The ACR Resident and Fellow Section

RFS Meeting Minutes: July 8, 2003
Conference Call

Member Participants

Jesse Davila, M.D.
Gregory Galdino, M.D.
Kay D. Lozano, M.D.

Joshua L. Rosebrook, M.D.
Sanjay K. Shetty, M.D.
Christoph Wald, M.D., Ph.D

Invited Participants

Joshua McDonald, M.D.
Vipul Thakker, M.D., Association of Residents in Radiation Oncology ACR Representative
James A. Urso, M.D., Chair, ACR Committee on Resident and Young Physician Activities (Commission on Member and Chapter Programs)
Kelly Foster, ACR Staff

Introduction
The meeting was convened at 8:00pm EDT. Committee on Resident and Young Physician Activities Dr. Urso provided a brief introduction to the Committee on Resident and Young Physician Activities, which is still in the process of forming.

Largely a membership tool, but also a mechanism to provide a voice to the unique concerns of recently graduated residents and fellows just beginning in practice.
Historically, this period is characterized by decreased involvement in the ACR due to outside constraints on time.

Resident Call and Abuse Survey Review of a draft version of the Resident Call and Abuse Survey prepared by Dr. MacDonald:

Goal to finalize questions by August 1st with a target web release date of September 1st
Survey Content:
Concerns about length of survey and possible impact on participation
Consider adding open-ended questions to web-based survey site
Concern about addition of questions about 4th year responsibilities and call to survey, as data might be used by other parties
Please return comments about survey to Dr. Macdonald as soon as possible
Possible use of Chief Residents as an initial sampling pool
Would require compiling an updated list of Chief Residents, possibly with help of A3CR2 or APDR
Would permit broad sampling of programs and generate responses from those most knowledgeable about call issues
Using the APDR resource might allow us to solicit information from program directors about similar topics
An incentive to increase participation, such as raffle for ACR discs, was suggested.
Distribution:
Plans to publish final survey results in the JACR
Requires involvement of statisticians early to ensure collection of "good" data
Presentation of results to the A3CR2

MR Training
Dr. Wald is currently drafting a publication describing the results of the MR Training Survey. He is trying to expedite submission to ensure publication in the 1st or 2nd issue of the JACR. In order to expand on data collected in the initial survey, Dr. Wald administered a second, mini-survey on cardiac imaging to respondents to the initial survey. This data will be included in the publication. An MR Training Resources List was discussed, possibly to be included as part of the ACR RPS website. This would provide a central resource to residents seeking more information about MR.

Categories should include: Books, Websites, CD-ROMs, Fellowships (including mini-fellowships), and Courses.
Plans to discuss list with Dr. Bradley

Body MR will be the topic of the 2004 ACR Annual Meeting Categorical Course, which will likely generate a lot of interest from RPS attendees. Timing of the Oral Boards The ABR met in June and approved a recommendation to continue the administration of the Diagnostic Radiology oral examination in the 4th year of training. (http://www.theabr.org/boardupdates.htm) Other updates from the ABR June Meeting:

The June 2004 oral examination will include a virtual cardiac section (composed of questions from Interventional Radiology, Cardiopulmonary, Nuclear Medicine, and Pediatric Radiology). This virtual section will have equal standing to the other sections, and a candidate may pass, fail, or condition in the cardiac section
The ABR approved a change in the required length of Nuclear Medicine training to 4 months (from 6 months), effective with the class taking the oral examination in 2005.

The EC discussed the apparently lost ABR Oral Boards video. It was decided that the RPS should not pursue creating a new video at this time, since there is no perceived need for a new video and because of concerns that this might further blur the distinction between the ACR and ABR in the minds of residents. AMA Update Dr. Rosebrook (the ACR RPS AMA representative) presented a report from the AMA Meeting in Chicago, which took place in June. Some of the major issues that were raised or discussed at the AMA:

The ACGME made several (largely unpublicized) changes to the work hour rules. These include a 6-hour grace period, the possibility of an 8-hour extension to the 80-hour workweek, exclusion of extramural moonlighting from duty hour limits, and removal of a requirement for 10-hour break between shifts.
Stafford loan rates were fixed at double the current rates.
A resolution to remove restrictions against reimbursement of ultrasounds performed with certain types of machines (using arbitrary standards such as weight of the machine) was passed.
The AMA (like the ACR) supports limits on non-economic damages in medical malpractice. This is unlikely to pass during this session of Congress and will likely be a campaign issue.
The Medicare Prescription Drug Act addressed the Medicare Conversion Formula issue that was discussed on Capitol Hill by the ACR. There will be a 1.5% increase in physician reimbursement for 2004 and 2005.

Communication Communication Dr. Galdino presented an update from the Commission on Communication:

The Commission is seeking suggestions for changes to the ACR website. Dr. Galdino suggested the possibilities of a resident forum and online cases. He also suggested maintaining contact information through an alias e-mail address through the ACR (for e-mail forwarding).
Another suggestion was a web content search engine for point-of-care education and reference by residents.

Ms. Foster suggested the possibility of a quarterly e-newsletter to be sent to all residents, similar to the ACR e-news.

The EC agreed that this would be a useful means of communication with the residents
Dr. Shetty will help to organize preparation and publication of the e-newsletter, with the first issue planned for the fall

2004 Annual Meeting Planning
Before the Annual Meeting:

The EC agreed that providing resources online (such as on-demand web seminars) to attendees before the 2004 annual meeting would be valuable.
Dr. Amis (Chair of the ACR Board of Chancellors) seems willing to possibly increase funding for resident participation at future annual meetings. This will be unlikely to effect funding for the 2004 meeting, however, since budget discussions will not be held until the spring.
Dr. Lozano will prepare a resolution for the 2004 Annual Meeting to officially change the name of the section to the RFS (Resident and Fellows Section) to more accurately reflect our membership. The deadline for submission of resolutions is February 1st.

At the meeting:

The Categorical Course on Saturday will focus on Body MR, which will likely be popular with residents (and would likely preclude scheduling any resident events concurrently with the course).
Organizers of the ACR In-Service Examination would like to meet with residents during the meeting for feedback. It was agreed that this could take place with a smaller group of residents later in the meeting, since the lunch with the leadership and the introductory remarks by the ACR president were particularly valuable experiences for attendees.
There are plans in place for Dr. Gundermann to return again next year as part of the leadership forum. It was felt that he would be amenable to feedback and suggestions about discussion topics and questions for next year's presentation.
Dr. Lozano will pursue continuing the ACR RPS EC Chair's address to the Council during the Annual Meeting. This was a successful presentation at the 2003 Annual Meeting and contributed to the increasing profile of the RPS.

ACR Task Force Updates The Task Force for Communications Standards deals with communication of results to patients and referring physicians, which was a contentious issue at the 2003 Annual Meeting. Dr. Wald mentioned that he is attempting to specifically address concerns of residents, such as obstacles to communicating with clinical teams rather than individual physicians in the hospital setting and difficulties with adhering to standards in a changing practice environment.

The Task Force for 24/7 Coverage is currently addressing issues of radiology coverage during off-hours, a topic of concern to residents. There is currently no resident representation on this group, and the EC will explore means to increase resident involvement as the issue is studies and recommendations are drafted.

Next Meeting
The committee would like to meet next via conference call.

Adjournment
There being no further business, the meeting was adjourned.

Respectfully Submitted,
Sanjay K. Shetty, MD
Secretary, ACR Resident Physician Section Executive Committee Boston, MA