Tag: program director

Posted on by

Radiology Residency Makeover: What Can Make A Truly Excellent Program!

radiology residency makeover

Everyone has a different vision of what residency should be when they start. And some discover that residency is nothing as expected. Perhaps, you thought that you would get more lectures, but you are not receiving enough. Or, maybe you thought you would receive more thorough assessments by the faculty every week, but no one is checking up on you. Every residency has its sore points. But let’s say you could construct a radiology residency from scratch; what are some of the most critical elements you would like to fix? From an associate program director’s perspective, here are some essential items for a radiology residency makeover from the beginning!

Filling Out Evaluations- Seriously

In many residencies, evaluations get placed on the back-burner because attendings are busy and barely have time to do their work. But, what if faculty took these assessments seriously and took the time to give you real constructive criticism? I mean the type of analysis that would help fix your dictations or make you better at performing procedures. That takes a bit of time. But, receiving constructive criticism such as this would be well worth the price.

Formalized Guideposts For Applicants

Yes, most residencies claim to use milestones to ensure that residents are well on their way toward becoming independent radiologists. However, it’s more of a checkbox that most residencies place in residents’ portfolios to document progress. However, wouldn’t it be nice to have a radiology residency makeover so that you have specific achievable requirements to meet the goals and expectations of the program. I am talking about the type of thing such as the ability to read x numbers of chest films in a day by year two or having a formal standardized assessment for performing paracenteses that everyone needs to complete before allowing residents to do them independently. These guideposts are helpful and will enable you to know where you are at any given moment!

Lectures- Quality And Quantity

Some residencies promise lectures to all residents but do not deliver. Lecturers regularly cancel noon conferences due to other work obligations that they need to meet. Other residences give talks, but they are not of sufficient quality for residents to learn the material. Wouldn’t it be nice to have a residency that consistently provides the material you need to know with excellent lectures? And, lecturers that cancel permanently have a backup on deck—furthermore, all lessons are of homogeneously excellent quality.

A Radiology Residency Makeover So That All Faculty Care About Resident Welfare

Every program has some knowledgeable faculty. Nevertheless, it is another thing to care about resident well-being. Wouldn’t it be nice to have all faculty on board looking out for residents’ self-interest? It only takes a few caring attendings to help their residents along so that they can achieve great things. Whether it is helping pass the boards or having an interested soul to talk to, caring faculty can make all the difference in the residency experience.

Residents Running The Show

In the end, we need to be able to train residents to work competently and independently. On the other hand, some residencies don’t give the residents enough independence on all the rotations to truly get the experience they need to take charge of their service. Maybe they have needy patients that want attendings performing all the procedures. Or the faculty does all the work. Perhaps, an attending on-call overreads all your dictations. Wouldn’t it be nice if you could show that you could run the rotation at some point during your four years?

Residency Makeover: What Can Make A Truly Excellent Program!

As an associate program director, taking evaluations seriously, formalized guideposts, quality lectures, caring faculty, and allowing residents to take charge are some features that can transform a mediocre program into an excellent one. If you are lucky, your program follows these descriptions to a tee. But, life is not perfect, and neither are residency programs nor their faculty. Nevertheless, now you know, in an ideal world, this is probably your residency director’s dream!

Posted on by

You Are Not Right: Radiology Is Less Competitive This Year!

less competitive

Statement From A “Questionable Program Director”

Hi, I saw your post and talking to all the programs in the south this year, radiology was less competitive with our program receiving 60-80 fewer applications than last year. I state this because this year was not more competitive. But if you check the NRMP and look at the numbers instead of writing from your gut, you would not spread false information.

I will take a page from Barry and speak from my gut and say it is getting less competitive in the next few cycles with the horrors of taking candidates with no inclination for radiology via the SOAP to only fail the boards will start again.  In retrospect, I wish that I had interviewed more students because many have already been to 20-30 places with their prepared responses.

Fellow program director

________________________________________________________

Response From A “Real Associate Program Director”

Not quite sure if y0u are a real program director since you did not leave an email or another way to contact you. Most folks that are “real” will put their money where their mouth is. Additionally, the grammar was horrible (so I took the liberty to edit it a bit), and the note was challenging to read. (But that does not disqualify you from being a program director!) Regardless, I thought it would be fun to reply to this email in an ask the residency director format, now that we know our program has matched all four spots.  So, here we go!

