Residency programs face sweeping changes

The Accreditation Council for Graduate Medical Education has proposed major modifications to radiology residency programs. Among other changes, the move would extend the training period required before residents can take call without supervision.

The ACGME's Residency Review Committee (RCC) for Diagnostic Radiology began the latest revision to the specialty's Program Requirements for Resident Education in fall 2005. Through December 2006, the RCC presented several drafts for discussion at various venues: the RSNA meeting, the Association of University Radiologists meeting, and the Association of Program Directors in Radiology meeting.

The ACGME board and the radiology RCC should sign off on the final version in February. The proposed revisions will become effective July 1.

The proposed changes deserve the attention of radiologists at all levels because they will likely affect the future of the specialty, according to Dr. David B. Larson, a radiologist at the University of Colorado at Denver. Larson's comments appeared in the January issue of the American Journal of Roentgenology.

Perhaps the most controversial change is the proposal to delay independent call until residents have completed 12 months of training instead of the six currently required. Proponents argue that residents cannot master the skills needed to work safely without supervision in six months. They also contend that radiology must get in line with other specialties that do not allow residents to take unsupervised call in their first year.

Opponents argue that 12 months is just as arbitrary as six. They say independent call provides a valuable learning opportunity and criticize comparisons between first-year radiology residents and interns as unfair.

Another potentially controversial change would require all radiology residents to perform academic research and to publish or present the results of such projects at local or national meetings.

Other proposals have stirred up less controversy:

• change of requirements for radiologic/pathologic education

• end of the current 1:1 faculty-resident ratio requirement

• special attention on nuclear medicine education, with a focus on safety

• 24-hour online access to major journals

• requirements for teaching files

RRC members hope these changes will strengthen resident education. Many of them, however, could have unintended effects, Larson said. The revisions may have an uneven impact on small residency programs, affect recruitment of residents into academic radiology, and even endanger certain programs such as the one hosted by the Armed Forces Institute of Pathology.

The 25-page document with the proposed revisions can be viewed at the ACGME Web site.

For more information from the Diagnostic Imaging archives:

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