Current Problems in Diagnostic Radiology最新文献

This article is about two highly diverse radiologists, who fortuitously came together by working as Career and Professional Advisors in the Student Affairs Department of a U.S. medical school. This job opportunity offered each radiologist, albeit for markedly different reasons, a means to transition from full-time Radiology to the opportune world of medical school education. The focus of this paper will be on Career and Professional Advising, while also highlighting the many opportunities for radiologists in current medical school education.

Introduction

Medical imaging has undergone significant technical advancements in recent years, posing a considerable challenge for radiologists to stay up-to-date with emerging modalities and their applications in daily practice. This challenge is even more daunting in developing countries with limited resources compared to the US and other developed nations with greater economic assets. The collaboration between the United States and other advanced nations with radiological institutions in Latin America has been a significant achievement in the pursuit of new opportunities for continuous medical education. The aim of this study was to evaluate the effectiveness of international collaborations among Spanish-speaking Latin American institutions and radiologists through a survey.

Materials and Methods

A group of radiologists and institutions from various countries, including the USA, Spain, and Argentina, who have been working together for several years to improve Radiology education across Latin America, were selected. An online survey was conducted. The survey included questions about interest in the activities, participation, and impact of radiologic education during these educational efforts.

Results

The survey received responses from 166 participants, all of whom reported knowledge of at least one type of educational activity. The most well-known activity was ALAT Webinars. The primary motivators for participation were the quality of the content and the opportunity to learn new information. Additionally, improving local education in radiology and receiving expert advice on radiology issues were identified as priorities for participation in international collaborations. The Cronbach alpha coefficient was calculated for individual and global Likert questions, resulting in a global score of 0.96.

Conclusion

The study confirms the significance of a multifaceted approach to address gaps in radiology education. While traditional models have relied on hosting international visitors or sending US teachers abroad, the results suggest that using a variety of methods will have a greater impact than relying on a single technique for those who benefit most from collaborative efforts.

The Anti-Kickback Statute was passed by Congress in the 1970s to reduce the overuse of government-reimbursed medical services. It attempts to eliminate fraud, abuse, and waste of medical services by outlawing the incentive of personal gain when referring patients for government-funded services. Although safe harbors were written into the law to maintain transactions beneficial to society, they require strict adherence. Anti-Kickback Statute violations are subject to the whistleblower provision of the False Claims Act, and violations can yield significant civil and criminal penalties.

Radiology and pathology, though distinct fields within medical education, share a common foundation in their essential roles for accurate diagnosis and understanding of diseases. While pathology, particularly histopathology, has long been integrated into preclinical medical education in the United States, radiology education has traditionally been less emphasized. This paper examines the historical development of histopathology training in medical education and its central role, contrasting it with the comparatively peripheral position of radiology education. We explore the historical context of medical education in the United States, tracing the integration of histopathology following the Flexner Report of 1910. In contrast, radiology, emerging later as a specialized field, has faced challenges in achieving comparable integration into medical curricula. Despite the increasing importance of medical imaging in diagnosis and treatment, radiology education remains variable and often lacking in standardization across medical schools. We highlight the need for greater emphasis on radiology education to better prepare medical students for modern clinical practice, where medical imaging plays an increasingly pivotal role. A call for a comprehensive assessment of radiology education and advocacy for its integration into preclinical curricula is made, emphasizing the importance of collaboration between the radiology profession and accrediting bodies to ensure competence in imaging across medical specialties. As medical imaging continues to advance and become more integral to healthcare, it is imperative that medical education reflects this evolution by establishing radiology as a fundamental component of preclinical training.

Purpose

The ultrasound specialists face a substantial issue with work-related musculoskeletal disorders (WMSDs), characterized by occupation-related pain, reaching an estimated frequency of up to 90.5%. The type and location of pain vary depending on the sonographers specialty and the specific anatomical areas being examined. Our study aimed to assess the prevalence and intensity of pain among Polish doctors from various specialties conducting ultrasound examinations.

Materials and methods

The study has been performed between July and December 2023, involving 90 participants (51.9% women) actively practicing ultrasound diagnostics. The data collection process utilized a structured questionnaire developed by the researchers for this study. The questionnaire covered personal factors, including gender and age, and work-related aspects like workplace, specialty, sonography experience, and the types of examinations conducted. Statistical analysis involved both descriptive statistics and correlation analysis.

