Dr. Levine is Chief of the Gastrointestinal Radiology
Section in the Department of Radiology at The University of
Pennsylvania Medical Center, Philadelphia, PA.
Managed healthcare has had a major impact on academic radiology,
as escalating demands for clinical productivity have made it
increasingly difficult for academic radiologists to pursue their
other essential missions of research and teaching. This changing
economic environment has caused an alarming number of young
radiologists to forego careers in academic radiology because of
frustration over the lack of time and resources needed to pursue
their academic interests. What can we in academics do to help
reverse this trend? How are we to have successful and exciting
academic careers when our research activities are threatened by the
ever-increasing clinical demands on our time? And how are we to
stimulate today's best trainees to join academic departments?
Although funded research is one solution, only a small number of
academic radiologists have the skills and training to obtain such
funding. In fact, most radiologists who engage in various forms of
teaching, research, and clinical scholarship do so without benefit
of grants. How can these radiologists be expected to find the time
to engage in scholarly research while simultaneously handling their
increased clinical workloads?
One possibility is for faculty to work more closely with
trainees (both radiology residents and medical students), a
phenomenal yet underutilized resource for research at academic
medical centers. Such trainees often are highly motivated
individuals who are eager to collaborate with faculty on all types
of research and are willing to devote extraordinary effort and
energy for the completion of this work. In the case of senior
medical students who take research electives in radiology, they
also have that most valuable of all commodities--time. With proper
guidance and mentoring, these trainees can be led through every
facet of the research experience, from reviewing the literature to
collecting and tabulating the data, and eventually preparing an
original manuscript on the subject. This collaborative effort
allows the faculty to serve as the coordinator for the project,
while the trainee performs the more labor-intensive and
time-consuming aspects of the work.
Despite the many advantages of collaborating with residents and
medical students, involved faculty must also be aware of the
pitfalls. As a rule, these trainees have limited skills and
expertise in the technical aspects of medical research and cannot
be expected to function as independently as professional research
assistants. Therefore, faculty who mentor residents and students
must be willing and able to provide frequent guidance and feedback
to ensure the success of the collaboration. Whatever the
limitations of the trainees, their drive and desire to excel
ultimately make them indispensable partners for these research
endeavors.
Senior medical students who are applying for residency programs
in radiology are a particularly ideal group for this form of
collaboration because of the symbiotic nature of the
student-faculty relationship. Depending on their performance, these
students hope to receive letters of recommendation from their
faculty mentors and even a first- or second-authored publication in
a peer-reviewed journal. Such letters and publications can be
tremendously motivating forces for students who are well aware of
the intense competition for residency programs. Just as
importantly, these students are exposed to the process of
radiologic research, and if their manuscripts ultimately are
accepted for publication, they experience the satisfaction of
making real contributions to the medical literature. This
interaction, therefore, represents true symbiosis between faculty
and students in the best sense. The end result is greater academic
productivity from involved faculty and greater commitment from
students to pursue careers in academic radiology because of the
positive, often exhilarating nature of their research
experience.
Some things even money can't buy.