Tag: Covid

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No Longer Practicing Radiology During The Covid Crisis? How To Keep Up!

practicing radiology

Many hospitals and imaging centers throughout the country have recruited radiology residents to help out with the Covid crisis. But that leaves many of these residents in a bind. Some residents may feel that they may be losing some of their hard-learned skills. And many have not had time practicing radiology, the main point of completing their residency. So, I am going to outline some steps to make the next several months more relevant to your training. I will do this by going through each residency year and what you should do to keep up your skills. And, I will divide what residents should into First Years, Second and Third Years, and Fourth Years as each of these groups are in different boats.

First Years

For many first years, you are probably not getting the same case experience as you did before. However, for those of you lucky to have some extra time outside of an ICU rotation, I would go through essential books in each subspecialty section. You will find some ideas for books that you may want to read through in my books and links section of this website. (as recommended by my residents) Make sure to read through some of the recommended reading materials at home, now that you may have more time (or even if you don’t!) The key to a successful first year is reading as a basis for the rest of your residency. Don’t squander this opportunity.

Also, if you are interested in interventional radiology, I would recommend participating in some of the procedures that a clinical rotation like the ICU may offer. Volunteer for lumbar punctures, central venous lines, and paracenteses, if possible. These are some procedures that overlap with radiology and will help to maintain what you have learned.

Second And Third Years

Second and third years are years to practice and learn the art of Radiology. So, in addition to reading like the first years.  I would make sure to emphasize radiology cases over only reading raw reading materials/textbooks. So, make sure to go through the case series. Also, when you have the chance, go to the PACS systems and review older cases from the year in different subspecialties, now that some of the regular imaging volumes have dried up. For instance, pick up some of the earlier MSK MRI and make your interpretations and match them up with the final dictations. This action will help to keep your skills and search patterns fresh in your mind since many elective sorts of cases have probably dried up a bit.

Also, even though the ABR has delayed the core examination, it is likely at the forefront of your mind. Make sure to continue to review test questions from sources like RadPrimer and others. (Check out a great post called Up To Date Book Reviews For The Radiology Core Examination from a former resident for some ideas) You certainly want to reinforce this information when you do take the test. Rinse and repeat as much as you can.

Fourth Years

Finally, we need to talk about the fourth year separately. Fourth-year is the best time to learn practical radiology. So, during this time, you should be reviewing areas of practice that you may feel less comfortable with. Especially now, more than ever, I would recommend doing this since the job market will most likely be changing. (Check out my recent post What’s In The Cards For The New Radiologist Job Market After Covid?). So, make sure to read cases in your weaker subspecialties to keep up or learn new imaging skills. (PACS is a godsend!) You may be using some of these skills at your next job!

Keep Practicing Radiology Skills: You Have Worked Too Hard To Lose Them!

Just because some of your radiology training has been canceled does not mean that you should stop practicing radiology. Now, more than ever, you should be making a concerted effort to hone your skills. Whether you are just starting as a first-year radiology resident and need the basics, or if you need more practical training in your final year, allowing your reading and procedural abilities to slip away would be a shame. Reading books and reviewing cases on PACS now is vital. Even though you may be busy outside of radiology with Covid patients, make a concerted effort to stay in the game. Don’t lose your hard-earned skills!

 

 

 

 

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Should Hospitals Force Radiology Residents To Work In The ICU During The Covid Crisis?

ICU

Radiology residents are working in the ICU or the wards to meet the increasing demands of an influx of Covid-19 patients, sometimes having little to do with their training. And, most residents have graciously accepted their new duties, in the name of helping a higher cause. But why must residents comply with these demands? Are hospitals treating these physicians fairly? Is it ethical for h0spitals to require residents to participate and forego training in their desired subspecialty? And, what must the hospital ethically provide in return? Let’s answer some of these burning questions as it reveals some underlying issues about residents and residencies themselves.

The Government Indirectly Hires Residents

Once you sign your residency contract on the dotted line (or solid line!), you are receiving a salary from not just the healthcare system that employs you, but also indirectly from a pool of money provided to the hospitals by Medicare. And, most residents receive these government funds in one way or another. Therefore, you are indirectly working as the Government’s servant. In this setting, residents must comply with the Government and the hospital to receive a salary. So, hospitals do have the right to set aside educational objectives for the moment (even though it may not be what you bargained for!)

Residency Has Service And Educational Obligations

It’s not all about take, take, take! There are two components to any residency, educational and service obligations. Not too long ago, in an attempt to get back Social Security taxes from the Federal Government, residents sued the IRS because they claimed that medical residents were students and not employees. (Check out this article) In the end, the Government returned taxes to residents because the Government never clarified the definition of a resident. However, nowadays, the definition of residency changed. Today, the Government/IRS considers residents to be employees, not just students. And, for that reason, all current residents pay Social Security taxes as well as need to comply with government/hospital demands for service. (That includes time in the ICU!)

What Do Hospitals/Government Need To Provide In Return?

Hospitals have a moral and ethical obligation to provide a safe environment for resident trainees. Any institution that does not offer such a setting violates the spirit of a resident’s contract with the institution. What does that mean? Well, hospitals should treat residents like any other employee. In the case of this epidemic, hospitals should provide residents with the protective equipment they need to stay safe. No resident should risk life and limb without the appropriate accommodations of the institution in return.

And, hospitals should continue to pay their residents at their negotiated salary. Understandably, hospitals are struggling with the lack of revenue from canceled elective procedures. However, the amount that they receive for maintaining residency programs remains fixed by the Government. Therefore, it is only fair that residencies should continue to receive their salaries without furlough or pay cut. They are not the same as general employees whose wages can be subject to market forces.

A New World Order For Radiology Residents: Time In The ICU

No. ICU work is not what most residents signed up for when they began their radiology residencies. However, radiology trainees are still, first and foremost, physicians with service obligations. Part of these requirements is a duty to do no harm and help patients. Moreover, hospitals also have ethical and moral responsibilities toward their residents. Therefore, when both the resident and hospital meet these conditions, radiology residents can and should play a role in meeting the new needs of the healthcare system. Hey, when did you ever sign up for something that was as you exactly expected?