• Medical Trainees and Medical Training

  • Scenario 1 of 4

    As the Vice-Chair of Education, you had welcomed the arrival of three new fellows into the 12-month, non–ACGME-accredited radiology fellowship training programs (in ultrasound, interventional radiology, and emergency radiology) at your institution. At the onset of the fellowship program, all of the fellows were eager and excited, having just successfully passed their oral boards in Louisville, Kentucky, and were ready to start their careers in radiology.

    However, 3 months into training at this busy hospital (where there has traditionally been no overnight attending call coverage), one of the fellows decided to resign for “personal reasons.” This resulted in redistribution of the clinical duties to the two remaining fellows, because the majority of the radiology group practice feels that working hard is a good part of the trainee experience, and “since we have all done it, we know that the best thing for a fellow is to stay busy and see and learn from as many good cases as possible.”

    You notice shortly thereafter that there has been a change in disposition of one of the remaining fellows. He had been very happy and energetic during the first couple of months of fellowship but more recently has exhibited a depressed affect and appears fatigued. You also notice that the level of his personal hygiene has changed (even on days when he is not on call), and some of the attending radiologists have commented that the quality of his work has decreased, although they feel that he is working very hard and learning a lot.

    You are concerned for this fellow’s health but see no signs of weight loss or coughing; he actually may have gained weight. You also do notice on a few occasions that the fellow is swallowing pills, but you never see the bottle. It also appears that the fellow attends few social functions, rarely interacts or socializes with people outside of work, and has not been seen with his family (contrary to their visible togetherness exhibited during orientation week).

    In discussion with colleagues, you have also heard about a few comments from referring physicians that he has recently “flown off the handle” when consulted for CT readings while on overnight call. Given all of this information, you want to find out what is going on with this fellow and help him out, but you don’t want to run the risk of offending him or provoking a confrontation.

    Question 1 of 4: On the basis of the available information and your familiarity with the process of medical training, what would be the least likely explanation for this fellow’s behavior? 


     Drug abuse. 





     Choice of wrong subspecialty. 



     Mental illness (such as anxiety or depression). 



     Marital difficulties



    « Return to Vignettes Table of Contents

    « Return to Professionalism Home Page

We appreciate your comments and suggestions in our effort to improve your RSNA web experience.

Name (required)


Email Address (required)


Comments (required)





Discounted Dues: Eligible North American Countries 
Costa Rica
Dominican Republic
El Salvador
Netherlands Antilles
St. Vincent & Grenadines
Country    Country    Country 
Afghanistan   Grenada   Pakistan
Albania   Guatemala   Papua New Guinea
Algeria   Guinea   Paraguay
Angola   Guinea-Bissau   Peru
Armenia   Guyana   Phillippines
Azerbaijan   Haiti   Rwanda
Bangladesh   Honduras   Samoa
Belarus   India   Sao Tome & Principe
Belize   Indonesia   Senegal
Benin   Iran   Serbia
Bhutan   Iraq   Sierra Leone
Bolivia   Jordan   Solomon Islands
Bosnia & Herzegovina   Jamaica   Somalia
Botswana   Kenya   South Africa
Bulgaria   Kiribati   South Sudan
Burkina Faso   Korea, Dem Rep (North)   Sri Lanka
Burundi   Kosovo   St Lucia
Cambodia   Kyrgyzstan   St Vincent & Grenadines
Cameroon   Laos\Lao PDR   Sudan
Cape Verde   Lesotho   Swaziland
Central African Republic   Liberia   Syria
Chad   Macedonia   Tajikistan
China   Madagascar   Tanzania
Colombia   Malawi   Thailand
Comoros   Maldives   Timor-Leste
Congo, Dem. Rep.   Mali   Togo
Congo, Republic of   Marshall Islands   Tonga
Cote d'Ivoire   Mauritania   Tunisia
Djibouti   Micronesia, Fed. Sts.   Turkmenistan
Dominica   Moldova   Tuvalu
Domicican Republic   Mongolia   Uganda
Ecuador   Montenegro   Ukraine
Egypt   Morocco   Uzbekistan
El Salvador   Mozambique   Vanuatu
Eritrea   Myanmar   Vietnam
Ethiopia   Namibia   West Bank & Gaza
Fiji   Nepal   Yemen
Gambia, The   Nicaragua   Zambia
Georgia   Niger   Zimbabwe
Ghana   Nigeria    

Legacy Collection 2
Radiology Logo
RadioGraphics Logo 
Tier 1

  • Bed count: 1-400
  • Associate College: Community, Technical, Further Education (UK), Tribal College
  • Community Public Library (small scale): general reference public library, museum, non-profit administration office

Tier 2

  • Bed count: 401-750
  • Baccalaureate College or University: Bachelor's is the highest degree offered
  • Master's College or University: Master's is the highest degree offered
  • Special Focus Institution: theological seminaries, Bible colleges, engineering, technological, business, management, art, music, design, law

Tier 3

  • Bedcount: 751-1,000
  • Research University: high or very high research activity without affiliated medical school
  • Health Profession School: non-medical, but health focused

Tier 4

  • Bed count: 1,001 +
  • Medical School: research universities with medical school, including medical centers

Tier 5

  • Consortia: academic, medical libraries, affiliated hospitals, regional libraries and other networks
  • Corporate
  • Government Agency and Ministry
  • Hospital System
  • Private Practice
  • Research Institute: government and non-government health research
  • State or National Public Library
  • Professional Society: trade unions, industry trade association, lobbying organization