In-Person Second Look During a Residency Virtual Interview Season: An Important Consideration for Radiology Residency Applicants.

RATIONALE AND OBJECTIVE: The transition to an all-virtual residency interview process, in response to the COVID-19 pandemic, has seen numerous benefits beyond applicant and program safety. These benefits include improvements in equity, access and even lowering the applicant's carbon footprint. However, a significant portion of applicants have concerns with being unable to visit a program and interact with residents and faculty in person. A second look opportunity for radiology residency applicants was developed to address applicant concerns while maintaining an equitable interview process for all. MATERIALS AND METHODS: The second look opportunity took place after our program's final rank list was completed. Second look attendees completed a 10-question online survey after completion of our program's second look to ascertain financial obstacles of attending, the importance of a second look opportunity, and reasons why applicants chose to attend. RESULTS: 24/24 (100%) of attendees completed the survey. The majority of attendees were from >100 miles away (54%). Only 21% felt that the financial burden of the second look was substantial. However, this response was more common among attendees from >100 miles away (p = 0.013). All applicants surveyed chose to attend the second look in order to see the radiology department facilities and to meet the faculty in person. All applicants agreed or strongly agreed that they learned more about the residency program through in-person discussions with residents and faculty than they were able to remotely and that the in-person second look opportunity is a valuable tool to help make an informed rank decision when interviewing virtually. CONCLUSION: The second look opportunity offers multiple benefits for applicants to help make an informed rank list decision during a virtual interview season.

Radiology residency program management post-pandemic-peak: looking down the curve and around the bend.

The three stage model set forth by the ACGME, which provides a framework for pandemic residency program management, is insufficient and could best be expanded to 5 stages to include post-pandemic-peak residency program management. Stage 4, "Increased non-COVID clinical demands," present the challenge of an increased clinical workload in the setting of social distancing while reengaging the educational mission of the residency program. In Stage 5, "Business as usual, redefined," the residency program must learn to adapt to new challenges including uncertainty surrounding the American Board of Radiology (ABR) Core examination, uncertainty in the job market, and potential diminished medical student interest in radiology. Despite these challenges, this post-pandemic environment offers tremendous opportunity to build on and enhance the residency program now and into the future.

Recover Wisely From COVID-19: Responsible Resumption of Nonurgent Radiology Services.

RATIONALE AND OBJECTIVES: Following state and institutional guidelines, our Radiology department launched the "Recover Wisely" for all nonurgent radiology care on May 4, 2020. Our objective is to report our practice implementation and experience of COVID-19 recovery during the resumption of routine imaging at a tertiary academic medical center. MATERIALS AND METHODS: We used the SQUIRE 2.0 guidelines for this practice implementation. Recover Wisely focused on a data driven, strategic rescheduling and redesigning patient flow process. We used scheduling simulations and meticulous monitoring and control of outpatient medical imaging volumes to achieve a linear restoration to our pre-COVID imaging studies. We had a tiered plan to address the backlog of rescheduled patients with gradual opening of our imaging facilities, while maintaining broad communication with our patients and referring clinicians. RESULTS: Recover Wisely followed our anticipated linear modeling. Considering the last 10 weeks in the recovery, outpatient growth was linear with an increase of approximately 172 cases per week, (R2 =0.97). We achieved an overall recovery of 102% in week 10, as compared to average weekly pre-COVID outpatient volumes. The modalities recovered as follows in outpatient volumes: CT (113%), MRI (101%), nuclear medicine including PET (138%), mammograms (97%), ultrasound (99%) and interventional radiology (106%). When compared to identical 2019 calendar weeks (May 4, 2020-July 10, 2020), the total 2020 radiology volume was 11% reduced from the 2019 volume. The reduction in total weighted relative value units was 8% in this time period, as compared to 2019. CONCLUSION: Our department utilized a data-driven, team approach based on our guiding principles to "Recover Wisely." We created and implemented a methodology that achieved a linear increase in outpatient studies over a 10-week recovery period.

COVID-19 Impact on Well-Being and Education in Radiology Residencies: A Survey of the Association of Program Directors in Radiology.

RATIONALE AND OBJECTIVES: The COVID-19 pandemic has forced rapid evolution of the healthcare environment. Efforts to mitigate the spread of the virus through social distancing and shelter-at-home edicts have unintended consequences upon clinical and educational missions and mental well-being of radiology departments. We sought to understand the impact of the COVID-19 pandemic on radiology residencies with respect to the educational mission and perceptions of impact on well-being. MATERIALS AND METHODS: This study was IRB exempt. An anonymous 22 question survey regarding the impact of COVID-19 pandemic on educational and clinical missions of residencies, its perceived impact upon morale of radiologists and trainees and a query of innovative solutions devised in response, was emailed to the Association of Program Directors in Radiology membership. Survey data were collected using SurveyMonkey (San Mateo, California). RESULTS: Respondents felt the COVID-19 pandemic has negatively impacted their residency programs. Regarding the educational mission impact, 70.1% (75/107) report moderate/marked negative impact and 2.8% (3/107) that educational activities have ceased. Regarding the pandemic's impact on resident morale, 44.8% (48/107) perceive moderate/marked negative effect; perceived resident morale in programs with redeployment is significantly worse with 57.1% (12/21) reporting moderate/marked decrease. Respondents overwhelmingly report adequate resident access to mental health resources during the acute phase of the pandemic (88.8%, 95/107). Regarding morale of program directors, 61% (65/106) report either mild or marked decreased morale. Program innovations reported by program directors were catalogued and shared. CONCLUSION: The COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the United States.

Rescheduling Nonurgent Care in Radiology: Implementation During the Coronavirus Disease 2019 (COVID-19) Pandemic.

OBJECTIVE: To meet hospital preparedness for the coronavirus disease 2019 pandemic, the Centers for Disease Control and Prevention and ACR recommended delay of all nonemergent tests and elective procedures. The purpose of this article is to report our experience for rescheduling nonemergent imaging and procedures during the pandemic at our tertiary academic institution. METHODS: We rescheduled the nonemergent imaging and procedures in our hospitals and outpatient centers from March 16 to May 4, 2020. We created a tiered priority system to reschedule patients for whom imaging could be delayed with minimal clinical impact. The radiologists performed detailed chart reviews for decision making. We conducted daily virtual huddles with discussion of rescheduling strategies and issue tracking. RESULTS: Using a snapshot during the rescheduling period, there was a 53.4% decrease in imaging volume during the period of March 16 to April 15, 2020, compared with the same time period in 2019. The total number of imaging studies decreased from 38,369 in 2019 to 17,891 in 2020 during this period. Although we saw the largest reduction in outpatient imaging (72.3%), there was also a significant decrease in inpatient (40.5%) and emergency department (48.9%) imaging volumes. DISCUSSION: The use of multiple communication channels was critical in relaying the information to all our stakeholders, patients, referring physicians, and the radiology workforce. Teamwork, quick adoption, and adaptation of changing strategies was important given the fluidity of the situation.