Proceedings of the 49th Annual Meeting of the Association of University Radiologists

Vol 8, No 10, October 2001

Toronto, Ontario

Proceedings of the 49th Annual Meeting of the Association of University Radiologists The 49th Annual Meeting of the Association of University of Radiologists (AUR) was held in Toronto, Canada, on May 16 –20, 2001, and was attended by over 600 registrants. The meeting was held in conjunction with the Society of Chairmen of Academic Radiology Departments (SCARD), the Association of Program Directors in Radiology (APDR), the American Association of Academic Chief Residents in Radiology (A3CR2), the Alliance of Medical Student Educators in Radiology (AMSER), the Radiology Research Alliance (RRA), the Association of Administrators in Academic Radiology and Radiation Oncology (AAARRO), and the newly formed Association of Program Coordinators in Radiology (APCR) and Association of International Academic Radiologists (AIAR). The theme for the AUR 2001 Annual Meeting was “Working Together to Lead Change and to Strengthen Academic Radiology.” The meeting’s offerings included scientific sessions, plenary sessions, society-specific sessions, the AUR Research Symposium, the Marconi-AUR Junior Faculty Development Program, the GE-AUR Radiology Research Academic Fellowship (GERRAF) Session, the Awards Ceremony, the Kay Vydareny Film Interpretation Competition, and several enjoyable social functions. Plenary Sessions Highlights Seven plenary Joint Sessions were held. The first of these was sponsored by SCARD and was entitled “ABR, RRC, ACR; Who, What and Why.” Carl E. Ravin, MD, moderated the session, and Robert R. Hattery, MD, president of the American Board of Radiology (ABR); Ronald J. Zagoria, MD, chairman of the Residency Review Committee (RRC) for Diagnostic Radiology; and Harvey L. Neiman, MD, president of the American College of Radiology (ACR) presented the mission, role, and future plans for the organizations they represented.

The RRA Symposium was moderated by N. Reed Dunnick, MD, and focused on “Attracting and Retaining Academic Faculty.” Presentations were made by Mark E. Schweitzer, MD, on “Engaging Residents in Research,” David F. Kallmes, MD, on “Research Requirements and Opportunities for Fellows,” G. Scott Gazelle, MD, MPH, PhD, on “Subsidizing Research: Pros and Cons,” and Joseph K. T. Lee, MD, on “Funding: The Chairman’s View.” The Brogdon Panel Session, sponsored by the A3CR2, discussed “Reading, Reporting, and Reproducing Images: Relearning Radiology in the Digital Era,” moderated by radiology resident Kevin Duwe, MD. The panel discussants were Masoom Hadair, MD, Curtis P. Langlotz, MD, PhD, and Robert L. DeLaPaz, MD. The new AIAR plenary session discussed “The European Perspective of Academic Radiology.” The session was moderated by Gabriel P. Krestin, MD, from the University Hospital Rotterdam, the Netherlands. Presentations were given by Hans G. Ringertz, MD, from the Karolinska Institute, Stockholm, Sweden, and Adrian K. Dixon, MD, from Addensbrook Hospital, Cambridge, England. The speakers compared and contrasted the organization of academic radiology in Europe and the United States, as well as differences in radiology training programs and the radiology research environment. The AUR Research Symposium was entitled “Disease Screening with CT.” It was moderated by G. Scott Gazelle, MD, MPH, PhD, and thought-provoking presentations were made by William Black, MD, on “Screening for Lung Cancer with Helical CT,” and Thomas J. Brady, MD, on “Cardiac Imaging: Opportunities for Radiologists.” The APDR-sponsored plenary session was an Accreditation Council for Graduate Medical Education (ACGME) Symposium. David Leach, MD, executive director of the

