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The Internet has changed the practice of medicine in many ways, from enabling telemedicine to making the scientific literature easily accessible and searchable. Medical education also has changed and benefited a great deal from the Internet. Lectures, tutorials, and other educational materials readily available online to medical students, residents, and other physicians have increased the opportunities for self-study. Radiology, more than any other medical specialty, is extremely well suited to Webbased study. Just as a surgeon gains experience from performing surgery and an internist gains experience from caring for patients, a radiologist gains experience from examining many radiologic images. Although it is less helpful for teaching image-guided therapies, the Web lends itself to self-study of visual materials and provides an easily accessible resource for gaining experience in radiologic interpretation. Sifting through the numerous radiologic Web sites for useful teaching tools, however, may require more time than a student or resident can spend. Many sites must be explored to find useful teaching material, because the quality of online educational resources is uneven. A student or resident interested in radiologic self-study may be deterred by these obstacles. We therefore have identified and reviewed a number of Web sites offering useful materials, listing them in three categories: those offering teaching files (Table 1), those offering tutorials (Table 2), and those sponsored by radiologic organizations offering a variety of educational resources (Table 3). Our purpose is to provide an easily accessible and understandable reference for residents and medical students who wish to explore Web-based self-study in radiology. The information outlined here should allow students to spend more time learning rather than surfing the Internet. These site listings are snapshots in time. Web resources are truly moving targets. Soon after one describes the current status of resources on the Web, that status may change. Therefore, there is no possible guarantee of the future accuracy of these sites. The future likely holds more resources, perhaps of even higher quality. One major asset of Web-based resources, however, is that they are available anywhere and at any time. These resources can also provide outreach to practitioners in underdeveloped countries who may be unable to afford printed materials or travel to continuing medical education courses. In addition, these resources can be updated according to current practice and are not bound by a printing date. It is an ongoing challenge to keep abreast of the availability of current and new Web sites. Sites were reviewed for this article from the perspective of a 1st-year radiology resident or 4th-year medical student. The comments are meant to help users find sites that best fit their needs. Program directors are encouraged to bookmark useful sites on resident workstations, making the gateway available to any resident or medical student with a spare minute to find a site and learn. These resources can be incorporated into picture archiving and communication system workstations of the future, so that when the queue of pending cases is exhausted and e-mails are answered, a few cases or a structured teaching session can occupy the available minutes until more cases are ready. The Radiological Society of North America (RSNA) has an extensive portal page for radiology education. We used this portal and popular Web search engines (eg, Google, Yahoo, MSN, and Excite) to compile a large list of sites to explore. The search terms that consistently produced the best results were “radiology” and “teaching.” Two types of education pages were sought: teaching files, to allow practice in radiographic diagnosis, and Webbased tutorials, to provide a more basic education in radiology. The teaching file Web sites were assessed according to several criteria, including the number of files, the ability to view the cases as both known and unknown diagnoses, the depth of case discussion, image quality, the Acad Radiol 2003; 10(suppl 1):S81–S86

Rationale and Objectives. This purpose of this study was to determine if a 1-month, mandatory research rotation results in resident interest and productivity in research. Materials and Methods. A survey composed primarily of closed-end questions was constructed to evaluate the opinions and experience of 24 residents who completed the research rotation during a 3½-year period. Results. All 24 residents filled out the survey. Seventeen residents did clinical projects, two did bench research, and two did projects that were socioeconomic or legal in nature. Thirteen residents presented data at a meeting, and three of these presentations won awards. Resident research projects resulted in 18 manuscripts at the time of the survey (seven published, eight in preparation, and three in revision or review). Seventeen residents thought the experience was worthwhile and the research month should be continued; two residents did not. Ten residents reported that in retrospect, they would have done the rotation even if it had not been required, and eight reported the experience increased their appreciation of the value of research in medicine. Conclusion. A 1-month, mandatory resident research rotation produces resident interest in research and enhances departmental research productivity.

Rationale and Objectives. We surveyed diagnostic radiology group preferences and considerations in hiring radiologists and compared these findings with those of a survey performed in 1990. We sought to identify changes in hiring practices that might have occurred because of socioeconomic changes. We also sought to identify features of job candidates that make them more attractive to hiring groups. Methods. One hundred surveys were mailed to a stratified random sample of diagnostic radiology groups identified by the American College of Radiology. We solicited information on the importance of various attributes and the level of experience of a candidate, the fellowship training considered, most desirable, and the effect of changes in the health care socioeconomic environment. The responses were weighted by group size and geographic location to estimate what results might have been obtained if we had surveyed all groups in the United States. Results. Seventy-five groups returned the survey. The two most important factors in choosing a candidate were motivation and radiologic knowledge. The fellowships that groups that were hiring considered, to be the most desirable were body imaging, neuroradiology, and angiography/interventional radiology. Groups overwhelmingly preferred recent training over long experience. Conclusion. Fellowship training increases a candidate's marketability, but the two factors that hiring groups consider the most important are motivation and radiologic knowledge.