Results

The age distribution ranged from 26 to 74 years, with mean (SD) of 43.1 (12.2) years. The leading specialties among physicians were radiology (22.2%) and internal medicine (22.2%). Among all physicians, 65.6% reported pain during or after ultrasound scans, with a mean (SD) pain intensity of 6.17 (2) in a 1–10 scale. The analysis indicated no correlation between age and gender and the occurrence of discomfort.

Conclusions

WMSDs pose a significant risk to Polish sonographers, especially those specializing in vascular surgery, general surgery and obstetrics and gynecology specialties. The study underscores a notable deficit, with only 10% of the personnel reporting training in ergonomics for ultrasound work.

Interventional radiology is a new medical specialty that recently created an integrated residency. This study serves a comprehensive review of literature discussing the challenges that medical students encounter in light of this new pathway, with a specific emphasis on the virtual application process. An analysis of 24 articles revealed that exposure to interventional radiology in medical school is lacking, with a limited pool of diverse mentors in the field. Moreover, medical school advising to students applying to interventional radiology may be inadequate. Although initiatives have been successful in increasing exposure, and there is encouraging data on diversity in the field at the trainee level since the start of the integrated residency, addressing the needs of medical students and focusing on the gaps in mentorship, advising, and curriculum is crucial for the success of applicants and overall specialty recruitment. The virtual process has provided on average $6008 of savings for applicants.

Rationale and objectives

Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents’ perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them.

Material and methods

Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous.

Results

Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome.

Conclusion

Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes.

Primary adrenal lymphoma (PAL) is a particularly rare subset of malignant adrenal neoplasms, accounting for ∼1% of all non-Hodgkin's lymphomas. Reported outcomes of PAL, though limited, are dismal, with a 12-month survival rate of ∼20%. PAL is treated with polychemotherapy and early tissue diagnosis to allow initiation of chemotherapy is associated with improved outcomes. Early and accurate radiological diagnosis of PAL is therefore essential in improving outcomes through informing decisions to biopsy and thereby facilitating timely initiation of chemotherapy. To date, however, imaging features of PAL have not been conclusively defined, and a range of divergent imaging appearances have been reported. Cinematic rendering (CR) is a 3D post-processing technique that simulates the propagation and interaction of photons as they pass through the imaged volume. This results in the generation of more photorealistic images that may allow for more comprehensive visualization, description and interpretation of anatomical structures. This manuscript presents the first characterization of the various CR appearances of PAL in the reported literature and provides commentary on the clinical opportunities afforded by CR in the workup of these heterogenous tumors.

Gap years taken between undergraduate completion and entrance into medical school have become increasingly popular. We examine the role of gap years among college graduates interested in medicine and how they might contribute to academic research productivity within clinical environments. Recently, academic faculty have struggled to balance increasing clinical responsibilities with their scholarly endeavors. Academic medical departments may have incentives to hire pre-medical students to help ease the research burden on faculty. Properly motivated pre-medical students may view research positions in academic medical departments as ideal opportunities to learn in areas that will broaden their scientific knowledge and help prepare them for medical school, while greatly enhancing their medical school applications through distinguishing themselves as co-authors published in medical journals. Our experience, with two co-authors working as research associates while preparing for their medical school applications and careers, suggests that pre-medical students can strengthen their medical school applications during their gap year(s) while proving instrumental in enhancing research output thus alleviating the workload of clinical faculty.

An ongoing challenge in academic radiology is balancing the need to read the scans and generate relative value units (RVUs) with the need to ensure academic leadership and the consistent production of impactful publications. Indeed, the tripartite mission of academic radiology (i.e. clinical care, research, and teaching) does not lend itself to obvious answers in an era when institutions and departments are increasingly focused on RVU generation. Even the minority of radiologists who are interested in pursuing the academic mission and accept academic jobs are likely to find their time increasingly squeezed by massive volumes of scans to read and the priority placed on RVU generation. There are often no incentives for impactful academic work, leading to a decreasing relative number of manuscript submissions from U.S.-based researchers. With the lack of external incentivization for publication, writing and publishing papers must instead be driven by intrinsic enjoyment and a sense of accomplishment. The ability to think of an idea, to get a group of co-authors together, to acquire the data and/or put together the idea into a form that is ready for final publication, and to see that process through to the end is rewarded only by personal satisfaction. Perhaps, in the era of RVU generation, publishing papers in a form of defiance of a system that is hampering the academic mission.