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THE INTERNAL REVIEW: SIMPLIFYING A TEDIOUS TASK, David Hartman. M.D.. Penn State UniversitY, Hershey, PA

P E~rjZO_~: To design a reliable, simplified technique to perform a meaningful internal review as mandated by the Accreditation Council for Graduate Medical Education (ACGME).

Methods: The ACGME Institutional Requirements and Special Requirements were converted into a series of yes/no questions. Individual questionnaires for program director, staff radiologist and resident were created utilizing these questions. These completed questionnaires became the basis for the internal review.

• ~es~lts: These Completed questionnaires accurately refiect the perceptions 6f the ifrbgfam-direclot, • staff and resident concerning the program's compliance'with ACGME stand~ifd§~"Th'ese clueS ti0nna_ife~"" can be completed rapidly and are easily updated as the standards change. This internal review format is independent of the Residency Review Committee (RRC) Inspection Document which is typically mailed several weeks before the formal RRC inspection,

_C, onclusion: The yes/no questionnaires derived from ACGME standards provide a simplified technique to perform a meaningful, timely internal review.

RESIDENT C O N F E R E N C E AT THE VIEWBOX - A N E W A P P R O A C H , Rober t S. Garo fa lo , M.D., I. Col l ins , NLD., U n i v e r s i t y of Wiscons in , M a d i s o n , WI Pu rvose : I m p l e m e n t a t i o n of a n e w r a d i o l o g y r e s i d e n t c o n f e r e n c e f o r m a t i n t e n d e d to inc rease r e s i d e n t pa r t i c i pa t i on a n d i m p r o v e case p r e s e n t a t i o n skills. Me thods : S ix t een r a d i o l o g y re s iden t s w e r e p a i r e d to f o r m e igh t teams. C o p i e s o f e i g h t CXR cases w e r e m a d e a n d g i v e n to e a c h t eam. Each t e a m w a s a s s i g n e d a v i e w b o x a n d w a s g i v e n 16 m i n u t e s to r e v i e w the e igh t cases. Each case w a s d i s c u s s e d in f ron t of t he g r o u p , b y o n e m e m b e r of a t e am,

such tha t all t e a m s p a r t i c i p a t e d in oral p re sen ta t ion . F o l l o w i n g e a c h p r e s e n t a t i o n the m o d e r a t o r p r o v i d e d a h a n d o u t a n d a succ inc t d i s cus s ion of t he f ind ings , d i f fe ren t ia l , a n d d iagnos i s . Res iden t s a n o n y m o u s l y e v a l u a t e d e a c h o ther ' s p e r f o r m a n c e , as we l l as t he t e a c h i n g e f fec t iveness of t he c o n f e r e n c e fo rma t . Results: This c o n f e r e n c e f o r m a t as well as t en t r ad i t iona l case con fe rences w e r e e v a l u a t e d b y the res idents . T h e resu l t s wi l l be p r e s e n t e d . Conc lus ion : This c o n f e r e n c e f o r m a t s h o u l d s e rve as a va luab le a l t e rna t ive to t he t r ad i t i ona l "hot seat" c o n f e r e n c e b y i n c r e a s i n g r e s i d e n t par t i c ipa t ion , i nc reas ing the n u m b e r of cases p r e s e n t e d p e r confe rence , a n d p r o v i d i n g f e e d b a c k to r e s iden t s r e g a r d i n g the i r p e r f o r m a n c e in case d iscuss ion .

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FIRST YEAR RESIDENT INSTRUCTION: DEVELOPMENT OF A RELEVANT CLIRRICULUM, David Harlman~M.D. R Mahraj, M.D., K Eggti, M.D., Penn State University, Hershey, JSA . . . . . . . . . . . . . . . . . . . PURPOSE: To develop a relevant, meaningful curriculum for first year radiology (R1) residen~,s. MATERIALS A curriculum for R1 residents was developed which emphasized anatomy, terminology and & METHODS techniques. A systematic approach to plain films, common problems in emergency

radiology arid normal variants were stressed. A staff radiologist served as a teaching coordinator (TC) for the following areas: chest, gastrointestinal, genitourinary, pediatric, orthopedic and neuroradiology Reading assignments and questions were developed for each conference. The format for each conference was case-based emphasizing R1 discussion and probfem solving with the TC acting as a facilitator (vice lecturer)._.The .R.l.x:onference was

.concurrent. with but independent of the conference for all other.radiology residents, fellows, and staff. The R1 curriculum extended from I July to 1 November.

