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AVOID UPENN radiology department
UPenn Radiology department performs a poorly designed study comparing TWO radiology techs with TWO months of training to radiology residents on 49 radiographs.
Study did not get IRB approval or consent from residents bc listed as PQI project. Residents didnt even know. And now its published widely that UPenn residents suck.
I would avoid this program like the plague.
[link=https://www.jacr.org/article/S1546-1440(20)31004-8/fulltext]https://www.jacr.org/arti…40(20)31004-8/fulltext[/link]
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7 Replies
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[link=https://www.diagnosticimaging.com/view/radiology-extenders-outperform-radiology-residents-with-chest-x-ray-interpretations]https://www.diagnosticima…-x-ray-interpretations[/link]
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I’m not sure the program can be faulted, but the chair, one of the authors, should know better.
SHAME-
Interestingly the paper has been temporarily removed from the journal.
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I respect indebtforlifes passion about respecting radiologys turf from mid level encroachment. Nonetheless I think it is taking things a tad far when telling prospective residents to avoid an institution like the plague based on a research project put together by a few faculty members.
Penn is still a well respected radiology department and I think any applicant would do well to go there.
Based on their retraction of the paper it seems the negative fall out has caused them to reconsider their approach, which may be a positive thing.
However, I still think telling people to avoid the institution or calling for the replacement of the chair is a tad extreme, dont you?
That is the problem with anonymity. It causes people to say more extreme things than they normally would. Lets try to be professional, and while criticism is fair, lets avoid this cancel culture approach.
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Using residents for secondary gain to publish crap is pretty scummy. I think avoiding the institution and the chair stepping down would be very reasonable.
It was supposed to be a QI project, not some proof of radiology midlevel capabilities to be generalized throughout the country. It also sounds like the residents weren’t even aware how this was going to be used.-
Ok, I read the link to Diagnostic Imaging shared above. There is one word on that link which disgusts me. It is the word outperform in the title. My question is whether that word came from the original Penn article or faculty or whether that word came from Whitney Palmer who wrote the synopsis for DI.
I say that because there is absolutely nothing in the paper that implies the techs outperformed the residents. The article states that the accuracy of interpretations was similar between residents and techs. And that is no insult to the residents. Most chest x rays are either normal or have trivial findings. It would take thousands of complex X-rays with rare findings like unexpected pneumothorax or mediastinal hematoma to prove who is more accurate.
The advantage, according to the authors, is that reading out the reports from the techs was faster for attendings. The explanation for this is obvious and simple. They taught the techs to dictate with standardized templates. OBVIOUSLY if all tech reports are standardized and they are not having read outs and receiving teaching and leaving for noon conference, it is going to be more efficient for attendings to read out reports from techs over non standardized reports from residents. That in no way implies they are better.
So I will concede that if the authors used the term outperform or condoned that term it is inexcusable and they should submit a further explanation.
I just think it is a shame an institution should suffer from a poor decision by one or two individuals.
What nobody has touched on is having techs prelim chest x rays has benefits to the residents and attendings. If a big academic institution has 1,000 chest x rays per day and 3 residents on rotation, asking each resident to prelim 300 x-rays hurts rather than helps their education. Anything that can be done to save residents from being scutted out and to keep attendings from quitting from a miserable work day is understandable in my opinion. As a private practice radiologist who reads 30 chest x rays per day I would never hire a tech to prelim chest x rays as it makes no sense. But the reality is different in an academic thoracic department where there are 1,000 chest x rays per day. I dont think there is any role or need for midlevels to interpret chest x rays in general practice, but it may make sense in an academic setting.
I would be interested to know the perspective of active Penn residents on this research or to hear more from the faculty involved.
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Slippery slop with tech creep. Please review NP/PA displacement of MDs in primary care & increasingly Derm. Perfect for consolidated systems & PE who view doctors as an unnecessary expense. Dont chop your own feet off by advocating techs into the reading room. Upenn needs to be censured/vilified for this.
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