Perspectives From the RadDiscord Annual Survey: Overview of the Top Study Tools and Evaluation of Study Time and Various Resources.

RATIONALE AND OBJECTIVES: Each year, senior radiology residents take the American Board of Radiology Qualifying (Core) exam to evaluate competency. Approximately 10% of first-time examinees will fail this exam (1). Understanding factors that contribute to success will help residency program directors and trainees prepare for future exams. RadDiscord (www.raddiscord.org), an international radiology educational community, is in the unique position to evaluate different study materials and resources. The goal of this paper is to report the results from the RadDiscord survey and analyze the factors that correlate with higher exam performance and passing. MATERIALS AND METHODS: Following the February 2021, June 2021, and June 2022 exams, RadDiscord members were provided an anonymous survey, collecting information on study resources and exam scores. The collected data were analyzed using various statistical methods. Both descriptive and inferential analyses were performed. RESULTS: A total of 318 residents responded (95% passed). Significant variability in Qualifying (Core) exam performance and perceived quality of internal didactics existed between program types. Residents who did less than 2000 practice questions performed lower on the exam. The Diagnostic Radiology In-Training (DXIT) exam was the most predictive for passing and performance. Qualifying (Core) exam performance negatively correlated with study time, though certain residents did receive some benefit from study time. CONCLUSION: Many factors correlate with passing and Qualifying (Core) exam performance. Residency programs with fewer resources should consider alternative ways to support residents beyond offering study time. Residents who complete at least 2000 practice questions are more likely to pass and DXIT results can be a useful gauge to identify exam readiness.

Educational Strategies to Achieve Equitable Breast Imaging Care.

As the population of the United States becomes increasingly diverse, radiologists must learn to both understand and mitigate the impact of health disparities. Significant health disparities persist in radiologic care, including breast imaging. Racial and ethnic minorities, women from lower socioeconomic status, those living in rural areas, and the uninsured bear a disproportionate burden of breast cancer morbidity and mortality. Currently, there is no centralized radiology curriculum focusing on breast health disparities available to residents, breast imaging fellows, or practicing breast radiologists. While patient-, provider-, and system-level initiatives are necessary to overcome disparities, our purpose is to describe educational strategies targeted to breast imaging radiologists at all levels to provide equitable care to a diverse population. These strategies may include, but are not limited to, diversifying the breast imaging workforce, understanding the needs of a diverse population, cultural sensitivity and bias training, and fostering awareness of the existing issues in screening mammography access, follow-up imaging, and clinical care.

A rare cause of dysphagia due to esophageal intramural pseudodiverticulosis: a case report and review of literature.

BACKGROUND: Esophageal intramural pseudodiverticulosis is an uncommon, idiopathic disorder characterized by multiple small outpouchings protruding from the esophageal lumen. Esophageal intramural pseudodiverticulosis is associated with conditions such as gastroesophageal reflux disease and diabetes mellitus, as well as emergent complications including pneumomediastinum. The most common presenting symptom is dysphagia with associated esophageal stricture formation. While the pathogenesis of EIP has yet to be determined, it is important to bring awareness to this unique disease with distinctive diagnostic findings and treatment options. CASE PRESENTATION: In this case, we present a 62-year-old woman who suffered from dysphagia, an inability to tolerate a regular diet, and unintentional weight loss for several years prior to her diagnoses. She was diagnosed by esophagram and esophagogastroduodenoscopy to have esophageal intramural pseudodiverticulosis, complicated by severe stricture formation. Following treatment with sequential dilatation and maintenance H2-blocker therapy, she achieved significant symptomatic improvement. CONCLUSIONS: This case highlights the importance of accurate identification and treatment of an uncommon cause of dysphagia, esophageal intramural pseudodiverticulosis. Treatment includes dilatational therapy, as successfully demonstrated in our patient. Furthermore, treatment is focused on optimizing medical management, as demonstrated in our patient with the addition of an H2-blocker for GERD, or addressing potentially serious underlying causes, such as carcinoma, with surgery.

Benign Metastasizing Leiomyoma.

Benign metastasizing leiomyoma is a rare diagnosis in women with history of uterine leiomyomata. Distant metastasis may occur anywhere but is most commonly seen to the lungs. The age of presentation is often young to mid age, with patients often having a history of hysterectomy or myomectomy for uterine leiomyomata. The clinical course of these patients is most often indolent. However, the size and number of nodules can result in pulmonary symptoms. Differentiating benign metastasizing leiomyoma from malignant metastatic disease, including from leiomyosarcoma, is important to avoid unnecessary procedures or delayed treatment. The treatment with hormonal suppression is often successful for decreasing the size of lesions and alleviating pulmonary symptoms.

Identifying Gaps and Inconsistencies in Urogynecologic Surgical Training of Obstetrics and Gynecology Residents.

OBJECTIVE: This study aims to determine the expectations of Obstetrics and Gynecology (ObGyn) residency and Female Pelvic Medicine & Reconstructive Surgery (FPMRS) fellowship program directors (FPDs) for the independent performance of urogynecologic procedures during residency and to compare these expectations with the Council on Resident Education in Obstetrics and Gynecology (CREOG) educational objectives. MATERIALS AND METHODS: Two parallel, anonymous surveys were distributed simultaneously to all directors of accredited ObGyn residency and FPMRS fellowship programs in the United States. Respondents provided their own professional and program demographic information and indicated whether they expected their residents to independently perform 27 selected urogynecologic procedures. RESULTS: Among residency program directors (RPDs) and FPDs, the online survey response rate was 24.8% (n = 59) and 51.9% (n = 27), respectively. More RPDs expected residents to perform prolapse procedures with mesh, including laparoscopic sacrocolpopexy, all apical suspensions, mesh excisions, and cystotomy repairs, than FPDs. In addition, RPDs expected mastery of most urogynecologic procedures by the Post Graduate Year 3 level, whereas most FPDs did not expect independent performance of these procedures during residency at all. There were notable differences between RPDs' expectations and CREOG objectives regarding several surgical procedures. Whereas CREOG recommends independent performance of anterior and posterior repair, vaginal suspension, vaginal hysterectomy, and transobturator slings, a significant number of RPDs did not report expecting mastery of these procedures during residency. Approximately 30% of RPDs expected residents to perform open sacrocolpopexy and vesicovaginal fistula repair, whereas CREOG recommends only the understanding of these, without procedural mastery. CONCLUSIONS: Although community needs vary by region and setting, CREOG objectives serve as the standard for resident surgical education. This study highlights the discordance between these objectives and ObGyn RDPs' reported expectations for resident performance as well as those held by FPMRS FPDs, the outcome of which reflects a misalignment in graduate medical education between RPDs and FPDs, thus hindering a clear standard for resident surgical competencies.