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The Juggle Is Real: Balancing Teaching and Clinical Productivity 平衡教学和临床生产力是真实的。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.12.010
Angela I. Choe MD , Anna Rozenshtein MD, MPH , Lori Deitte MD , Judy Yee MD , Ryan K. Lee MD, MBA , Alison Chetlen DO
Resident education is a cornerstone of academic medicine. However, increasing pressures to generate revenue through clinical productivity metrics like relative value units have introduced complex tensions between education and clinical service. Balancing teaching with relative value unit generation is a common and complex challenge in academic radiology. It requires a strategic approach that addresses both the need for high-quality resident training and the economic pressures of clinical practice. In this article, we discuss practical strategies to achieve balance between resident education and revenue production, including developing academic compensation models and identifying innovative teaching methods.
住院医师教育是学术医学的基石。然而,通过相对价值单位等临床生产力指标创造收入的压力越来越大,这在教育和临床服务之间引发了复杂的紧张关系。平衡教学与相对价值单位的产生是放射学学术中常见而复杂的挑战。它需要一种战略方法来解决对高质量住院医师培训的需求和临床实践的经济压力。在本文中,我们讨论了实现居民教育与财政收入平衡的可行策略,包括制定学术补偿模式和确定创新的教学方法。
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引用次数: 0
The Future of Radiology Residency Training 放射学住院医师培训的未来。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.08.009
Eric England MD , Carolyn C. Meltzer MD , Alexa O. Levey MD , Greg Zaharchuk MD, PhD , Judith A. Gadde DO, MBA
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引用次数: 0
Educational Debt Among US Medical Graduates Entering Radiology 美国医学毕业生进入放射学的教育债务。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.08.011
Pavan Khosla BA , Dheeman Futela MBBS , Seyedmehdi Payabvash MD , John E. Jordan MD, MPP , David Seidenwurm MD , Dheeraj Gandhi MD , Ajay Malhotra MD, MMM

Objective

The aim of this study was to identify trends in medical educational debt for US medical school graduates pursuing radiology and examine associations with socio-economic factors.

Materials and methods

Data were obtained from the Association of American Medical Colleges Graduation and Matriculating Student Questionnaires to identify self-reported medical educational debt for graduates pursuing radiology training. The proportion of medical graduates with debt in radiology were compared with those in other medical specialties. Trends in medical educational debt (inflation adjusted to 2024 US dollars) were calculated from 2015 to 2024. Descriptive statistics were used to assess characteristics associated with debt. Debt-to-income ratios were calculated using compensation data from Association of American Medical Colleges and Medical Group Management Association data.

Results

There were 162,081 responses from US medical graduates recorded from 2015 to 2024, of which 6,477 planned on radiology training. The percentage of students pursuing radiology with medical educational debt decreased from 76.5% in 2015 to 64.6% in 2024. The median medical educational debt increased from $237,600 in 2015 to $248,000 in 2018 and has been decreasing since, to $200,000 in 2024. Higher likelihood of debt was reported by graduates from self-identified race and ethnicity groups who are underrepresented in medicine (URiM) (odds ratio 1.74, 95% confidence interval 1.48-2.06), but with a lower total debt (median $208,530; interquartile range $133,915-$280,810) when compared with graduates not self-identifying as URiM ($226,600; interquartile range $153,400-$298,388; P = .004). In 2015, 25.8% of indebted radiology-bound graduates indicated plans to use Public Service Loan Forgiveness, which increased to 44.9% in 2024 (P < .001). In 2023, the median debt for radiology graduates represented between 35% and 45% of total annual compensation.

