material generated during collaborative sessions at the 56th Annual Meeting of the Association of University Radiologists in Seattle, Washington, in March 2008, including strategies on maintaining an appropriate emphasis on education in the face of increasing service obligations, with a review of the pertinent literature.

Results

Although the topic of service and education has been explored in the medical and surgical literature, little has been published in the radiology literature. The portability of radiology and the relative lack of patient contact can lead to the redistribution of residents as a matter of convenience to fill service gaps, often at the expense of the educational goals of training programs. Residents and faculty members alike must take part in both service and educational obligations without compromising patient care. Physician extenders, call schedule optimization, and other strategies and resources can help ensure that a proper balance is maintained.

Conclusion

The radiology residency presents unique challenges to the service and education balance. The authors highlight several strategies to address these challenges.

Balancing service and education in residency training programs is a difficult task facing program directors and clinical faculty members. Although some of these challenges are common across the various specialties of graduate medical education, there are aspects that are unique to radiology. Some of these factors include the portability of radiology as a service and the relative lack of continuity of patient care. Although the service versus education debate has been explored in the surgical and internal medicine literature , the radiology literature has not addressed these issues, which become more pressing in the face of increasing demands to provide faster and more efficient service. Duty-hour restrictions also have the potential to significantly affect the balance of service and education.

Discussion

To begin to discuss service and education, these concepts must be better defined. Merriam-Webster’s Collegiate Dictionary lists several definitions of “service,” including “the occupation or function of serving,” “contribution to the welfare of others,” “a helpful act,” and “useful labor that does not produce a tangible commodity.” “Education” also has several definitions: “the action or process of educating or of being educated” or “the knowledge and development resulting from an educational process.” The term “service” implies a recipient who benefits from the service provided, without little if any benefit to the provider. In contrast, “education” implies a two-way exchange between a teacher and learner, which ultimately prepares the learner for future careers and opportunities.

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Review of the Literature

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Service Versus Education Issues in the Radiology Residency

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Conclusion

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References

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3. Boex J.R., Leahy P.J.: Understanding residents’ work moving beyond counting hours to assessing educational value. Acad Med 2003; 78: pp. 939-944.
4. Podnos Y.D., Williams R.A., Jimenez J.C., et. al.: Reducing the non-educational and nonclinical workload of the surgical resident: defining the role of the health technician. Curr Surg 2003; 60: pp. 529-532.
5. Brasel K.J., Pierre A.L., Weigelt J.A.: Resident work hours: what they are really doing. Arch Surg 2004; 139: pp. 490-494.
6. Merriam-Webster’s collegiate dictionary.11th ed.2003.Merriam-WebsterSpringfield, MA
7. Accreditation Council for Graduate Medical Education : The ACGME’s approach to limit resident duty hours 2007-08: a summary of achievements for the fifth year under the common requirements. Available at: http://www.acgme.org/acWebsite/dutyHours/dh_achieveSum0708.pdf Accessed February 17, 2009
8. Accreditation Council for Graduate Medical Education : Program requirements for residency education in internal medicine. Available at: http://www.acgme.org/acWebsite/downloads/RRC_progReq/140pr703_u704.pdf Accessed February 24, 2009
9. Accreditation Council for Graduate Medical Education : ACGME program requirements for graduate medical education in diagnostic radiology. Available at: http://www.acgme.org/acWebsite/downloads/RRC_progReq/420_diagnostic_radiology_07012008.pdf Accessed February 24, 2009
10. Lu Y., Zhao S., Chu P.W., et. al.: An update survey of academic radiologists’ clinical productivity. J Am Coll Radiol 2008; 5: pp. 817-826.
11. Jackson V.P.: Funding for graduate medical education. J Am Coll Radiol 2006; 3: pp. 945-948.
12. Accreditation Council for Graduate Medical Education : ACGME program director guide to the common program requirements. Available at: http://www.acgme.org/acWebsite/navPages/commonpr_documents/CompleteGuide_v2%20.pdf Accessed January 29, 2009
13. Mezrich R., Nagy P.G.: The academic RVU: a system for measuring academic productivity. J Am Coll Radiol 2007; 4: pp. 471-478.

Balancing Clinical Service and Education in the Radiology Residency

Rationale and Objectives

Materials and Methods

Results

Conclusion

Discussion

Review of the Literature

Service Versus Education Issues in the Radiology Residency

Conclusion

References

Further Reading

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