Attitudes of Radiology Program Directors Toward MD-PhD Trainees, Resident Research Productivity, and Dedicated Research Time

Evaluating the Outcomes and Trainee Performance of a Canadian Medical Imaging Clinician Investigator Program

Purpose: To measure the research productivity of trainees from the University of Toronto's Medical Imaging Clinician Investigator Program (MI-CIP) and comparing it with the research productivity of trainees from MI-non-CIP and General Surgery (GSx) Clinician Investigator Program. Methods: We identified residents who completed an MI-CIP, MI-non-CIP and GSx-CIP from 2006-2016. In each group of trainees, we assessed 3 research productivity outcomes with non-parametric tests before residency and at 7 years post-CIP completion/post-graduation. Research productivity outcomes include the number of total publications, the number of first-author publications, and the publication's average journal impact factor (IF). Results: We identified 11 MI-CIP trainees (male/female: 9 [82%]/2 [18%]), 74 MI-non-CIP trainees (46 [62%]/28 [38%]) and 41 GSx-CIP trainees (23 [56%]/18 [44%]). MI-CIP trainees had statistically significant higher research productivity than MI-non-CIP in all measured outcomes. The median (interquartile range, IQR) number of total publications of MI-CIP vs MI-non-CIP trainees was 5.0 (8.0) vs 1.0 (2.0) before residency and 6.0 (10.0) vs .0 (2.0) at 7 years post-CIP completion/post-graduation. The median (IQR) first-author publications of MI-CIP vs MI-non-CIP trainees was 2.0 (3.0) vs .0 (1.0) before residency and 2.0 (4.0) vs (.0) (1.0) at 7 years post-CIP completion/post-graduation. The median (IQR) average journal IF of MI-CIP vs MI-non-CIP trainees was 3.2 (2.0) vs .3 (2.4) before residency and 3.9 (3.2) vs .0 (2.6) at 7 years post-CIP completion/post-graduation. Between MI-CIP and GSx-CIP trainees, there were no significant differences in research productivity in all measured outcomes. Conclusion: MI-CIP trainees actively conducted research after graduation. These trainees demonstrated early research engagement before residency. The similar research productivity of MI-CIP vs GSx-CIP trainees shows initial success of MI-CIP trainees.

The Anesthesiology Physician-Scientist Pipeline: Current Status and Recommendations for Future Growth-An Initiative of the Anesthesia Research Council

The limited number and diversity of resident physicians pursuing careers as physician-scientists in medicine has been a concern for many decades. The Anesthesia Research Council aimed to address the status of the anesthesiology physician-scientist pipeline, benchmarked against other medical specialties, and to develop strategic recommendations to sustain and expand the number and diversity of anesthesiology physician-scientists. The working group analyzed data from the Association of American Medical Colleges and the National Resident Matching Program to characterize the diversity and number of research-oriented residents from US and international allopathic medical schools entering 11 medical specialties from 2009 to 2019. Two surveys were developed to assess the research culture of anesthesiology departments. National Institutes of Health (NIH) funding information awarded to anesthesiology physician-scientists and departments was collected from NIH RePORTER and the Blue Ridge Medical Institute. Anesthesiology ranked eighth to tenth place of 11 medical specialties in the percent of "research-oriented" entering residents, defined as those with advanced degrees (Master's or PhDs) in addition to the MD degree or having published at least 3 research publications before residency. Anesthesiology ranked eighth of 11 specialties in the percent of entering residents who were women but ranked fourth of 11 specialties in the percent of entering residents who self-identified as belonging to an underrepresented group in medicine. There has been a 72% increase in both the total NIH funding awarded to anesthesiology departments and the number of NIH K-series mentored training grants (eg, K08 and K23) awarded to anesthesiology physician-scientists between 2015 and 2020. Recommendations for expanding the size and diversity of the anesthesiology physician-scientist pipeline included (1) developing strategies to increase the number of research intensive anesthesiology departments; (2) unifying the diverse programs among academic anesthesiology foundations and societies that seek to grow research in the specialty; (3) adjusting American Society of Anesthesiologists metrics of success to include the number of anesthesiology physician-scientists with extramural research support; (4) increasing the number of mentored awards from Foundation of Anesthesia Education and Research (FAER) and International Anesthesia Research Society (IARS); (5) supporting an organized and concerted effort to inform research-oriented medical students of the diverse research opportunities within anesthesiology should include the specialty being represented at the annual meetings of Medical Scientist Training Program (MSTP) students and the American Physician Scientist Association, as well as in institutional MSTP programs. The medical specialty of anesthesiology is defined by new discoveries and contributions to perioperative medicine which will only be sustained by a robust pipeline of anesthesiology physician-scientists.

