Academic radiology departments have the responsibility of training the next generation of radiologists. They want to attract the best medical students into our field and give them the most appropriate training for their careers, which may consist entirely of clinical patient care or may include substantial portions of teaching, research, or administration.
There is a wide variation among the 188 Accreditation Council for Graduate Medical Education–approved radiology residency training programs in diagnostic radiology. Programs vary in number of residents, volumes and types of clinical cases, size and degree of subspecialization of the faculty, learning resources available, and research opportunities for the trainees. Some programs feel their mission is to train radiologists to provide patient care for the citizens of their state or region, whereas others, such as those described by Grimm et al. , feel their mission is to train the next generation of academic faculty. How can these different radiology programs attract and select those applicants best suited to their missions?
Grimm et al. reviewed the application materials from radiology residents who graduated over a period spanning almost 20 years. Although one may quibble with some of their definitions, objective criteria were used. Of greater concern is how graduates were classified as “academic” or “not academic”. Those who appeared on the Association of American Medical Colleges faculty online directory and published articles after training were considered “academic,” whereas those who were not listed and had not published scientific articles were considered “not academic.” Thus, a gray zone exists that composed of faculty in university departments who do not publish and radiologists working in the private practice who do publish scientific articles. Nevertheless, the authors identified factors that predicted which of the medical students applying for a radiology residency would choose academic careers. Publishing one or more scientific articles during medical school was highly associated with a career in academic radiology. A dedicated year of research during medical school was also significantly associated with a career in academics, although merely having research time during medical school was only “borderline significant.”
Medical students applying for radiology residency programs are knowledgeable about the field and have often received extensive mentoring in ways to optimally present themselves to residency selection committees. Both men and women arrive on interview day wearing a dark suit and a nervous smile, and virtually, all have done a rotation in radiology. Their personal statements usually express a desire for a career in academic radiology, although, as Grimm et al. point out, these personal statements are more likely to reflect what they feel programs want to hear than their true career aspirations. Such comments in a personal statement are not associated with a future career in academics.
How can radiology residency programs best select candidates whose career aspirations are most closely aligned with the mission of the training programs? Boyse et al. reported that the United States Medical Licensing Examination scores correlated strongly with scores on the written clinical examination offered by American Board of Radiology (ABR). From the same department, Adusumilli et al. found that the performance of the resident correlated poorly with how highly the applicants were ranked by the resident selection committee. The review by Grimm et al. points out that scientific publications during medical school have the strongest association with a subsequent career in academic radiology. Clearly, students interested in research are likely to have published a scientific article, and that research interest makes it more likely that they will pursue an academic career. Even those who completed a research project only to make themselves maximally attractive to prestigious residency training programs may develop an interest in research. Their experience may remove the mystique of medical research, and success with publications may alleviate the anxiety about their ability to be successful in an academic career. Indeed, as I counsel residents and fellows about their careers, a common complaint among trainees is “I have no new ideas for research projects.” After several years as a faculty, the complaint has changed to “I have so many ideas I don’t have the time to pursue them all.”
The field of radiology has expanded dramatically. No one can master the entire field, and each of our practice domains is limited to some extent . The recent change in the examination structure by ABR allows radiology residents to demonstrate their general competence on a core examination at the end of their third year of residency. This opens much of the fourth year to begin subspecialty training and to take elective rotations that will complement their planned fellowship training.
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References
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