How Important Is Level One Trauma To My Radiology Training?
Bullet wounds, stabbings, motorcycle accidents, falls, and blunt trauma from severe car accidents… These are some of the incidents that make up a bulk of the trauma at a level one trauma center. But, let’s say you attend a program that does not have a level one trauma center and you don’t see as many of these cases. Are you at a loss compared to your colleagues who do? And, what are the consequences for your future practice of radiology? Will you be a second class radiologist? For many of you that have to decide on a residency with or without a significant trauma component, these questions cast doubts on some training programs. As I have trained at a level one trauma center and have been operating a residency without one, we will go through the training from a level one trauma you might “miss” during training.
Trauma Resident Checklists
Do you like to have multiple residents in other subspecialties waiting for you to check off the boxes? Well, that is exactly what you will experience at a level one trauma center. You will find that a lot of the exhausted nighttime residents take a keen interest in only finding out if you have read all those films yet, not worrying about the final diagnosis. Yes, it reminds you of all the films you need to see with each trauma. But, making sure that the specialists have checked all the boxes does not really add much to one’s training!
Limited Four Quadrant Ultrasounds
Interested in looking for free fluid at all hours of the night? Well, this is your opportunity. And unfortunately, the limited four quadrant ultrasound is the tool of choice. Guess who wields the probe? You do!!! I can guarantee that you will be scanning everyone with a horrible accident that comes through the pearly gates of the emergency department. Is it really worth all those additional sleepless nights just so you can find the free fluid? I’ll let you make that choice.
Repetitive Injury Patterns
Do you like variety? Trauma comes in so many fewer flavors than other interesting disease entities. Knife wounds exhibit most of the same findings over and over again. After your 15th splenic laceration, it really gets old. And, it’s not just the knife wounds. Blunt trauma, bullet wounds, and severe falls work the same way. I prefer a little more variety in my life!
Fewer Bread And Butter Cases
What does trauma experience usually replace? Typically, you will see that many fewer bread and butter cases. And, the time working up trauma cases has to replace something else. What do I mean by that? Level one trauma centers may divert some of the diverticulitis, appendicitis, oncology, and renal stone patients down the street. I mean who wants to go to an emergency department with all that bloody trauma when you can go to a hospital that is much less hectic. Unfortunately for that reason, you get less experience with the diseases that most emergency departments see all the time. And, these diseases are the ones that residents need to learn the most, the more common entities you will be working up the most in practice.
Level One Trauma- A Necessity For Training?
Yes, I will admit that level one trauma centers provide a specialized experience. But for the most part, radiologists can learn what they need to know from the standard trauma that they encounter at a hospital without completing a residency with a level one trauma program. In addition, it is not hard for the resident to supplement their training with trauma reading. So, if you find a great program without a level one trauma center that otherwise matches what you want, by all means, still consider it. The absence of level one trauma does not imply a significant gap in your radiology education!