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ACGME, presented “Outcomes,” “Institutional Requirements: How to Do an Internal Review—New Requirements and How to Implement Them,” and “How the ACGME Can Help Programs and How the ACGME and APDR Can Help Each Other.” Judith S. Armbruster, MD, executive director of the Diagnostic Radiology RRC of the ACGME, discussed “How to Prepare for an Inspection,” and included documentation tips, the new program information form, common citations and how to avoid them, things programs have done to overcome problems, and the how the RRC and the APDR can help each other. AMSER presented a three-part plenary session. The first part was entitled “The Medical School Radiology Course: Keys to Early Success,” presented by Jac D. Scheiner, MD. The second part was entitled “Incorporating Electronic Media into Medical Student Education” and was presented by Kitt Shaffer, MD, PhD, Gary L. Merhar, MD, Judith K. Amorosa, MD, and Robert A. Novelline, MD. Topics included a “Survey of AMSER Members,” “Internet Applications,” “CD-ROM Applications,” and “Instructing Students on the Management of Electronic Diagnostic Images.” Henry I. Goldberg, MD, concluded the session with a presentation on “Issues Regarding Integrated Radiology Education.” Scientific Session Highlights There were 53 oral paper presentations during the nine scientific sessions. In addition, 37 poster presentations were on display. The scientific program covered a wide range of topics including neuroimaging, body imaging and imaging science, medical student education, resident education, and education technology, as well as the GEAUR fellow presentations on various aspects of technology assessment and health services research. One scientific session was devoted entirely to education technology and was moderated by Nicholas Papanicolau, MD. Two scientific sessions were devoted exclusively to presentations by radiology residents; the session on clinical abstracts was moderated by Steven E. Seltzer, MD, and Ella A. Kazerooni, MD, and the session on

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technology abstracts was moderated by H. Dirk Sostman, MD. One scientific session was again devoted entirely to medical school education, moderated by Kitt Shaffer, MD, PhD. SCARD Highlights In addition to its plenary session, SCARD held a twopart 3-hour joint session with AAARRO. AAARRO also held a 31⁄2-hour members-only session. Part 1 of the joint session, “Productivity: Measurement, Barriers, and Solutions,” was moderated by Donald P. Harrington, MD. Speakers Ronald L. Arenson, MD, Michael J. Cortegiano, MD, N. Reed Dunnick, MD, and Robert K. Zeman, MD, discussed how to improve both productivity and measurements of productivity in academic radiology, cultural barriers to increasing productivity within academic radiology, methods for optimizing faculty work time, and the use of physician extenders and concluded with solutions for increasing productivity by using technology, including workflow improvement with picture archiving and communication systems (PACS) and with voice transcription. Part 2 was entitled “Manpower Issues: An Open Forum.” Speakers Laurie L. Fajardo, MD, and E. Stephen Amis, Jr, MD, discussed “Manpower Issues: A View from the Academic Trenches,” and “Manpower Issues: A View from the ACR,” respectively. An “Open Forum” panel discussion ensued, moderated by Laurie L. Fajardo, MD. The panelists included William J. Casarella, MD, C. Douglas Maynard, MD, Carl E. Ravin, MD, Steven E. Seltzer, MD, and Ronald J. Zagoria, MD. This was a very timely presentation with frank discussion by the speakers, panelists, and audience given the current job climate in radiology. APDR Highlights The APDR presented nine sessions, in addition to a plenary session; one session was jointly sponsored by AMSER and another by A3CR2. The first session, “Legal Responsibilities and Potential Problems of the Program Director,” was a breakfast session presented by Leonard

