The interventional radiology residency: gaining medical student perspective using a survey tool

Recent media articles have stirred controversy over anecdotal reports of medical students practising educational pelvic examinations on women under anaesthesia without explicit consent. The understandable public outrage that followed merits a substantive response from the medical community. As medical students, we offer a unique perspective on consent for trainee involvement informed by the transitional stage we occupy between patient and physician. We start by contextualising the role of educational pelvic examinations under anaesthesia (EUAs) within general clinical skill development in medical education. Then we analyse two main barriers to achieving explicit consent for educational pelvic EUAs: ambiguity within professional guidelines on how to operationalize ‘explicit consent’ and divergent patient and physician perspectives on harm which prevent physicians from understanding what a reasonable patient would want to know before a procedure. To overcome these barriers, we advocate for more research on patient perspectives to empower the reasonable patient standard. Next, we call for minimum disclosure standards informed by this research and created in conjunction with students, physicians and patients to improve the informed consent process and relieve medical student moral injury caused by performing ‘unconsented’ educational pelvic exams.

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Expanded Scope of Practice Fellowships for Radiologists: a Survey of Interest Amongst Current Canadian Radiology Residents

10.1101/626770 ◽

2019 ◽

Author(s):

Joseph J Barfett ◽

Errol Colak ◽

Christopher U Smith ◽

Paraskevi Vlachou ◽

Aren Mnatzakanian ◽

...

Keyword(s):

Emergency Medicine ◽

Interventional Radiology ◽

Sports Medicine ◽

Patient Management ◽

Fellowship Training ◽

Scope Of Practice ◽

Vascular Medicine ◽

Radiology Residency ◽

Radiology Residents ◽

Direct Management

AbstractRationale and ObjectivesRadiology residents acquire a diverse educational experience and skill set, including a general internship year, which may enable the direct management of patients. In order for radiology residents to define new scopes of practice, however, additional fellowship training may in certain instances be warranted.Materials and MethodsUsing the Canadian family medicine Enhanced Skills Program as a model, we conducted a Canada-wide survey of radiology residents to assess interest in additional fellowship training to expand their scope of practice.ResultsOur results indicate that a majority of residents (69.2%) would like to routinely see patients in clinic and more than half (52%) are willing to undergo an additional year of fellowship to enhance their skill set. The most popular choices for such fellowships were sports medicine (22.8%), emergency medicine (19.6%) and vascular medicine (18.5%). In addition, a majority (52.9%) of residents felt capable of offering incidentaloma clinics without additional training beyond their core radiology residency.ConclusionTraditional diagnostic and interventional radiology fellowships must be reconsidered to reflect the interests and capabilities of modern radiology trainees. Expansion of training options into the domain of direct patient management will likely prove popular among current residents.

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