Tag: applications

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DO Friendly Programs- Should I Bother To Apply?

do friendly

Question About DO Friendly Programs!

 

Hello! Thank you so much for this website; it has helped me out immensely. What is your take on small community programs with lots of DO residents? They seem to have a pretty good fellowship match (IR in some top programs, a pretty good mix of fellowships overall).

 

Thanks a bunch,

Low Tier

 

Answer:

 

I am somewhat biased as our program has welcomed both DO and Caribbean medical school graduates for years. And, yes, folks consider us a “community” program. (although that will change with our impeding merger)

 

My philosophy on radiology education is that a residency is only as good as what you put into it. Regardless of the name, if you work hard and read a lot, you will come out of your residency as a great radiologist. The big difference some of the more popular programs afford is additional subspecialty work that you might not get elsewhere and hardcore research that you may or may not want. However, all is not lost if your residency does not fit this category. Indeed, you can get some of these experiences during your fellowship. And, most residents complete a fellowship after residency.

 

In terms of being a DO friendly program, I have no problem with that. As long as education is of high quality and the program’s resources are adequate, it should not matter if the residents are Caribbean, foreign, or DO. In our residency, some of our best residents tend to be Caribbean grads, for one reason or another. That should not dissuade you from applying to a program if you know that the program’s quality is high, and you will receive the training you want. We have had excellent residents from American, Caribbean, and DO residencies alike.

 

Hope that helps,

Barry Julius, MD

 

 

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Didn’t Take The USMLE And Still Want To Apply To Radiology Residency!

USMLE

Question About Applying Without The USMLE

Hello,

Currently, I am starting the intern year as a categorical surgery resident. I know I would be happier as a radiologist, but now I am in a tricky situation. I am a D.O. with decent scores. Unfortunately, I did not take the USMLE (I entered medical school thinking of pediatrics, and my advisor told me to focus on just one examination). Even though I have not taken the USMLE, I have published research from undergrad in pediatrics from an excellent medical school. Moreover, I was a part of the medical honor society, a tutor during medical school, had prior work experiences, and plenty of volunteering/club involvement. I know the radiologist I worked with would be willing to write me a persuasive letter of recommendation.

As a student, I initially applied for general surgery due to a passion for anatomy, and because I enjoyed working with breast cancer patients. I thought I wanted to be a breast surgeon. However, I had the pleasure of working with a radiologist working in breast/women’s imaging. I loved it. Being able to detect subtle changes in breast tissue was fascinating. From the mammograms, stereotactic biopsies, and needle localizations, the days would seem to fly by. I couldn’t get enough of it. Never did I think I would be so interested in radiology, but without any prior exposure in the field, I would have never known. 

I guess at this point I am unsure what to do. The current hospital I am at does not offer a radiology residency but is a part of a healthcare system that is about an hour away. What is the best advice you have for someone in my position? Any help would be much appreciated.

Thank you for your time!

What To Do?

 

Answer

Dear Applicant,

As an intern in surgery, you are well within the window to change specialties from the standpoint of government medicare funding. But, if you make your decision to enter radiology too late, that may no longer be the case. Applying later will reduce the number of residencies that will give you an interview. So, there is no better time than now to apply for radiology, as that is your area of interest.

Also, you may not want to hear this. The best way to ensure that you will get a spot in radiology would be to take the USMLE Step I and II exams. Many residencies disregard the COMLEX scores. Now that the AOA has merged with the ACGME, the USMLE tests are the standard throughout the country. A good score on the USMLE Step I would go a long way to giving your application some more “street cred.” (Eventually, in 2022 the USMLE Step II will be more critical exam since Step I will be a pass/fail test only). 

If you only have the COMLEX exam, you will be limiting the number of residencies that will seriously examine your application. I would try to take these exams as soon as possible so that the residency programs will have your scores. (Not sure if you can fit it in before this application cycle ends, but if you can, that would be great!)

All the other stuff that you have done, such as research, tutoring, and volunteering, is excellent. But, everyone else applying for radiology residency has done the same. So, although you need to add it to your ERAS application, it’s not going to differentiate you.

A recommendation from a radiologist within a health care system that has a residency can still support your application. Even if there are no other residency programs within the healthcare system, it will still help a little bit (but not as much).

