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

2019 ◽  
Author(s):  
Joseph J Barfett ◽  
Errol Colak ◽  
Christopher U Smith ◽  
Paraskevi Vlachou ◽  
Aren Mnatzakanian ◽  
...  

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.

2016 ◽  
Vol 67 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Philip S. Mok ◽  
Linda Probyn ◽  
Karen Finlay

Purpose The study aimed to examine the postresidency plans of Canadian radiology residents and factors influencing their fellowship choices and practice preferences, including interest in teaching and research. Methods Institutional ethics approval was obtained at McMaster University. Electronic surveys were sent to second to fifth-year residents at all 16 radiology residency programs across Canada. Each survey assessed factors influencing fellowship choices and practice preferences. Results A total of 103 (31%) Canadian radiology residents responded to the online survey. Over 89% from English-speaking programs intended to pursue fellowship training compared to 55% of residents from French-speaking programs. The most important factors influencing residents' decision to pursue fellowship training were enhanced employability (46%) and personal interest (47%). Top fellowship choices were musculoskeletal imaging (19%), body imaging (17%), vascular or interventional (14%), neuroradiology (8%), and women's imaging (7%). Respondents received the majority of their fellowship information from peers (68%), staff radiologists (61%), and university websites (58%). Approximately 59% planned on practicing at academic institutions and stated that lifestyle (43%), job prospects (29%), and teaching opportunities (27%) were the most important factors influencing their decisions. A total of 89% were interested in teaching but only 46% were interested in incorporating research into their future practice. Conclusions The majority of radiology residents plan on pursuing fellowship training and often receive their fellowship information from informal sources such as peers and staff radiologists. Fellowship directors can incorporate recruitment strategies such as mentorship programs and improving program websites. There is a need to increase resident participation in research to advance the future of radiology.


Author(s):  
Daisy Fancourt

Emergency medicine involves the care of patients who require immediate medical attention. The specialty encompasses a broad range of medical disciplines, including anaesthesia, cardiology (a field related to the heart), neurology (a field related to the brain), plastic surgery, orthopaedic surgery (surgery relating to the bones or muscles), and cardiothoracic surgery (surgery relating to the heart, chest, or lungs). There are also a number of subspecialties including extreme environment medicine, disaster medicine and sports medicine. Related to emergency medicine is the specialty of critical care medicine, which is concerned with the care of patients with life-threatening conditions often treated in intensive care settings....


2019 ◽  
Vol 21 (1) ◽  
pp. 149-151 ◽  
Author(s):  
Ashley Rider ◽  
Tiffany Anaebere ◽  
Mariko Nomura ◽  
David Duong ◽  
Charlotte Wills

Interprofessional education (IPE) has been shown to improve health outcomes and patient satisfaction. IPE is now represented in the Accreditation Council for Graduate Medical Education’s emergency medicine (EM) milestones given the team-based nature of EM. The Highland Allied Health Rotation Program (H-AHRP) was developed by residents to enhance and standardize IPE for EM residents in a single hospital setting. H-AHRP was incorporated into the orientation month for interns starting in the summer of 2016. EM interns were paired with emergency department preceptors in registered nursing (RN), respiratory therapy (RT), pharmacy (PH), laboratory (LAB), and social work (SW) in either a four-hour shadowing experience (RN, RT, PH) or lecture-based overview (LAB, SW). We conducted a survey before and after the program. Overall, the EM interns reported an improved understanding of the scope of practice and day-to-day logistics after working with the preceptors. They found the program helpful to their future as physicians and would recommend it to other residencies. The H-AHRP program allows for the early incorporation of IPE into EM training, enhances interns’ understanding of both the scope and logistics of their colleagues, and is a well-received effort at improving team-based care.


