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Results of the 2015 Survey of the American Alliance of Academic Chief Residents in Radiology

Rationale and Objectives

The American Alliance of Academic Chief Residents in Radiology conducts an annual survey of chief residents in Diagnostic Radiology programs in North America. The survey serves as a resource for observing trends and disseminating ideas among radiology training programs.

Materials and Methods

An online survey was distributed to chief residents at 181 residency programs, with questions on a broad range of topics including resident benefits, program and call structure, American Board of Radiology Core exam preparation, fellowships, and the job market.

Results

A total of 193 individual responses were received from 120 programs, for a response rate of 66%. The responses were compared to data from prior years’ surveys, principally from 2012 to 2014.

Conclusions

Programs are shifting resident benefits spending toward Core exam preparation resources and away from lead aprons. In addition, 24-hour attending coverage continues to spread among programs, and the fraction of programs providing face-to-face postcall readouts continues to decline. Finally, although resident perception of the job market is now improving, residents feel that the job market continues to discourage medical students from entering radiology, a fact borne out by the 2015 match results. How the upcoming change to a direct interventional radiology residency will affect medical student interest is as yet uncertain.

The American Alliance of Academic Chief Residents in Radiology (A 3 CR 2 ) is an organization composed of chief residents at North American Diagnostic Radiology residency training programs with the purpose of developing leadership skills in chief residents and fostering collaboration and idea dissemination among its members . Each year, as part of its mission, the A 3 CR 2 conducts a survey of its members regarding a broad range of topics including resident benefits, program and call structure, American Board of Radiology (ABR) Core preparation, fellowships, and the job market. The results of this survey are presented at the Association of University Radiologists (AUR) annual meeting and are also made available on the A 3 CR 2 Web site. The survey has been administered since 1971, with maintenance of survey data at the Mallinckrodt Institute of Radiology .

Many chief residents and residency program directors and chairs of academic departments use the information from the survey to compare their programs to peer institutions and potentially guide program policies and budgetary decisions. Survey questions are formulated by chief residents at the Mallinckrodt Institute of Radiology using input from faculty advisors involved in the A 3 CR 2 and chief resident members of the A 3 CR 2 Steering Committee. The questions are updated each year based on findings in previous years’ data and emerging trends in the world of academic radiology and radiology training programs.

Materials and methods

Survey

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Participants

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Analysis

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Results

Programs

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Figure 1, Mean program size and percentage of female residents per program over time. The mean number of residents is graphed on the left-hand vertical axis, whereas the mean percentage of female residents per program is graphed using the right-hand vertical axis. Percentage of female residents was unavailable for 2012 and 2013.

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Resident Benefits

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Figure 2, Resident benefits by year, proportion of programs offering each benefit in the years 2012–2015. The listed percentages reflect the percentage in 2015 (the current survey). ABR, American Board of Radiology; AIRP, American Institute for Radiologic Pathology.

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Figure 3, Moonlighting opportunities over time (years 2011, 2014, and 2015). Data for total moonlighting opportunities were not available for 2011. Listed percentages reflect the data from 2015 (the current survey).

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Chief Residents

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After-Hour Coverage and Call Responsibilities

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Figure 4, Routine weekend services provided by programs over time. “Saturday” reflects the percentage of programs providing either half-day and full-day coverage, similarly for “Sunday.”

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The Core Exam

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Table 1

Logistic Regression Model for ABR Core Examination Pass Rates

Variable Odds Ratio (95% CI)P Value Number of residents in program 1.09 (1.02–1.17) .015 24-Hour attending coverage 0.35 (0.08–1.44) .145 Program pays for external board review 1.43 (0.41–5.00) .580 Program provides a block of time away from clinical service (wk) 0.15 (0.03–0.62) .009 Program provides a period of time per day off clinical service 1.40 (0.35–5.56) .637

ABR, American Board of Radiology; CI, confidence interval.

Predictors of programs with a Core exam pass rate >75% (as compared to ≤75%), analyzed using a multivariate logistic regression model. A total of 101 programs were included in this analysis, with 17 of 101 cases having a pass rate ≤75%. Odds ratios greater than 1.0 imply a higher chance for that program to have a pass rate >75%.

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Table 2

Popular Core Exam Review Resources

Resource Number of Programs (%) RSNA/AAPM physics modules 100 (94) RadPrimer 100 (94) External review course on physics topics (eg, Huda) 86 (81) Radiology review books not directed toward the Core exam (eg, RadCases, case review series) 82 (77) Radiology physics review books (eg, Huda) 74 (70) External review course on radiology topics (eg, Duke) 67 (63) ABR quality and safety document 63 (59) Radiology review books specifically directed toward the Core exam 51 (48) Radiographics articles 49 (46) RAPHEX exams 45 (42) Review course on DVD 31 (29) Question Bank other than RadPrimer (eg, Qevlar) 26 (25)

ABR, American Board of Radiology; AAPM, American Association of Physicists in Medicine; RSNA, Radiologic Society of North America.

Popularity of various Core exam review resources, of 106 programs responding to the question.

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Fellowships

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Figure 5, Fellowship choices of graduating radiology residents (2012–2015). Listed percentages reflect the data from 2015 (the current survey); from this year's survey, 102 programs responded corresponding to 674 residents. MRI, magnetic resonance imaging; MSK, musculoskeletal radiology; VIR, vascular and interventional radiology.

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Job Market

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Figure 6, Residents' perceptions of the job market over time.

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Resident Feedback and Milestones

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Discussion

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Resident Benefits

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After-Hour Coverage

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Core Exam

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Fellowships

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Job Market

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Acknowledgments

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Supplementary data

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Supplementary Materials

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