Less Competitive This Year?

First of all, the NRMP has not released any of the numbers about the 2019 match. They are not yet available. Can’t say that I know what figures you are talking about from the NRMP. (another red flag regarding the credibility of your post!) However, I find it interesting that you reported having 60-80 fewer applications this year. That statistic flies right in the face of what our program has experienced for this year’s match. And, it also differs from what I have heard other programs saying. But, then again, we will find out the actual numbers of the match statistics when the real NRMP releases the stats for this year.

Second, my article called 2018-2019 More Competitive For Radiology? A Midyear Perspective is just a perspective. I based it on the hard and soft facts of what we saw at our program at the time of the article.  I use pieces of evidence to support the conclusion that this year was more competitive, not gut reactions. But again, we will see if my prediction bears out when we do get the final word from the NRMP.

Next, I want to put a pitch in for those folks that will be matching in the SOAP. What you are implying about the SOAP candidates could not be further from the truth.  Our former residents that matched through this process have been some of the most dedicated and fervent radiology residents that we have ever had. Most residents that match through the SOAP do not fail their boards. To the contrary, these residents perform extraordinarily during their four years and beyond.

And, finally, I am sorry to hear that you wish you should have been interviewing more students. (if you are real!) I think that says more about your program and your region of the country than the state of the radiology match this year.

Too-da-loo,

Barry Julius, MD

Posted on by

What Does It Mean To Be One Of The Successful Radiology Residents?

successfui radiology residents

So, your residency director begins to talk about his most successful radiology residents over the past ten years. But what does that mean exactly? And do you want to be part of that list? Well, maybe or maybe not.

Most of the time, the resident’s and program director’s expectations align precisely. But other times, the definition of a successful resident from a residency director’s perspective may vary widely from yours. In this light, we will talk about the expectations of a residency director and your expectations of the meaning of a “successful” radiology resident. Moreover, we will look into those conflicts of interest that may arise between the two expectations.

Residency Director Expectations

So, what makes a residency director happy with his residents? Well, for many directors, it comes down to reducing the heavy workloads. And, to keep their work to a minimum, most residency directors want their residents to comply with the basic expectations of a radiology residency program during the four years. In other words, these are some of the phrases that a residency director would want to apply to their best residents.

1. Passes the core exam on the first try

2. Completes all the necessary work on his own

3. Doesn’t create too much noise during residency.

4. Is expeditious with his work

5. Gets along well with others

6. Completes fellowship after residency

7. Enters academics and has a radiology career

8. Creates his research projects independently

9. Continues to produce research independently after graduation

 

Radiology Resident Expectations

On the other hand, what does a resident think would make the best sort of resident during his training? Here are some short descriptive sentences.

1. Reads enough during residency to have a good background for his career

2. Experiences and learns about all the procedures and modalities in the field.

3. Gets along well with colleagues and attendings

4. Makes connections for fellowship and beyond

5. Does not get sued

6. Can find a quality job in a desirable location with reasonable income after his residency

 

What Are The Potential Conflicts Of Interest Between The Resident’s and Program Director’s Expectations?

Research

The program gains more clout for a residency director when it produces large amounts of academics. For one, the Radiology Review Committee/ACGME will be much less likely to cite a residency if they have sent many abstracts to national conferences and have written numerous publications. On the other hand, many residents can care less about pursuing research and utilize it only as an avenue to graduate residency.

Making Noise

Often, residency directors like the status quo. To accomplish this, they would rather have their residents go through the motions of completing their work without changing the system. It becomes a less complex pathway with fewer chores to do. However, on some occasions, by not vocalizing educational issues, radiology residents may sacrifice their education and career. So, the resident may not find it appropriate to maintain silence.

Finding A “Good” Job

Sometimes, the program director’s definition of an acceptable career choice differs widely from his radiology residents. For instance, she may expect residents to go on to academic or prestigious private practice careers to maintain the “lineage” of the program. Nevertheless, the best career pathway may not always apply to each resident who comes through the system. Some residents may have business interests or may not have the desire to enter a typical career.