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Lucey, JD, associate counsel general for the ACR. The second session, a breakfast jointly sponsored with AMSER, was the first of several presentations by visiting speaker Edward M. Hundert, MD, from the University of Rochester, and was entitled “The Hidden Curriculum.” The APDR Visiting Professor lecture, “The Troubled Resident,” the APDR Visiting Professor lunchtime presentation, “Integrating Basic Sciences and the Clinical Curricula,” and the APDR Visiting Professor Workshop, “Mock Counseling Sessions and Critiques,” were all presented by Dr Hundert. A nationally recognized leader in the fields of psychiatry, ethics, and medical education, Dr Hundert is the dean of the medical school at the University of Rochester, and prior to that, served as the senior associate dean for medical education. The sixth session, “Update on Organizations,” included seven presentations. M. Paul Capp, MD, executive director of the ABR, presented “The ABR Report.” Jerome H. Arndt, MD, presented “Preventing Performance Failures.” John C. Poggio, PhD, a psychometrician, presented “The ACR Report: Psychometric Evaluation of the ACR InTraining Exam,” and Marilyn Siegel, MD, chair of the ACR Committee on Residency Training in Diagnostic Radiology, presented “Changes in the ACR Training Exam.” Theresa C. McLoud, MD, member of the ACR Committee on Cardiovascular Imaging, presented an update from the ABR/ACR/ARRS/RSNA Taskforce on Cardiovascular Imaging, entitled “Cardiovascular Task Force.” Vijay M. Rao, MD, chair of the Radiological Society of North America Research and Education Foundation Consensus Conference on New Pathways for Education Radiologists for the Future, held August 26 –27, 2000, presented a report entitled “Consensus Conference Report.” The session ended with a presentation by H. Esterbrook Longmaid III, MD, on the radiology match. The seventh session continued the theme of the APDR plenary session on the ACGME. Part 1, presented by M. Paul Capp, MD, Coralie Shaw, MD, and Jannette Collins, MD, MEd, discussed the “ABMS/ACGME Joint Initiative on Resident Evaluation: Patient Care, Medical Knowl-

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edge, Interpersonal Skills and Evaluations, Practice-based Learning and Improvement, Professionalism, and Systems-based Practice.” Ronald J. Zagoria, MD, discussed “Suggestions on How to Prepare for an ACGME Review.” Ralene Coble and Sherry Bucholz discussed “How I Prepare for an ACGME Review” from the perspective of residency coordinators in a university program and in a private practice program, respectively. The topics for the APDR Resident Issues Session were “Motivating Residents,” presented by Jannette Collins, MD, MEd, and “Remediation for Residents,” presented by Beverly P. Wood, MD. The topic of the APDR-A3CR2 joint problem-solving breakfast session was “Night and Weekend Call/Duty.” A roundtable discussion session was jointly sponsored by the APDR and AMSER. The table topics included teaching students and residents about the use of PACS; how to teach the new ACGME competencies (patient care, medical knowledge, systems-based practice, and practice-based learning and improvement); interpersonal and communication skills; professionalism; residents as teachers—teaching residents to give conferences; teaching faculty to teach at the view box; study groups; optimizing the medical student radiology rotations content and delivery; negotiating with the department chair; general learner (resident) needs assessment before call and before promotion; how APDR and ACGME can help each other; quality improvement and outcome analysis in a residency program; best Web sites for radiology residents; Internet teaching programs; marketing a residency program; staffing shortage in radiology. APCR Highlights This year the newly formed APCR held formal sessions for the first time as scheduled items at the AUR annual meeting. Nurtured by the APDR, the APCR is growing quickly and represents the coordinators behind the residency directors who are essential to the success of any diagnostic radiology residency. The first session on “What is a Coordinator?” was moderated by Dianna Ot-

