An Untapped Resource

Next year, I will be beginning Radiology Residency at Western University. My decision to pursue radiology came rather late in medical school. Although we were introduced to the specialty in first year, our experience with the everyday functions of radiologists were minimal. It wasn’t until I decided to do a few electives that I truly understood radiology and made my decision. I enjoy radiology for three main reasons: the knowledge, the practicality and the academic nature, including research and teaching. While my electives confirmed my first two reasons, they fell rather short in supporting my third.

Radiology is a field with immense knowledge. To be a radiologist means to be a master of anatomy from head to toe and to know pathology of virtually every organ, in all ages and with the associated clinical presentations. Often, one has to even know the treatment options in order to guide the clinician or surgeon. The point is, will so much knowledge, one would think the specialty would be saturated with teaching, subsequently generating great interest among medical students. Sadly, as I learned, this is not the case.

Throughout my electives, I realized that given the heavy workloads in medical imaging, most radiologists hardly have time to teach residents, let alone medical students. Near the start, I often found myself being passed from staff to staff since they did not want the burden of teaching. When I did sit with a staff, often hours would pass by before a word was spoken to me. As I soon discovered, if I wanted to gain value out of my electives, I would need to be proactive, especially since my future depended on it. Therefore, I would use the first few days of my elective to seek out the keener teachers and then try to spend as much remaining time with them as possible. Although this system worked for me, I could see many issues with it. First, I potentially missed out on a lot of teaching opportunities with other “undiscovered” staff by working with a select few. Second, and more importantly, I only actively sought out my teaching because I wanted to pursue radiology. Many of my colleagues who were interested in other fields but chose a radiology elective did not make the effort and subsequently gained very little from the rotation. On the flip side, some students select radiology blocks precisely because they know there is very little responsibility and that preceptors don’t care if they show up or not. Given the importance of imaging currently, which will only grow in the future, there is a glaring deficiency with respect to radiology medical education at the medical school level.

Of course, as a future student of radiology, I cannot simply blame everything on radiologists. There are legitimate barriers to teaching from their perspective. As I experienced, radiologists often have work lists with studies in the hundreds. The faster they work, the quicker patients get their results and the more efficient the health care system runs. At the same time, there is only a finite amount of time during medical school and sometimes there is resistance from other departments in implementing radiology education. Despite these barriers, it is imperative that all schools engage in effective education surrounding medical imaging. Radiology departments often argue that it is unnecessary to generate interest because there is an abundant number of applicants each year anyways. However, evidence both scientific and anecdotal shows that students are still choosing radiology as a specialty because of income and lifestyle considerations rather than genuine interest. Casting moral judgement aside, radiology residencies undoubtedly want the best and most devoted students. Arguably even more important, teaching radiology to non-radiology-bound students can have a profound effect on the health care system. Radiologists often complain when imaging requisitions are filled out poorly or not enough clinical information is given. Considering that many community physicians have very little imaging knowledge, this shouldn’t be surprising. Clarifying requisitions and revising incorrect studies represents a huge inefficiency and often introduces unnecessary radiation.

The points I mention above and many others represent my motivation in learning about medical education. I think there is a great academic potential in radiology and it is a shame that departments are resistant to exploring it. My dream is to develop a radiology curriculum that exposes the field to 1^st year medical students in a practical and realistic way through effective didactic and socractic teaching. My goal is to introduce radiology both conceptually and practically to attract genuinely interested students and to instill important radiological concepts to all students. I guess you could say enrolling in this selective was my first step. 

-DW