The Problem with Radiology Rotation in Medical School

October 2, 2015

Medical students are actually calling their radiology rotation a “radiation vacation.”

Having recently graduated medical school, rotated in several radiology departments, and engaged in discussion with fellow students, I would like to offer some insight on and suggestions for medical education.

The radiology rotation in US medical schools is known for being an easy rotation for third- and fourth-year medical students. The term on the street is “radiation vacation.” Program structure can include spending two to four weeks in the reading room, engaging in self-guided image reading, scrolling through PowerPoint modules, and giving a presentation at the end of the rotation. In the reading rooms, students typically “shadow” radiologists, which entails sitting next to or behind someone in a dark room while they read and scroll through images.

As an anonymous student recalls, “It’s so easy to fall asleep, given that the chairs are so comfortable, the radiologist’s voice is so soft, and I have no idea what I’m looking at.” Understandably, students quickly become bored in this passive role and may resort to maladaptive coping mechanisms, including exorbitant amounts of caffeine or attempting to leave early. Unfortunately, with the current course structure, there is little value we offer students, and less value students bring to us.

Just as radiology will play a large role in the future of medicine, it is also important to establish a significant place in medical education and draw bright minds to the field. Instilling value in the medical student rotation is a matter of changing perspective and channeling resources in a way that is productive for both the student and department.

Teaching hospitals maintain excellence through stratification of care. Just as medical students are patient liaisons on other rotations, students in radiology can spend more time on the forefront of patient care.

Students would be engaged through greeting patients, looking up their medical history, learning the indication for imaging, and working with technologists, nurses, and residents to acquire the image. Students would see the image stream live as it gets captured and later compare their impression with the attending or resident’s interpretation.

This kind of bottom to top approach is a deconstructed curriculum that helps students understand radiology from a familiar reference point, the patient. From there, students can see the need for imaging and get an overview of the inner workings of a radiology department, ultimately appreciating the role of the radiologist.[[{"type":"media","view_mode":"media_crop","fid":"41959","attributes":{"alt":"radiology rotation","class":"media-image media-image-right","id":"media_crop_6266856036746","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4499","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 263px; width: 351px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

Students are motivated when they believe they are able to succeed at a given task and when they value the outcome of the task. By spending more time with the patient and the process of obtaining the image, students can synthesize information by putting together knowledge from radiology lectures with first hand experience. Students feel less overwhelmed compared to starting off with image interpretation in the reading rooms.

Furthermore, this allows students to contribute value to the radiology department by assisting where the nurse or technologist may need an extra hand, and enhance patient satisfaction by answering any concerns or explaining the exam. In summary, the advantages of this approach are the following:

1. More interactive

2. Level appropriate role

3. Assesses and applies student’s basic knowledge

4. Enhances patient experience

I am interested in your commentary and feedback; especially from programs who are planning to implement changes or have recently changed their curriculum. Please leave a comment below.