E1480. Children’s Hospital Experiences: Do Timing and Prevalence of Rotations Contribute to the Shortage of Pediatric Radiologists?
Milton S. Hershey Medical Center/Penn State Health
Staten Island University Hospital; Zucker School of Medicine at Hofstra/Northwell
The University of Texas Southwestern Medical Center
The US is currently experiencing a shortage of pediatric radiologists. The need for diverse exposure to pediatric pathology often requires that these rotations take place at separate children’s hospitals. If these rotations occur later in training, affected residents are subject to less contact with pediatric radiology before choosing a fellowship. Children’s hospital rotations were likely affected by the curriculum shifts implicit to the 2014 changes in the ABR board exams which included a movement of the major written exam to the end of the PGY-4 year. This study examines the current trends of when children’s hospital rotations take place during diagnostic radiology residency training and classifies children’s hospital experience based on residency program type.
Materials and Methods:
Data regarding children’s hospital rotations were acquired from the publicly accessible ACGME database. All diagnostic radiology programs were queried, and those with children’s hospital rotations were further classified according to the number of rotations per year of training. Programs were designated as university, community, or hybrid according to the FREIDA database. The affected children’s hospitals were analyzed separately and characterized by number of diagnostic radiology residents hosted per training year. Pediatric radiology fellowship training data at children’s hospitals were obtained from the ACGME database.
Only 42% of community-based radiology programs offer a children’s hospital experience, while this proportion is 52% for university-based programs and 60% for hybrid programs. The proportion of children’s hospital rotations overall are 13% PGY-2, 37% PGY-3, 35% PGY-4, and 15% PGY-5. The average number of rotations was 0.20 PGY-2, 0.70 PGY-3, 1.10 PGY-4, and 0.20 PGY-5 for community programs, 0.22 PGY-2, 1.16 PGY-3, 1.05 PGY-4, and 0.23 PGY-5 for hybrid programs, and 0.57 PGY-2, 1.28 PGY-3, 1.00 PGY-4, and 0.60 PGY-5 for university programs. Overall, represented children’s hospitals host 4.83 radiology rotations per year with resident complements approximating relative hospital size. 38% of all 64 pediatric radiology fellows were concentrated in 3 children’s hospitals during the 2019-2020 academic year. In the 2019-2020 academic year, less than 0.3% of all diagnostic radiology rotations occurred at a children’s hospital in which more than 1 pediatric radiology fellow was in training.
Community-based radiology programs are less likely to offer a children’s hospital experience, and when they do, they take place later during residency. Residents have minimal exposure to pediatric radiology fellows during training and rarely work in children’s hospitals before their PGY-3 year. Children’s hospital rotations during PGY-5 are relatively infrequent leading to decreased mini-fellowship opportunities in pediatric radiology for diagnostic radiology residents. These factors likely contribute to the current shortage of pediatric radiologists. Stakeholders should consider a more uniform distribution of pediatric radiology experiences throughout residency.