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2002 ACR RPS Meeting Report:
Report from the 2002 ACR Meeting, Miami Beach, Florida
Thanks to a commitment and financial sponsorship from both the ACR and
individual state chapters, the number of residents and fellows attending
the ACR's annual meeting each year continues to grow. Representatives
from every corner of North America were present, from Maine to Hawaii,
Puerto Rico to Ontario, and from programs large and small, university-
and community-based.
The opening day began with a Resident Physicians Section Executive
Committee meeting over breakfast. Chair-elect Christoph Wald M.D.,
Ph.D., from Massachusetts, who was presiding over the 2002 annual
meeting of the ACR RFS, welcomed this year's contingent and provided an
overview of events for the ensuing five days. Next was the day-long PET
Categorical Course, which was an outstanding collection of talks and
images from the field's best. The timeliness and quality of this course
was evinced by an enrollment far surpassing that in prior years,
necessitating a much larger venue than anticipated.
During the break for lunch, ACR President Kay Vydareny, M.D., provided
our section with an overview of the organization and orientation to the
role of the RPS within it. She reviewed the structure of the ACR
Council, the legislative body of the College through which each member
helps establish policies affecting all of radiology. Each state chapter
sends a minimum of one councilor and one alternate to the Council with a
total of 247 voting councilors; the RPS has one voting councilor (the
executive committee chairperson) and one alternate (the vice chair).
On the second day, a pair of lively RPS business meetings focused
largely on the resolutions to be voted on by this year's Council. The
RPS Executive Committee members had identified those resolutions of
particular interest to residents, fellows, and recent graduates and
distributed copies of them to attendees in advance of the meeting. These
ranged from standards for teleradiology and arteriography to formal
Council representation for the Association of Program Directors in
Radiology. The implications of these resolutions for
radiologists-in-training were often obvious, such as requirements for
the performance of a specific number of angiograms as primary operator,
but some were more complex. In establishing a position on each, RPS
members had an entertaining exchange of anecdotes and opinions, touching
on issues like proliferation of radiology physician assistants, collapse
of vascular-interventional departments, and coverage of multiple outside
hospitals via teleradiology while on call. Call rooms reminiscent of
Sanford and Son's garage, threatened conference time, and the 80-hour
work week were familiar concerns, but there were more disturbing tales
as well: orthopedic residents dictating MRIs and plain films while on
their radiology electives, radiology residents assisting vascular
surgeons while covering interventional call, and unpaid, mandatory
"internal moonlighting" effectively doubling more than one program's
workload.
Day two also included the Resident Physician Leadership Development
Seminar, sponsored by Berlex Inc. Conducted by Jean Frankel from Tecker
Consulting, the session was much less corny than I'd feared, and
provided many specific ideas on how we can be more effective as
residents and as active members of the radiology community. This was
followed by a luncheon with Dr. Vydareny and other ACR leaders, giving
us a chance to see how they combined the clinical duties of radiology
with their leadership roles. Dr. Vydareny cited many resident comments
from the lunchtime session as she spoke to the Council later that day
about the current crisis in academic radiology.
At the RPS Caucus, the topic causing the greatest stir was the proposal
by the Society of Chairmen of Academic Radiology Departments to change
the timing of the resident ABR examinations, with oral boards to be
delayed for at least one year following completion of residency. A
response to the perception of excessive fixation on the oral exam by 4th
year residents, the proposal was universally opposed by the RPS. The
overwhelming feeling was that this would severely detract from the
residents' ability to prepare for the oral boards and put the finishing
touches on their education. For example, a move to delay the boards
would effectively end the ability for senior residents to attend board
reviews at outside institutions. Furthermore, once a radiology resident
graduates the scope of his or her practice narrows quickly (unlike most
other specialties) and soon after graduation from residency no longer
encompasses the subjects currently tested in the oral board examination.
Trying to keep current in all of radiology, in order to pass the boards,
would be difficult. Finally, the legality of graduates reading
mammograms without being board-certified was questioned. It was decided
that moving the boards would limit the influx of new radiologists
available to read mammograms and further exacerbate the general manpower
shortage in private practices by forcing graduates to study during their
early years as staff.
Also at the forefront of this year's issues was the new ACGME common
duty hour recommendations pertaining to all residents in the US. A quick
poll indicated that most of the residents' programs were already in
compliance. However, a brief discussion followed about the fact that
these work hour guidelines also encompass moonlighting. This was
surprise to many of the residents attending. Several of them indicated
that, due to the shortage of fellows, they were now taking extra call
and working additional hours. This may result in their programs not
being in compliance with the ACGME guidelines.
Another topic of discussion was the growing tendency of newly graduated
radiologists to drop their ACR membership. Suggested remedies included
opening up committee posts to interested "young physicians" or trainees,
increasing the budget for RPS recruitment and ACR meeting attendance,
adding positions within the state chapters for the newly graduated,
forming a separate Young Physician Section (newly graduated to five
years out), formalizing resident mentoring relationships with state
leaders, and inviting interested residents at the AFIP to the annual
meeting, which is moving to Washington, D.C., beginning in 2003.
A survey of MRI training was distributed and collected for input to the
ACGME Residency Review Committee for diagnostic radiology. In an effort
to collect more robust data, the ACR RFS has now made the MRI survey
available on its section of the Web site. Please visit
http://www.acr.org/dyna/?doc=/departments/residents/rps/forms/rps-
survey02.html and fill out the survey. Responses will form the basis for
improvements to the MRI training. [Thanks to these survey results and
the persistent efforts of Kelly Foster and the RPS executive committee,
the RRC has decided to ask their site inspectors to include questions
regarding the satisfaction of residents with MRI training, and has
included MRI training on the agenda for its next meeting in February,
2003. Check the residents' forum on the ACR Web site for more details.]
The ACR Council meeting opened on Sunday, September 29, with reference
committee hearings on specific resolutions the next day. RPS
representatives spoke on each of the resolutions discussed at the RPS
business meetings and caucus, creating a very visible presence for the
section. The resolution that created the most controversy during
Reference Committee proceedings was the proposal to change the name "ACR
Standards" to "Practice Guidelines."
Following the reference committee sessions, a panel discussion on
radiation accidents, radiation protection, and nuclear terrorism
provided a fascinating and often chilling inside look at the new nuclear
fear and our role as radiologists in dealing with the unthinkable. The
ACR has produced a pamphlet titled "Disaster Preparedness for Radiology
Professionals: Response to Radiological Terrorism," which covers much of
this topic and should be required reading in all departments.
Two days of debate on the proposed resolutions by the Council members
then followed. Ultimately, the term "standards" was retained for the ACR
guidelines. Most of the proposed resolutions passed with few amendments.
One resolution that was deferred was the ACR standard on esophagrams.
The council session concluded with some strong pina coladas on the
beach.
Elections for the RPS executive committee were held, with the 2002-2003
committee composed of:
| Member Name |
Position Description |
Training Institution |
| Christoph Wald, M.D., Ph.D. |
Chair |
Lahey Clinic, MA |
| Kay Spong Lozano, M.D. |
VC/Chair-Elect |
University of Washington, WA |
| Shannon Campbell, M.D. |
Secretary |
University of Rochester, NY |
| Jonathan Luchs, M.D. |
AMA Rep |
Winthrop-University Hospital, NY |
| Jesse Davila, M.D. |
A3CR2 Rep |
Mayo Clinic, MN |
The next ACR meeting will be held in Washington, D.C. in May, 2003.
Report respectfully submitted by:
Erik Nelson, M.D., MRS RFS
and
Seth Hardy, M.D., Secretary, MRS RFS
Boston, November 2002
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