Taking And Passing The Boards

For most residents, completing the radiology boards become a critical step to obtaining a desirable job. And it also adds to the positive statistics of a program. But sometimes, passing the big exam is unnecessary to get the career the radiology resident wants. Perhaps, they want to enter the business world. Or, they have a job lined up in some other area. Taking and passing a board may become less critical to this resident than the radiology program.

Bottom Line About “Successful” Radiology Residents

The program director’s and the radiology resident’s expectations of the “successful” resident usually align. However, occasionally they don’t match up. It’s like parenting. Sometimes, we need to let our residents take an untraversed pathway. We, as program directors, cannot always force our residents down the same well-trodden trails. And radiology residents should not expect that they always need to perform the desired requirements. Instead, radiology residency directors, residents, and the external regulating bodies should redefine their expectations for success with the understanding that “successful” residents do not always fit an identical mold.

 

 

Posted on by

Why A Strong Department Chair Is Critical To Residency

chair

As an associate program director, I work with all the residents and faculty. But, one role, in particular, plays an even more significant role in the quality of the residency than the others. Which one would that be? (Hint: Well, if you have not guessed it by now, you may want to look at the title again! The Chair)

OK. So, the chair is critical to running a great residency. But what is it about a chairperson that makes the role so important? Well, the importance of the position is what we will run through over the following, oh, say, 8oo or so words!

Backbone When The Going Gets Tough

Everyone, once in a while, events conspire to mangle a residency program. Perhaps, a resident decides to leave for another career, and the hospital wants to take away the residency slot forever. Or, the emergency department determines they no longer want residents to give the final dictations at nighttime. In any of these cases, you need a firm chair to prevent these issues from negatively affecting the residency program. Sometimes you need a leader to fight for your department!

Allocation of Resources To The Residency Program

What would happen if you had a chair that decided to commit more resources to non-residency-associated imaging centers at the expense of a hospital-based residency program? Chaos, of course! You may not have enough physical bodies to teach the residents. Or, the chairperson decides to stop giving the program directors administration time to run the residency program. Either way, the chair controls many of these outcomes. And, if she decides to allocate the resources to the outside facilities instead, the residency loses out.

Carrot And The Stick

In any practice, some physicians have more or less interest in teaching. But, what happens if some of the attendings decide that they no longer want to give conferences? Well, the chair has the practice’s long arm to ensure that does not happen. The chairperson can either decide to provide money or non-monetary incentives to make sure that the faculty performs. Or, she can remove incentives from staff members who do not participate. Either way, the chair’s ability to utilize her power directly affects the program’s quality.

Sets The Tone Of The Department

Let’s say your chair runs the department as a dictator. Or, he is always just trying to appease friends instead of doing what is best. What happens to the residency in these cases? In the first case, the residency program runs on fear and misery. And in the second case, nothing ever gets accomplished. Bottom line: the chair sets the quality of interactions in the department and the residency.

Liaison Between The Hospital And The Program Director

Some departments have a chair who does not communicate the critical issues of the institution to the residency. What occurs in these situations? First, residents may lose out on remaining compliant with national requirements such as hospital ACLS training. Or the radiology program may not fulfill its obligations to stay accredited. Poor communication between the hospital, chair, and the program director can become a nidus for a residency to implode!

The Ceremonial Function

Sometimes, a chair may decide not to attend essential residency functions. The chairperson may not participate in the residency graduation or the annual hospital ball. What does this say about the department? Do you think the hospital will look fondly upon the residency program when its leader is remiss? Probably not. In this case, the chairperson and department will be much less likely to receive the resources they need from the hospital. It’s a “give and take” relationship. So, the chair must step up and set an excellent example for the residency and hospital.

Residency Advisor

We, as program directors, often need to get a feel for how the faculty will respond to a change before implementation. And residencies constantly need to institute new requirements. But will the faculty buy-in so we can implement the new development? A strong chairperson who knows his department well can ensure you can fulfill your change. Moreover, she can guide what works and what doesn’t. Without serving this role as a residency advisor, a program director will encounter many more pitfalls during his tenure!

The Chair As Leader

In any medical department, a chairperson plays a critical role in running the specialty service and ensuring the residency moves along smoothly. So, when you decide to look into a residency department, observe the chair. Does he participate in the interview process? Can you get a feel for how he behaves toward the department? All these factors will affect you long after the interview day. A chair reflects the face and culture of the department!