ACR Bulletin

Covering topics relevant to the practice of radiology

A Century of Excellence

The ACR has empowered radiologists through peer recognition and professional development over the past 100 years.
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The Education Center is unique in that it simulates our work environment while providing individualized feedback.

—Lori Deitte, MD, FACR
February 21, 2023

As medical technologies have advanced and healthcare systems have evolved over the past century, the learning curve for physicians has heightened. To keep radiologists on the leading edge of the inevitable changes and challenges they encounter, the ACR has developed a unique space for professional excellence and growth since its inception in 1923 — achieving its mission of “empowering members to serve patients and society by advancing the practice and science of radiological care.”

What started as an honorary group of physicians committed to upholding the position of radiology in the medical field soon developed into an organization dedicated to advancing the quality of care provided by the specialty. Naturally, the College began to put an emphasis on education — not just in the medical aspects of the field but also in the role radiology plays in society. The quest to be the best was on, and it continues today.

“As radiologists, we are continuously learning,” says Lori Deitte, MD, FACR, chair of the ACR Commission on Publications and Lifelong Learning since 2018. “Anytime there are new imaging modalities, techniques, protocols or guidelines, it requires a new or updated set of knowledge and skills. That’s why education is such an important part of what the ACR provides. We are supporting and empowering radiologists throughout their careers from medical students to residency, through fellowship and practice, into retirement.”

The ACR’s educational continuum has matured over the past century as new programs have been added to empower a rapidly changing profession. All along, the College has committed to serving members without duplicating the educational programs of other radiological societies — distinguishing itself as a world leader in radiology training.

“Although the College’s role in education has not historically been its primary mission during its first 100 years, it has been extremely important at providing unique educational offerings,” says Brad Short, ACR vice president of governance and membership services.

From residency training programs to “practice simulator” learning environments and continuing education, the College has developed new ways to offer members what they need — when,
where and how they need it.

“The ACR’s current educational programs are unique in both their content and their delivery platforms,” says the College’s CEO, William T. Thorwarth, MD, FACR.

Here’s a look at some of the ACR’s most impactful educational offerings that continue to lead the radiology profession.

Reaching Globally

Starting in the early 1900s, the Armed Forces Institute of Pathology (AFIP) played a pivotal role in teaching residents the correlation between radiologic imaging and underlying pathologic findings. From its humble beginnings as the U.S. Army Medical Museum in 1862, it branched out from a case collection into education and opened to civilians in 1920. The institute launched formal training programs following World War II. Virtually all radiology residency programs in the country were soon sending residents to the AFIP’s Radiologic Pathology Correlation Course (known as “rad-path”).

But when the military’s Base Realignment and Closure Commission mandated the disbanding of the AFIP in 2005 to cut costs, the ACR stepped up to ensure the rad-path course wouldn’t be lost as a casualty of the cutbacks. In January 2011, the popular four week course was re-established as the ACR Institute for Radiologic Pathology (AIRP®) — maintaining the program’s longstanding legacy, bolstered by the ACR’s strong technological infrastructure.

“We felt strongly that this was a vital component to the education of residents, and the ACR was the natural organization to continue it,” says Mark D. Murphey, MD, FACR, who served as the chief
of musculoskeletal imaging at the AFIP from 1993 to 2010, then spearheaded the transition to the AIRP, where he now serves as physician-in-chief. “We recognized the value of helping radiologists limit their differential diagnoses to improve patient care and lessen medical costs by avoiding additional tests.”

With the requirement that residents submit cases from their own institutions, the AIRP has amassed a massive database of more than 90,000 pathology-proven cases that lay the groundwork for this
renowned training. Historically, an estimated 90% to 95% of all U.S. radiology residents attend the course, which averages approximately 1,500 students each year. International students make up at least 20% of this volume because the program has expanded its reach around the globe.

“It’s very valuable to have a common educational curriculum that almost everyone experiences,” says Jamie Marko, MD. He attended the course at AFIP during his residency in 2010, then got more involved in the AIRP during his fellowship before becoming the section chief of genitourinary imaging in 2020 and associate physician-in-chief in 2021. “Many radiologists describe their time at the AIRP as one of the most important parts of their residency training because it equips them to do less memorizing and more understanding. As we move toward more interdisciplinary care, knowing more than just the imaging — knowing the basis of the disease — allows us to speak the same language as other physicians and participate better in that care.”

Many radiologists describe their time at the AIRP as one of the most important parts of their residence training because it equips them to do less memorizing and more understanding.

