Transcript Radiology_Residency

Behnam Vahdati Nia - OMSI
Co-president of Rad Club
Touro University – California
Spring 2011
Radiology: An Overview
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A medical specialty in which a variety of radiologic
methodologies are used to diagnose and treat diseases
Been around for over 100 years
Great technological advancements in the last 30 years
Diagnostic Radiology uses diagnostic and image guided
therapeutic techniques in:
 Nuclear radiology
 Diagnostic ultrasound (US)
 Magnetic resonance (MR)
 Computed tomography (CT)
 Interventional procedures
 Use of other forms of radiant energy
Over 80% of Radiologists
sub-specialize in:
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Abdominal Radiology
Endovascular Surgical Neuroradiology
Neuroradiology
Pediatric Radiology
Nuclear Radiology
Vascular and Interventional Radiology
Cardiothoracic Radiology
Musculoskeletal Radiology
http://www.radiologyinfo.org/en/careers/index.cfm?pg
=diagcareer
Patient Details
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Most patients are ambulatory and then inpatient
~50% adults and ~40% 65+
~50% acute, ~30% chronic, the rest check-ups/terminally ill
Five Most Frequently Encountered Illnesses/Conditions:
1. Trauma
2. Cancer/malignancy
3. Central nervous system disease
4. Respiratory diseases
5. Breast disease/mammography
Work-force (2010)
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Total # 26.5K = 8.48 per 100,000
 An increase from 7.70 in 1996
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Only 30% female
Work-place:
 Office Based Patient Care <70%
 Hospital:
○ 4,654 residents (<18%) , CA ~13% total
○ <12% physicians
 Other (~5%)
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Administration
Medical Teaching
Research
Locum Tenens (subs)
Other
Compensation
 Academic Medicine: ~$300K-400K
 Clinical Practice: ~$300K-650K
 Resident: ~$49K
Personal Characteristics
Interest
Specialty Average Score
Complex Problems
4.5
Comprehensive Care
4.0
Diagnostic Precision
5.3
Emergency-Critical Care
4.0
History Taking
2.8
Home Health Care
2.3
Immediate Results
5.5
Knowledge of Anatomical Structures
5.0
Knowledge of Organ Systems
4.4
Laboratory Results
4.6
Palliative Care
2.9
Patient Counseling
2.3
Prevention and Education
3.4
Procedural Care
4.8
Psychological Care
2.3
Reproductive Care
2.6
Social Context
2.6
Technology in Medicine
5.1
CiM
Residency: An Overview
Generally 5 years, including a PGY-1 year
 First year in a preliminary medicine, transitional program, or
preliminary surgery program
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 PGY-1 year must consist of training in internal medicine, pediatrics,
surgery or surgical specialties, obstetrics and gynecology, neurology,
family practice, emergency medicine, or any combination of these
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Four years in radiology at the same or different institution
 Categorical programs: less common - PGY 1-5
○ PGY 1 intern year and the radiology residency are combined , and applied to
together
 Advanced programs: most common - PGY 2-5
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Most programs participate in the Electronic Residency Application
Service AND the National Resident Matching Program.
What’s residency like?
For PGY1
Average hours on duty per week
51.4
Average maximum consecutive hours on duty
18.1
Average days off duty per week
1.7
Average percent of training in hospital outpatient
clinics
33.2%
Average percent of training in non-hospital
ambulatory care community settings
5.8%
Average resident/fellow compensation
$48,806
Average number weeks of vacation
3.5
Residency Spots
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25 AOA spots at 14 sites (7 at Michigan)
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141 ACGME PGY-1 spots at 34 sites
 8 filled by DOs
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949 ACGME PGY-2 spots at 163 sites
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All DOs In The NRMP
 2045 applied, 1444 matched = 70.6%
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DOs active in ACGME DR residencies
 2009: 178 = 4% total
What do Program Directors look
For when…
Selecting for interviews (From NRMP 2010)
Factors
Percent of
Programs
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Class ranking/quartile
Personal Statement
USMLE/COMLEX Step 1 score
Grades in required clerkships
71%
71%
69%
67%
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Medical Student Performance Evaluation (MSPE/Dean's Letter)
67%
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Letters of recommendation in the specialty
65%
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Honors in clinical clerkships
Grades in clerkship in desired specialty
Gaps in medical education
Consistency of grades
62%
59%
59%
59%
What do Program Directors look
For when…
Ranking applicants in the Match (From NRMP 2010)
Factors
Percent of
Programs
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Interactions with faculty during interview and visit
Applicant was flagged with Match violation by the NRMP
Interactions with housestaff during interview and visit
Interpersonal skills
4.8
4.8
4.7
4.6
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Feedback from current resident
4.6
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Evidence of professionalism and ethics
4.4
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Class ranking/quartile
USMLE/COMLEX Step 1 score
Grades in required clerkship
Honors in clinical clerkship
4.3
4.3
4.2
4.2
Some tips from our matches…
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Radiology, its a tough field to get into, as is all the R.O.A.D
residencies, and even worse, it seems that most good residencies
are getting even harder to get into
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“You won't be disappointed in radiology. No matter what anyone
says, we are the happiest bunch of people in the hospital - we
enjoy our jobs more, we have less stress, we fill out less
paperwork, we make more money, and we take more vacation. It's
a pretty winning deal. Plus we are constantly evolving, we are
completely evidence based, and we will always be needed.”
