Thanks to a commitment and financial sponsorship from both the ACR and individual state chapters, the number of residents and fellows attending the ACR's annual meeting each year continues to grow. Representatives from every corner of North America were present, from Maine to Hawaii, Puerto Rico to Ontario, and from programs large and small, university- and community-based.

The opening day began with a Resident Physicians Section Executive Committee meeting over breakfast. Chair-elect Christopher Wald M.D., Ph.D., from Massachusetts, who was presiding over the 2002 annual meeting of the ACR RFS, welcomed this year's contingent and provided an overview of events for the ensuing five days. Next was the day-long PET Categorical Course, which was an outstanding collection of talks and images from the field's best. The timeliness and quality of this course was evidenced by an enrollment far surpassing that in prior years, necessitating a much larger venue than anticipated.

During the break for lunch, ACR President Kay Vydareny, M.D., provided our section with an overview of the organization and orientation to the role of the RPS within it. She reviewed the structure of the ACR Council, the legislative body of the College through which each member helps establish policies affecting all of radiology. Each state chapter sends a minimum of one councilor and one alternate to the Council with a total of 247 voting councilors; the RPS has one voting councilor (the executive committee chairperson) and one alternate (the vice chair).

On the second day, a pair of lively RPS business meetings focused largely on the resolutions to be voted on by this year's Council. The RPS Executive Committee members had identified those resolutions of particular interest to residents, fellows, and recent graduates and distributed copies of them to attendees in advance of the meeting. These ranged from standards for teleradiology and arteriography to formal Council representation for the Association of Program Directors in Radiology. The implications of these resolutions for radiologists-in-training were often obvious, such as requirements for the performance of a specific number of angiograms as primary operator, but some were more complex. In establishing a position on each, RPS members had an entertaining exchange of anecdotes and opinions, touching on issues like proliferation of radiology physician assistants, collapse of vascular-interventional departments, and coverage of multiple outside hospitals via teleradiology while on call. Call rooms reminiscent of Sanford and Son's garage, threatened conference time, and the 80-hour work week were familiar concerns, but there were more disturbing tales as well: orthopedic residents dictating MRIs and plain films while on their radiology electives, radiology residents assisting vascular surgeons while covering interventional call, and unpaid, mandatory "internal moonlighting" effectively doubling more than one program's workload.

Day two also included the Resident Physician Leadership Development Seminar, sponsored by Berlex Inc. Conducted by Jean Frankel from Tecker Consulting, the session was much less corny than I'd feared, and provided many specific ideas on how we can be more effective as residents and as active members of the radiology community. This was followed by a luncheon with Dr. Vydareny and other ACR leaders, giving us a chance to see how they combined the clinical duties of radiology with their leadership roles. Dr. Vydareny cited many resident comments from the lunchtime session as she spoke to the Council later that day about the current crisis in academic radiology.

At the RPS Caucus, the topic causing the greatest stir was the proposal by the Society of Chairmen of Academic Radiology Departments to change the timing of the resident ABR examinations, with oral boards to be delayed for at least one year following completion of residency. A response to the perception of excessive fixation on the oral exam by 4th year residents, the proposal was universally opposed by the RPS. The overwhelming feeling was that this would severely detract from the residents' ability to prepare for the oral boards and put the finishing touches on their education. For example, a move to delay the boards would effectively end the ability for senior residents to attend board reviews at outside institutions. Furthermore, once a radiology resident graduates the scope of his or her practice narrows quickly (unlike most other specialties) and soon after graduation from residency no longer encompasses the subjects currently tested in the oral board examination. Trying to keep current in all of radiology, in order to pass the boards, would be difficult. Finally, the legality of graduates reading mammograms without being board-certified was questioned. It was decided that moving the boards would limit the influx of new radiologists available to read mammograms and further exacerbate the general manpower shortage in private practices by forcing graduates to study during their early years as staff.

Also at the forefront of this year's issues was the new ACGME common duty hour recommendations pertaining to all residents in the US. A quick poll indicated that most of the residents' programs were already in compliance. However, a brief discussion followed about the fact that these work hour guidelines also encompass moonlighting. This was surprise to many of the residents attending. Several of them indicated that, due to the shortage of fellows, they were now taking extra call and working additional hours. This may result in their programs not being in compliance with the ACGME guidelines.

Another topic of discussion was the growing tendency of newly graduated radiologists to drop their ACR membership. Suggested remedies included opening up committee posts to interested "young physicians" or trainees, increasing the budget for RPS recruitment and ACR meeting attendance, adding positions within the state chapters for the newly graduated, forming a separate Young Physician Section (newly graduated to five years out), formalizing resident mentoring relationships with state leaders, and inviting interested residents at the AFIP to the annual meeting, which is moving to Washington, D.C., beginning in 2003.A survey of MRI training was distributed and collected for input to the ACGME Residency Review Committee for diagnostic radiology. In an effort to collect more robust data, the ACR RFS has now made the MRI survey available on its section of the Web site. Please visit:

http://www.acr.org/dyna/?doc=departments/residents/rps/forms/rps-survey02.html

and fill out the survey. Responses will form the basis for improvements to the MRI training. [Thanks to these survey results and the persistent efforts of Kelly Foster and the RPS executive committee, the RRC has decided to ask their site inspectors to include questions regarding the satisfaction of residents with MRI training, and has included MRI training on the agenda for its next meeting in February, 2003. Check the residents' forum on the ACR Web site for more details.]

The ACR Council meeting opened on Sunday, September 29, with reference committee hearings on specific resolutions the next day. RPS representatives spoke on each of the resolutions discussed at the RPS business meetings and caucus, creating a very visible presence for the section. The resolution that created the most controversy during Reference Committee proceedings was the proposal to change the name "ACR Standards" to "Practice Guidelines."

Following the reference committee sessions, a panel discussion on radiation accidents, radiation protection, and nuclear terrorism provided a fascinating and often chilling inside look at the new nuclear fear and our role as radiologists in dealing with the unthinkable. The ACR has produced a pamphlet titled "Disaster Preparedness for Radiology Professionals: Response to Radiological Terrorism," which covers much of this topic and should be required reading in all departments.

Two days of debate on the proposed resolutions by the Council members then followed. Ultimately, the term "standards" was retained for the ACR guidelines. Most of the proposed resolutions passed with few amendments. One resolution that was deferred was the ACR standard on esophagrams. The council session concluded with some strong pina coladas on the beach.

Elections for the RPS executive committee were held, with the 2002-2003 committee composed of:

The next ACR meeting will be held in Washington, D.C. in May, 2003.

Report respectfully submitted by

Erik Nelson, M.D., MRS RFS and
Seth Hardy, M.D., Secretary, MRS RFS
Boston, November 2002

How to get involved

I strongly encourage any of you interested in the current and future practice of radiology to get involved in the ACR by becoming active in the Radiological Society of New Jersey, Resident and Fellows section. For additional information about the meeting and other resident related issues see the Resident section of the ACR website

http://www.acr.org/dyna/?doc=frames/main-residents.html

Ajay Sood, M.D., RSNJ

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