When it comes to knowing codes of ethics pertinent to their profession, radiologists and radiology trainees are largely wandering around in a darkness of their own choosing: In a recent survey, widely distributed and promoted online, more than three-quarters of rad respondents said they’ve never read the American Medical Association’s Code of Medical Ethics.

Meanwhile, more than two-thirds indicated similarly low familiarity with the ethics code published by the American College of Radiology.

The designers and conductors of the survey, David Yousem, MD, MBA, and colleagues at Johns Hopkins, further found that 57.3 percent of respondents felt their medical-school ethics education was insufficient, while 70 percent said the same of their ethics training during residency.

The American Journal of Roentgenology published the findings online June 7.

The authors emailed a link to an online questionnaire to 1,569 radiologists and rad trainees who are in a Johns Hopkins CME database. They promoted the survey via numerous blogs, social media pages and other radiology-based online outlets last autumn.

The survey drew responses from a total of 424 recipients, most but not all of whom practice in the U.S.

Just 22.8 percent said they’d read the AMA ethics code, and only 32.6 percent had read ACR’s.

Further, the authors report, ACR data show that its ethics code was downloaded 723 times in the 1-year period ending last May 31, a time frame they selected because it followed an update in the code. More than 700 downloads isn’t nothing—but the ACR has more than 38,000 members, the authors point out.

“[I]f each download was intended for review by a single person, only 1.9 percent of those 38,000 members have viewed the most recent version of the ACR Code of Ethics,” they write. “This finding highlights that many physicians do not consider ethics a critical educational subject but, rather, a personal concept based on their own perceptions.”

Calling for change in medical ethics training and education in radiology residencies, Yousem and colleagues make four recommendations.

1. Noting that the Accreditation Council for Graduate Medical Education has added a mandatory component covering business principles, the authors suggest a similar number of hours be required for learning medical ethics during residency.
2. They encourage the ACR’s Radiology Leadership Institute to come up with an updated online program dedicated to ethics. “[T]his program should be made accessible to all radiologists,” they write. “Leadership demands ethical behavior.”
3. They urge radiology subspecialty societies to create subspecialty-specific materials “with relevant case scenarios included for discussion.”
4. They ask radiology journals to do their part by publishing more ethics-oriented articles.

“Ethics education plays an essential role in building the professional character and self-understanding of physicians, both of which are fundamental qualities for establishing a safe and high-quality practice,” the authors write. “Teaching medical ethics is also justified by the high incidence of ethical misbehavior that leads to disciplinary action, malpractice, insurance fraud and the loss of physician licenses.”