The bottom line is that all is not lost. It will take a bit of work to study for the USMLE Step I and start your application soon. If you can’t get those USMLE scores before the application cycle, you can try to apply regardless. However, the chances of getting into radiology residency will be a little bit less. I think it is still worth a shot because you don’t want to lose out on government funding. Alternatively, you can take off a year of residency and find a job in research. That would potentially postpone the medicare funding issue and allow more time to study for the USMLE. When there’s a will, there is a way!

Good luck,

Barry Julius, MD

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Do IR-DR Programs Hold Grudges Against DR Applicants?

grudge

Question About IR-DR Program Grudges Against DR Applicants:

Hi, Dr. Julius!

Thank you so much for creating such an excellent resource for students who are interested in Radiology as a profession. I am interested in applying to Interventional-Diagnostic Radiology (IR-DR) as my preferred specialty this Fall. I am still confused by applying to IR-DR and Diagnostic Radiology (DR) at the same time. To give some context, I currently live in the United States, and my husband is an Orthopedics resident who will complete his training in 2023. We have a young son, and so location is very high on my considerations as it pertains to different programs. I love IR and want to pursue an integrated residency. However, since you can still get into IR-DR from DR, location is more important to me than an integrated program.

I guess my real question is that specific DR programs will hold it against you that you applied to their attached IR-DR program and will not grant you an interview. Considering that the match rate for IR-DR is only around 50-60%, I cannot risk applying only IR, but will program A’s DR program still consider me if they know that I have sent applications to residency A’s IR-DR program as well? Thank you so much for your input!

Sincerely,
Future Interventionalist

 

Answer:

Dear Future Interventionalist,

According to my experience over the past few AUR meetings, unfortunately, some residency programs hold grudges against residents who apply to both DR and IR-DR programs. However, most don’t. For those that do, from what I gather, they will often take residents that apply to IR-DR programs if they believe that they are good anyway. So, I would not let that stop you from sending applications to both sorts of residencies simultaneously. As you have stated, IR-DR is competitive, and you are better off applying to both programs. DR programs still have a pathway to get into IR-DR. The numbers game makes it not worth your while to worry about individual programs’ grudges!

Good luck!

Barry Julius, MD

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Are Two Fellowships Too Many? Probably Most Of The Time!

two fellowships

Since most job seekers look for new jobs for only a few years and the majority of those job seekers are fellows, the collective consciousness of the radiology job market at any given time rapidly fades away. And, when the job market changes, we often forget about what new radiology residents had to deal with only a few years ago. But, talk to radiologists that graduated around 5 or 6 years ago. You will find that many of these folks had experienced a 180 degree opposite job market of today’s when they started to look. Moreover, if you ask them which fellowships they have completed, you shouldn’t be shocked to hear that they finished two of them. In all likelihood, that may have been the norm!

So, the question I pose for today, is there still a role for completing two fellowships? Are there any economic advantages to finishing two advanced subspecialty programs? And, what circumstances should lead a new resident to achieve more than one? You should find this discussion enlightening!

Why Should Anyone Complete Two Fellowships?

OK. From a monetary standpoint, it no longer makes much sense. Most folks can receive the same pay regardless of whether they have completed one or two, let alone none! And, indeed, the job prospects don’t change all that much nowadays if you have finished one or two. So, let’s scratch that reason off the list.

What about future job security? Well, again, I believe that folks that fellows that have completed two fellowships are just as likely to get canned as those have finished one. If you are an excellent radiologist, it should not matter much. And, you can be a lousy radiologist regardless of if you have one or two fellowships. Additionally, I can make the argument that some less competent radiologists have completed two advanced programs because they did not feel comfortable initially starting in the job market with just one. So. let’s nix that reason as well.

How about allowing you to do what you want in practice? No, most jobs have a niche that they need to fill. And, they will meet the demand regardless of the number of fellowships you complete. Sure, you may find a job that advertises for someone that could perform two specialties competently. But, by no means in most cases, do you need to complete two fellowships to fill the position. Those positions tend to be more general. And, it probably does not matter if you have graduated from two subspecialty programs.

So, When May Two Fellowships Come In Handy?

Honestly, I could come up with three main reasons for completing two different fellowships in the market in general. And, one reason specifically for economic reasons.

So, let’s start with the economic reason. (Does not apply for the current market!) When the job market is terrible, you may need two fellowships to stand out from the crowd. And, precisely, that situation happened five or six years ago. It was not uncommon to find these applicants at that time.

