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  • Residents Gain Critical Experience Through Academic Research Program

    May 01, 2013

    The Introduction to Academic Radiology program provides a primer on academic radiology not typically offered by residency programs.

    C. Douglas Maynard, M.D.
    John Eng, M.D.
    Martha Mainiero, M.D.
    Michael L. Richardson, M.D.
    Richard B. Gunderman, M.D., Ph.D.

    While radiology residents with excellent academic track records throughout medical school are poised for success, many are missing one component that could prove critical to their professional advancement: a research background.

    More than 20 years ago, realizing that residencies primarily focus on clinical training, a group of visionary radiologists set out to create an academic radiology research program offering residents exposure to research pivotal not only to their long-term careers but also in securing that first radiology position.

    In 1990, the Introduction to Research program was established by RSNA, the Association of University Radiologists (AUR) and the American Roentgen Ray Society (ARRS). The program was renamed Introduction to Academic Research (ITAR) in 2008 to better reflect its content. Exposing second-year radiology residents to the wide world of teaching and research, ITAR is part of a comprehensive and ongoing effort to improve the quantity and quality of imaging research produced by radiologists.

    “In the 1980s, very little research was being done and very few radiologists had National Institutes of Health (NIH) funding,” said C. Douglas Maynard, M.D., 2000 RSNA president and a founder of the ITAR program along with Robert Stanley, M.D. and Bruce J. Hillman, M.D. “We knew we needed to do something to better prepare our physicians to do more research.”

    By reaching out to radiologists in training—before their career aspirations are finalized—ITAR provides a primer on academic radiology that isn’t offered by residency programs.

    “Residencies are primarily focused on clinical training; there is little exposure to academic research,” said John Eng, M.D., an associate professor of radiology at The Johns Hopkins University in Baltimore, a former volunteer ITAR director and a seminar alumnus. “This program is a great way to give residents interested in an academic career more information so they can better make a career decision.”

    Program in Demand by Residents

    Since 1990, approximately 1,760 residents from the U.S. and Canada have participated in ITAR, while others are waiting for their chance at an opening in the highly competitive program.

    Held each year at the RSNA and ARRS annual meetings, ITAR includes 15 hours of presentations, small group discussions, a dinner reception and networking opportunities spanning four and a half days. ITAR is open to just 40 residents at each meeting, each of whom must be nominated by their department chair or residency director and then selected by RSNA and ARRS. To defray expenses, each resident’s radiology department receives a $1,000 stipend.

    “Due to class size limitations, we have to turn away people every year,” said Fiona Miller, director of RSNA’s research department. “This type of programming is difficult to find—a comprehensive course that is experienced in the setting of a prestigious medical meetings. It’s a big draw.”

    In addition to highlighting the various roles of academic radiologists, ITAR focuses on mentoring residents and providing them with skill sets they can use throughout their careers.

    “I view our work as tending to the whole pipeline, from residents to junior faculty to RSNA Research & Education (R&E) Foundation scholars,” said Ruth C. Carlos, M.D., a professor of radiology at the University of Michigan, Ann Arbor, and an ITAR volunteer director. “That is how we will guarantee that radiologists will continue to conduct the molecular imaging, translational and outcomes research that will drive the field forward.”

    Medical school faculty members are equally enthusiastic about the program. “We love it,” said Martha Mainiero, M.D., a professor of diagnostic imaging and residency program director at Brown University in Providence, R.I., and a past-president of the Association of Program Directors in Radiology (APDR). “I think the number one thing the seminar accomplishes is to get residents excited about research.”

    Exposing residents to the breadth of imaging research under way is one of the major objectives of ITAR, Dr. Carlos added.

    “In practice, you know what you’re getting into, but in academia, there’s more latitude in shaping your career,” Dr. Carlos said. “We cover all the opportunities from directing a residency program to bench research to translational research to conducting randomized controlled trials to bringing novel techniques to the bedside.”

