Alan S. Brody, MD, Editor

World Wide Web Sites for Radiology Residents

Title Web Address

AItaVista Amazon.corn American Board of Radiology American College of Radiology American Roentgen Ray Society Armed Forces Institute of Pathology Atlas of Gastrointestinal Endoscopy Barnes and Noble CTisus Discount Medical Books Federation of State Medical Boards LivTrauma National Library of Medicine PubMed Online Atlas of Surgery RadBooks Radiologist.com RSNA Launch Pad Society of Skeletal Radiology Society of Thoracic Radiology Uniformed Services Radiology Desktop University of Iowa Virtual Hospital Radiology University of Pennsylvania Medical Center Radiology WebPath Wheeless' Textbook of Orthopaedics

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h ttp ://www. alta vista, com h ttp ://www. amazon, com http://www, theabr, org http://www.acr.org h ttp ://www. arrs. o rg http://radpath.afip.org/radpath/ http://www.atl.mindspring.com/~dmmmd/index.html h ttp://www, bn. com http://www, ctisus.org http://www.discmedbooks.com/radiologymri.html http://www, fsmb.org http://www, swsahs.nsw.gov.au/livtrauma http://www, ncbi.nlm.nih.gov/PubMed/ http://www, bgsm.edu/surg-sci/atlas/atlas.html http://www, radbooks.com http://www.radiologist, com http://www.rsna.org/REG/launchpad/launchpad.html http://www.skeletalrad.org http://www, thoracicrad, org/str99/home99.htm http://rad.usuhs.mil/radiology_toolbar.html http://www, vh.org/Providers/ProviderDept/InfoByDept, Rad.html http://www.rad.upenn.edu http://www-medlib.med.utah.edu/VgebPath/webpath.html http://www.medmedia.com/med.htm

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WORLD WIDE WEB RESOURCES FOR RADIOLOGY RESIDENTS

An article in RSNA EJ (1) reported that a search of the World Wide Web for the word "radiology" performed on February l 1, 1998, returned 34,266 pages when the AltaVista search engine was used; a similar search on March 8, 2000, returned 301,235 pages, up over 750% in just over 2 years--an increase worthy of a "dot corn" initial public offering. For radiology residents at many institutions, the same span of time has meant the end of one of our most important responsibili- ties, hanging filmed images. This has freed up countless hours that can now be spent in more productive activities, like research, reviewing teaching cases, and day trading in the aforementioned dot corns. This article provides an over-

view of Web resources relevant to radiology residents; a list of site names and addresses (current as of March 2000) is provided in the Table for easy reference.

Societies, Fellowships, and Jobs

The Web site for the Radiological Society of North America (RSNA) includes online access to Radiology and RadioGraphics and the RSNA Launch Pad--a comprehen- sive list of radiology sites divided into categories, many of interest to residents, including teaching files and fellowship information. The American Roentgen Ray Society now pro- vides online access to the American Journal of Roentgenol- ogy and has recently begun reviewing radiology-oriented sites, an increasingly important function given the explosion of available material. Many state and subspecialty societies

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also have sites that allow one to join online. The American Board of Radiology site includes information concerning board examinations, including dates, procedures, and sam- ple questions.

The American College of Radiology (ACR) site maintains a listing of fellowship programs that can be searched by state, in- stitution, subspecialty, and faculty; however, the list does not include all available fellowships, and the entries contain only basic contact information. The ACR also provides online ac- cess to its job listings, a service that is free to members. Many subspecialty societies, including the Society of Skeletal Radiol- ogy and the Society of Thoracic Radiology, also maintain lists of fellowships and available jobs at their sites. Radiologist.com maintains an index of links to radiology sites, including a convenient list of links to pages containing residency and fel- lowship information at over 75 institutions. Having secured a position, senior residents can review licensing requirements and even download some state forms by following state agency links at the Federation of State Medical Boards site.

Books and Electronic Media

Someday soon, the idea of a printed textbook updated once every 10 years will seem quaint, but for now residents can use the Web to get books at substantial savings. Large "e-bookstores," like Amazon.com and Barnes & Noble, will often have discounted prices on radiology texts, especially newer releases, and they will special order any book, in or out of print. There are several online vendors that cater spe- cifically to radiologists and other physicians, including Discount Medical Books and RadBooks. Most publishers also have Web sites that contain descriptions of their books and offer online shopping, although usually at higher prices. The ACR teaching file CD-ROMs can be purchased only from the ACR Web site, but many other discs, including teaching file collections and hypertext versions of printed textbooks, can be purchased at the sites listed above.