Next, some folks choose the wrong fellowship from the get-go. I know of one interventionalist that never really liked it much. And, this person practiced for years and years with the hope that one day she would grow into it. It never happened. So, she chose to start from scratch at a different fellowship. That could make some sense in certain situations.

What else? Say you want to bolster your academic credentials. Well, in the game of academics, numbers of papers, lectures, abstracts, and even degrees matter. And, yes, having an additional fellowship is like having an extra degree. It has the potential to boost your academic prospects in that sort of venue. (A bit different from my world!)

Is More Than One Fellowship Too Many?

Based on our short discussion, the answer is sometimes. And, for most people today, that want to set out into the world of radiology, two fellowships is most likely overkill. But, there is a time and a place for the second fellowship. The question is: is it yours?

 

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Do Recommendations Come With An Expiration Date?

recommendations

Do letters of recommendation last forever? Obviously not! But, if someone provided you with a kind word once, shouldn’t it last? It all depends on the type of recommendation and what purpose it serves.  So, let me provide you with a basic outline of the staying power of different sorts of recommendations for radiology residents and radiologists (kind of like the shelf life for foods!)

To organize this into something useful that you can use as a resource that you can come back to many times, I will divide the recommendation categories into both timing and purpose. And, I will begin in the order of training and subdivide the recommendations into subtypes. Let’s start at the beginning, medical school, and end with recommendations for attending radiologists.

Medical Students Applying To Radiology Residency

General Recommendations

Of course, before you even start talking about expiration dates, we need to mention the sorts of recommendations that medical students should obtain. It is not fixed (and dilated!). Instead, it can be fluid. From my experience, I like to see one radiology related reference and a couple of non-radiology recommendations for our program. But, I’ve seen some impressive applications with credentials coming from all radiologists and also all non-radiologists. So, in general, it is essential that the referrer knows you, the applicant well.

Unexceptional Recommendations

Now that we got this general caveat out of the way, how old can the average recommendation be before it begins to get stale? For the average, unexceptional reference, I would say no more than two to three years. Usually, it is best to get these recommendations from physicians with whom you work in your medical school. These recommendations are a general evaluation of your work ethics during this time. So, it shouldn’t be much older than that.

Exceptional Recommendations

Instead, let’s talk about extraordinary recommendations. What do I mean by that? Let’s say you are a former olympian, and your coach gave you an incredible reference and testament to your grit and personality. Or, maybe the President of the United States knew you and wanted to put in a word (for some that may not be so great!). But, I think you get the idea. These sorts of residency recommendations can be used as an adjunct and have a longer shelf life, perhaps indefinite. You can probably afford to put one of these in your application to differentiate your application from the others. And, this recommendation has some staying power. More importantly, it can help the program director to remember your credentials at the time of interview selection and ranking.

Known Entities

And, then, finally, what about the recommendation from a known entity/physician within the radiology residency or someone that the program director knows directly? These recommendations also come with a longer shelf life. These sorts of recommendations last until the referrer is no longer known to the program/program director.  If you are talking about someone that a resident knows within the program, that shelf life only lasts until the resident leaves and no longer has much influence anymore.

Residents Applying To Fellowship

General/Unexceptional Recommendations

For your “Average Joe” recommendation for fellowship, generally, you should ask an attending from your institution to write you a reference. At the bare minimum, it shows that you can interact with your team and garner the appropriate support to apply for fellowships. These recommendations should be no older than the time you have already been within your residency. I would not request references from your former ERAS application for residency. That would show a bit of laziness as well.

Exceptional Recommendations

For Fellowships, the unique/unusual recommendation now has much less meaning. Most importantly, at this stage in your career, you want to show that you are capable of performing the work. Although it would be interesting to get a recommendation from the President, that will not help your program director to figure out if you can perform liver biopsies. Recommendations at this stage should be much more laser-focused on your future specialty. The role of this sort of reference wears off as you advance in your career.

Known Entities

These recommendations become more important than ever. Why? Well, that would be because the fellowship director wants to feel comfortable that he will be working with someone capable. And, for residency, there is no better way to accomplish that than to receive a recommendation from someone that you know. Therefore, the shelf life of one of these recommendations will last much longer. It may last as long as the person recommending you is actively involved with radiology!

