Residency program directors agree: Medical students don't receive enough radiology training

Medical students today are largely unprepared for standard radiologic interpretation as interns, according to research published in Academic Radiology this month. That lack of knowledge could be costing U.S. healthcare.

“Medical imaging has become increasingly integral to the practice of medicine and, accordingly, increasingly emphasized in undergraduate medical education (UME),” corresponding author Patrick T. Schiller, BA, and colleagues said in the journal. “However, there are variations in how much is taught in medical school, ranging from no formal imaging education to required radiology clerkships.”

Though published guidelines for med school curricula exist, Schiller and co-authors wrote they’re often ignored, resulting in a massive variation of what is taught to medical students—and how—across the country. Past research has found graduate medical education trainees, med school deans and radiology chairs alike support a push toward more uniform imaging education, but the task has historically fallen on UME’s shoulders.

“It seems unlikely that current UME in the United States is sufficiently providing the imaging skills most useful for intern year,” the authors said. “In fact, a national study of interns recently reported a lack of confidence in a variety of important imaging skills, including determining normal from abnormal in basic imaging modalities, indications for various imaging tests and when to consult radiologists.”

Aiming to expand current research on the subject, Schiller and his team targeted program directors across pediatrics, internal medicine, obstetrics and gynecology and general surgery specialities, asking them via a survey to assess the actual and desired imaging skills of their incoming interns, those interns’ variability of skill levels and which imaging skills make the most successful hire.

Of 216 respondents returned the survey, the researchers said, everyone was in agreement on one subject: a perceived shortcoming relative to directors’ expectations for both image interpretation and utilization skills by interns. Participants also noted wide variability of imaging skill levels among interns, which they claimed was a hindrance to their programs.

Still, despite those deficiencies, just one-third of undergrad medical programs offer more than “some” of their program time to any kind of formal imaging instruction. 

“This supports the need for an overall increase in imaging education in medical schools, as well as improved methodologies and resources available in medical school curricula, in order to ensure greater penetration of and uniformity in UME imaging preparation,” the authors said.

Program directors also pointed out that communication skills were valued above just about everything else, Schiller and colleagues wrote—though all imaging skills listed in the survey were ranked as either “very important” or “absolutely essential” to the leaders. 

The gaps are obvious, the authors said, but with fewer than 200 medical schools in the country and more than 10,000 residency programs to prep for, it’s important to realize these intern shortcomings could stem from poor resource allocation. The more medical trainees who graduate undergrad with limited imaging skills, the more underqualified interns will be costing the field in unnecessary imaging exams.

“The current inadequacy of imaging instruction is a national, system-wide issue that will require a national, system-wide intervention,” Schiller et al. wrote. “The two main categories of system-wide approaches are to target either undergraduate or graduate medical imaging education.”

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After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.

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