Teaching Files and Web Lectures

Many institutions maintain Web-based teaching files or case collections. The RSNA Launch Pad lists approximately 70 sites, most of which were reviewed in RSNA EJ (1) in 1998. The collections range in size from just a few cases to over 3,700 with varying amounts of discussion and references. One noteworthy entry is CTisus, sponsored by Johns Hopkins Medical Institutions. This very well designed site contains over 2,000 teaching file cases, spiral and 3D computed tomographic (CT) protocols, and illustrated CT atlases of musculoskeletal and vascular disease with numerous examples. Most teaching file sites also have lists of links to many other sites, so you won't soon run out of cases to review.

Faculty are beginning to transfer their lectures to Web format. Residents who have attended the Armed Forces In- stitute of Pathology (AFIP) course can find all of Dr James Smirniotopoulos' neuroradiology lectures online, with im- ages, at the Uniformed Services University of the Health

Sciences Radiology Desktop. Dr Jeffrey G alvin's chest lec- tures are in the radiology section of the University of Iowa's Virtual Hospital; this site is an incredible reference tool with very detailed, high-quality content, much of it peer reviewed. Incidentally, the AFIP site contains course information, forms for preparing your cases, and a listing of available housing in the area.

One of my most frequent work-related uses of the Web is to find reference material about nonradiologic aspects of di- agnosis and treatment. As in radiology, there is a tremendous amount of information available on the Web concerning other specialties including complete textbooks, such as Wheeless ' Textbook of Orthopaedics. WebPath, from the University of Utah, is an extensive source for general pathology information and includes many examples of radiologic-pathologic correla- tion. A gastroenterologist in private practice in Georgia has assembled an impressive collection of over 250 endoscopic photographs in the Atlas of Gastrointestinal Endoscopy. The Online Atlas of Surgery, from the Department of Surgery at Wake Forest University, is a must-visit site for residents wish- ing to understand postoperative imaging; this site contains detailed descriptions of surgical techniques, including line drawings and intraoperative photographs, as well as discus- sions of indications and potential postoperative complications of specific procedures. In addition, the site contains numer- ous presentations on surgical topics available for download in PowerPoint format. Another useful site is LivTrauma, from Liverpool Hospital in Australia, which contains information concerning trauma management and suggested protocols for work-up of specific types of injuries, including which ra- diographic studies should be ordered and which are unnec- essary. Of course, the National Library of Medicine 's free PubMed interface to the MEDLINE database is a daily staple of resident life.

Content on the Web is copyrighted and should be treated as such. As with journal articles, Title 17 allows limited rights to reproduce material for use in education, and representative material can be quoted for citation or review as long as it is properly referenced. However, unless permission for use is explicitly given on a site, it is best to contact the authors to discuss your intended use of any material posted on the Web. In contrast, it is a generally accepted tenet of "netiquette" that unless explicitly prohibited, you may place on your own Web site a link to any Web content.

The Future

The future will undoubtedly see the transfer of more tradi- tional content such as teaching files and lecture notes onto the Web. Having material in digital format has numerous advan- tages including decreased storage space, easier updates, and nearly instantaneous dissemination to radiologists and other physicians around the world and in our own institutions. At present, the entire curriculum of the University of Pennsyl- vania School of Medicine is available on the Web, including hypertext lecture notes with online images and links to digital

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Academic Radiology, Vol 7, No 7, July 2000 ELECTRONIC RESOURCE SITE

video versions of the lectures. All images acquired in the ra- diology department are available on the Web through GE Medical Systems' PACSWeb server. This is very useful for residents, who can now incorporate images into presentations, manuscripts, or personal digital teaching files with a click of the mouse. Also, referring physicians, in or out of the hospital, can view images and reports on any computer with a Web browser. Rather than leading to isolation of radiology residents in the reading room, this development has resulted in more productive consultations with other house staff, who now actu- ally look at the images when they call to discuss a report.

The future of radiology is on the Web; an AltaVista search in another 2 years will probably return over a million pages. Future radiology residents will spend most of their day online and using Web-based picture archiving and communication systems, voice recognition dictation systems, audio and video

conferencing for consultations, and teaching and reference resources such as those outlined above. The American Board of Radiology is currently preparing facilities for computer- based board examinations. These could be given over the Web; this would mean the end of trips to Louisville (Ky), truly marking a new digital era in radiology.

Harold I. Litt, MD, PhD

University of Pennsylvania Medical Center

Philadelphia, Pa

'EFERENCI=

Gentili A, Bard J. Preparing for the board by using teaching cases on the Internet. RSNA EJ/RadioGraphics Archives [serial online]. June 11, 1998; http://ej.rsna.org/ej2/OO71-98.fin/default.htm.

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