Fellows Applying For Radiology Attending Jobs

General/Unexceptional Recommendations

These recommendations are a bare minimum requirement before beginning to look for your first job. Typically, most of these references are no longer actual letters. Instead, they come through direct phone conversations with the referrer. Practices will often place random phone calls to the referrers that you list on your application. So, these recommendations will only last as long as the person that recommends you is at your current institution. If that person leaves, the reference is no longer “kosher.”

Exceptional Recommendations

These sorts of recommendations no longer should play any role in your application for a job. Your future employer is only interested in two things, mostly. Can you function as an attending in your new job? And, can you get along with others. A recommendation from a President or other interesting source cannot tell you the answer to either of those questions.

Known Entities

At this point, these recommendations are the most critical. If the applicant receives a reference from someone that the practice knows, it is like proverbial “gold.” It is most likely a checkmark for you to get the job. Most partnerships take these recommendations the most seriously. Why? Because most other measures do not provide valuable information about the candidate. These recommendations will last as long as the referrer is in practice.

Bottom Line About Recommendations: Different Strokes For Different Folks

Depending on the stage of your training, recommendations do have different shelf lives and impact. Known entities usually have the most significant influence on chances of admission or getting a job, and they tend to have the most extended shelf life. On the other hand, “exceptional” recommendations play a smaller role as you go further in your career training. Additionally, in general, make sure that an average reference should not be older than your medical school or residency training time. Or, if you are trying to get your next job, these recommendations will last as long as your faculty are present and continue to remember you.

Laziness can prevent you from getting into the residency, fellowship, or faculty position of your choice, especially when it comes to references.  Don’t rely on ancient endorsements. Instead, remember these guidelines the next time you ask for your recommendation. Don’t just leave the process on autopilot!

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Full-Time Practicing Primary Care Physician: How Do I Get A Radiology Residency Slot?

primary care

Question:

 

Hi.
I am a physician in a primary care specialty looking to go back to residency, specifically in radiology. I have been in practice for ten years and have realized that I do not want to practice primary care for the rest of my life. Have you had a resident in a similar situation? What factors do I need to consider? How does Medicare funding for residency come into play?

Thank you so much for your blog and the book. I realize this is a rather late stage to make a change, and I would appreciate your input.

 

Answer:

So, this is the deal: I would love to have physicians that have previously trained in other specialties. They make the best radiologists because they understand the clinical implications of diagnostic imaging. Some of my best radiologist mentors had completed another specialty first.

However (and this is a big caveat), it does become more challenging to obtain a slot because of the Medicare funding situation. Once you have graduated from a U.S. residency and start to practice medicine, Medicare does not fund the additional years of training.
But all is not lost. If I were you, this is what I would do. Some residencies throughout the country have their spots funded by private sources in addition to Medicare. For instance, I know in New Jersey that University Radiology Group supports several residency slots privately for the Robert Wood Johnson program. These are the slots that you would need to find. You may want to try calling the departments up individually to find out if they would take a previously trained physician. Otherwise, you will potentially waste your time and money applying to places that would not enroll you regardless of how excellent your application.
And finally (and perhaps most critically), you need to be ready to go through the mental and financial hardships of repeating another residency. Depending on your family situation, you need to make sure that all members are “on board” with the change. It’s certainly not an easy four years. But, I can tell you that going into radiology was one of the best decisions I have ever made!
Good luck with the decision process,
Barry Julius, MD
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Why MD-PhDs and Radiology Residency Sometimes Don’t Mix

Getting an MD-PhD is no small achievement. These candidates often take eight, nine, ten or more years to complete their training by the time they apply to medical school. Meanwhile, their friends and colleagues have long since graduated from medical school. And, working on a thesis as a PhD can be brutal. I admire the tenacity it takes to get through this program.

Now, you would think that with all this training, all these applicants would turn into the most incredible radiologist residents. (of course, some are great) However, based on my own experiences and the sentiments of other program directors throughout the country, nothing could be further from the truth. And, let me tell you why.

Too Detail Oriented

MD-PhD training (especially the PhD part) utilizes a whole different philosophy from medicine. These teachers teach with bottoms up approach. You start from all the details and then work your way upward to the whole. On the other hand, in radiology, you start with the general disease or imaging findings and then work your way into the details. These two approaches clash. Concentrating on the features of a hepatic cyst on a CT scan while an aorta actively ruptures can cause real problems for patient care! Imagine the issues misses like this can create when a resident starts his first call.