—Jamie Marko, MD

Simulating Radiology in Practice

To bridge the gap between classroom learning and real-life practice, the ACR extended its training programs over time to give radiologists more hands-on experience interpreting images. The opening of the ACR Education Center in 2008 provided real-world simulation by leveraging the technologies and PACS workstations that radiologists use every day.

“The Education Center offers the only courses I’m aware of that closely simulate what radiologists do in practice,” says Murphey. “You have your own workstation and full-blown DICOM® images to
evaluate, interposed with lectures from renowned faculty.”

With a limited faculty-to-student ratio of 10:1, the Education Center offers plenty of personalized feedback and unparalleled opportunities to learn firsthand from experienced radiologists. Offering a range of courses focused on various areas of clinical practice, the curriculum is designed to teach practical mid-career radiology skills and techniques by sharing emerging clinical information through one-on-one guidance.

“The Education Center provides a unique hands-on experience that simulates image interpretation at the workstation with individualized feedback,” Deitte says. “Being able to apply what you’ve learned to clinical practice is critical to providing the best possible patient care as imaging evolves.”

When the COVID-19 pandemic paused in-person courses in the spring of 2020, the Education Center started producing virtual micro-courses consisting of pre-recorded lectures and faculty case review sessions. Since on-site programs resumed in September of 2022, the Education Center has continued to offer virtual courses along with in-person training to provide extensive case-based experience.

Equipping Leaders

While radiologists receive ample clinical training throughout medical school, residency and other educational programs, they also need non-interpretive skillsets to navigate increasingly complex practice environments. To fill this gap, in 2012 the ACR launched the Radiology Leadership Institute (RLI®), the first program dedicated to professional development and leadership training for radiologists.

Unlike earlier iterations of radiology leadership training previously offered specifically for practice leaders, the RLI adopted a mantra of “leadership for everyone” to empower radiologists with critical business skills at all career levels.

“Whether you’re a resident, a mid-career radiologist or an experienced leader, all radiologists have a role to play in the future success of their practice or department and the specialty,” says Anne Marie Pascoe, senior director of the RLI. “Our goal is to help radiologists understand the business and financial world in which they operate and provide the skills and resources needed to build strong teams, manage change and deal with challenging work situations.”

Designed by radiologists for radiologists, the RLI curriculum covers non-interpretive skills encompassing finance and economics, ethics and professionalism, strategic planning and effective communication — all within the context of radiology.

More than 9,000 radiologists had participated in the RLI by the time it celebrated its 10th anniversary in 2022. As practice environments continue to shift, Pascoe says, leadership skills will become increasingly critical.

“The healthcare landscape has changed so much in just the past 10 years,” she says. “Reimbursements and other requirements have changed the way radiologists work, as they move toward more team-based care and into C-suites and committees. The RLI is going to be a lasting hallmark of the ACR because it’s filled a gap and given radiologists the tools to give the best care to their patients as part of a cohesive team.”

Building a Community

The ACR’s educational continuum spans a wide spectrum of resources for medical students, residents, practicing radiologists, technologists, radiation oncologists and other physicians. Ongoing
training such as CME sessions at the ACR Annual Meeting, Continuous Professional Improvement self-assessments, Case in Point® files emailed to members daily and lung cancer and breast
imaging educational programs keep radiology on the forefront of a rapidly changing medical landscape.

As valuable as these training programs are from a purely educational standpoint, the benefits transcend the curriculum. Networking opportunities surround the ACR’s learning environment,
connecting members from different practice areas, career stages and backgrounds. “Those connections can be as important as the knowledge gained,” Deitte says.

The AIRP, for example, unifies residents from all over the world. “It’s probably the only area in medicine where residents from across the country uniformly attend the same program,” Murphey says. “The professional networking that occurs here is unmeasurable. It’s not just listening to lectures; it’s the interaction with colleagues — being able to ask, ‘Is that the way you do it at your institution?’ — that provides so much value.”

These connections and networking opportunities comprise the shared experience of education that keeps radiologists at the top of their field, fostering in them a love of lifelong learning.

“The only way to provide the best and most up-to-date care is constant education and commitment to lifelong learning,” Marko says. “As radiologists, we have limited time to advance our knowledge, so knowing that the ACR is always going to provide high-quality educational materials makes it easier for us to become experts in our field and provide the best care possible.”

Author Brooke Bilyj  ACR Press freelance writer