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Academic Radiology, Vol 11, No 6, June 2004
REPORTING INSTRUCTION FOR RADIOLOGY RESIDENTS From: Ferris M. Hall, MD Beth Israel Deaconess Medical Center and Harvard Medical School Department Radiology Beth Israel Deaconess Medical Center 330 Brookline Ave Boston, MA 02215
Editor: Sistrom et al (1) lament that their survey of radiology program directors found that trainees received “no more than 1 hour of didactic instruction in radiology reporting per year.” They opine that “general improvement of radiology report quality is a desirable goal,” but this improvement is in the eyes of the beholder. This problem was addressed by Hickey (2) 80 years ago and by countless others since that time, including myself (3). The American College of Radiology, in conjunction with physicians in both imaging and clinical subspecialties, are currently attempting to address this problem and, as pointed out by Sistrom et al, the Breast Imaging Reporting and Data System system for breast imaging is one such notable success. However, there are immense problems in reach-
ing and possibly mandating consensus over a broad spectrum of physicians. As I emphasize in print (3) and in lectures, the major problem with attempting to didactically teach this subject is the lack of faculty consensus on what constitutes a “good” report. I contend that we have identified the enemy, and he is us. There are many members of my department who would be happy to provide more teaching in reporting but their suggestions frequently conflict with others, including my own. You name it: history, use of sentences and paragraphs, brevity, terminology, impressions, etc.– each radiologists does it differently. And they all seem to feel so strongly! The survey by Sistrom et al (1) is composed of e-mails to radiology program directors. The authors might have obtained a different appreciation of the problem had their questionnaires been directed to chief residents. Harried residents want consistency in reporting not so much because they feel strongly about one style, but because each of their dictations has to be tailored to the peculiar idiosyncrasies of an individual faculty member or departmental section. Radiologists, heal thyselves. REFERENCES 1. Sistrom C, Lanier L, Mancuso A. Reporting instruction for radiology residents. Acad Radiol 2004; 11:76 – 84. 2. Hickey PM. Standardization of roentgen-ray reports. AJR Am J Roentgenol 1922; 9:442– 425. 3. Hall FM. The language of the radiology report: primer for residents and wayward radiologists. AJR Am J Roentgenol 2000; 175:1239 –1240.
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REPORTING INSTRUCTION FOR RADIOLOGY RESIDENTS From: Ferris M. Hall, MD Beth Israel Deaconess Medical Center and Harvard Medical School Department Radiology Beth Israel Deaconess Medical Center 330 Brookline Ave Boston, MA 02215
Editor: Sistrom et al (1) lament that their survey of radiology program directors found that trainees received “no more than 1 hour of didactic instruction in radiology reporting per year.” They opine that “general improvement of radiology report quality is a desirable goal,” but this improvement is in the eyes of the beholder. This problem was addressed by Hickey (2) 80 years ago and by countless others since that time, including myself (3). The American College of Radiology, in conjunction with physicians in both imaging and clinical subspecialties, are currently attempting to address this problem and, as pointed out by Sistrom et al, the Breast Imaging Reporting and Data System system for breast imaging is one such notable success. However, there are immense problems in reach-
ing and possibly mandating consensus over a broad spectrum of physicians. As I emphasize in print (3) and in lectures, the major problem with attempting to didactically teach this subject is the lack of faculty consensus on what constitutes a “good” report. I contend that we have identified the enemy, and he is us. There are many members of my department who would be happy to provide more teaching in reporting but their suggestions frequently conflict with others, including my own. You name it: history, use of sentences and paragraphs, brevity, terminology, impressions, etc.– each radiologists does it differently. And they all seem to feel so strongly! The survey by Sistrom et al (1) is composed of e-mails to radiology program directors. The authors might have obtained a different appreciation of the problem had their questionnaires been directed to chief residents. Harried residents want consistency in reporting not so much because they feel strongly about one style, but because each of their dictations has to be tailored to the peculiar idiosyncrasies of an individual faculty member or departmental section. Radiologists, heal thyselves. REFERENCES 1. Sistrom C, Lanier L, Mancuso A. Reporting instruction for radiology residents. Acad Radiol 2004; 11:76 – 84. 2. Hickey PM. Standardization of roentgen-ray reports. AJR Am J Roentgenol 1922; 9:442– 425. 3. Hall FM. The language of the radiology report: primer for residents and wayward radiologists. AJR Am J Roentgenol 2000; 175:1239 –1240.
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