Decision Paralysis Because They Know Too Much

With some residents in radiology, the problem is they know too little. That is not true for the MD-PhD graduate. Instead, in a way, often, MD-PhD know too much to make a quick decision. They think about cases too profoundly (which of course, is sometimes a good thing). But, sometimes it also leads to decision paralysis. Harping on one imaging study at nighttime for 45 minutes can lead to a backup of cases for the entire call shift. Imagine the constant phone calls from the emergency department when this happens. Getting bogged down in decision making instead of acting can lead to poor outcomes!

Question Everything

In the MD/Ph.D. world, you need to question everything. By doing so, the art of making questions leads to incredible research. But, in the radiology world, we can query some things. However, we do not have the time to question every detail. That doesn’t work well for radiology residents or attendings. We will be working until the cows come home!

Out Of Clinical Practice

Unlike the standard MD pathway, the MD-PhD approach often involves performing their clinical rotations early. So, by the time these residents apply to your program, they have already had three or four years of PhD work without even seeing a patient. It is not uncommon to forget about how to talk to patients and make them happy. Just like PC Richards, customer service is king for radiologists. You need to have the patient skills to be a consummate radiology resident. And, you know what?  If you don’t use your skills, you lose them!

Different Knowledge Base During Medical School Training

A typical MD will emphasize learning about disease processes and pathology during the clinical years. By the time she arrives at the radiology program, she knows the basics about medicine.  On the other hand, MD-PhD grads may have been profoundly learning about focal adhesion kinase enzymes for years before arriving at the radiology residency. Unfortunately, learning about complex biological chemistry is not directly transferable to the clinical duties of a radiologist. And, it shows when these residents first start!

How Can MD-PhD Grad Be Successful In Clinical Radiology When Their Medical School Training Stacks The Odds Against Them? 

Now you can see why some program directors hesitate when they face the decision to accept their next MD-PhD applicant. But, with all of these issues how can you, the average MD/PhD succeed? I mean that is the bottom line, right? If I can’t help out the poor MD-PhD grad than what is the point?

Well, fortunately for the MD-PhD applicant to the clinical radiology program, solving these issues is straightforward. How can you go about making yourself a better candidate? First, you may want to apply to programs that have a bench research component, if that is what you want.

Second, stay connected with clinical medicine. What do I mean by that? Make sure to volunteer to participate in additional clinical rotations when you shift to the PhD portion of your medical school training.

And finally, remember that you need to think a bit differently when you enter your radiology residency program than your PhD training. Creating a connection to the clinical realm will give you an edge!

 

 

 

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Radiology As A Backup Specialty: Should Radiologists Be Offended?

backup

During the AUR meeting a few years ago, one of the speakers announced that more medical students than ever used radiology as a backup specialty. Well, how can that be? I mean, radiology is a fantastic specialty, right? Yet, our medical students have chewed us up and spit us out. At that point, you could just about hear the moans and groans in the background of the lecture hall. But then, I thought about it and felt a bit differently. Why? Well, that is what I would like to delve into today.

Most Applicants Don’t Know What They Want

Over the years, I have found that most radiology applicants, like other specialties, think they know what they want. However, when you dig a bit deeper, you find out they are not sure. Hell, I had no clue when I entered the specialty. When you ask applicants why they want to join specialty X, many have difficulty verbalizing their true motivations. Often you hear, “I like using my hands” or” I like coming up with differential diagnoses.”

Truthfully, however, these reasons are, at best nonspecific. And, if you dissect what these residents are saying, you would recognize that the reasons why an applicant claims to have applied to a specialty have no bearing upon what he wants. You can apply to surgery, interventional radiology, urology, and other specialties because you want to use your hands. Or, you can come up with differential diagnoses in almost any specialty in the medical field.

Often, applicants bury the real reason for applying to a specific specialty deep within their psyche. Perhaps, they want to say it’s the lifestyle, the culture, or the money. So, how can we become offended by medical students that don’t know what they want?

Our Specialty Is Getting Noticed!

For applicants to apply to our specialty, even as a backup, it means that they must have some foreknowledge about us, to begin with. That means we are doing something right. Maybe, we are training more medical students about imaging in medical school. Or, perhaps, they hear about an improving job market. In either case, residents have found reasons to apply to us, even though it may not be their first choice!