Discussion

Although the debt burden and the proportion of radiology-bound graduates with medical educational debt declined from 2015 to 2024, interest in Public Service Loan Forgiveness nearly doubled. Graduates from lower-income families and those of URiM racial or ethnic groups had a higher likelihood of debt burden.
目的:本研究的目的是确定美国医学院攻读放射学的毕业生的医学教育债务趋势,并研究其与社会经济因素的关系。材料和方法:从美国医学院协会(AAMC)毕业问卷(GQ)和入学学生问卷(MSQ)中获取数据,以确定从事放射学培训的毕业生自我报告的医学教育债务。比较了放射医学毕业生与其他医学专业毕业生的负债比例。计算2015年至2024年医学教育债务趋势(通货膨胀调整为2024美元)。描述性统计用于评估与债务相关的特征。债务收入比的计算采用AAMC的薪酬数据和医疗集团管理协会(MGMA)的数据。结果:2015 - 2024年,美国医学毕业生共收到162081份反馈,其中6477人计划接受放射学培训。有医学教育债务的放射学学生比例从2015年的76.5%下降到2024年的64.6%。医学教育债务中位数从2015年的23.76万美元增加到2018年的24.8万美元,此后一直在下降,到2024年降至20万美元。来自自我认同的种族和族裔群体的毕业生在医学(URiM)中代表性不足(OR 1.74, 95% CI 1.48-2.06),但与不自我认同为URiM的毕业生相比,负债者的总债务(中位数为208,530美元[IQR $133,915 - 280,810美元])较低(226,600美元[IQR $153,400 - 298,388美元]);P = 0.004)。2015年,25.8%的负债放射科毕业生表示计划使用公共服务贷款减免(PSLF),这一比例在2024年增加到44.9% (P < 0.001)。到2023年,放射学毕业生的债务中位数占总年薪的35%至45%。讨论:尽管从2015年到2024年,债务负担和有医学教育债务的放射科毕业生比例有所下降,但对PSLF的兴趣几乎翻了一番。来自低收入家庭和非民族/族裔群体的毕业生有较高的债务负担可能性。总结句:从2015年到2024年,美国放射科医学毕业生的医学教育债务总体下降,但来自代表性不足和低收入背景的学生的债务仍然不成比例地增加,对公共服务贷款减免的兴趣几乎翻了一番。要点(3-6):•放射科医学毕业生的医学教育债务患病率下降,从2015年的76.5%下降到2024年的64.6%。•负债的放射科毕业生的教育债务中位数从2015年的237,600美元上升到2018年的248,000美元,上升4.4%,然后在2024年下降19.4%至20万美元(经通胀调整的2024美元)。•2024年,与麻醉、急诊医学和家庭医学专业的毕业生相比,放射学专业的毕业生比例更低,债务中位数也更低;但比皮肤科和眼科都高。•社会人口债务差距持续存在,与同龄人相比,老年人、男性和非裔美国人更有可能负债。然而,在负债的个人中,与非乌尔姆大学的同龄人相比,乌尔姆大学毕业生的债务中位数较低。•负债的放射科毕业生对公共服务贷款减免(PSLF)的兴趣大幅增加,从2015年的25.8%上升到2024年的44.9%。•父母收入和项目类型强烈影响债务负担,来自高收入家庭的放射科毕业生和许多双学位或加速项目的毕业生的债务几率和金额显著降低。
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引用次数: 0
Clarification on the Methodology for Identifying Practicing Interventional Radiologists and Calculating Work Relative Value Units 关于认定执业介入放射科医师及计算工作rvu方法的澄清。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.07.035
Ammar Sarwar MD, Zohaa Faiz MD, Julie Bulman MD
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引用次数: 0
Radiologists’ Perceptions of the 21st Century Cures Act 放射科医生对21世纪治愈法案的看法。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.09.025
Jessica H. Porembka MD , Emily L. Paton MD , Yin Xi PhD , Ruth C. Carlos MD, MS , Sheena Bhalla MD , Jeremy P. Cetnar MD, MSHPR , Sukh Makhnoon PhD, MS , Arun Krishnaraj MD, MPH , Eric M. Rubin MD , David E. Gerber MD
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引用次数: 0
The Academic Mission Starts, or Ends, at the Top 学术使命从高层开始,也从高层结束。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.09.028
Elliot K. Fishman MD , Daniel J. Lee MD , Linda C. Chu MD , Steven P. Rowe MD, PhD
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引用次数: 0
Preoperative Breast MRI for Extent-of-Disease Evaluation Following New Breast Cancer Diagnosis: A Retrospective Cohort Study 新的乳腺癌诊断后术前乳房MRI评估疾病范围:一项回顾性队列研究。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.10.001
Chi Trinh MD , Victoria Shi BA , Tiffany Pham BS , Skylar Mackay BS, BA , Alexandra J. Davis BS , Eniola T. Oluyemi MD , Emily B. Ambinder MD

