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The Radiology Residency Exit Interview- Why Should You Care?

exit interview

You’re finally about to hang in the towel. You’ve taken and passed your core exam, completed all your overnights, given your last tumor board, and finished your final residency dictation. Suddenly, you receive a call from the program coordinator. He says the residency program director wants you to come to her office for your last exit interview. Why even bother? What’s the point of a final discussion when heading out of Dodge anyway? Well, let me give you some reasons why this interview is the most important of your residency from a program director’s perspective.

Want A Recommendation?

Believe it or not, even after you leave your residency, faculty still receive phone calls from your employers if you are looking for a job or decide to change to a new one. And the last thing that you want your residency program director to say is, “That darn resident, he didn’t even care to give an exit interview.”

These folks that call for you from your subsequent practices are serious. And any bit of bad news about you can derail your next great job. Especially when the job market may or may not be the same as it is now!

No Holds Barred Summary Of Residency Issues

After residency, you feel you have no more obligations to the program. Anything you say now is not encumbered by your desire to impress or achieve. You can now have a heart-to-heart with your program director without any of the “BS.” It’s a great time to give the real lowdown on the residency, both good and bad. This interview is the best time to get a reality check on your program from the program director’s perspective.

The Exit Interview– A Last Chance For Great Residency Advice

For the resident, now is the time to ask any burning questions about how the world works, what you need to do to become great, or other residency-based training tidbits you can use for the rest of your career. So, residents will usually ask excellent questions at this time, right before they leave. Residency is usually a once-in-a-lifetime experience. And becoming an attending is so different. Subsequently, residents will often ask inspired questions to learn what they need to succeed in their next radiology life!

Maintaining Contact Information

Not everyone will remain in the same institution forever, and the same goes for your residency faculty. This interview is an excellent last opportunity to cull the contacts from your residency. Get those phone numbers, linked-in addresses, and social media connections finalized. You never know when you will need to contact your faculty again. It may be to consult on an interesting case, recommend a new job, or just to say hi. In any case, keeping this information safe and sound is critical!

Making Sure Everything Is In Order For Future Jobs- They Do Check!

Procedure logs, iodine treatments, and the number of cases completed are critical statistics that your next employer may need. So, ensure you have all the information you will require before you leave. To get hired, you need to back up your previous experiences. Also, make sure that your learning portfolio is all squared away and that you have records of all the academic research, presentations, and posters safe and sound. Often, you will continue to need all this information well into the future. This interview is your last shot at getting all of this straight!

The Radiology Exit Interview- A Critical Component

Between all these factors, including recommendations, giving the real low down on residency, getting some quality advice, garnering contacts, and ensuring everything is in order for your future career, the radiology exit interview is an integral but final component of the residency process. So, it has many more uses than you may have thought. You are not just paying homage to your residency program. Instead, you are providing a genuine service to your future career and helping out your program director. Therefore, you should take the interview seriously. During residency, it is your last chance to help out your program and ensure a great future for yourself in your radiology career!

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How Do I Gain Confidence To Read Complex Cases Outside Subspecialty?

confidence

Question About Confidence About Reading Outside Subspecialty

I will be completing a neuro fellowship in one year. Still, my potential job opportunities require that I read everything, including MSK and Body MRI, which I don’t have the confidence about for one reason or the other. I need to learn to read these studies; how do I do this? Would I have to do a second fellowship?

Not quite sure how to proceed!

Answer

Yes, many of the great radiology opportunities indeed involve generalist work with the ability to do your subspecialty (in your case, neuro). And, from my experience, most general radiology practices expect that their neuroradiologists cross over to all sorts of other subspecialties within MRI in addition to the sophisticated neuro cases. So, the big question here is how you get the confidence to read other complex subspecialty cases outside your wheelhouse. And, I believe in your situation, a second fellowship is most likely not the answer. How do I know that? Well, I have already been there.

So, what did I do to ensure that I would feel confident enough to read MSK MRI on the job even though my primary specialty was nucs? During my residency training, I made sure to read extra cases in the modality when I was on site. I accomplished some of this just before my fellowship in nuclear medicine. And, this was in the days just before PACs started. So, it was much harder to do back then.

Nowadays, it’s much more manageable. Start picking up cases from the PACS, read them, and then look at the dictations afterward. This method is a simple way to gain confidence and familiarity with other specialty areas you usually don’t read. You can even do this at your up-and-coming neuro fellowship since most are affiliated with a hospital or outpatient center that does MSK MRI. So, I would try this first. How do I know this will work? Well, it certainly worked for me. I feel reasonably comfortable with reading MRI MSK to this date.

