ACR Annual Meeting 2002

REPORT: 2002 ACR Annual Meeting
Miami Beach, Florida

Thanks to a commitment and financial sponsorship from both the ACR and individual state chapters, the number of residents and fellows attending this year’s annual meeting of the American College of Radiology continued to show growth. Representatives from every corner of North America were present, from Maine to Hawaii, Puerto Rico to Ontario, in programs large and small, university- and community-based.

The opening day began with a Resident Physicians Section Executive Committee meeting over breakfast. Chair-Elect Christoph Wald MD PhD from Massachusetts who was presiding over the 2002 annual meeting of the ACR RFS, welcomed this year’s contingent and provided an overview of the caleidoscope of events for the ensuing 5 days. This was followed by the day-long PET Categorical Course, which was an outstanding collection of talks and images from the field’s best. The timeliness and quality of this course was evinced by an enrollment far surpassing that in prior years, necessitating a much larger venue than anticipated.

During the break for lunch, ACR President Kay Vydareny provided our section with an overview of the organization and orientation to the role of the RPS within it. She reviewed the structure of the ACR Council, the legislative body of the College through which each member helps establish policies affecting all of radiology. Each state chapter sends a minimum of one councilor and one alternate to the Council with a total of 247 voting councilors; the RPS has one voting councilor (executive committee chairperson) and one alternate (vice-chair).

On the second day, a pair of lively RPS business meetings were focused largely on consideration of the resolutions to be voted on by this year’s Counicl. The RPS Executive Committee members had distributed copies of those resolutions identified as being of particular interest to residents, fellows, and recent graduates to attendees in advance of the meeting, ranging from standards for teleradiology and arteriography to formal Council represenation for the Association of Program Directors in Radiology.

The implications of these resolutions for radiologists in training were often obvious, such as requirements for the performance of a specific number of angiograms as primary operator, but some were more complex. In establishing a postion on each, RPS members had an entertaining exchange of anecdotes and opinions, touching on issues like proliferation of radiology physician assistants, collapse of vascular-interventional departments, and covering multiple outside hospitals via teleradiolgy while on call. Call rooms reminiscent of Sanford and Son’s garage, threatened conference time, and the 80 hour work week were familiar concerns, but there were more disturbing tales as well: orthopedic residents dictating MRIs and plain films while on their radiology electives, radiology residents assisting vascular surgeons while covering interventional call, and unpaid, mandatory “internal moonlighting” effectively doubling more than one program’s workload.

The second day also brought the Resident Physician Leadership Development Seminar, sponsored by Berlex Inc. Conducted by Jean Frankel from Tecker Consulting, the session was much less corny than I’d feared, and provided many specific ideas on how we can be more effective as residents and as active members of the radiology community. This was followed by a luncheon with Dr. Vydareny and other ACR leaders, giving a chance to see how they combined clinical duties of radiology with their leadership roles. In her address to the Council later that day, Dr. Vydareny cited many lunchtime resident comments in highlighting the current crisis in academic radiology.

At the RPS Caucus, the topic causing the greatest stir was the proposal by the Society of Chairmen of Academic Radiology Departments to change the timing of the resident ABR examinations, with oral boards to be delayed for at least one year following completion of residency. A response to the perception of excessive fixation on the oral exam by 4th year residents, the proposal was universally opposed by the RPS. The overwhelming feeling was that this would severely detract from the residents’ ability to prepare for the oral boards and put the finishing touches on their education. For example, a move to delay the boards would effectively end the ability for senior residents to attend board reviews at outside institutions. Furthermore, once a radiology resident graduates the scope of their practice narrows quickly (contrary to most other specialties) and soon after graduation from residency no longer encompasses the subjects currently tested in the oral board examination. Trying to keep current in all of radiology, in order to pass the boards, would be difficult. Finally, the legalities of graduates reading mammograms without being board certified was questioned. It was decided that moving the boards would limit the new influx of radiologists reading mammographies as well as only exacerbating the general manpower shortage in private practices by forcing graduates to study during their early years as staff.

Also, at the forefront of this year’s issues was the new ACGME common duty hour recommendations pertaining to all residents in the US. A quick poll indicated that most of the residents’ programs were already in compliance. However a brief discussion followed that these work hour guidelines also encompass moonlighting. This concept was new to many of the residents attending. Several attendees also indicated that due to the shortage of fellows they were now being forced to take extra call and work additional hours that may result in their programs not being in compliance with the ACGME guidelines.

Another issue discussed was the consistent drop in the ACR by newly graduated radiologists. Suggestions to deal with this included opening up committee posts to interested “young physicians” or trainees, increased funding for RPS recruitment and ACR meeting attendance, addition of positions within the state chapters for the newly graduated, formation of a separate Young Physician Section (newly graduated to 5 years out), formalizing resident mentoring relationships with state leaders, and inviting interested residents at the AFIP to the annual meeting, which is moving to Washington, D.C. beginning in 2003.

A survey of MRI training was distributed and collected for input to the ACGME Residency Review Committee for diagnostic radiology. In an effort to collect more robust data, the ACR RFS has now made the MRI survey available on their website. Please visit and fill out the survey. Responses will form the basis for potential future improvements to the MRI training. [Thanks to these survey results and the persistent efforts of Kelly Foster and the RPS executive committee, the RRC has since decided to ask their site inspectors to include questions regarding the satisfaction of residents with MRI training, and has included MRI training on the agenda for its next meeting in February, 2003. See residents’ forum on the ACR web site for more details.]

The ACR Council meeting opened on Sunday, September 29, with Reference Commitee hearings on specific resolutions the next day. RPS representatives spoke on each of the resolutions discussed at the RPS business meetings and caucus, creating a very visible presence for the section. The resolution creating the most controversy during Reference Committee proceedings was the proposal to change the name “ACR Standards” to “Practice Guidelines.”

Following the Reference Committee sessions, a panel discussion on radiation accidents, radiation protection, and nuclear terrorism provided a fascinating and often chilling insider’s look at the new nuclear fear and our role as radiologists in dealing with the unthinkable. The ACR has produced a pamphlet titled “Disaster Preparedness for Radiology Professionals: Response to Radiological Terrorism,” which covers much of this topic and should be required reading in all departments.

Two days of debate on the proposed resolutions by the Council members then followed. Ultimately, the term “standards” was retained for the ACR guidelines. Most of the proposed resolutions passed with few amendments. One resolution which was deferred, was the ACR standard on esophagrams. The council session concluded with some strong pina coladas on the beach.

Elections for the RPS executive committee were held, with the 2002-2003 committee composed of:

Chair: Christoph Wald, M.D., Ph.D. Lahey Clinic, MA
VC/Chair-Elect: Kay Spong Lozano, M.D. University of Washington, WA
Secretary: Shannon Campbell, M.D. University of Rochester, NY
AMA Rep: Jonathan Luchs, M.D. Winthrop-University Hospital, NY
A3CR2 Rep: Jesse Davila, M.D. Mayo Clinic, MN

The next ACR meeting will be held in Washington, D.C. in May, 2003.

Report respectfully submitted by
Erik Nelson, M.D., MRS RFS and
Seth Hardy, M.D., Secretary, MRS RFS
Boston, November 2002