You can't compete without boards  You must take and do well on
USMLE: 235+ on both steps (average for matched). Use First Aid by adding
notes.
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Do well on first two years  class ranking
Get good letters. Consider doing a rads research rotation and getting a
small paper done and your mentor should write you a strong letter. Also, you
need a good letter from one primary care and one surgical doc.
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Get application done early and submit it day one. Apply broadly (20-30 on
average to get 10-15 interviews)
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Do away rotation at places you are interested in and make a good
impression. If you have a connection to a place let them know about it
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Clinical grades are more important. Didactic grades don't matter much
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Do research and get published
USMLE questions required understanding concepts, where COMLEX was
more basic recall.
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There are a few good DO programs out there, but they are small, and often
not in the best locations
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Newly matched example application:
 Good grades (very good in the actual science classes, not so much in OD, OMM)
 Mostly studied on his own with review books (versus lecture/powerpoints)
 Used First aid, BRS Pathology, BRS Physiology, Microcards
 Practice questions were extremely useful
 USMLE World > Kaplan Q bank
 COMLEX: ~620
USMLE 1:~250
USMLE 2, COMLEX 2: not taken at time of application
Strong letters, one particularly strong one from the chief of
abdominal imaging
6 weeks research rotation and 1 case report written with said chief
Volunteering: nothing
 Withdrew from AOA match, Matched ACGME on his 6th (and last) ranking
Note: He did not take Step 2s at time of applying and wished he had. Taking the step 2
and doing well on it will further support your application. I also recommend doing some
volunteer work?
Resources: Radiology
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Dr. Pera
 Advising
 US machines late May?
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Dr. Hisley
 Research
 OsiriX (Mac OS)
 BB site / elective?
RSNA (Radiological Society of North America)
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http://www.rsna.org/medstudents.cfm
 Cases, training, DDx, journals, etc…
StatDx
https://my.statdx.com/
 Cases with precise diagnostic info and images
+ anatomy + more
 Residents/radiologist use it (on call too)
 One login at a time
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Learning Radiology
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http://www.learningradiology.com
Others…
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http://www.radrounds.com/
 Connections
 Cases
Others…
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http://www.auntminnie.com/
 Forum for anything regarding
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radiology/residency
News
Cases
Career
CME
Resources: Residency
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Careers in Medicine (CiM)
 https://www.aamc.org/students/medstudents/cim/
 Identify career goals
 Explore specialty and practice options
 Choose a specialty
○ Questionnaires  characteristic to specialty match
 Select and apply to residency programs
○ Application timeline
 Make good career decisions
○ Four-Step Career-Planning Process
Residency Programs
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FREIDA
 http://www.ama-assn.org/ama/pub/education-
careers/graduate-medical-education/freida-online.page
 Information + Statistics
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AOA List
 http://www.opportunities.osteopathic.org/
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ACGME List
 http://www.acgme.org/adspublic/
Applications & Match
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ERAS (Electronic Residency Application Service)
 https://www.aamc.org/students/medstudents/eras/
 transmits applications, letters of recommendation (LoRs), Medical
Student Performance Evaluations (MSPEs), medical school
transcripts, USMLE transcripts, COMLEX transcripts, and other
supporting credentials from applicants and their designated dean's
office to program directors.
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NRMP
 http://www.nrmp.org/
 For matching applicants' preferences for residency positions with
program directors' preferences for applicants (both MD/DO)
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AOA Intern/Resident Registration Program
 http://www.natmatch.com/aoairp/index.htm
Some Points About AOA & NRMP Matches
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Match to AOA Residency, NRMP is OVER
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Do Not Match AOA, ALIVE in the NRMP
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No Match with AOA or NRMP, Free Agent
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Match with AOA Internship, ALIVE for PGY- 2 Residency in the
NRMP
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Critical to Understand the Distinction Between PGY-1 and PGY-2
Matches in the NRMP
Any attempt for an applicant or program to supply specific rank
order info. prior to the match is a violation of the match
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Thank you!