Two days into my radiology residency and I’m already producing reports for body CTs. What a terrifying thought.
On day one, when they sat me down at a PACS workstation, they taught me how to log in, how to select a study and scroll through it, and which button to press to record dictations. The senior resident then basically just said “go for it. Say what you see!”
To be fair, I suppose expectations aren’t particularly high for a first-week radiology resident; the senior resident steps in to cover literally everything, and the attending radiologist then reviews everything de novo before reports are released. However, I do not exaggerate the absence of preparation. No one has sat down with us fresh residents to teach us a systematic technique for reading, the proper syntax for dictating, or the expectations for sensitivity and accuracy of identifying anatomy. Some of us have observed general reading room etiquette during radiology electives as medical student two years ago, but even that is not guaranteed with all incoming residents. Our preliminary year residencies that we’ve just completed often bar us from enrolling in radiology electives to prevent “redundant training.”
Thus, to be handed a dictophone and real scans of real patients to read is truly intimidating. For years I’ve been interpreting the published radiology reports as objective data. As recently as last week, I was a clinician caring for patients on the floor, ordering scans, and relying on the reads to guide clinical plans. My team discussed data such as “vitals, labs, and imaging,” instinctively grouping radiological interpretations with the highly engineered outputs of carefully calibrated laboratory machines, in essence commoditizing radiologists’ reads. We easily forget that those reports amount to — quite simply — the consultation of a radiologist to interpret images on our behalf. There are practitioners out there that will read reports and simply think as I have often thought: “a radiologist read this, so it must be right.”
Of course, the constant oversight protects my patients from erroneous reads, but my idolization of radiology as a field has inadvertently generated enormous personal pressure, even more than when I entered doctorhood and internal medicine one year ago (I’m finishing a post about that, btw). Suddenly, now I’m on the other side. Now I am doing the reading. That is terrifying.