2010 A 3 CR 2 Annual Chief Resident Survey Caitlin C. Lopez, MD Mallinckrodt Institute of Radiology

Survey Format Confidential online survey (surveymonkey.com) Multiple choice questions (single and multiple answer), free text for additional comments

Survey Topics Recurring – Basic Program Information – Resident Benefits – Chief Resident Duties/Benefits New in 2010 – Additional questions in several sections – Outside hospital studies – After-hours attending & resident coverage – Proposed 3+1 curriculum

Limitations Opinions and estimations Sampling bias (only chief residents included) Limit duplicate responses from programs with multiple chief residents

2010 – 228 individual responses – 140 unique programs – 85% completed the entire survey 2009 – 143 individual responses – 112 unique programs 2008 – 100 total responses Data will be available by on request THANK YOU FOR PARTICIPATING! Participation

Chief Responsibilities

Schedule MethodPerson-hours

Chief Benefits Salary bonus 2010 – Range $ – Median $ – Range Range $ – Mean $ – Range $ – Mean $1475

Meetings/Conferences Others: regional radiology society; one ‘extra’ conference of chief’s choosing; AMA; ACR TimeRegistrationTravelHousing AUR68%64%63%61% RSNA30%15% 14% ARRS6%4%2%

A 3 CR 2 American Alliance of Academic Chief Residents in Radiology Members – 30% programs pay dues – 8% chief residents pay dues – : $25 in addition to AUR membership Non-members – 26% programs would pay dues – 35% programs would not pay dues

State of the Chiefdom Outgoing Chief Residents 136/228 (60%) respondents had completed >75% chief time 80% ‘very’ or ‘somewhat’ satisfied 92% would accept position again Job Satisfaction

Chief Residents Fellowship: 94% plan to complete fellowship 87% in % in 1999

Chief Residents Practice Setting:

Program Details

Hospitals Covered Studies per Year

Program Details Current Program Size Per program – average 26.6 residents – range 6-72 residents Per class – Mean 6.6 residents – Mode 6 residents Future Program Size (2010 match) – 17% increased in size – 79% did not change in size – 5% decreased in size (2011 match) – 21% of programs plan to increase size – 78% plan no change in size – <1% plan to decrease size

Resident Benefits

AFIP stipend – $ Book fund – $ per year – If include travel allowance, up to $5000 per year Other benefits – Meals – Parking – StatDx subscription – ACR Learning file

Vacation Allocation of vacation – 86% of programs allocate vacation as individual days and/or 1- week blocks 36% do combination – 12% allocate in 2-week blocks Many programs consider ‘interview days’ as vacation days

Sick Time 82% of programs do not permit transfer of sick time from year to year 40% require that vacation and/or sick time be used for maternity/paternity leave

Work Day

After-Hours: Residents 71% use some type of night float – 16% 4-6 weeks – 18% 7-9 weeks – 23% weeks – 20% weeks – 19% > 15 weeks Number of residents in-house for night float – 61% one resident – 26% two residents – 6% three or more residents Number of residents in-house for separate call pool – 34% zero residents – 41% one resident – 16% two residents – 6% three or more residents

After-Hours: PGY-2 Residents is first year PGY-2 residents were not allowed to take unsupervised call per ACGME Others roles for PGY-2 – ‘Buddy call’ during last 6 months of year to prepare for independent call – PGY-2 work weekend service rotations with attendings/fellows – Integrated PGY-1 program so that PGY-2 can read independently

After-Hours: Residents Not sub-divided between resident independent reads and resident with extended hours attending coverage

After-Hours: Residents Ultrasound Examinations – 38% have 24/7 sonographer in-house – 36% have extended hours sonographer in-house – 43% have sonographer home call – 21% have residents perform after-hours US – Others: combination of above to achieve extended sonographer coverage Ex: Sonographer available 24 hours Sunday-Thursday; residents Friday & Saturday nights Ex: Sonographer available in-house Monday-Friday; home call Saturday & Sunday

After-Hours: Final Reports 58% of departments have final reports (attending read) for after-hours studies within 12 hours

After-Hours: Attendings 57% of programs have sub-specialty coverage 54% attendings go home at end of day (5-6pm) – 5% review all after-hours studies from home – 50% review select after-hours studies from home 45% in-house extended hours (10pm or MN) – 35% in % 24-hour in-house – 14% in % NightHawk coverage

After-Hours: Attendings 24-hour in-house attending: resident education 24-hour in-house attending : patient care 8% of programs plan to implement 24-hour in-house attending coverage during the next year, which would bring the total to 20% of programs with 24-hour in-house coverage

Outside Hospital Studies: Reinterpretation 95% of departments spend 0-10% reviewing OSH studies during day 84% of departments spend 0-10% reviewing OSH studies after-hours

Outside Hospital Studies: Reinterpretation 18% require OSH report be provided prior to re- interpretation 32% have written policy regarding resident re- interpretation 79% archive OSH studies to PACS PACS archiving – 95% have support staff archive during work day – 62% have support staff archive after-hours – 5% have radiologists archive during work day – 10% have radiologists archive after-hours – Other: requesting physician archives

Outside Hospital Studies: Reinterpretation Other: cost to patient, time constraints

3 + 1 Curriculum 4% have existing 3+1 curriculum 20% will implement 3+1 in July, % will implement 3+1 in July, 2011 or 2012

3 + 1 Curriculum: Selectives Time allotted – 17% will offer 4-6 months – 13% will offer 7-9 months – 4% will offer months – Remainder unknown Use of time – 36% permit division of time between multiple subspecialties – 3% require time reserved for single subspecialty – Remainder unknown

Thank You Chief resident participants Laurie May at RSNA Dave Naeger Jennifer Gould Travis Henry, Matt Gipson, Jim Kelly, Vinnie Mellnick, and Jessica Huang