What makes a great radiology resident

Radiology faculty members, future employers of radiologists, and radiology residents all have a keen interest in clearly understanding what makes a great resident. To hit a target, it is necessary to see it clearly, and the characteristics of great residents can serve as a target for both faculty members and trainees throughout the 4 years of radiology training. No one’s interests—least of all, those of patients—would be well served if either group treated residency training as a period of indentured servitude during which residents simply “put in their time” while accumulating sufficient knowledge to achieve professional certification. It is better if everyone sets their sights on higher levels of achievement. Even if our loftiest goals are not always achieved, their constant presence helps us reach a higher level of performance than we otherwise would. For some radiology residents, the transition from medical school to residency is difficult. Throughout college and medical school, we grow accustomed to a system with relatively clear performance expectations—a system in which evaluations are frequent and unequivocal. We learn that to receive an A in this or that course, we must achieve a cumulative total of X points. By tracking our performance on each examination, we can readily determine whether we were meeting the standard. In contrast, many residency programs provide less clear-cut feedback, less regularly. As a result, radiology residents may be less likely than college and medical students to understand what is expected of them and how well they are performing. If radiology residency programs are to equip trainees with the knowledge they need to thrive during their training, it is vital that radiology educators develop and articulate a clear vision of resident performance—a vision that extends beyond mere competence to excellence. Some residents’ main goals may be to survive on-call duties, pass the board examinations, and avoid mistakes (1). We must show them that they are capable of more. Optimal residency training also prepares residents to provide outstanding diagnostic, consultative, and patient service, and thus to achieve the highest levels of clinical practice. Furthermore, in the area of research, it is vital that some graduates do more than simply apply extant knowledge to patient care. They must challenge and extend the frontiers of radiology, continually renewing its knowledge base to support the work of the next generation of radiologists. In education, we must encourage the formation of academic radiologists who look beyond standardized test scores, by providing residents with training that addresses the full range of radiology-related activities, including those that are not assessed on the standard examinations. The quality of tomorrow’s radiologists hinges in part on how we educate today’s residents. In each of these spheres—patient care, research, and education—we should foster excellence, as opposed to mere adequacy. As educators, we spend thousands of hours teaching residents how to detect lesions, formulate differential diagnoses, and perform various diagnostic and intervenAcad Radiol 2003; 10:554–558