National Survey to Identify Subspecialties at Risk for Physician Shortages in Canadian Academic Radiology Departments

AbstractPurposeTo identify subspecialty fields in Canadian academic radiology departments that are at risk for future manpower shortages. To determine reasons for the potential shortages and suggest potential solutions.MethodsAn anonymous online survey was sent by e-mail to radiology residents and academic radiology department heads in Canada. The survey was open from April 1 to August 1, 2006. Statistical analysis by using the SAS Frequency Procedure was performed on the results.ResultsInterventional radiology, neuroradiology, mammography, cardiac imaging, and pediatric radiology were identified as areas in which there will be increasing workforce demands. Mammography, pediatric radiology, and cardiac imaging were identified as areas in which there will be a potential decrease in supply. Of the residents, 65.83% intended on pursuing subspecialty training. Priorities were interesting work, job availability, and work schedule. Nuclear medicine, mammography, pediatric radiology, and interventional radiology were identified as the top 4 areas in which residents specifically did not want to pursue further subspecialty training. Only 15% of resident respondents received career counseling during residency, and only 50% of those residents thought it was adequate.ConclusionsOur survey results indicate that mammography, cardiac imaging, and pediatric radiology are at risk for manpower shortages, and interventional radiology may be at risk. Increased efforts to recruit trainees may be necessary to ensure that these subspecialties maintain their presence in the future. Only 15% of the surveyed residents received career counseling during residency. This is a relatively untapped forum that academic staff could use to help recruit new trainees into these underserved subspecialties

Identification of tumor size as the only factor associated with non-diagnostic biopsies in patients with small renal masses

Introduction: As greater numbers of small renal masses (SRMs) are discovered incidentally, renal tumor biopsy (RTB) is an increasingly recognized step for the management of these lesions, ideally for the prevention of surgical overtreatment for benign disease. While the diagnosis can often be obtained preoperatively by RTB, indeterminate results create greater difficulty for patients and clinicians. This study examines a series of RTBs, identifying the portion of these that were able to yield a diagnosis, and correlates patient factors, including RENAL and PADUA scoring, with the outcome of a non-diagnostic result.&#x0D; Methods: Patients were identified as having undergone RTB at the Princess Margaret Cancer Centre in Ontario, Canada, between January 2000 and December 2009. Data was compiled from these 423 patients and analyzed using CART methodology to determine the level of association between various patient and tumor factors and the outcome of a non-diagnostic biopsy. Tumor size was further used to develop a classification tree to describe the prediction of a non-diagnostic biopsy.&#x0D; Results: Of these 423 patients undergoing RTB, 66 (16%) resulted in a non-diagnostic biopsy. The only patient or tumor factor that was found to be associated with a non-diagnostic outcome was mass size, where small masses (&lt;1.28 cm diameter) were found to have a 38% chance of being non-diagnostic, compared with a 13% chance in those tumors &gt;1.28 cm diameter (86% accuracy, 95% confidence interval [CI] 0.82–0.89).&#x0D; Conclusions: When evaluating SRMs for diagnostic workup, mass size is the only tumor or patient characteristic associated with a non-diagnostic RTB.</jats:p