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terstad, with a presentation given by Ralene Coble. Guest discussants included Jerome H. Arndt, MD, George C. Curry, MD, Jennifer Grosky, MD, and Michael Catron, MD. A problem-solving session was held, and it was moderated by Ralene Coble. Topics for discussion included credentialling, physician recruiting, and head hunters. Reports were presented by Georgia Washington on “Residency Libraries,” by Louise Marshall on “Resident Time Off,” by Julia Clark on “Medical Student Rotations,” and by Patricia Clayton on “Communications.” A3CR2 Highlights Chief residents from university and community programs throughout the country again gathered at the AUR meeting to discuss issues of common interest and to present to their peers and mentors. The department chairs and program directors take great pleasure and pride in interacting with their own chief residents at the meeting and also in meeting these future leaders in radiology from other programs. Chief residents had the opportunity to socialize among themselves, as well as with the chairs, program directors, and other meeting participants. In addition to the Brogden Panel, the A3CR2 conducted a full program of seven sessions for its members. Two film panels were held, moderated by Annabel Galva, MD, and Steven Lee, MD. The cases were selected by residents and were discussed by residents from other institutions with the goal of demonstrating the effective presentation and discussion of radiologic cases. In place of a third film panel, a new educational program took place, the A3CR2 Cardiac Imaging Tutorial. This well-attended and highly successful program was presented by Martin J. Lipton, MD, and Larry M. Boxt, MD, with the objective of introducing residents to basic and advanced cardiac imaging for clinical practice. Two problem-solving sessions were also held, both moderated by Pardeep Mittal, MD, and Deborah Steen, MD. Effective methods to deal with everyday problems of radiology resident management were discussed, and small-group sessions were held to discuss

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specific issues in depth; the small groups reported back to the group as a whole to develop consensus. Two A3CR2-sponsored breakfast sessions were held for members. The speakers, E. Stephen Amis, MD, vice chair of the ACR Board of Chancellors, and M. Paul Capp, MD, executive director of the ABR, discussed “The American College of Radiology,” and “The American Board of Radiology,” respectively. The third breakfast session was jointly sponsored with the APDR on “Night and Weekend Call/Duty.” The annual Malcolm Jones Oration was given by Carl J. Zylak, MD, and was entitled “Shadow of a Leader.” AMSER Highlights AMSER, a fairly new member of the AUR family, is an alliance of radiologists involved in the teaching of medical students. The AMSER-sponsored portion of the AUR program continues to grow and improve each year and has broadened the scope of presentations at the AUR annual meeting. In addition to the AMSER plenary session, AMSER sponsored a breakfast symposium, a problem-solving breakfast, and breakout sessions. The topic of the breakfast symposium was “Redefining Scholarship in Academic Radiology: Keys to Academic Achievement.” Speakers Wilbur L. Smith, MD, Linda Lanier, MD, Jannette Collins, MD, MEd, and Vijay M. Rao, MD, discussed “Scholarship of Integration,” “Scholarship of Application,” “Scholarship of Teaching,” and “Support for Scholarship,” respectively. The AMSER-sponsored teaching fair increased in size from the previous year, with computer stations set up to demonstrate the latest in computer-based educational and evaluation software, including PC-based and Internet sources. A two-part AMSER breakout session followed the AMSER Joint Session. Part 1, “A Workshop on How to Evaluate Medical Students in Radiology Courses,” was presented by Kevin Volkan, PhD, EdD, MPH, and Kitt Shaffer, MD, PhD. Part 2, “A Workshop on Medical Student Teaching Methods,” was presented by Beverly P. Wood, MD, Dixie Fischer, MD, and Jac D. Scheiner,

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MD. AMSER again held a problem-solving breakfast for its members to discuss educational problems; this was facilitated by Jac D. Scheiner, MD, and Henry I. Goldberg, MD. AMSER jointly sponsored two sessions with the APDR: a breakfast session on “The Hidden Curriculum,” presented by Edward M. Hundert, MD, and the roundtable sessions described in more detail under the APDR section of this text. RRA Highlights In addition to a plenary session, the RRA presented a panel discussion on research. “Finding the Time” was discussed by Felix S. Chew, MD, “Finding the Resources” was discussed by Robert F. Mattrey, MD, and “Finding the Environment” was discussed by Judy Illes, PhD. The speakers effectively communicated the complex issues surrounding the very timely and important subject of finding, developing, and maintaining time and infrastructure for research within academic radiology departments. Cosponsored Sessions The AUR program continues to incorporate not only program sessions planned by the individual associations and alliances within in the AUR, but also many sessions cosponsored by two or more groups. This collaboration among the family of AUR organizations is a highly rewarding aspect of the AUR meeting, and every group that participates gains not only from the experience of others within the organization to which they are the most closely aligned, but also from the experience of the other groups. The annual Kay Vydareny Film Interpretation Competition was again both an entertaining and an educational program, as well as a highlight of the AUR meeting. Sponsored by the AUR/SCARD/APDR/A3CR2/AMSER/ RRA, this event exemplifies the collaboration of the AUR family of associations and alliances. Departmental teams, which must include the chair, chief residents, and faculty members, competed to diagnose the 10 challenging but “fair” cases presented by Martha B. Mainiero, MD, and