A Badge Of Honor

Only a few years ago, the radiology applications had dropped precipitously. In addition, the quality of applications had significantly decreased as well. Instead, today, we have become respectable enough to apply to! We are returning to the old norm. So, we should feel excited that qualified applicants are again considering our specialty.

So, We Are A Backup Specialty. Should We Be Offended?

Back to the original question again… Let’s look at radiology for what it is. It’s one of few specialties that allow physicians the flexibility to pursue so many avenues and satisfy the academic and clinical wants of most. And now, if we dissect why residents perceive us as a backup, I think we should not become offended. Instead, we should give the new applicants some credit. They are beginning once again to recognize the specialty of radiology for what it is: an excellent choice for a great career!

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Is The Specialty of Radiology Better Off With Increased Competition?

increased competition

With the increasingly hot job market for new radiologists, medical student applications to residency programs have steadily increased over the past several years. But that got me thinking. Is the specialty of radiology better off with more hardcore medical students wanting to enter the profession? Or does radiology benefit more from residents who genuinely want to be here when times are tough? So, let’s go through the advantages and disadvantages of having both a competitive and a non-competitive application process. And then, we will come up with a conclusion to the final question: Is the specialty of radiology better off with increased competition?

 

What Happens With A Competitive Application Process

Advantages

From a program director’s perspective, let’s begin by saying that a program director’s job becomes much easier with increased competition. To find applicants, you do not have to interview as many candidates. And the applications tend to have fewer “blemishes.” That said, as much as it helps me, this factor impacts the specialty very little.

So, what other advantages does a competitive process offer? First, the candidates will often have more experience in research. But does this create better radiologists? Depending on whether the resident wants an academic career, that is up for debate. However, I can say that it again makes the program director’s job a little bit easier because the faculty do not need to teach some of the primary research mechanics to get them started. Additionally, this resident will also likely produce more research during residency.

With increased competition, residents tend to be slightly more attentive to keeping up with reading. Moreover, these residents tend to be more motivated by passing tests. In other words, they may be a bit more “obsessive-compulsive.” Now, this would theoretically work in favor of passing the boards. However, according to the infinite wisdom of the test makers (the ABR), this doesn’t change the pass rates since they opt to create tests based on curves, not content.

Disadvantages:

Over the years, I have noticed that competition also motivates applicants who want radiology because of the competition, not necessarily for the love of radiology. In the long run, this can lead to increased burnout. Furthermore, it can change the culture of radiology residency and radiologists into a less forgiving and highly pressured environment. Again, this is more of a tendency rather than a truism.

Increased competition also brings out fewer nontraditional applicants to radiology. These include folks who have completed other residencies and different careers. In the setting of increased competition, they have a much harder time receiving interviews because programs often screen them out of the system due to their increased time in or before residency. However, nontraditional applicants bring a different perspective to residencies. Moreover, they have been through more, are more mature, and often make better leaders.

What Happens With A Non-competitive Application Process

Advantages

Residents who apply during a less competitive time are a different group of candidates. I like to call them type B personalities. These folks create a less pressured environment and a calmer culture for the residency program. This decreased stress can make the four-year residency process more tolerable for everyone.

Likewise, during tough times, the limited selection of candidates forces residency programs to accept nontraditional candidates. As stated, these candidates lend a mature perspective to a residency program. In addition, these residents want to be involved in radiology for the love of the specialty rather than the competition and the “great” job market.

And then, programs will often downgrade their expectations of these non-competitive residents. Decreased expectations lower the pressures on the residents during their program and can create a less harried culture with reduced burnout.

Disadvantages

I don’t have the statistics to back this up. But, from my experience, tough times lead to residents with a higher dropout rate. Sometimes, these residents cannot meet the rigorous academic challenges of residency. When this occurs, residencies can lose their precious spots to other specialties like primary care.

Also, these residents have overall less experience with research. So, most residencies with non-competitive applicants will create less output during these challenging times. (This is a disadvantage for the more academic residency!)

And then, finally, residencies have more work cut out for them. They must put more time into teaching and spoon-feeding the residents to ensure they complete the program.

Weighing The Balance- Is Increased Competition Better For The Specialty?

So, where do I stand in this controversy? Well, residency directors and their programs must put more work into the residents during the “tough” years to get them “up to snuff.” But, you know, I’ve seen great residents during the lean times and times of abundance. So, I think we put more emphasis on competition to get better residents than we should. In the end, good residencies mold their residents into great radiologists regardless of the zeitgeist of the times. And that’s the way it should be!

