Historically Black Schools of Medicine Radiology Residency Programs: Contributions and Lessons Learned.

INTRODUCTION: Black radiologists remain significantly underrepresented in the radiology workforce, despite a 1973 plea by Black radiologists of the National Medical Association to increase training programs for minority radiologists. OBJECTIVE: The authors provide a qualitative narrative that highlights the radiology residency programs of three historically Black schools of medicine (HBSOM) in the U.S., their contributions, and lessons learned from their closure. METHODS: Data from public repositories, interviews, and conversations were conflated to chronicle significant events and establish a timeline during these residency programs' existence. RESULTS: Radiology residencies at Howard University School of Medicine (1945), Meharry Medical College (1949), and Charles R. Drew University of Medicine and Science (1972) were established to train Black doctors to treat communities of color. These programs provided care to underserved and under-resourced areas of the country, where inequitable health care fueled a legacy of poor health outcomes. These radiology residency programs collapsed under the weight of suboptimal funding, strapped capital budgets, attrition of faculty, a declining hospital patient census, and failure to maintain other residency specialty programs.` CONCLUSION: Understanding the history and impact of these programs, and of their closure, can be leveraged to develop strategies to increase the representation of racial and ethnic minorities in radiology. Possible reinstatement, with appropriate allocation of resources and creation of intentional policies to ensure sustained success, merits further investigation and may be a pathway to achieve optimal representation.

Systematic approach to difficult problems in breast sonography.

Although there is an increasing use of more imaging modalities in breast imaging, the role of breast sonography has not diminished--in fact, the applications of sonography have increased with the improvement of high-frequency equipment. Compared with other breast imaging modalities, current sonographic equipment has excellent spatial resolution and outstanding image contrast. Furthermore, sonography does not have the disadvantages of other modalities such as magnetic resonance imaging including exposure to intravenous contrast, higher expense, patient claustrophobia, and potential adverse contrast reaction or renal damage. The primary disadvantage of sonography is that this technique is highly operator dependent, particularly in the breast. However, if one can overcome the barrier of operator dependence, then one potentially may reduce the cost of diagnosis of breast cancers. Although many articles review sonographic appearances of solid neoplastic breast masses, relatively little attention has been directed toward subtle or confusing clinical and sonographic findings of breast cancer. This review defines methods to sonographically approach identifying vague mammographic and subtle magnetic resonance imaging lesions. Furthermore, because sonography is operator dependent, this article also involves discussing some of the pitfalls of breast sonography and how to avoid them.

Improving diversity, inclusion, and representation in radiology and radiation oncology part 2: challenges and recommendations.

The ACR Commission for Women and General Diversity is committed to identifying barriers to a diverse physician workforce in radiology and radiation oncology (RRO), and to offering policy recommendations to overcome these barriers. Part 2 of a 2-part position article from the commission addresses issues regarding diversity and inclusion in the context of career choices and professional advancement. Barriers to improving diversity and representation in RRO are reviewed. Discussion focuses on the development and implementation of concrete strategies designed to eliminate the current subspecialty disparity and highlights the need for the ACR to introduce programs and incentives with targeted and achievable goals with measurable outcomes. Recommendations are made aimed at fostering an environment of inclusion and diversity, so as to secure a successful future for all members of the RRO workforce. The future of radiology will be enhanced by increasing diversity and representation in the professional workforce, which will allow us to better address the varied needs of increasingly diverse patient populations, and to mitigate disparities in healthcare access, delivery, and outcomes. By leveraging diverse backgrounds, experiences, and skills of those in RRO, we will create new, effective ways to not only educate our trainees, medical colleagues, and patients but also improve delivery of health care and our service to society.

Improving diversity, inclusion, and representation in radiology and radiation oncology part 1: why these matter.

The ACR Commission for Women and General Diversity is committed to identifying barriers to a diverse physician workforce in radiology and radiation oncology (RRO), and to offering policy recommendations to overcome these barriers. In Part 1 of a 2-part position article from the commission, diversity as a concept and its dimensions of personality, character, ethnicity, biology, biography, and organization are introduced. Terms commonly used to describe diverse individuals and groups are reviewed. The history of diversity and inclusion in US society and health care are addressed. The post-Civil Rights Era evolution of diversity in medicine is delineated: Diversity 1.0, with basic awareness, nondiscrimination, and recruitment; Diversity 2.0, with appreciation of the value of diversity but inclusion as peripheral or in opposition to other goals; and Diversity 3.0, which integrates diversity and inclusion into core missions of organizations and their leadership, and leverages its potential for innovation and contribution. The current states of diversity and inclusion in RRO are reviewed in regard to gender, race, ethnicity, sexual orientation, and gender identity. The lack of representation and unchanged demographics in these fields relative to other medical specialties are explored. The business case for diversity is discussed, with examples of successful models and potential application to the health care industry in general and to RRO. The moral, ethical, and public health imperative for diversity is also highlighted.