Rationale and Objectives. The purpose of this study was to assess the effect of Health Care Financing Administration (HCFA) regulations on radiology fellowship training. Materials and Methods. Surveys were sent to 157 fellowship program directors in body imaging and vascular/interventional radiology. Questions addressed program accreditation status, faculty supervision of fellows, and any change in faculty supervision of fellows in response to HCFA's revised plan for Medicare Part B reimbursement. Results. Eighty of 157 (51%) surveys were returned. Thirty (37%) respondents indicated supervision of fellows had changed after institution of the new HCFA rules in July 1996. Vascular/interventional program directors (n = 25, 49%) were more likely to have changed their practice than body imaging program directors (n = 5, 17%). Nearly all respondents (29 of 30, 97%) indicating a change stated supervision had increased. Twenty-seven (33%) respondents also indicated faculty supervision was beyond that necessary for patient care and house staff education; most of these respondents (21 of 27, 78%) stated the new HCFA regulations were responsible. Many program directors also expressed concern the HCFA regulations might prevent fellows from obtaining sufficient experience to effectively learn independent clinical decision-making. Conclusion. HCFA regulations intended to address attending physician billing practices at teaching institutions may have had the unintended effect of substantively altering the training of radiology fellows.

Rationale and Objectives. We evaluated whether a breast biopsy phantom device would aid in the development of skills in freehand ultrasound liver biopsy. Methods. Three radiologists who were inexperienced in freehand biopsy of the liver were observed. Each radiologist was timed and scored during attempts to biopsy lesions created in a beef liver. The time required for biopsy and the success of each pass was recorded. A commercially available breast biopsy phantom was then used by each of these radiologists during two 20-min practice sessions. Posttraining testing on the beef liver was performed in the same manner as pretraining testing. Results. Freehand biopsy practice using the breast biopsy phantom resulted in a reduction in the mean time required for biopsy from 32 to 17 sec. Each of the three subjects reduced the mean time required for successful biopsy after training using the breast biopsy phantom. The total number of lesions missed was reduced from 14 of 43 to 0 of 45. Conclusion. Practice using the ultrasound breast biopsy phantom improves performance in freehand ultrasound biopsy of the liver.

Rationale and Objectives. The authors' purpose was to evaluate radiology residents' assessment of their own computer skills for potential development of computer training in a residency curriculum. Methods. The authors conducted a survey to evaluate the attitudes of radiology residents concerning personal computing. Surveys were completed by 136 radiology residents from six academic institutions. Results. Sixty percent of residents surveyed considered themselves to be computer literate and 93% would like further computer training. Fifty-six percent had a computer at home and 9% had a laptop. Almost all residents had access to a computer at work. Word processing and medical literature searches were the most common computer tasks performed by residents. Image processing was the least common task performed. Although all hospitals surveyed were connected to the Internet, only 26% of residents used the Internet and 14% used Internet teaching files. Most residents expressed a preference for self-paced, on-line evening training sessions. Conclusion. Most radiology residents believed they possessed adequate computer skills. This proportion has markedly increased over that found in previous surveys. Radiology residents desire and could likely benefit from computer training included as part of the residency curriculum.

D iagnostic radiology and its graduate medical education programs are experiencing unprecedented change and uncertainty. Radiologists completing residencies and/or fellowships find securing permanent employment increasingly difficult, and training programs face the prospect of significant reductions in financial support and growing pressure to train fewer specialists. Together, these realities have produced calls to reduce the number of residency positions. The Accreditation Council for Graduate Medical Education (ACGME) and its Residency Review Committee in Diagnostic Radiology (RRC) are often mentioned as vehicles to accomplish such reductions. Any such action may carry potential antitrust liability under federal law as represented by the Sherman Act.

Rationale and Objectives. This survey was compiled to provide current data on the structure and content of radiology residency programs and the role of the residency program director. Methods. A survey, created in electronic form and on paper, was distributed to all United States academic, private, and military radiology residency program directors. Results. Of the 202 survey forms distributed, 168 (83%) were completed and returned. Eighty percent of respondents support national curriculum guidelines, but most do not favor national curriculum requirements. About half (53%) of programs spend 6 months in “view box” nuclear medicine; others provide some experience by lectures and on-call time. Most programs (60%) relieve residents of some call during the senior year. Some programs (28%) allow seniors time away from clinical duties to study for the oral board exam, and 17% permit time away to study for the written boards. Seventy-eight percent of programs have had a “problem resident,” and 47% have asked a resident to leave the program. Directors' most frequently expressed concern was threat of diminished residency numbers due to decreased funding.