Toronto, Ontario

William W. Mayo-Smith, MD, from Brown University during round 1. The top 10 finalist teams competed in round 2, with cases presented by Kyuran A. Choe, MD, and Gary L. Merhar, MD, from the University of Cincinnati School of Medicine. This year the competition was won by Duke University and accepted by Linda L. Gray, MD. Other cosponsored sessions included the APDR/ AMSER Roundtable Discussions, the APDR/AMSER Visiting Professor Breakfast, and the APDR/A3CR2 Problem-Solving Breakfast. Marconi Program Highlights The half-day Marconi-AUR junior faculty development program was again held this year. Forty junior faculty from around the country were invited to attend the program, each receiving a $1,000 stipend to defray the expenses of attending the program and the AUR meeting. Ella A. Kazerooni, MD, organized and chaired the program, and Bruce J. Hillman, MD, served as co-chair. The program began with a lunchtime presentation by Ronald L. Arenson, MD, on why academic radiology is an exciting career choice and what the future may hold for academic radiology. A series of presentations was again given, including “How to Write and Publish a Scientific Paper,” by Stanley Baum, MD, editor-in-chief of Academic Radiology, and Felix S. Chew, MD, executive associate editor of Academic Radiology. William M. Thompson, MD, discussed “How to Present to an Audience,” and Dana Davis from the RSNA Office of Research Development discussed an “Introduction to Seeking Research Funding.” Two series of concurrent smallgroup workshops were held, with participants selecting one from each session. These included “Angiography/ Interventional Radiology,” with Elvira V. Lang, MD, “Creating Digital Education Materials,” with Felix S. Chew, MD, “Laboratory Research,” with Robert F. Mattrey, MD, “Outcomes and Cost-Effectiveness,” with Curtis P. Langlotz, MD, PhD, and G. Scott Gazelle, MD, MPH, PhD, “Neuroradiology,” with Laurie A. Loevner,

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MD, and “Climbing the Ladder and Breaking the Glass Ceiling as a Female Academician,” with Etta D. Pisano, MD, and Laurie L. Fajardo, MD. After the small-group sessions, Jannette Collins, MD, MEd, discussed “Teaching and Medical Education Research,” and N. Reed Dunnick, MD, discussed “Administration: How Academic Radiology Works.” Closing remarks were made by Ella A. Kazerooni, MD. All attendees, faculty, and AUR Executive Committee members were invited to attend a social hour immediately following the program. Honors and Awards A high point of the AUR meeting is the presentation of honors and awards to our members and contributors. Steven E. Seltzer, MD, AUR president, presided over the ceremonies. The Stauffer Awards are presented to the authors of the best articles published in Academic Radiology in the previous year. In memory of Herbert M. Stauffer, MD, these awards have been presented annually since 1981. This year’s awardee for outstanding clinical research was “Thermosensitive Paramagnetic Liopsomes for Temperature Control during MR Imaging-guided Hyperthermia: In Vitro Feasibility Studies” by Sigrid L. Fossheim, PhD, and colleagues (Acad Radiol 2000; 7:1107–1115). This year’s awardee for outstanding laboratory research was “Nontraumatic Osteonecrosis: MR Perfusion Imaging Evaluation in an Experimental Model” by Satomi Kawamoto, MD, and colleagues (Acad Radiol 2000; 7:83–93). Albert A. Moss, MD, chairman of the GERRAF Board of Review, introduced four new recipients of GE-AUR Radiology Research Fellowships. They were Ruth C. Carlos, MD, from the University of Michigan (“What’s It Worth to You? The Added Value of Diagnostic Testing for Evaluating Postmenopausal Bleeding”), Stephanie K. Carlson, MD, from the Mayo Medical School (“Clinical Efficacy of a Breath-hold Monitoring and Feedback System for CT Fluoroscopy– guided Biopsy of the Chest or Upper Abdomen: Technology Assessment and Outcomes Analysis”), Christopher L. Sistrom, MD, from the Univer-

