As Workloads Increase, Radiologists Participate in Less Resident Training
New research from the Harvey L. Neiman Health Policy Institute reports that radiologists who teach residents are spending significantly less time each year in that teaching role. The study, published in the Journal of The American College of Radiology, tracked the workload of 35,595 radiologists in Medicare Part B claims data from 2008 to 2020. As a percentage of total clinical workload measured in relative value units, work that involved resident training dropped from 35.3% in 2008 to 26.3% in 2019. In 2020, when the COVID-19 pandemic hit the US, the teaching share of work dropped further to 24.5%.
The researchers also observed that radiologists’ aggregate workload increased by 80% from 2008 to 2019. “Increasing volume has been a challenge in radiology departments, which provided impetus for this study. Anecdotally, the burgeoning workload appears to be a barrier for radiologists to engage in training residents, but no studies have evaluated these teaching trends with objective evidence. Our national study shows a 19% drop-in rate of cases read with a trainee among teaching radiologists, representing a significant and meaningful decrease,” said Judah Burns, MD, Radiologist and Vice Chair of Radiology Education at Montefiore Medical Center.
The data indicated that the total increase in imaging workload was absorbed to some extent with an increase in the total number of radiologists who read cases with trainees – from 20,530 in 2008 to 22,502 in 2020. However, the average Medicare Part B workload per radiologist still increased by 7% through 2019, before the pandemic. “This increase in workload could impact the time available to dedicate to teaching the next generation of radiologists and has additional implications regarding burnout,” commented senior author Andrew Rosenkranz, MD, Director of Health Policy, Department of Radiology, NYU Grossman School of Medicine.
“Although our data does not include information about training effectiveness, the observed dispersion of training across a broader pool of radiologists, many of whom are doing very little training overall, indicates a need to evaluate change in quality and consistency,” said YoonKyung Chung, PhD, Principal Policy Researcher at the Neiman Institute. “While a subset (top 20%) of teaching radiologists is still doing a majority of their work with residents, this group has also demonstrated the largest drop in teaching workload, which is changing the training landscape.”
The research team also observed shifts in the characteristics of teaching radiologists, who were more often subspecialists, in urban practices, and female compared with non-teaching radiologists. However, the downward trend in training participation was not confined to certain subsets of radiologists but was consistently observed across a wide range of radiologist and practice characteristics.