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Everything Old is New Again


The joys of learning radiology.

Sometime in the murky past, I wrote a column about stepping outside of one’s comfort zone. I have a hazy recollection of entitling it something like “Care to step outside?” for those curious to go looking.

Most steady jobs won’t give you too much of an opportunity to do it, during regular working hours; there’s more than enough on your plate which is squarely in your comfort zone. Either the workload has been tailored to your strengths, or you’ve simply been there long enough that your zone has morphed to include whatever work they routinely send your way.

For instance, I never considered myself particularly good at mammo, but my last couple of private practice jobs threw enough of it at me that, willingly or not, I completely lost my sense of unease when reading the stuff. I occasionally thought it a shame that what little MSK MRI I had learned from residency was seeing zero use, and had half-baked notions of going to conferences or otherwise regaining my skills.

The ROI (return on investment, not region of interest, you silly rad) for such efforts seemed pretty low, however. Suppose I did go ahead and render myself capable of reading MR on wrists, ankles, elbows, etc. Where was I going to find cases to keep my skills current and sharp? Other folks in the outpatient imaging centers were already reading them, and probably wouldn’t be too interested in coughing any up in exchange for some of my usual workload.

Moving to teleradiology didn’t suddenly give me more opportunity in this regard; when you’re providing nighttime and weekend coverage for ERs and ICUs, MR cases to rule out rotator-cuff tears aren’t too plentiful. Still, I knew they were out there, and one of the nice things about the week-on, week-off telerad schedule is that you have more time to engage in other pursuits.

So I looked into going to some conferences. This summoned up old recollections of sitting in residency lectures and struggling to stay awake, perhaps remembering a tidbit or two from each session. Certainly not emerging from a talk about imaging of body part X by modality Y, feeling confident and ready to read cases.

Then, I stumbled across some online videos-free on YouTube-posted from various academic institutions, of radiology lectures being given to their residents, fellows, etc. Google “how to read shoulder MRI,” for instance, and one of the first hits is from Stanford. (Not exactly a fly-by-night source.) What the heck, I thought, and clicked Play.

It was a strikingly different experience than I recalled from attending such talks during my own training, or from CME conferences during the next few years. Maybe because I’m older (and hopefully wiser). Maybe because it was in the comfort of my own home, and I could pause, rewind, take breaks, re-view portions, etc. to my heart’s content. Or maybe because, unlike in training, I’m not sitting in a conference room on a daily basis and trying to force-feed my brain far more information, far faster, than it could possibly absorb.

Whatever the reasons, it was a joy. I felt myself thoroughly interested, and absorbing info like a sponge. Even wondering why this stuff set me to daydreaming and dozing off back in the day. After, I found some relevant cases and went through them, feeling surprisingly clueful.

The thought occurred to me-this is what CME should be. Forget stuff like journal articles followed by nitpicky quiz questions about trivial details buried in their paragraphs; take a topic of interest, and a virtual stroll down memory lane to something you never quite learned as well as you wish you had (or maybe something you did, but could use a refresher on). Either you emerge a more capable radiologist, or just stimulate your intellect for a while. Not because some facility or governmental authority says you need to rack up a certain number of credits per year.

Give it a try; I think you’ll be pleasantly surprised if you’ve been away from academic facilities for more than a couple of years. Pick a topic off your beaten path, and you can probably find a 30-60 minute recorded residency/fellowship lecture with a little Googling. You might be surprised how novel and interesting the material can be…and even wanting to incorporate it into your routine workflow.

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