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sity of Florida (“Free Text versus Structured Format for Radiology Reports: Measuring Performance and Preference of Selected Medical Personnel in Extracting CaseSpecific Information”), and Karen A. Tong, MD, from Loma Linda University Medical Center (“Comparison of a New High-Resolution Blood-Sensitive MR Imaging Technique with MR Spectroscopy in Predicting Outcome in Adults Experiencing Severe Traumatic Brain Injury”). The 2001 AUR Memorial Award winner for the best study submitted by a resident or fellow went to Jennifer H. Park, MD, for “Comparison of Precontrast and Postcontrast Spiral CT for Assessing Interval Change in Colorectal Liver Metastases.” The Joseph E. and Nancy O. Whitley Award has been presented annually since 1991 to recognize exemplary scientific presentations on teaching in radiology. The award was given to Jannette Collins, MD, MEd, for “Teaching Noninterpretive Skills to Radiology Residents: A Collaborative Effort between the American College of Radiology and the Association of Program Directors in Radiology.” Of note, this is the third time in the past 6 years that the award has been given to Jannette Collins, MD, MEd. The A3CR2 Advisor’s Award was established in 1995 for the best scientific abstract presentation by a resident during the scientific sessions of the AUR annual meeting. This year the award was presented by Arvin Robinson to Tedric D. Boyse, MD, from the University of Michigan for “Does Medical School Performance Predict Future Radiology Resident Performance.” In addition this year, three awards were presented for the best papers presented by a resident or fellow during the scientific sessions of the annual meeting, and three awards were presented for the best scientific exhibits by a resident or fellow. These awards were made possible by a gift from Berlex Laboratories. For the paper presentations, the first place award went to Michael S. Valade, MD, from the University of Virginia Health System for “A Web-based Chest Quality Assurance Monitor.” The second place award went to George Vatakencherry, MD, from the University of Chi-

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cago Hospitals for “On-Call Errors: Are They Reproducible?”, and the third place award was given to Alexandra N. Funaki, DO, from the University of Chicago for “Previewing and Using Answer Sheets during Case-based Teaching Conferences.” For the scientific exhibit awards, the first place award was given to Lei Feng, MD, PhD, from New York Presbyterian Hospital for “Examination of Endothelial Gene Expression in Patients with Diabetes Using Molecular and Endovascular Techniques.” The second place award was given to Laura M. Fayad, MS, MD, from the ColumbiaPresbyterian Medical Center for “K Space: The Final Frontier,” and the third place award went to Paul J. McGinnis, MD, from Boston Medical Center for “Initial Experience with Virtual Magnetic Resonance Imaging of

Toronto, Ontario

the Human Brain: A Comparison of Quantitative-based Synthetic Magnetic Resonance Imaging to a Standard Clinical Protocol.” The AUR has awarded Gold Medals since 1978 to exemplary academic radiologists. This year the awards were presented to Edmund A. Franken, Jr, MD, and William M. Thompson, MD. The Gold Medal tributes were given by Wilbur L. Smith, MD, and N. Reed Dunnick, MD, respectively. The Achievement Award from the APDR was also awarded to William M. Thompson, MD. Ella Kazerooni, MD, MS University of Michigan Medical Center Ann Arbor, Mich

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