The presence of radiology and radiologists in medical school curricula is important for many reasons. Future physicians must learn how to use medical imaging effectively and efficiently for better patient care. Additionally, if medical students are not specifically trained in or exposed to radiology during their coursework, they may not have adequate opportunity to consider radiology as a career option. Finally, teaching radiology to medical students provides an excellent opportunity for radiologists to develop a positive reputation and to form strong collaborative relationships between radiology and other medical specialties. As a first step in attempting to enhance the profile of radiology in the curricula of US medical schools, it is important to define its current status.
Toward this end, we conducted a survey of the membership of the Association for Medical Student Educators in Radiology. The survey consisted of a 22-question instrument, with both multiple-choice and open-ended items. Requests to complete the survey were sent out in January and April 2012, and a total of 83 responses were received. Many respondents did not state which institution they were affiliated with, and duplicate responses were received from at least 3 institutions. This brief report summarizes the results.
Responding to the question, “Does your medical school have a required radiology course?” 43% of the respondents indicated that their institution has at least one required course in radiology, whereas 57% do not. Because this survey was sent only to Association for Medical Student Educators in Radiology members, it is highly likely that the actual percentage of all schools requiring a radiology course is lower. Also, responses to this question may underestimate the role radiology is playing in medical school curricula, because medical students can receive high-quality radiology education outside of required radiology courses.
The number, timing, and duration of radiology courses are all important. A dedicated clinical clerkship in radiology would likely benefit students as they learn to use medical imaging in patient care. Ideally, realizing the full potential of radiology in teaching during medical school should also include instruction during preclinical courses in anatomy and physiology. Similarly, students whose radiology exposure lasts only a few days or even a few hours are unlikely to achieve the same breadth and depth of understanding as are those whose exposure lasts multiple weeks.
Most schools that have a required radiology course have only one. Among respondents, 77% reported one course, 20% reported two courses, and 3% reported three courses. Of these, 53% are taken in the same year as other required clerkships, 20% can be taken in third or fourth year, 17% are available only in the fourth year, and 10% occur during the preclinical years. In terms of the duration of these courses, 47% have 4-week long courses, 23% are 2 weeks long, 3% have a 1-week course, and 27% did not specify the course length.
If students are to understand the roles that radiology plays in health care, it is important for them to gain some practical exposure to the daily work of radiologists. Among survey respondents, 37% of courses devote 26% to 50% of student time to clinical experience, 30% dedicate 0% to 25%, and 30% allot 51% to 75%. One respondent institution reported that 76% to 100% of student time in radiology is spent acquiring clinical experience. To some degree, the optimal percentage will vary between schools, depending on the quality of clinical experience and faculty dedication to teaching.
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A physician ordered a chest CT with contrast on a patient who had a pulmonary embolism (PE)-protocol CT the day before. When I asked why, he replied that yesterday’s exam was for PE, while today’s exam was intended to evaluate the lungs. Not only had he not read the prior day’s report but he clearly did not understand the nature of a chest CT.
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I get no release time for running our radiology elective course. Everything I do takes place at free moments during the day or on vacations, nights, or weekends. My colleagues simply do not see teaching medical students as a valuable way of spending my time. We need time not just to give lectures and lead discussions, but also time to develop new course material, and people who teach medical students should get credit for what we do.
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