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Results of the 2012 Survey of the American Association of Academic Chief Residents in Radiology

Rationale and Objective

Every year, the American Association of Academic Chief Residents in Radiology conducts a survey of the chief residents in accredited radiology training programs in North America. The survey serves as a tool for gathering information, sharing ideas, and voicing opinions.

Materials and Methods

An online survey was made available to the chief residents from 187 training programs in North America. Questions were presented in multiple-choice and free response formats, designed to address many issues ranging from program structure to on-call policies, changes for the new board examination format and fellowships, and the effects of health care reform on radiology practices. The results of the survey were tabulated and responses to the repeated questions were compared with those from earlier surveys dating to 2003.

Results

Among those surveyed, 185 individual responses representing 135 unique programs were completed, yielding a 73% response rate. Thirty-eight percent of programs responded from the northeast and 17% of programs responded from the southeast. Nineteen percent of responses were from central United States, 14% of responses were from western United States, and 12% of responses were from Canada.

Conclusions

There is an increasing number of programs, which cover more hospitals, during the past decade. There are more programs providing ultrasound and magnetic resonance services after hours, with an associated increase in after-hours attending physician coverage. Many changes are being made for the future board examination format. Health care reform is affecting how residents are preparing themselves for their future practices.

The American Association of Academic Chief Residents in Radiology (A 3 CR 2 ) includes chief residents from all accredited radiology programs, including university, community, and military hospitals. The organization meets annually to discuss issues related to the training of diagnostic radiology residents. In addition, the A 3 CR 2 conducts an annual survey of resident training programs and presents the data at the annual A 3 CR 2 meeting held in conjunction with the Association of University Radiologists meeting .

The survey has been conducted since 1971, and the database is maintained at the Mallinckrodt Institute of Radiology . The survey is intended to not only to analyze trends regarding residency programs but also address the current issues that radiology programs face and provide information regarding the changes that many programs are making in the future . Survey questions are generated by the chief residents at the Mallinckrodt Institute of Radiology. Questions are added or changed by the chief residents and several faculty members of Mallinckrodt to address residency program issues that are discussed at A 3 CR 2 throughout the year. These questions are then proposed to the Steering Committee of the A 3 CR 2 for final changes. Programs with more than one chief resident were asked to select one representative to state their institution’s name and answer program-specific questions. Any duplicate answers from the same institution were removed after responses were collected. The following data represent the results from the survey conducted from February 14–24, 2012, discussing trends in program characteristics, resident benefits, chief resident roles, call structure, the effects of the changing board examination, fellowships, the impact of the current economy and health care reform, and performance and quality improvement projects. In the following sections, unless otherwise noted, there are no changes in the data compared to the previous year’s data.

Program information

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Figure 1, Percentage of programs performing a given number of studies per year in 2004, 2009, and 2012. (k indicates 1000.)

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Resident benefits

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Figure 2, The median salaries (and interquartile ranges) of first- and fourth-year radiology residents (postgraduate year 2 and 5, respectively), in 2009 and 2012.

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Figure 3, The percentage of programs that offered specific benefits to radiology residents in 2008 and 2012. ABR, American Board of Radiology; AFIP, Armed Forces Institute of Pathology; AIRP, Armed Institute of Radiologic Pathology; e-Anatomy, e-Anatomy ( www.imaios.com/en/e-Anatomy ); RAD, RAD Primer ( www.radprimer.com ); STAT Dx, STAT Dx ( www.amirsys.com/statdx.php ).

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Chief resident

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Figure 4, The percentage of chief residents with specific responsibilities in 2012.

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Call structure

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Figure 5, The percentage of programs that provided certain types of reports while on-call in 2011 and 2012. Prelim, preliminary.

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Figure 6, (a) The percentage of programs in 2009 and 2012 that offered 24-hour sonographers, home-call sonographers, and residents who perform the ultrasound (US) examinations and those programs that have nonradiologists perform the examination and that do not offer after-hours ultrasound examinations. (b) The percentage of programs in 2012 that offered ultrasound examinations for the emergency department (ED), inpatient services for emergent indications, and inpatient services for routine indications.

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Figure 7, (a) The percentage of programs in 2012 that offered specific types of magnetic resonance (MR) examinations after hours. (b) The percentage of programs in 2012 that provided interpretations for MR examinations performed after hours, by on-call residents, fellows, and/or attendings, and those that did not interpret MR examinations performed overnight.

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Figure 8, The percentage of programs from 2009 to 2012 that have attending physicians go home at the end of the work day, stay in-house for extended hours (ie, 5:00 to 10:00 pm ), stay in-house overnight 7 days a week, review cases at home, review cases that residents call about in the middle of the night, and have external teleradiology services read on-call studies. Other methods include having attendings read only neuroradiology studies after hours and having attendings read studies after hours on different days of the week.

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Figure 9, The percentage of programs that provide routine service coverage for half- or full-day Saturdays and Sundays, as well as the percentage of programs that do not provide routine service coverage over the weekend.

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Changing board examination

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Figure 10, The percentage of programs from 2010 to 2012 that already have, plan to have, or do not plan to have a 3-year “core” curriculum in place for the new board examination planned for 2013.

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Figure 11, The percentage of programs in 2011 and 2012 that are making changes for preparing radiology residents for the future “core” board examination.

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Fellowships

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Figure 12, The distribution of residents in the United States who matriculated and plan to matriculate into fellowships in 2009 and 2012, respectively. “Other” fellowships include emergency radiology and combined fellowship programs. MRI, magnetic resonance imaging; MSK, musculoskeletal; NeuroIR, neurologic interventional radiology; Nucs, nuclear medicine; Peds, pediatrics; VIR, vascular interventional radiology.

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Health care economics and the job market

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Performance and quality improvement projects

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Discussion

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