Of course, your confidence will continue to build even after you start working. However, at least you will give yourself a head start if you begin the process. I hate to say it (because I’m not too fond of the ABR jargon), but this skill is what the ABR calls practice-based improvement in a nutshell!

That’s some advice that has worked for me!

Barry Julius, MD

 

 

 

 

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How To Prevent Home PACS Systems From Causing Chaos

chaos

We all have different ways in which we like to work. Some folks find that clutter and chaos foster creativity. And others can’t stand the slightest mess in front of them (or behind them!) I am in the first camp. I find clutter a bit cozy, allowing me to feel comfortable sitting down and starting to write. It is almost like a stimulant. But, this layout does not work for everyone. So, figuring out where to put a bulky PACS system in your office is no small task. Your well-being depends on it.

Integrating our newfound large multi-monitor computers into the overall theme of our office caused chaos. For those of us with other family members in the same workspace, these systems can interfere with the room, taking over large swaths of workspace real estate and increasing the appearance of clutter even more. So, how do you ensure the PACS does not dominate the room? And how can finding a space for it allow the rest of the family to coexist peacefully? Based on my experience, here are some tips to avoid family disputes over losing working real estate to a PACS.

Get A New Connection For A Better Workspace

Sometimes, the internet connection can limit the options for arranging a workspace. I prefer a direct hookup of the PACS system to the ethernet rather than a wireless connection. The information just gets sent to the computer that much quicker. If you don’t have the correct arrangement of hookups in the office, you may be unable to place the PACS in the right spot. Well, there is a quick fix for that. Just get a new connection and put it wherever you want!

Put The System In An Unused Space Within The Office

Only some offices have a ton of space. But, occasionally, a room may have an underutilized unique niche where that PACS system can go. It could cover up a blemish in the room or, even better, make it look more like an office. Go ahead and fill that spot with the computer system. See how it fits. It may make the office space feel like a great workspace.

Build A New Enclosure Within The Room For The PACS System

You may have the room for the PACS at other times, but you may need the appropriate spot to place it. To ensure that you can have the space you desire, you need a bit of creativity to reshape the room, add a desk, or build some cabinets around it. Either hire the carpenter to create what you want or do the woodwork yourself. Either way, a new enclosure may be all you need to make the workspace of your dreams.

Divide The Room

You may have no other option but to divide the room into two. One person wants their workspace without interruption, and the other can’t stand that eyesore called a PACS system. If you have the space to divide the room into two, go for it!

Find Another Room Altogether To Prevent Chaos

OK. Only some people have space in the house to create another office dedicated to a PACS system. But, sometimes, finding that extra room is the only solution. You can’t put an entire PACS system on top of another family member’s workspace. It’s a great way to create a battle royale!

Removing The Chaos Of A New PACS!

For many folks, a bulky PACS system is a necessary evil. It is an eyesore. Yet, it is what allows us to improve our radiology work-life balance. Before plunking it down somewhere random in a room, consider making it more appetizing for everyone. Whether it takes making a new connection, finding a new niche, building a spot for the PACS, dividing the room entirely, or moving somewhere out of the space completely, making space work for everyone is critical. Placing the PACS in the right spot should be more than an afterthought! 

 

 

 

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Don’t Hesitate To Call Your Colleagues!

call your colleagues

One of the most challenging parts of becoming a radiologist is developing an awareness of when you don’t know something. Of course, when you discover what you are missing, you can look for information on the web to fill in some gaps. But, just as important, it is also critical to know when you need more than your research. Many times, experience alone can teach you the correct diagnosis or management. As a radiologist, I don’t hesitate to pick up the phone if I doubt that I can get the information myself. I call the expert in the subspecialty. So, what are some benefits when you reach out to your colleagues? Well, here are some of the advantages that I have encountered.

Experience Trumps Books Sometimes

Most books only give you some information on how to make a diagnosis. Sometimes, only a vast breadth of experience can help solve some cases. And, if you don’t know, what are the chances you can make that diagnosis? Much less, of course. So, finding someone who can confidently read that temporal bone study can make all the difference in diagnosing a rare congenital disorder. Doing the research yourself is different.

Subtle Management Issues Are Not Easy To Find Online

Many times, you can figure out the patient’s diagnosis, but you can’t find any resources to tell you what to do next. Again, managing a patient’s condition can sometimes only be appropriately triaged when you have made the diagnosis before. So, why not pick up the phone and find the expert who has managed this patient many times? Get it right the first time!

