One question that seems to come up often: what material should I study since there is so much information to learn? But, I think a more appropriate question may be: how can I get the most bang for my buck when there are so many reading materials out there? In this post, I am going to specifically address this issue by talking about when you should be reading textbooks and when you should emphasize case reviews since both play a role in getting up to speed during radiology residency or learning about a new area of interest as an attending. (This is our death match!!!)
Sometimes you lack any understanding of a modality when you begin a residency program, are starting a new rotation, or are attempting to learn a new modality such as MRI, perhaps not covered in you residency. For instance, most radiology residents when they start have no clue about ultrasound: both how it works and the images that the technologist takes. Therefore, starting to read a case series on ultrasound may not be helpful when beginning. Instead, a general introductory textbook such as the Ultrasound: The Requisites makes more sense at this point in order to understand the basic principles of ultrasound and the key images that need to be taken and interpreted during a renal ultrasound, ob/gyn ultrasound, etc. Another example would be reading CT scans of the chest. Most residents when they start out do not have a search pattern for reading chest CT scans. Nor do they know their CT chest anatomy well. An introductory textbook on chest CT scans such as Computed Tomography and Magnetic Resonance of the Thorax by Webb would be appropriate prior to starting to read a case series.
In addition, good textbooks usually better outline the fundamental knowledge that is needed to interpret images better than a case review series can. Textbooks tend to be better organized by topics whereas case review series tend to be more haphazard. For example: it is my be more direct and efficient to learn the fundamentals of how to determine whether an intracranial mass is intra-axial or extra-axial once in a textbook than to read 10 case series on the topic and try to figure the same approach out.
How To Read Textbooks
When you read a textbook, you should try to emphasize the images, read the captions, and then read the text in order to get the most out of it. Reading in this manner reinforces the information that you need to know better than starting from the text first. This process differs vastly from the reading of a medical school general medicine textbook where the text is usually more important than the images. You are now a radiology resident so you have to think differently!
Why Case Review Series?
In our field, we solely exist because we are image interpreters. So, it makes sense to learn those images and what they mean. What better means than a case review series to reinforce and learn radiology? But, this assumes that the reader has some background knowledge on the topic and can understand the basic principles/fundamentals/meanings behind the images in the case review series.
In addition, case review series tend to have more of a “real word bent”. The images that we read on a daily basis tend not to follow in orderly manner by topic. In fact, there is a usually an almost random distribution of cases that come through our departments. Going through a case review series is usually more similar to this process of going through lots of images in no particular order.
How To Approach Case Review Series
Case review series should be started as soon as you have the fundamental knowledge to understand the modality, anatomy, and fundamental disease processes on imaging. On each initial rotation, you should aim to start reading at least one case review type of book after you have learned the basic fundamentals from lectures and textbooks. Do not wait too long to get started, however. Going through case review series is going to be more helpful and applicable than most textbooks when you are actually reading out cases with attendings and also when taking oral cases at noon conferences. But remember- it often does not summarize the fundamentals of a given subject as well as a textbook.
The Moral Of The Death Match
Both textbooks and case review series have their place in the learning armamentarium of the beginning resident. Be wary of someone that tells you that you can get through residency by just reading textbooks or case reviews by themselves. Each has its own place and you should use the correct one depending upon your level and knowledge base at the time. Now become great radiologists: go forth and read!!!