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Students' misperceptions about what radiologists actually do should be changed

An article which appeared in the August issue of RSNA News analyses various factors that attracts medical students to the Radiology speciality. Radiology professors believes that improving perceptions of the students and increasing early efforts to expose medical students to radiology could help counteract recent waning interest in the specialty. While radiology remains in the top 10 specialty choices, it has fallen from number five in 2007 to number eight in 2009, according to the National Residency Matching Program. The private, nonprofit corporation's 2009 report includes nearly 37,000 applicants and 4,000 graduate programs.

"Some of the shift has to do with students' misperceptions about what radiologists actually do and the central role that we often play in patient care," said David M. Hovsepian, M.D., a professor of radiology at Stanford University Medical Center and vice-chair of the RSNA News Editorial Board. "We can't expect them to choose a career in radiology if we don't make this clear to them from the very start of their training." According to Dr. Hovsepian, the ebb is partly due to limited federal funding for postgraduate medical education which pays for training up to five years, discouraging potential applicants who might discover radiology while training in other programs. "It used to be that you could complete a residency in medicine, for instance, and then do radiology and the government would keep paying for your training," Dr. Hovsepian said. "Now you have to choose your career path to do radiology specifically. From the standpoint of maintaining robust programs, we lose some vitality as well, since our residents now come from a less diverse pool as a result of that limitation." he added.

Terry Desser, M.D., residency program director of Stanford's radiology department says "It is, in fact, the perception of a better lifestyle that keeps radiology among the top specialties." "They're looking for what's going to be intellectually stimulating, emotionally fulfilling and lucrative," Dr. Desser said. "Many students seem to be starting families at an earlier age and they all have massive amounts of debt, so they make a very practical calculation. They look at the income potential and lifestyle and radiology winds up pretty high on their list."

Drs. Hovsepian and Desser agree that subspecialization adds credibility to a radiologist's work, but expressed concern about the impact on appeal to students. "Training in radiology can't be lengthened in perpetuity," said Dr. Desser. "We're competing with specialties where the entire length of training is three years." Another concern, Dr. Desser expressed is the compartmentalizing of emerging radiologists. Medical students often say they are attracted to radiology because of the broad knowledge base required to interact with multiple specialties, she said. "If radiologists are seen as pigeonholed and subspecialized, then that appeal potentially goes away."

Aaron Eifler, a second-year student at Northwestern University's Feinberg School of Medicine in Chicago, attributes his current career path to his mentors' guidance. Eifler's work in interventional radiology, investigating a novel treatment for pancreatic cancer that combines intraarterial catheter-targeted delivery, MR perfusion monitoring and a functionalized gold nanoparticle, earned him a 2009–10 Howard Hughes Medical Institute Research Training Fellowship. "Awareness of prestigious research opportunities like this might help induce more medical students to consider this path," said Reed A. Omary, M.D., M.S., vice-chair of research for radiology at Northwestern and an RSNA Research & Education (R&E) Foundation grant recipient who has mentored Eifler since the student's undergraduate years.

Dr. Desser says that radiologists face an uphill battle in getting face time in the medical student curriculum, but the fight is worth the effort. "We need to be the ones teaching them anatomy and about imaging and the manifestations of pathophysiology on imaging early in their training, so they recognize what we do and what we contribute." she said.

Radiologists are more than familiar with the stereotypes surrounding their specialty. David Wen, a student finishing his first year at the University of Minnesota Medical School in Minneapolis, admits much of his knowledge of radiology stems from rumor.

For radiologists who want to survive in a competitive market, the days of "easy hours" are over, said David M. Hovsepian, M.D., a professor of radiology at Stanford University Medical Center and vice-chair of the RSNA News Editorial Board. "You can't sit there waiting for the phone to ring," said Dr. Hovsepian. "Somebody's going to outsource you to another specialty or will quickly move in to fill the gap."

Naturally, radiology's allure also depends on the current job market. "If there's worry that those jobs are going to disappear, the turnaround is pretty quick in terms of drop-off applications and people leaving the specialty," Dr. Desser said. "We saw this in the 1990s during the Clinton healthcare reform. It'll be interesting to see how specialty choices play out next year vis-à-vis the Obama healthcare changes."Desser added.

Source: RSNA

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