1. 2010 A 3 CR 2 Annual Chief Resident Survey Caitlin C. Lopez, MD Mallinckrodt Institute of Radiology

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

3. 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

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

5. 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 e-mail on request THANK YOU FOR PARTICIPATING! Participation

6. Chief Responsibilities

7. Schedule MethodPerson-hours

8. Chief Benefits Salary bonus 2010 – Range $0-5000 – Median $1500 2005 – Range Range $0-3600 – Mean $1615 2000 – Range $0-6000 – Mean $1475

9. 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%

10. A 3 CR 2 American Alliance of Academic Chief Residents in Radiology Members – 30% programs pay dues – 8% chief residents pay dues – 2009-2010: $25 in addition to AUR membership Non-members – 26% programs would pay dues – 35% programs would not pay dues

11. 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

12. Chief Residents Fellowship: 94% plan to complete fellowship 87% in 2009 82% in 1999

13. Chief Residents Practice Setting:

14. Program Details

15. Hospitals Covered Studies per Year

16. 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 2010-2011 (2010 match) – 17% increased in size – 79% did not change in size – 5% decreased in size 2011-2012 (2011 match) – 21% of programs plan to increase size – 78% plan no change in size – <1% plan to decrease size

17. Resident Benefits

18. AFIP stipend – $1000-2500 Book fund – $200-1500 per year – If include travel allowance, up to $5000 per year Other benefits – Meals – Parking – StatDx subscription – ACR Learning file

19. 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

20. 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

21. Work Day

22. After-Hours: Residents 71% use some type of night float – 16% 4-6 weeks – 18% 7-9 weeks – 23% 10-12 weeks – 20% 13-15 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

23. After-Hours: PGY-2 Residents 2009-2010 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

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

25. 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

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

27. 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 2005 12% 24-hour in-house – 14% in 2005 11% NightHawk coverage

28. 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

29. 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

30. 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

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

32. 3 + 1 Curriculum 4% have existing 3+1 curriculum 20% will implement 3+1 in July, 2010 20% will implement 3+1 in July, 2011 or 2012

33. 3 + 1 Curriculum: Selectives Time allotted – 17% will offer 4-6 months – 13% will offer 7-9 months – 4% will offer 10-12 months – Remainder unknown Use of time – 36% permit division of time between multiple subspecialties – 3% require time reserved for single subspecialty – Remainder unknown

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