CJEM ◽  
2009 ◽  
Vol 11 (03) ◽  
pp. 196-206 ◽  
Author(s):  
Ian M. Scott ◽  
Riyad B. Abu-Laban ◽  
Margot C. Gowans ◽  
Bruce J. Wright ◽  
Fraser R. Brenneis

ABSTRACTBackground:Studies indicate that a student's career interest at medical school entry is related to his or her ultimate career. We sought to determine the level of interest in emergency medicine among students at the time of medical school entry, and to describe characteristics associated with students primarily interested in emergency medicine.Methods:We surveyed students in 18 medical school classes from 8 Canadian universities between 2001 and 2004 at the commencement of their studies. Participants listed their top career choice and the degree to which a series of variables influenced their choices. We also collected demographic data.Results:Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 6.1% (95% confidence interval 5.1%–7.1%) of respondents cited emergency medicine as their first career choice. When compared with students primarily interested in family medicine, those primarily interested in emergency medicine reported a greater influence of hospital orientation and a lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical specialties, those primarily interested in emergency medicine were more likely to report medical lifestyle and varied scope of practice as important influences. When compared with students primarily interested in the medical specialties, those who reported interest in emergency medicine were more likely to report that a hospital orientation and varied scope of practice were important influences, and less likely to report that social orientation was important.Conclusion:Students primarily interested in emergency medicine at medical school entry have attributes that differentiate them from students primarily interested in family medicine, the surgical specialties or the medical specialties. These findings may help guide future initiatives regarding emergency medicine education.


2020 ◽  
pp. 084653712094138
Author(s):  
Hilary Strong ◽  
Mary Beth Bissell ◽  
Jennifer Collins ◽  
Angus Hartery

Purpose: Limited radiology curriculum during postgraduate year 1 of radiology residency combined with increasing workloads during emergency radiology call have contributed to heightened anxiety and responsibilities for junior residents. This study aimed to evaluate the effectiveness of a 12-month emergency radiology curriculum on self-rated confidence and general competence of Canadian postgraduate year 1 radiology residents. Methods: A cohort of Canadian postgraduate year 1 Diagnostic Radiology residents voluntarily enrolled in a 12-month self-directed online emergency radiology curriculum (9 modules). Participants completed pretest and posttest surveys and examinations to gauge their self-rated competence on module material and knowledge acquisition, respectively. Average pretest and posttest scores were compared using Student 2-tailed unpaired t test, and Likert data from self-reported confidence were compared using a Mann Whitney U test. Statistical significance was defined as P < .05. Results: Sixty-six trainees completed at least 1 module, and 15 trainees completed all 9 modules. Both self-rated confidence and posttest scores were statistically higher after module completion ( P < .001) for all 9 learning modules. The greatest improvement in test scores was seen in the female genitourinary module (28.12 ± 3.018; difference between pretest and posttest means ± SEM). Conclusions: Our study demonstrates learning benefits for junior radiology trainees who participated in a self-directed online emergency radiology curriculum during postgraduate year 1. In the face of ever-increasing demands for imaging in on-call settings across Canada, inclusion of a self-directed online curriculum may become more important for upcoming competency-based medical education as it encourages a learner-driven and non-time-based method of education.


2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0007
Author(s):  
Henry B. Ellis ◽  
Curtis VandenBerg ◽  
Jennifer Beck ◽  
Andrew Pennock ◽  
Aristides I. Cruz ◽  
...  

