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.