Purpose

Despite potential benefits for surgical planning, prior studies have demonstrated disparities in the use of preoperative breast MRI, raising concerns about equitable access to this imaging tool. In this study, the authors assessed how the rates of preoperative breast MRI use vary by patient sociodemographic and clinical factors and evaluated MRI benefits in this context.

Methods

This was a retrospective cohort studying including all patients who underwent breast surgery after a new breast cancer diagnosis at a tertiary care multisite academic institution between July 1, 2016, and December 31, 2022 (n = 1,792). Patient characteristics were compared between the patients who did (n = 992) and did not (n = 800) undergo MRI for disease extent evaluation using the χ2 test.

Results

MRI examinations were completed more frequently in patients 50 years or younger and those 51 to 70 years of age compared with those older than 70 years (77% and 50% vs 25%, P < .001) and in those of white and other races than those of black race (55% and 62% vs 44%, P < .001). The rate of MRI increased with increasing breast density (P < .001) and higher tumor stage (P < .001). It was also influenced by receptor status and histology, with the highest utilization in patients with Her2+ enriched disease (P < .001) and those with invasive lobular carcinoma (P < .001). Among patients who underwent preoperative MRI, 51.5% were found to have additional suspicious lesions, and 69.1% of these patients underwent image-guided biopsy (26.6% malignant, 16.6% high risk). Patients who underwent preoperative MRI underwent mastectomy more commonly than those who did not (49% vs 31%, P < .001) but were significantly less likely to require reexcision (8% vs 14%, P < .001).

Conclusions

The present results suggest that preoperative MRI improves surgical planning by detecting additional lesions and decreasing the need for reexcision but is also associated with higher mastectomy rates. Utilization varied significantly by age, race, tumor features, and breast density, highlighting sociodemographic and clinical disparities. These findings underscore the need for targeted efforts to ensure equitable access and to develop guidelines.
目的:尽管对手术计划有潜在的好处,但先前的研究表明,术前乳房MRI的使用存在差异,这引起了人们对公平使用这种成像工具的关注。在这项研究中,我们评估了术前乳房MRI使用率如何随患者社会人口统计学和临床因素而变化,并在此背景下评估MRI的益处。方法:这是一项回顾性队列研究,包括2016年7月1日至2022年12月31日期间在三级医疗多中心学术机构新诊断为乳腺癌后接受乳房手术的所有患者(n=1792)。采用卡方检验比较进行MRI检查(n=992)和未进行MRI检查(n=800)的患者的特征。结果:与70岁以上的患者相比,50岁或以下的患者和51-70岁的患者完成MRI的频率更高(77%和50% vs. 25%)。讨论:我们的结果表明,术前MRI通过检测额外病变和减少再次切除的需要来改善手术计划,但也与更高的乳房切除术率相关。根据年龄、种族、肿瘤特征和乳腺密度的不同,使用情况有显著差异,突出了社会人口统计学和临床差异。这些调查结果强调需要有针对性地努力确保公平获取和制定指导方针。
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引用次数: 0
Recent Trends in Diagnostic Radiology Application and Match Rates 放射诊断应用及配准率的最新趋势。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.09.033
Dheeman Futela MBBS , Sachi Malhotra , Seyedmehdi Payabvash MD , Dhairya A. Lakhani MD , Dheeraj Gandhi MD , Achala Vagal MD, MS , Max Wintermark MD, MBA , Ajay Malhotra MD, MMM

Objective

We aimed to assess recent trends in diagnostic radiology residency positions, rates of applications per applicant, application burden for programs, match probability rates, and impact of preference signaling on the match process.

