Tag Archives: Radiology

Robots and Radiologists

In an article titled “The Robot as Radiologist,” Dr. Douglas Green from Univ. of Washington acknowledges the rapid advances in computational image recognition and advent of IBM’s Watson.  He concludes the commentary by taking solace in the fact that, at least for the time being, artificial intelligence is complementary rather than substitutional to human radiologists.  I wholeheartedly agree.  However, Harvard Business Schools gurus do not.

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5 Tech Tips Before Starting Radiology Residency

After a well-deserved celebration, the medical students who matched into radiology this year will realize what they’ve known all along – it will be a little more than a full year before they would start the actual residency they signed up for.

In many training programs, this post-match, pre-July-1 time is when the attention starts to focus on the folks who matched last year, those who will be starting in three months. Personally, April was when I also began to both getting psyched about starting a new residency program and getting nervous about preparing.

This post is about buying technology for those who are fixing to start radiology residency this year.

1. Find out If Your Program Has a Computer Fund

Any form of technology is a serious investment for a resident, as a computer can easily cost you a 2-week paycheck.

Before you buy anything, find out if your residency program provides funding for new computer and/or textbooks.

If it does, then great! It is then worth finding out when you can start using it. For instance, my residency program requires that you be officially working – i.e. July 1 – before you are eligible for the professional funding.

2. Get at Least One Portable Computer/Device

A paper in Academic Radiology states that having ready access to technology will become increasingly important in education.

The PACS stations at some hospitals provide unlimited access to the web and are outfitted with modern web browsers and office tools, but others may provide heavily filtered web access with minimal applications. Unless you are certain that your situation is the former, it would be worth having some form of portable computer/device.

Which form factor you decide to go with – tablet, ultrabook, regular notebook, or phablet – is a personal choice. Just keep in mind that the things you might end up using them for:

  1. Take notes during conference
  2. Look up a diagnosis or finding on Radiopaedia.org or one of its commercial competitors
  3. Integrate with electronic medical records – some institution’s EMR would ask that your device meet some security feature requirements
  4. Access the digital edition of a textbook
  5. Touch up a slides presentation for journal club or case conference

3. Get a Twitter Account

Social media is becoming increasingly important in radiology. Any national radiology conference you attend will have a strong Twitter presence, and many people are also on LinkedIn.

Since one of your tasks during the residency is to learn about the most pressing issues in the radiology community at large, becoming familiar with tools like Twitter can be tremendously helpful.

Also, if you start now, you can grab all the cool names before someone else gets them.

4. Avoid EInk Readers for Radiology Books

Radiology textbooks are expensive. It is made worse by the fact that there are so many of them! You will need a book for each subspecialty to really learn the nuances of each rotation.

Unfortunately, eInk readers are just not good enough for images on radiology. Kindle Paperwhite, for example, sports only 16 shades of grey. Reading the same books on a tablet like the iPad, Nexus 9, or Kindle Fire is a different experience, owing to the markedly improved contrast resolution over eInk.

However, be careful that sometimes Kindle or EPUB format books compress images so much that the quality is visibly degraded.

This is not to say electronic books are bad. Buying electronic books can be a good way both to save Benjamins and to reduce the weight of your bag if you load them on a tablet instead of carrying the hardcover incarnations.

EInk readers are great, and I love my Kindle Paperwhite. They are just not for radiology images.

5. Decide If You Want to Pay for an Anatomy Resource

If you are anything like me, you would find memorizing anatomy in a vacuum nearly impossible. Incidentally, it is also one of the most important funds of knowledge to acquire as a first year resident.

Therefore, it is sometimes worthwhile to have access to a good anatomy resource for use on-service. There are free resources like HeadNeckBrainSpine neuroradiology and XRayHead for MSK MRI. e-Anatomy by IMAIOS is an atlas that has some free content but is mostly a paid resource.

At some point you will have to decide whether free resources are sufficient for your needs. Your institution may provide access to a paid resource already, or your professional funding may cover it. If you have to pay out-of-pocket, consider the possibility of sharing an account with a co-resident (make sure you are not violating the user agreement, though).

Conclusion

Radiology residents use more technology than possibly more than other specialty residents from devices, educational resources, to social media. Ultimately how much technology plays a part in your training is a personal preference. However, keeping some of the above points in mind may help you avoid making bad purchase mistakes and be more prepared for July 1.

On The NRMP Residency Match, And What People Meant by “It’ll All Work Out”

The optimal solution of the NRMP match algorithm is deceptively simple, but its implication for the lives of applicants is anything but simple.

Three years ago, my then-girlfriend and I sat down and parsed through what would become the most important determinant of our lives moving forward.

Because we attended different medical schools, we carried on a long distance relationship for five years. The NRMP match was more than just a residency choice. It was also a solution that could finally close our distance and take the relationship forward again.

The ranked list seemed like the most difficult decision we had to make. There were so many variables, each with differing levels of importance.

match

Icons made by Freepik from www.flaticon.com is licensed under CC BY 3.0

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When We Care, We Share – But Where?

As radiologists, why keep a blog yourself when academic journals, professional blogs, or even newspapers offer a wealth of outlets to share your thoughts?

In a blog post, Arjun Sharma observes that the multitude of places to express his opinions a confounding option. Then, he and I exchanged a few emails seeking an answer.

Photo Source: www.jenniferjillharman.com

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Measure Differently to Think Differently

Credit: Innovation by Boegh, licensed by Creative Commons

There are many forms of innovations.  Sometimes medical innovation is nanotechnology, molecular imaging, high-precision targeted therapy, or 3D-printed prosthetic, which are advancements whose adaptation rate are limited by the rate of research.  This is a good thing.

And then, there exists technology that has become commonplace in every other industry but is still considered “innovation” in medicine due to their glacial adaptation rates in hospitals and clinics.  Case in point: When was the last time you saw a pager that doesn’t belong to a healthcare provider?

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The Gorilla Detection Exercises at Dawn – A Theory of Radiology Nightfloat

As a rite of passage as well as part of the regular work schedules of a radiologist, a resident trainee must take on the role of independent interpretation for exams that come into the hospital at night.  I happen to work at a place where attending backup is readily available by phone, but an attending radiologist is not in-house at night.  This provides an abundance of learning opportunities.

After finishing one week of radiology night duties as one of two trainees, I’ve begun to think how the progression of the night always seem to follow some pattern, and what that means for a radiologist trainee on call.

Pareto-Efficient

First, it’s probably useful to introduce the concept of a pareto-efficient curve. The curve explains the relationship between two desirable but partially mutually exclusive qualities.  For example, a radiologist wants to be very fast at interpreting studies.  A radiologist also wants to provide very high quality interpretations.  Alas, we cannot do both at the maximal capacity.  One might imagine the relationship between the two to look like this:

pec1

Standard pareto-efficiency curve

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Getting past that gotta-get-this-done-but-too-busy-right-now feeling

In the state of Pennsylvania you need a special permit to practice medicine outside of the supervision of an attending physician, called the unrestricted license.  For most residents, this is not a requirement – your training license allows you to train, and your unrestricted license allows you to practice, well, without restriction (really, it’s not that complicated).  Usually this means moonlighting.

Moonlighting is actually a glorious thing for a resident.  You get hands-on experience for problem solving, and the extra income goes a long way to supplement rent, food, and student loans for an in-training doctor. Continue reading