Call Your Colleagues To Increase Confidence In Your Dictations

Other times, you have all the necessary information to make the appropriate recommendations. But what you need is confidence in your report. And it reflects in your dictation. When you speak to an expert colleague, you can confidently diagnose and confirm the next steps. Why not be sure of what you should do next?

Better For Your Learning

When I hear information from someone else, I retain the knowledge more than by looking up a fact in a book or online. Your colleagues will often relay the information on the phone more excitingly so that you can remember the case for a long time. They may give you other examples of similar patients or situations. Or, they lace the information with a good joke! Regardless, sometimes, hearing input from others is the best way to learn.

More Time Efficient To Call Your Colleagues

You can sit around researching information forever or ask someone who has trained for years in the subspecialty and knows a lot. Which one will save you more time? That phone call to your colleague can save valuable minutes of your time and energy. We only have so many hours in a day!

You Will Begin To Get Consults From Others As Well

One of the most exciting parts of becoming a radiologist is getting interesting consults from others. When you ask questions of others, you are also more likely to get consults from your colleagues. They will feel comfortable enough to reach out to you when you have a patient in your subspecialty when they don’t know how to proceed. It’s good to feel needed in your practice!

Don’t Hesitate To Call Your Colleagues!

When you call your colleagues about something you don’t know, you gain experience that you don’t have, learn esoteric management skills, increase confidence, educate yourself, improve time management, and gain the trust of others. So, why not pick up the phone and call your colleague? It is an essential ingredient for excellent patient care!

 

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MOC And Practice Based Improvement: Easiest Ways To Satisfy The Requirement!

practice based improvement

As a steward to my private practice to keep everyone up to date for ABR maintenance of certification, one area more than any other has caused more confusion. And that is practice-based improvement. In the beginning when the ABR created this requirement, it was not clearly defined. And, it has undergone a more significant change than any of the other requirements that the ABR demands. Now, to this day, I still get radiologists in practice asking me – “How can I satisfy this requirement?” No doubt it isn’t all that apparent.

So, let me refer you to the ways to meet these ABR requirements (just click this link). It will describe what you need to satisfy the requirements of the ABR. But, for those of you that hate reading meaningless dry lists, let me give you my interpretation of six of the easiest ways that you can meet this obscure requirement!

Easiest Ways To Satisfy The Practice-Based Improvement Requirement!

“Participation as a member of an institutional/departmental clinical quality and/or safety review committee”

Most radiologists who work with or for a hospital have to be a part of a safety committee. For me, I am part of the nuclear medicine QA and MRI quality committees. So that fits the bill as meeting this requirement. But almost any committee that has anything to do with safety would satisfy this ABR requirement if, god forbid, you had an audit!

“Publication of a peer-reviewed journal article related to quality improvement or improved safety of the diplomate’s practice content area”

This requirement is also pretty benign for those who work for or with a radiology residency program. Nowadays, most academic and pseudo-academic world departments need to work on a quality improvement project with residents. It is pretty easy to get your name on one of these articles if you have a residency program. Most residents would be happy to have you on their project to help them out a bit!

“Participation as a member of a root cause analysis team evaluating a sentinel or other quality- or safety-related event”

Left up to interpretation, this can mean being a compliance officer or part of a team responsible for morbidity and mortality conferences. Many practices have baked this conference into their partners’ meetings already. So, you may be satisfying this requirement and may not even know it!

“Regular participation (at least 10/year) in departmental or group conferences focused on patient safety.”

Again, you may be doing this already. Many radiologists have to participate in tumor boards, surgery conferences, or other morbidity and mortality conferences. All these conferences count toward the requirement. You may already have more than ten. Just make sure to record them!

“Creation or active management of, or participation in, one of the elements of a quality or safety program”

If you are desperate and have a residency program, this can mean giving a lecture on a safety topic to residents. You can provide a pre-test and a post-test. Then, all you need to do is to show improvement. Oualaa… A quick way to satisfy the requirement if you can’t meet the others.

“Active participation in applying for or maintaining accreditation by specialty accreditation programs such as those offered by ACR, ACRO, or ASTRO”

For many, this is another easy one. Yearly, I am bombarded with questions for continuing accreditation for the ACR from my technologists, physicists, and more. And, there is a good chance that your practice requires ACR accreditation too. All you have to do is document your participation!

Meeting The MOC Practice-Based Improvement Requirement

So, there you have it, six relatively painless ways to satisfy the MOC requirements. Many of these you may be doing already and not even realize it. It seems silly to have these as a requirement to maintain accreditation in radiology because many of them are on the fringes of what we do as radiologists. But whatever works and makes our lives easier so that we can continue our ABR accreditation!