Radiology training: Are your residents performing up to par?

Radiology residents in trauma centers--particularly those in the third or fourth year of their training--have fairly low discrepancy rates according to a study published online in Emergency Radiology.

In the multi-year study--conducted by Jennifer Tomich, M.D., and colleagues at Eastern Virginia Medical School in Norfolk, Va.--the researchers found that resident miss rates ranged from 0.23 to 0.42 percent, which, they wrote, was at the lower end of discrepancies reported in previous research.

"Our residents do have a low overall discrepancy rate ... in line with what had previously been found in other programs," Tomich told

The study sample comprised more than 193,000 dictated studies, including 103,292 X-ray exams, 81,537 CT exams, 7,787 ultrasound exams, 484 nuclear medicine studies and 446 fluoroscopy studies. Discrepancy rates were highest for nuclear medicine studies at 0.62 percent, and CT studies at 0.49 percent. The rates were lowest for X-ray at 0.25 percent, fluoroscopy at 0.22 percent and ultrasound at 0.12 percent.

The most commonly missed fractures on radiographs were phalangeal fractures of the hand, followed by metatarsal fractures of the feet. On CT, the most commonly missed fractures were of the rib, while intracranial hemorrhage was the most common vascular discrepancy.

The researchers found that overall, fractures and lung nodules/infiltrates accounted for the most significant portion of misses across all levels of training. They recommended that radiology resident training programs ensure that the common discrepancies illustrated in their review be specifically addressed as part of a dedicated emergency radiology course.

"Our intent is to identify specific areas of concern that may be amenable to improvement through initiation of dedicated resident training in the field of emergency radiology," the authors said.

To learn more:
- see the study in Emergency Radiology
- read the article in