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Do Video Games Make Better Radiologists?

video games

Let’s face it. For some of us, radiology and video games go together like other classic combinations such as peanut butter and jelly or bread and butter. In the radiology profession, these games have enticed many of us since we were young. And, I think it has something to do with our love for technology. Even I enjoy playing an occasional video game on the Nintendo console we bought for the kids. But do they serve a role for the radiologist in training? What are some of the evidence that they may help with brain function? Finally, do they enhance radiology practice in a radiologist’s career? In today’s piece, I will investigate some of these burning questions.

Video Games And Radiology Learning

So, what evidence can we use video games to learn radiology? Well, let’s look at two articles that I found. One of these articles explicitly gives an example of a specific video game dedicated to radiology learning. The other indirectly provides evidence that we can learn radiology with video games.

In one case, I found an article that showed a video about a game developed at a Spanish university meant to teach radiology to physicians called Medgame. (1) At least from the video, it seems to be an enticing and possible alternative way to learn the basics of radiology. For those who love playing, I imagine a video game like this would be a great way to learn new material and reinforce radiological concepts. (If only I had something like this when I was a resident!) Although I can’t say that I have played the game, I would be interested in getting feedback on it.

More indirectly supporting the average video game player, another article from 2013 in the Journal of Molecular Psychiatry shows that you can alter the structure of your brain by playing video games. They claim several sites of increased gray matter thickness in those that played Super Mario 64. Moreover, they also espouse the potential for the increased gray matter to help with PTSD, Alzheimer’s disease, and schizophrenia. (2) In my mind, the increased gray matter should translate to increased neural complexity and networks, likely related to increased learning.

Video Games And Brain Function

More than just learning, some evidence supports increased brain function in video game users. In one article, I found some interesting information about how video games improve brain function in patients with multiple sclerosis. It describes increased thalamic connectivity in patients that played a particular video game. (3) Another study also showed that manual dexterity improved in more heavy video game users than young adults who did not play and those who played less often. Both of these articles provide some supportive evidence of the power of video games to enhance brain function.

Video Games Improving The Field Of Radiology

And then other articles have shown that technologies created for video games also have been found helpful in radiological applications. Thereby, these applications also have significantly improved patient care. One of these motion sensor technologies from an Xbox specifically reduces radiation dosages in X-rays by assessing motion and thickness. (4) Even back in 2008, Microsoft programmers created 3D technologies for video games that subsequently applied to radiology. (6)

These video game technologies are merely the tip of the iceberg. With so much recent virtual reality development for video game users and the great graphics technologies on current games, I believe the applications will become much more numerous. We will see many other applications from video games that improve patient care.

Are There Any Negatives For Radiologists?

With any discussion of video games, we also have to discuss the downside. I don’t know about you. But, when I get into playing an addictive one, it can interfere with other “life activities.” You want to know what will happen next and can easily sit down for hours at a time, passing the time without realizing you have been playing for so long. So, the individual radiologist video gamer must carefully monitor their gameplay usage. However, this situation may not be so bad if the game provides a significant radiological education benefit.

And then, we also need to confirm that video games created to enhance radiology performance do just that. Sometimes at the beginning, creators of products will tout the benefits of technology without evidence to support whether or not it helps. So, we need to justify that these video games truly enhance performance with an evidence base before making claims that the technology improves radiology and healthcare.

Video Games And The Radiologist

In this whirlwind tour through the world of video games and the potential applications to radiology, I believe the preponderance of evidence supports that they will enhance our lives as radiologists. Some of the takeaways include that they can enhance education, may improve brain function, and will continue to improve radiology practice for years to come. These benefits come with limited downsides that I think we can overcome. Nevertheless, the application of video games to radiology is far-reaching. We only need a bit of imagination and the willingness to adapt to new technologies for the betterment of our field.

 

(1) https://healthmanagement.org/c/imaging/news/mir-2015-learning-radiology-through-computer-games

(2) http://www.nature.com/articles/mp2013120

(3) https://press.rsna.org/timssnet/media/pressReleases/14_pr_target.cfm?ID=1879

(4) https://www.auntminnie.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=118512

(6) http://www.digitaljournal.com/article/258548