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Rethinking and Retooling the Average Diagnostic Radiology Rotation

During the clerkship years of medical school, each specialty offers a unique role for the interested medical student to fulfill. For instance, on internal medicine, the student follows several patients, presents key findings from each patient’s workup this far and proposes the new day’s plan on rounds. On a labor and delivery service, the medical student watches the fetal heart monitors, routinely checks on the patient’s progress and assists in the delivery. One specialty, however, that does not lend itself well to medical student involvement is radiology.

Unlike other specialties, radiology is often an elective rotation that focuses on diagnostics and image interpretation. Such tasks are mainly done by the specialty’s residents with little care for medical students to be involved with. It is vital for medical students, however, to understand radiology regardless of their chosen specialty. Unfortunately, only about a fifth of medical institutions require a radiology rotation. Of those that do, there is room to improve student involvement. Enhancing medical students’ experience on a clinical radiology rotation is no small task. Still, it will become a priority as the next generation of physicians will undoubtedly see an increasing number of diagnostic images in their careers.

While previous studies have explored the beneficial impact of early radiology exposure during medical students’ preclinical years, the clinical experience of upperclassmen is perhaps even more important to improve on in medical education. One proposed change that has seen success is offering simulation cases where the student may practice acting as a radiologist. Simulation would allow the student to interpret images and then apply the knowledge to future cases. Using simulation is one good step to take for improving the rotation, but medical students can also benefit from being included in the real-life management of patients rather than just simulation. 

It has previously been proposed that radiology residents can add value to the medical team by rounding with them. I propose a modification of this idea where we require medical students to select a few interesting cases each day, review the imaging findings and patient history with a resident radiologist and then later discuss the imaging results with the patient after the primary team rounds. Benefits of this newly described medical student responsibility present in two ways.

Primarily, this new patient responsibility gives the student an educational opportunity to dive deep into the technicalities of an imaging read and encourages them to take the time to fully process an image with the guidance of a trained radiologist. Secondly, the student can represent the radiology team by presenting the findings to the patient — therefore taking ownership of part of a patient’s care. This would also help the patient better understand their imaging findings and would give a much-needed face to the radiologists on the patient care team.

As resident and attending radiologists maintain busy schedules, the medical student can step in as a critical member of the team to fill an essential gap between the radiologist and the patient. In the current model, the radiologist is rarely able to see the patient to go over their imaging findings. With the help of the medical student, the radiology team can help provide patient-centered care by directly explaining the imaging to the patient and showing them exactly what is seen on the computer. By having a medical student take this active step, the patient will be better aware of what radiologists do and how imaging is used in their care, thus leaving the patient more satisfied.

This new radiology educational method comes with some caveats. Not all imaging will work for a medical student to present to a patient. Imaging sensitive in nature, such as cancer workups, would be best left to the primary team to discuss. Additionally, something like a chest x-ray of a sedated patient would not be a good image to discuss with the patient due to the patient’s current mental status. There are several situations that would render this educational model successful though, such as a CT of an abscess or a chest x-ray of a chemical pneumonitis. With the help of a trained radiologist, medical students will be able to identify these findings. Students will then be prepared to educate the patients on exactly how these diagnostic images are helping them receive excellent medical care. 

As diagnostic radiology becomes a larger field in medicine, it is increasingly important to ensure that medical students are adequately prepared to interpret and discuss imaging findings with their patients, whether in the hospital or clinic. While we know that a radiology rotation is invaluable for improving medical student opinion and knowledge of radiology, creating further student involvement in the rotation can continue furthering the student’s knowledge of diagnostic imaging. As medical education continues to advance and utilize new imaging techniques, we must strive to make clinical education changes that teach radiology to both the medical student and the patient.

Image credit: Siemens Biograph (CC BY-SA 2.0) by Thirteen Of Clubs

Martin Schwarze Martin Schwarze (1 Posts)

Contributing Writer

Saint Louis University

Martin Schwarze is a 4th year medical student at Saint Louis University. He is interested in diagnostic radiology. Martin is originally from Saint Louis, MO, and he enjoys activities such as golf, cryptocurrency, and watching football.