Radiology residents want more autonomy

Radiology residents in programs with full-time attending coverage value the feedback they get from attending physicians more than their peers at institutions without 24/7 on-call attending physicians, but regret the lack of autonomy that goes with it, according to a survey published online this month in Academic Radiology.

Researchers led by Jannette Collins, radiology chair at the University of Cincinnati College of Medicine, surveyed 146 radiology residents from six different institutions--three of which used attending physicians round the clock on a daily basis, and three of which that had their radiology residents ready overnight cases on their own.

Prior surveys have shown radiology departments trending toward having more overnight attending coverage. For example, a 2011 survey of program directors in radiology, published in the December 2012 issue of Academic Radiology, reported that while 10 percent of academic practices had on-call staff coverage during off hours in 2007, the "concept of 24/7 coverage has evolved" since then. The 2011 survey results suggested that nearly half of all training programs have staff radiologists in-house during off hours.

The current survey included questions that related to resident workload, level of autonomy, faculty feedback and supervision, comfort level and the resident's overall education experience while on overnight call.

The researchers found that residents in 24/7, in-house radiologist coverage read a smaller percentage of studies (46 percent) compared to residents in programs without such coverage (81 percent), and rated the quality of feedback they received more highly, as well.

But, residents in 24/7 programs lamented the lack of autonomy they experienced (3.6 on a scale of 1 to 5, compared to 4.5 to other residents), as well as their educational experience (3.6 compared to 4.2). Many of the comments submitted by residents along with their surveys included complaints about the lack of autonomy experienced by residents at institutions with 24/7 coverage.

In addition, report turnaround times were much lower in programs with 24/7 coverage than those without (1.7 hours compared to 9.1 hours), suggesting that lower turnaround times are coming at the expense of a less satisfactory educational experience for residents, the authors wrote.

To learn more:
- see the article published online in Academic Radiology
- read about the 2011 survey results (.pdf)

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