Establishing a Departmental Symposium for Resident Scholarly Activity: How We Did It

Many radiology departments have successfully increased trainee research involvement by providing protected academic time for research, offering travel funding for conferences, and developing research-focused curriculum via resident research tracks and other mechanisms. A departmental platform for trainees to share their scholarly projects can foster intradepartmental awareness and collaborations, supplement the existing resident research curriculum, encourage peer learning amongst trainees, and allow departmental celebration of their trainees' accomplishments. The authors describe the development of a departmental symposium for resident scholarly activity at their institution and detail a practical framework for implementation and lessons learned, which may serve as a guide for other radiology departments interested in establishing a similar event.

Impact of Longitudinal Focused Academic Time on Resident Scholarly Activity

RATIONALE AND OBJECTIVES

Meeting the Accreditation Council for Graduate Medical Education scholarly activity requirement can be challenging for residents. Time to engage in research is one of the commonly perceived barriers. To address this barrier, our residency program implemented a focused academic time initiative of a half day per week that can be taken while on rotation. At the end of the third year of implementation, we assessed the effectiveness of this initiative on the productivity of resident scholarly activity.

MATERIALS AND METHODS

Radiology resident scholarly activity submitted to the Accreditation Council for Graduate Medical Education web-based Accreditation Data System were reviewed and compared to the three academic years before (July 1, 2012-June 30, 2015) and three academic years after (July 1, 2015-June 30, 2018) implementing the focused research time. The types of scholarly activity, which consisted of peer-reviewed journal publications, national conference presentations, and textbook chapters were captured. PubMed-Indexed for MEDLINE (PMID) number was used to confirm publications. Descriptive statistics were used to analyze the data.

RESULTS

The total number of residents per year, ranging between 37-40, was similar between the academic years 2012-2015 (116 residents total) and 2015-2018 (117 residents total). After initiating focused academic time, the number of publications increased from 45 to 75 (67%), presentations at conferences increased from 112 to 128 (14%), the number of textbook chapters increased from 4 to 15 (275%), and total number of first author publications by residents increased from 21 to 28 (33% increase).

CONCLUSION

Longitudinal focused academic time of half a day per week increased productivity of scholarly activity among our radiology residents.

A roadmap of resident-led initiatives to promote research within the radiology department

RATIONAL

While radiology residents must participate in a scholarly project per Accreditation Council for Graduate Medical Education (ACGME) Program Requirements, some residency programs may lack a well-thought out, cohesive approach to research that incorporates the residents' perspective. Our objective was to improve the radiology resident research experience with resident-led initiatives.

MATERIAL AND METHODS

An annual resident research survey was created and distributed to 28 radiology residents in December 2018. Following the survey, a newly formed resident research committee developed a six-step strategic framework of resident-led initiatives to promote research and scholarly activity within the department: Reflect, Recruit, Regroup, Revive, Recognize, and Review. Outcomes of this framework were evaluated with the second annual resident research survey in December 2019.

RESULTS

Our institution identified areas of improvement on the 2019 survey after the implementation of the six-step initiatives upon comparison to the 2018 survey. A greater number of residents reported that they had adequate or somewhat adequate resources for research within the department in 2019 (95.2% [20/21]) in comparison to 2018 (70.6% [12/17]) (p = 0.03). A greater percentage of residents found available research projects engaging/interesting in 2019 (80.9% [17/21]) compared to 2018 (70.6% 12/17) (p = 0.49). The most commonly reported departmental resources needed to encourage research on the 2019 survey were dedicated research time (26.9%, 18 out of 67 total responses) and mentorship/encouragement from the faculty (19.4%, 13/67).

