Wanted: Radiology Resident Leaders

CHICAGO - With challenges looming on nearly every front, radiology needs a new group of strong leaders to navigate the trials and strengthen the profession, industry experts said at this year’s RSNA annual meeting.

Given proper leadership training, current radiology residents are positioned to be the profession’s next generation of leaders. But their training - if not already underway - must begin now if they’re going to fill the current void in the industry, said Richard Gunderman, MD, professor and vice chair of radiology at the University of Indiana.

“There are lots of radiology departments in the United States that lack leadership. Many have titular leaders, but in fact, they’re not being led or they’re being led poorly,” he said. “A lot of capability of the faculty and resident is lying dormant, and people are becoming more disengaged and discouraged than invigorated and encouraged.”

He recommended that faculty engrain in their residents the importance of team work - group accomplishment over individual successes - and embrace a leadership model that encourages others to work to their potential and contribute to either their practice or department.

It’s also paramount, he said, to encourage residents to think creatively so they will be best prepared to tackle future roadblocks.

“The single most important aspect of our residents isn’t their technical skills or their cognitive knowledge base. It’s their imagination,” Gunderman said. “What are we doing to foster the development of imagination in this next generation of radiologists?”

And, that creativity and outside-the-box thinking will be vital to addressing the difficulties the industry already knows are coming. Declining reimbursement, a new payment model, decreasing case volume, and encroaching teleradiology companies are just a few of the changes that threaten to erode the influence radiology departments and practices currently enjoy, said Vijay Rao, MD, chair of radiology at Jefferson Medical College at Thomas Jefferson University.

Surviving these trials requires a cultural shift in priorities that must start with residents, she said. Rather than perpetuate the culture of entitlement that is pervasive in many corners of radiology, faculty and private practitioners should teach residents to focus on quality and putting the patient first.

“We need to cultivate professionalism and eradicate apathy in the profession,” she said. “We must focus on reducing or eliminating inappropriate studies and doing the right thing by the patient.”

Focusing on quality can be overwhelming, but Rao recommended choosing five or six of the more than 300 quality metrics in radiology and dispatching your residents to work on these topics within your institution. Many will likely jump at the opportunity because a quality-focused project will fulfill their project requirement for the Accreditation Council for Graduate Medical Education.

In fact, according to Richard Sharpe, MD, MBA, a Jefferson Medical College radiology resident, several of his resident colleagues have implemented successful programs that have produced quantifiable quality improvements. For example, one resident recognized the board exams were changing, so he solicited input from his 40 colleagues about what curricular changes they felt would best help them prepare for the revamped test. He presented the organized data to the program director and the chief resident, and those curricular changes were implemented.

Another resident developed open-source software that helps radiologists and other clinicians track a patient’s exposure to radiation.

The most important aspect of these projects - and one of the most critical characteristics of a leader - is a resident’s willingness to dive into the profession and take risks, Sharpe said.

“Don’t think of yourself as a student. Consider yourself a physician. Ask questions, find answers, gather data, dedicate your research time to focus on projects, and apply for research grants,” he said. “And, always be sure you’re building relationships with stakeholders. Remember that those non-radiology residents will be the leaders of the future in another specialty. If you get to know them now, you can foster a mutual respect rather than the antagonism that is too often the default.”