INTRODUCTION: An increased rate of pediatric and adolescent patients undergoing ACL reconstruction has clearly been established, and now considered one of the most common arthroscopic procedures performed in youth patients. Little knowledge exists on whether these trends truly represent an increase in ACL injury, identification, or surgical management. Trends, including surgeon training, meniscus treatment, or geographic differences, have not been reported. The purpose of this study was to review data from ACL reconstructions performed in patients under the age of 17 years, that were submitted to the American Board of Orthopaedic Surgeons (ABOS) Part 2 examination, with a goal of evaluating national treatment trends over a 16-year period. METHODS: A query to the ABOS SCRIBE database was submitted for all ACL reconstructions performed in patients less than 17 years old between 2002 and 2016. The query was designed to search for CPT procedure codes submitted by each applicant. Query data included geographic region, fellowship training of the applicant, age and sex of the patients, and associated procedures. Each case had an associated applicant number, and thus, the total number of ACL reconstructions performed by each surgeon during board collection was provided. Trends were reviewed for the aggregate data and a Mann-Whitney test was used for comparison of data between 2002 – 2009 (Early-ACL) and 2010-2016 (Recent-ACL) groups. RESULTS: Since 2002, there has been a 2.6% increase in pediatric ACL reconstructions performed by candidates applying for Part 2 of the ABOS examination. Additionally, a 193% increase in dual pediatric and sports medicine fellowship trained candidates performing pediatric ACL reconstruction since 2010 was seen. A majority of pediatric ACL procedures were performed by sports medicine trained surgeons (75.9%). During this time period, a total of 362 (or 8.3%) of pediatric ACL procedures were performed by surgeons with neither sports medicine nor pediatric orthopaedic fellowship training. Following 2009, a 44% increase in pediatric ACL reconstructions performed was noted (Figure 1A). Additionally, an increase in reconstructions performed in female patients compared to males was noted (Figure 1B). A majority of pediatric ACL reconstructions did not require additional meniscal treatment, however, meniscus repair was more likely to be performed after 2009 (p=0.0012). The number of meniscal repair procedures reported in the setting of ACL reconstruction generally increased over the study period. In 2002, 24% of ACL reconstructions required a meniscal repair compared to 41% in 2016 (Figure 1C). A majority of these repairs were performed by surgeons with sports medicine fellowship training. Geographic trends reported are based on patients <16 per available census records (Figure 1D). Geographic variation exists with of the highest rates of pediatric ACL reconstructions occurring in the South (4.62 per million) and Midwest (4.07 per million) in comparison to the Southeast (1.85 per million). When adjusting for population size per year, each region saw a significant increase in reported ACL surgeries from the Early-ACL to the Recent-ACL timeframe (p=0.005). The largest increases in surgeries reported between Early-ACL and Recent-ACL were seen in the Southeast (68% increase), Midwest (50% increase) and Southwest (47% increase). Of all the providers who performed surgery, 74% submitted only 1-2 cases from 2002-2016, with 26% of providers performing more than 55% of all of the pediatric ACL reconstruction cases. More than 75% of all cases were performed by sports medicine fellowship trained surgeons However, a large change was seen in dual sports and pediatric trained surgeon case volumes over this time period, with these surgeons performing 7.5 times more surgeries from 2010 to 2016 (Recent-ACL) when compared to 2002-2009 (Early-ACL). CONCLUSION: Since 2009, pediatric ACL reconstructions are more likely to be female and are more likely to undergo a meniscal repair. Geographic variation is noticeable, with more surgeries reported to be performed in the South. Dual pediatric and sports medicine fellowship trained candidates performing ACL reconstruction have significantly increased over time, although those surgeons who are only sports medicine fellowship trained continue to perform the bulk of ACL reconstructions in young patients.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Haiko Kurt Jahn ◽  
James Kwan ◽  
Gerard O’Reilly ◽  
Heike Geduld ◽  
Katherine Douglass ◽  
...  

Abstract Background The number of Global Emergency Medicine (GEM) Fellowship training programs are increasing worldwide. Despite the increasing number of GEM fellowships, there is not an agreed upon approach for assessment of GEM trainees. Main body In order to study the lack of standardized assessment in GEM fellowship training, a working group was established between the International EM Fellowship Consortium (IEMFC) and the International Federation for Emergency Medicine (IFEM). A needs assessment survey of IEMFC members and a review were undertaken to identify assessment tools currently in use by GEM fellowship programs; what relevant frameworks exist; and common elements used by programs with a wide diversity of emphases. A consensus framework was developed through iterative working group discussions. Thirty-two of 40 GEM fellowships responded (80% response). There is variability in the use and format of formal assessment between programs. Thirty programs reported training GEM fellows in the last 3 years (94%). Eighteen (56%) reported only informal assessments of trainees. Twenty-seven (84%) reported regular meetings for assessment of trainees. Eleven (34%) reported use of a structured assessment of any sort for GEM fellows and, of these, only 2 (18%) used validated instruments modified from general EM residency assessment tools. Only 3 (27%) programs reported incorporation of formal written feedback from partners in other countries. Using these results along with a review of the available assessment tools in GEM the working group developed a set of principles to guide GEM fellowship assessments along with a sample assessment for use by GEM fellowship programs seeking to create their own customized assessments. Conclusion There are currently no widely used assessment frameworks for GEM fellowship training. The working group made recommendations for developing standardized assessments aligned with competencies defined by the programs, that characterize goals and objectives of training, and document progress of trainees towards achieving those goals. Frameworks used should include perspectives of multiple stakeholders including partners in other countries where trainees conduct field work. Future work may evaluate the usability, validity and reliability of assessment frameworks in GEM fellowship training.


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