CONCLUSION

With a specific framework and appropriate departmental support, resident-led initiatives can improve the research experience within the radiology department from the residents' perspective.

An Institutional Academic and Research Track Curriculum for Radiology Residents: Development, Implementation, and Outcomes Assessment at 6 Years

RATIONALE AND OBJECTIVES

We report the creation of a voluntary research development curriculum for radiology residents at our institution, detailing outcomes after 6 years of existence.

MATERIALS AND METHODS

We developed a comprehensive Academic and Research Track (ART) curriculum for radiology residents in our department, including mentorship, monthly meetings, didactic curriculum, ongoing evaluation/feedback, protected academic time, and financial support. A literature review identified all indexed publications for our residency graduates from 6 years pre- (2007-2012) to 6 years post-ART (2013-2018) intervention. We also documented career outcomes (academic versus private practice). Summary statistics, Chi-square, and Poisson regression analyses were performed.

RESULTS

ART group demonstrated significantly greater publication likelihood versus pre-ART predecessors (odds ratio [OR]: 3.59, 95% confidence intervals [CI]: 1.40-9.19; risk ratios [RR]: 1.58, 95% CI: 1.19-2.11; p= 0.01), contemporaneous non-ART cohort (OR: 3.03, 95% CI: 1.12-8.33; RR: 1.45, 95% CI: 1.08-1.96; p = 0.04), and combined pre-ART plus non-ART group (OR: 3.34, 95% CI: 1.35-8.22; RR: 1.41, 95% CI: 0.87-2.29; p = 0.012). In Poisson regression, ART was a significant factor for total, first author, and senior author publications among all graduates and among the subset which remained in academics (all p-values < 0.05). Estimators were positive in all regressions, indicating a positive effect of ART for increasing numbers of publications.

CONCLUSION

ART membership was associated with significantly increased indexed publications. A greater proportion of ART members remained in academics compared to non-ART members, but did not reach statistical significance. We detail our ART structure and curriculum, which may be used as a malleable template for other radiology departments.

Addressing research barriers and facilitators in medical residency

Objective:

To develop and implement an instrument to identify contributing factors and obstacles to resident research participation.

Materials and Methods:

Clinical Research Excellence Development in Innovation and Technology (CREDIT-20), a 20-point questionnaire, was developed through a four-stage methodology to measure opportunities and challenges to enhance participation of medical residents in research. The study was distributed to all medical residents at three Joint Commission–accredited academic medical centers in the emirate of Abu Dhabi between March 2017 and July 2018. Participant responses were analyzed and represented as mean ± standard error of mean, and subgroup analysis was conducted using Fisher's exact test.

Results:

In all, 314 of 380 residents completed the survey (83% response rate). Resident interest in research was high, with the majority of trainees responding that research will enhance their critical thinking (93%) and add to their knowledge of medicine (92%). Lack of protected time and lack of research methodology training were the most significant barriers. Over half of the residents cited the lack of a dedicated research budget as a program organization challenge. Age significantly correlated with resident perceptions of the benefits for conducting research, with trainees age 27 years or less indicating that they would be more likely to benefit from conducting research than their older counterparts (164 vs 128, P < 0.05).

Conclusion:

Improving research methodology training and dedicating structured-protected time for the scholarship are strategies to increase research output in international academic medical centers. The CREDIT-20 survey can identify specific barriers faced by trainees and assist medical educational leaders in implementing targeted interventions.

The American Board of Radiology B. Leonard Holman Research Pathway to Initial Certification: Opportunities Lost for Diagnostic Radiology

OBJECTIVE

In 1998, the American Board of Radiology introduced the B. Leonard Holman Research Pathway (HRP) to initial certification for trainees in diagnostic radiology (DR) and radiation oncology (RO) motivated to pursue research-oriented careers in academic DR and RO.

CONCLUSION

The HRP Committee anticipated that there would be a relatively even distribution between DR and RO participants, but with 18 years of experience that has not been the case. This article focuses on the HRP and DR.