AJR: Rads' interest in mammo waning

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The negative and positive views of radiology residents regarding mammography appear to be independent of time spent training in mammography or of future plans to pursue fellowship training in breast imaging, according to the results of a study published in this month's American Journal of Roentgenology.

In their assessment of the experiences and preferences of radiology residents with respect to breast imaging, Shrujal S. Baxi, MD, of the Health Outcomes Research Group within the department of epidemiology and biostatistics at Memorial Sloan-Kettering Cancer Center in New York City, and colleagues found that there may be a shortage of radiologists qualified to interpret mammography.

“Although leaders in the field are looking to graduating residents and breast imaging fellows to help address this manpower shortage, prior surveys of radiology residents have found a lack of interest in pursuing fellowships or employment in this subspecialty,” the authors said.

Between November 2007 and March 2008, the researchers surveyed radiology residents from 26 programs in New York and New Jersey, via the Fellowship and Residency Electronic Interactive Database (FREIDA). The paper-based surveys were completed by residents present during a scheduled visit at 21 of the programs and participants from the remaining five programs returned completed surveys by mail or email. The questions on the surveys focused on beliefs and attitudes toward breast imaging and breast cancer screening, as wells as plans for subspecialty training and the likelihood of interpreting mammography in the future, explained the authors. 

Of the initial 553 participating residents, 344 completed the survey, representing a response rate of 62 percent. Baxi and colleagues said that the length of time spent training in breast imaging varied from no dedicated time (37 percent), to one to eight weeks (40 percent) and to more than nine weeks (23 percent). While 97 percent of the respondents agreed that mammography is important to women's health and 85 percent of residents believed that mammography should be interpreted by breast imaging specialists, negative views regarding mammography were also observed.

According to the authors, 99 percent of respondents agreed with statements suggesting that mammography is associated with a high risk of malpractice, stress (94 percent) and low reimbursement (68 percent). Despite these opinions, however, 97 percent of respondents believed the field offers job availability, 94 percent agreed it offers flexible work schedules and 93 percent said it offers few calls or emergencies.      

The researchers reported that 93 percent of radiology residents noted that they were likely to pursue subspecialty training, and 7 percent expressed interest in breast imaging fellowships.

“For reasons including concern about malpractice litigation, job-related stress and low reimbursement, the number of radiologists choosing to interpret mammography is declining,” they wrote. “In our survey of more than 300 radiology residents in two large states, we found that residents at all levels of training shared these views regarding mammography.” 
They concluded, "The need to recruit mammography specialists to academic practice is especially critical… Systematic assessment of the plans and preferences of radiology residents can facilitate the development of strategies to attract trainees to careers in breast imaging.”