| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1
Department of Radiology, Baylor College of Medicine, One Baylor Plaza,
Houston, TX 77030.
2
Department of Radiology, University of Rochester, Box 648, 601 Elmwood Ave.,
Rochester, NY 14642.
Received September 24, 1999;
accepted after revision October 25, 1999.
Address correspondence to C. J. Goodman.
Abstract
 Top Abstract IntroductionMaterials and MethodsResultsConclusionsReferences |
|---|
MATERIALS AND METHODS. During the 47th Association of University Radiologists meeting, participants from the American Association of Academic Chief Residents in Radiology completed a questionnaire regarding the intentions of third- and fourth-year residents in their programs.
RESULTS. Seventy programs, representing 402 fourth-year and 395 third-year residents, responded. Of fourth-year residents, 322 (80.1%) accepted fellowships and 41 (10.2%) accepted jobs. Of third-year residents, 335 (84.8%) accepted fellowships. Eighty-eight (27.3%) fourty-year residents and 95 third-year residents (28.4%) accepted interventional radiology fellowships, and 104 (32.3%) fourth-year residents and 96 (28.7%) third-year residents accepted body imaging fellowships. Most residents who accepted fellowships did so in the same city in which they completed their residency training. Of fourth-year residents who accepted fellowship positions the year before, 14 (4.3%) withdrew their acceptance to pursue employment.
CONCLUSION. Most residents opt for fellowship training in interventional radiology or body imaging. We postulate that the practice of accepting fellowships during the third year of residency may contribute to the percentage of residents who rescind fellowship acceptance to pursue employment. We suggest that consideration be given to changing this practice.
|
TopAbstractIntroductionMaterials and MethodsResultsConclusionsReferences |
|---|
Residents can receive fellowship training in many subspecialties, each unique in challenges and disparate in approach. Traditionally, the decision regarding subspecialty training confronts the third-year resident, who must not only make the critical decision of which subspecialty to study, but also make it in the face of a rapidly shifting job market.
We gathered data concerning the decisions of the diagnostic radiology residency classes of 1999 and 2000.
|
TopAbstractIntroductionMaterials and MethodsResultsConclusionsReferences |
|---|
Chief residents were asked to list program name, total number of residents in the program, number of fourth-year residents, and number of third-year residents. For each of the third- and fourth-year classes, the chiefs were asked to list the number fulfilling fellowship, job, and military obligations. For each class, we asked, of those going on to fellowship training, how many would remain at the same institution and how many would remain in the same city but begin fellowship at a different institution. Chiefs were asked to list a subspecialty breakdown for residents going on to fellowship. Additionally, for fourth-year residents only, we asked how many residents had initially accepted fellowship positions, only to withdraw acceptance at a later date to pursue other opportunities. The questionnaires were collected, and the data were compiled and examined.
|
TopAbstractIntroductionMaterials and MethodsResultsConclusionsReferences |
|---|
Of 402 fourth-year residents, chiefs reported that 322 (80.1%) accepted fellowships, 41 (10.2%) accepted private practice opportunities, and 21 (5.2%) intended to fulfill military obligations. Of 395 third-year residents, 335 (84.8%) accepted fellowship training (Table 1).
|
Chief residents reported that 14 (4.3%) of 322 fourth-year residents initially accepted fellowship positions during the standard application process (which occurs during the third year of residency) only to rescind acceptances in favor of other opportunities made available during the subsequent year. These residents represented 34% (14/41) of residents who accepted jobs after residency.
For fourth- and third-year residents accepting fellowship positions, subspecialty choices were similar. Combined, interventional radiology and body imaging fellowships accounted for 192 (59.6%) of 322 positions accepted by fourth-year residents. The same mixture accounted for 191 (57.0%) of 335 positions accepted by third-year residents. One hundred four (32.3%) fourth-year residents and 96 (28.7%) third-year residents accepted body imaging fellowships. Eighty-eight (27.3%) fourth-year residents and 95 (28.4%) third-year residents accepted interventional radiology fellowships.
Neuroradiology was the third most prevalent subspecialty choice, with 45 (14.0%) of 322 fourth-year residents and 54 (16.1%) of 335 third-year residents accepting positions. Together, pediatric radiology, nuclear medicine, women's imaging, musculoskeletal imaging, and MR imaging specialty training accounted for 101 (17.4%) of the remaining fourth-year residents and 109 (32.5%) of the remaining third-year residents. Specifically, 5.6% and 4.8% of fourth- and third-year residents chose nuclear medicine, 4.0% and 4.2% chose women's imaging, 3.7% and 3.3% chose pediatric imaging, 3.4% and 3.3% chose musculoskeletal imaging, and 0.6% and 0.9% chose MR imaging fellowship training, respectively. (Figs. 1 and 2).