RESULTS: This interactive, structured curriculum was enthusiastically accepted by the R1 residents and TC's. Assessment by each TC was that the R1 residents had developed an excellent understanding of the basic principles in each respective area. The R1 curriculum has enhanced the R1 performance on clinical rotations and has improved the transition of R1 on-call responsibilities.

CONCLUSIONS: This structured R1 curriculum has been well accepted by R1 residents, R1 teaching coordinators and by the faculty.

A CORE COURSE FOR FIRST YEAR RADIOLOGY RESIDENTS. Sandra A. A, Oldham. M.D., A. Rawal, J. Chart, T. Harle and S. Goldman.

PURPOSE: In orderto enhance uniformity of radiological knowledge, provide first y e a r residents with materials to make didactic conferences more useful to them, and as a quality assurance tool in assessing competency to begin overnight call, we began a "Core course" during the first six months of residency. METHODS: Faculty give sessions three afternoons a week in each of the subspec ia l ty areas of radiology, including physics. Basic principles are presented at a first year level in the form of lectures, cases, and informal daily unknowns. Emphasis i~ placed on diagnoses residents will be expected to make once they begin taking night calf, Most subspecialty areas receive 3 week blocks of core course time. R E S U L T S : Subjectively, residents complete a questionnaire detailing their impression of this course~ Faculty already have stated that the course is having the desired effect , making residents more knowledgeable even prior to formal rotations. Objectively, residents will begin night call only after successful completion of the course and passing the final exam. CONCLUSION: This unique core course is our commitment to the education and ea r ly uniformity of experiences important in residency training.

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IMPLEMENTATION OF EDUCATIONAL CURRICULUM IN A LARGE MULTI-INSTITUTION RADIOLOGY RESIDENCY PROGRAM, Aseem Rawal. MD. Chan, Oldham, I--larle, & Goldman University of Texas, Houston PURPOSE: The purpose of this paper is to demonstrate implementation of an educational curriculum that in accordance with the recommendations of the Association of Program Directors in Radiology (APDR) balances the educational goals of a radiology residency while at the same time meets the needs and demands era busy multi-institutional program. METHODS: The four-year residency program was divided into 52 four-week blocks. Using guidelines suggested by the APDR, rotations were assigned based on educational priorities. Then the distribution of these rotations was evaluated. For example, it was felt that most rotations should be done once yearly, rather than clumping rotations during the junior & senior years. Also, consideration was given to the coverage needs of the individual hospitals. RESULTS: Residents received equitable and adequate rotations in different subspeeialties. A comprehensive schedule was designed to introduce residents to various subspecialties in their first year with gradual refinements of the basic principles in subsequent years. Improved learning in residency, on- call performance, morale & self-confidence was noted. This also prepared the residents to perform well in the examinations administered by the American Board & College of Radiology. CONCLUSION: An equitable curriculum can be designed in accordance with the recommendations of the APDR that not only emphasizes the educational priorities, but also meets the coverage requirements of the various hospitals.

ACADemIC PRODUCTIVITY DIFFERENCES BE~qEEN PGYI AND PGY2 RADIOLOGY RESIDENTS, Darick L. Jacobs I. Laufer, M.D., University of Pennsylvania, Philadelphia, PA Purpose: To determine if differences exist between PGYI and PGY2 radiology residents by examininE academic productivity as measured by papers authored. Methods: Institutions with both PGYI (no clinical training) and PGY2 (prior clinical training) radiology residents were identified and lists of residents were obtained. lfs/ng a Medline search, the number of papers for each resident was determined and an average for both PGYI's and PGY2's was calculated. Papers were separated into those written during and after residency. Results: A total of 112 residents were examined from three qualifyin~ progratus. 53% were PGYI and 80% were male. PGYI's were found to average 1.05 articles during residency while PGY2's averaged 1.36 (p=.43). After residency, PGYI's averaged 0.47 articles while PGY2's averaged 1.17 (p<O.05). No significant difference was found between the Dublishing habits of male and female residents. In the analysis, a single outlier was identified in the PGYI group who published sixteen times. Analysis excluding this individual revealed a PGYI average during residency of 0.79 articles compared to the 1.36 articles for PGY2's (p<0.05). Conclusions: These data indicate that PGY2 radiology residents tend to publish more 6 papers than PGYI residents both during and after residency. This may have significant implications for radiology in the future as the pre-radiology clinical year becomes a requirement in 1997. No significant difference was evident between the publishing habits of male and female residents. Interestingly, over half (52%) of the residents examined did not publish at all.