    According to Dr. Mainiero and participating residents, ITAR provides a great overview of academic radiology. “When residents come back, they are always amazed,” Dr. Mainiero said. “They say they never realized how much research was being conducted.”

    Seminar Topics are Useful, “Out of the Box”

    ITAR speakers are all well-established in their fields and address highly useful topics such as designing and planning clinical research, preparing a manuscript and developing a successful mentoring relationship. The seminar also offers a handful of “outside of the box” presentations, such as those offered at RSNA 2012 by Michael L. Richardson, M.D., a professor of radiology at the University of Washington in Seattle, and Richard B. Gunderman, M.D., Ph.D., a professor and vice-chair of radiology at Indiana University (IU) in Indianapolis.

    In his 45-minute lecture on public speaking, Dr. Richardson covered the evils of the bullet-pointed slide, managing stage fright and sure-fire ways to rivet your audience to your every word (hint, says Dr. Richardson: tell a story). Two of the many comments residents made about Dr. Richardson’s talk in post-seminar evaluations: “I will never approach PowerPoint presentations the same way again” and “The lecture on how to make a better PowerPoint presentation was amazing and has universal applicability.”

    Dr. Gunderman, who also teaches philosophy and philanthropy at IU, encouraged residents to pay close attention to their natural curiosities and the work activities that make them feel most alive, and find ways to devote more time to those endeavors.

    “Dr. Gunderman’s talk reshaped the way that I approach and view my career,” one resident commented about the presentation.

    “Residents really get a lot out of the program and some write pages and pages of compliments on their evaluation forms,” Dr. Eng said. “They appreciate the opportunity to be around other residents with similar career aspirations and to hear from established radiologists who have written their textbooks.”

    To help mentor residents, ITAR alumni are invited to return and participate in roundtable discussions, providing trainees with valuable feedback on life as junior faculty members. “When I went to school there were no role models for what I wanted to do,” Dr. Richardson said. “This program is a great idea.”

    Program Accelerates Radiology Research

    In addition to anecdotal data, there is ample evidence that the ITAR seminar—in concert with grant writing workshops, research scholarships and other RSNA programs—has helped radiology make significant strides in research.

    In a 1998 study published in Radiology, Dr. Hillman and colleagues concluded that ITAR has encouraged the development of successful research careers and that seminar participants had higher levels of academic achievement earlier in their careers than residents who did not attend the program.

    Over the last two decades, the amount of funding awarded to radiology departments from the National Institutes of Health (NIH) has significantly increased, from $75 million in 1995 to approximately $375 million in 2011, according to the 2012 Academy of Radiology Research Annual Report. As a percentage of the total NIH budget, imaging-related research has increased from 6.5 percent in 2001 to 12.2 percent in 2012, and is expected to continue to grow, according to the report.

    “It’s important to produce radiologists who conduct imaging research, especially clinician-radiologists who understand the problems of referring physicians,” Dr. Carlos said. “Patient care takes a team and so does research.”

    Web Extras

    To access the study, “The RSNA-AUR-ARRS Introduction to Research Program for 2nd Year Radiology Residents: Effect on Career Choice and Early Academic Performance,” in Radiology, go to radiology.rsna.org/content/209/2/323.full.pdf+html?sid=864b8131-8825-4bfd-96ad-60cad220f567.

    The application deadline for the 2013 Introduction to Academic Radiology program is July 15. To access the nomination form, go to RSNA.org/Introduction_to_Academic_Radiology_.aspx. 

    IRIYA and ITAR participants
    Since 1990, approximately 1,760 residents from the U.S. and Canada have participated in RSNA’s Introduction to Academic Research Program (ITAR), which exposes second-year radiology residents to the wide world of teaching and research. Above: ITAR participants collaborate with RSNA’s Introduction to Research for International Young Academics (IRIYA) participants during a joint session in 2012.
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