|
|
Most residents accepting fellowship positions did so in the same city in which they completed their residency training. One hundred seventy-four (54.0%) fourth-year residents and 183 (54.6%) third-year residents remained in the same city. Nearly 50% (149 [46.3%] fourth-year residents and 161 [48.1%] third-year residents) of residents that accepted fellowships remained at the same institution at which they received residency training. (Table 2).
|
|
TopAbstractIntroductionMaterials and MethodsResultsConclusionsReferences |
|---|
Reasons for the large percentage of residents that choose fellowship are debatable. The brisk pace at which technologic advances enable imaging and therapeutic progress may seem to mandate an extra year of training for some residents. Also, the perception of a relatively restrictive job market may influence some residents to seek further training as a method of acquiring more specific and, thus, more sought-after skills. However, if the studies by Crewson et al. [2, 4] are reasonably accurate measures of residents' attitudes toward the job market, then more residents will probably seek employment opportunities in the coming years. In any case, the perception of the job market is constantly in flux. What stands true one year may be patently false the next. Perhaps the drive to fellowship training represents a deep-seated insecurity concerning the state of the job market 2 years in the future.
Our subspecialty breakdown reveals that body imaging and interventional radiology represent most of the fellowships accepted. Breakdown percentages were roughly similar between the fourth- and third-year residents. One hundred four (32.3%) fourth-year residents and 96 (28.7%) third-year residents accepted body imaging fellowships. Eighty-eight (27.3%) fourth-year residents and 95 (28.4%) third-year residents accepted interventional radiology fellowships. Some of our percentages and numbers do not total exactly. This discrepancy probably results from the number of newly elected chief residents that filled out our questionnaires. Typically, these chiefs were near the end of their third year of training and they were probably unaware of the intentions of their fellow upper-level residents. This factor is a potential flaw in our study.
We were also interested in the number of fourth-year residents who accepted fellowship positions, only to rescind their acceptances and pursue other opportunities. In our survey, 14 (4.2%) fourth-year residents accepted fellowship positions during their third year of residency, only to rescind their acceptances in favor of private practice opportunities during their fourth year of residency. We postulate that the practice of applying for and accepting a fellowship position during the third year of residency may contribute to the percentage of residents who rescind fellowships and pursue jobs during the fourth year of residency. Further, the perception of a recent loosening in the job market may foster a growth in this trend. Unfortunately, sometimes residents and those offering alternative opportunities have no regard for commitment or other ethical considerations.
The reason why the application process takes place during the third year of residency is because of planning. The residents are, by this line of reasoning, too busy during the fourth year of residency to devote the time and energy needed to apply for fellowships. For example, most fourth-year residents spend their time studying for board examinations. The necessity of filling out applications, seeking and receiving letters of recommendation, and traveling to interviews is just the beginning of the application process. Eventually, residents accepting fellowships must also relocate: they must find a new place to live, pack, move, and make spousal and dependent arrangements. However, our results indicate that over half of the residents that accept fellowships enroll in programs in the same city in which they received their residency training, thus sparing the fourth-year resident the rigors of relocation. Interestingly, a study by Lalman et al. [5], noted that graduates who could not relocate had a significantly harder time finding employment. This finding, filtered down from previous graduates, may also influence the large percentage of residents who decide to stay in the same locale. Again, the perception of the job market may have a proportionately large influence on resident decision making 2 years before they actually enter the market.
Many reasons support our suggestion to alter the fellowship application process so that it takes place during the fourth year of residency. Fourth-year residents are better able to make well-informed decisions based on factors that may effect a possibly life-altering decision—not the least of these is the current trend in a seemingly volatile job market. A well-informed decision will be better for residents and better for fellowship programs. Fellowship programs will benefit because late withdrawal from accepted fellowships causes an increased burden on programs and is unfair to other candidates.
Future studies should include acquisition of data regarding the factors that influence fellowship and subspecialty decisions. We suggest that consideration be given to changing the fellowship application process to take place during the third year of residency.
|
TopAbstractIntroductionMaterials and MethodsResultsConclusionsReferences |
|---|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  D. M. Yousem and D. A. Hammoud Assessment of the Neuroradiology Fellowship Match: Year 3 AJNR Am. J. Neuroradiol., May 1, 2004; 25(5): 897 - 900. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. G. Mitchell, L. Parker, J. H. Sunshine, and D. C. Levin Body MR Imaging and CT Volume: Variations and Trends Based on an Analysis of Medicare and Fee-for-Service Health Insurance Databases Am. J. Roentgenol., July 1, 2002; 179(1): 27 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Enzmann, P. M. Anglada, C. Haviley, and L. A. Venta Providing Professional Mammography Services: Financial Analysis Radiology, May 1, 2001; 219(2): 467 - 473. [Abstract] [Full Text]
|
|
|
|
|
|
L. F. Rogers Missing the Meeting: Technologic Innovation and Work Demand Versus Payment Initiatives Am. J. Roentgenol., May 1, 2000; 174(5): 1189 - 1189. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
