Diagnostic radiology is one of the
broadest specialties in medicine. It overlaps most all of the clinical
specialties of medicine. For an individual to practice radiology at the highest
level and act as a meaningful consultant to other specialties of medicine, it
is mandatory that she or he be well grounded in all aspects of medicine.
Radiology allows one to have a wide spectrum of patient contact, yet function
as a key consultant for all areas of medicine. The principle purpose of the
elective program is to allow individuals to determine their strengths and
weaknesses, and then to elect subjects to "round out" their
undergraduate medical education. Therefore, the choice of electives should
depend upon one's clinical experience to date. In general, electives found to
be valuable for an individual entering radiology would include: general
medicine, medicine subspecialties, general surgery, surgery subspecialties,
pediatrics and its subspecialties.
In considering a postgraduate program in diagnostic radiology, a number of factors should be considered:
A. Patient Material: A good variety of clinical material for radiological study is mandatory. There should be a minimum of 50,000 radiographic examinations per year and preferably this should exceed 100,000. Clinical material should encompass all branches of medicine. This means that a radiological program should be centered in a medical center with depths and strength in all clinical specialties.
B. Equipment: In radiology, we are more equipment oriented than most specialties of medicine. One should have the tools available to be able to technically perform radiographic examinations of the highest caliber.
C. House Staff: One learns a great deal from one's peers and the quality of the house staff currently in the program should be objectively considered. It is desirable that there is a "critical mass" of house officers in radiology. In general, a minimum of eight residents in a program is desirable.
D. Radiology Faculty: The quality of the program is greatly determined by the quality of the faculty in radiology. One must consider not only their qualifications, but also the goals of departments. Certain departments have as their primary goal, patient care; others research; and others, education. It is most desirable to train in the department in which the educational program in radiology is considered to be the highest priority. There should be a minimum of one faculty member for resident. As one examines the teaching philosophy of programs, two polarities may be evident. In certain residencies it is felt that the individual learns best by observing good radiological practice. She or he may work closely with the staff radiologist but may be given little responsibility. In other programs, the individual is given responsibility early in the program and enters in decision-making when appropriate. People learn in different ways; however, until an individual accepts certain responsibilities, his or her rate of development is prolonged.
E. Radiology Conferences:
Organized radiological conferences and didactic sessions are important in that
they emphasize the department's dedication to the teaching program. Facts and
clinical material are shared among the staff and residents. There should be a
minimum of one hour of conference per day.
F. University vs. Non-University: The vast majority of the most desirable postgraduate training programs in radiology are in university centers. There are many quality non-university affiliated programs. One should evaluate the program, be it "university or non-university" using the criteria mentioned above.
G. Type and Location of Practice Desired: There may be advantages to receiving one's postgraduate training in an area in which one may ultimately wish to practice. This allows individuals to become acquainted with practice situations in the region and become known to individuals seeking practice associates. However, practice opportunities are available to quality applicants of the best program no matter where their location and location of a residency usually does not affect ultimate practice location.
Radiology is a fascinating specialty in which to spend one's professional career. It is one of the most rapidly changing areas in medicine, with numerous technologic advancements each year. The graduate of a radiology residency has many career options, from the practice of general radiology to subspecialist practice.
Valerie P. Jackson, M.D.
John A. Campbell, Professor and Chairman of Radiology
Department of Radiology