Methods

The Electronic Residency Application Service (ERAS) national applicant statistics from 2020 to 2025 were used to collect the total number of applicants to diagnostic radiology programs, along with the average applications submitted per applicant and average application count received per program. The biennial National Resident matching Program “Charting Outcomes in the Match” report was used to collect total positions offered in the match, number of applicants who participated in the match with diagnostic radiology as the preferred specialty (active match applicants), number of matched and unmatched applicants, and mean number of contiguous ranks by matched and unmatched applicants.

Results

Between 2020 and 2025, the total number of ERAS applicants who applied to diagnostic radiology programs increased by 9.4% and the number of positions offered in the match increased by 11.3%. The proportion of US MDs out of all ERAS applicants increased from 56.3% (1,068 of 1,897) in 2020 to 59.2% (1,230 of 2,076) in 2025. The average applications submitted per applicant increased by 30.4%, and the average number of applications received per program increased by 65.8% between 2020 and 2023. Match year 2022 had the greatest value of mean contiguous ranks (14.9), observed magic number (13.2), and normalized magic number (12.2). The number of applications per applicant, applications received by programs, number of interviews, and contiguous ranks have all decreased with the introduction of preference signaling since 2023.

Discussion

Our study results show that there was a significant increase in average applications submitted in the past 5 years, especially between 2018 and 2023. Introduction of preference signaling and geographic preferences in the ERAS application process has achieved the desired effect of reducing congestion given the high volume of applications and interviews. Match competitiveness increased sharply between 2016 and 2018 with no subsequent consistent trend.
目的:我们旨在评估诊断放射学住院医师职位的最新趋势,每个申请人的申请率,项目的申请负担,匹配概率率和偏好信号对匹配过程的影响。方法:采用ERAS 2020 - 2025年全国申请人数统计数据,收集诊断放射学专业申请总人数,以及每个申请人提交的平均申请人数和每个专业收到的平均申请人数。两年一次的NRMP“配对结果图表”报告,用以收集在配对中提供的职位总数、以放射诊断学为首选专业参加配对的申请人人数、(积极配对申请人)、配对及未配对申请人人数,以及配对及未配对申请人的平均连续职级数。结果:从2020年到2025年,申请DR项目的ERAS申请人总数增加了9.4%,而匹配的职位数量增加了11.3%。在所有ERAS申请人中,美国md的比例从2020年的56.3%(1068/1897)增加到2025年的59.2%(1230/2076)。2020年至2023年间,每位申请人提交的平均申请数量增长了30.4%,每个项目收到的平均申请数量增长了65.8%。2022年的平均连续排名(14.9)、观测幻数(13.2)和标准化幻数(12.2)的值最大。自2023年以来,随着偏好信号的引入,每位申请人的申请数量、项目收到的申请数量、面试次数和连续排名都有所下降。讨论:我们的研究结果表明,过去5年,特别是2018年至2023年期间,平均申请数量显著增加。在ERAS申请过程中引入偏好信号和地理偏好,在大量申请和面试的情况下,达到了减少拥堵的预期效果。比赛竞争力在2016-2018年间急剧上升,但随后没有持续的趋势。
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引用次数: 0
Re: “The Changing Landscape of Interventional Radiology: Growth in Nonprocedural Services and Market Dynamics” 回复:Hussain等人的《介入放射学的变化:非程序性服务和市场动态的增长》。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.06.042
Luke R. Wilkins MD, C. Matthew Hawkins MD, Raymond Liu MD, Elizabeth Y. Rula PhD, Robert Lookstein MD
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引用次数: 0
Transforming Health Care Value at the Intersection of Technology, Data Science, and Patient Care 在技术、数据科学和患者护理的交叉点转变医疗保健价值。
IF 5.1 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.07.015
Kurt Herzer MD, PhD, MID , Elliot K. Fishman MD , Linda C. Chu MD , Steven P. Rowe MD, PhD , Charles K. Crawford BS
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引用次数: 0
期刊
Journal of the American College of Radiology
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