Carol M. Rumack

Role of respiratory syncytial virus in early hospitalizations for respiratory distress of young infants with cystic fibrosis

To determine the frequency of respiratory syncytial virus (RSV) as the cause of hospitalization for acute pulmonary exacerbations in young infants with cystic fibrosis (CF), and to assess the clinical effects of RSV infections, we prospectively followed 48 children with a diagnosis of CF after identification by newborn screening. At a mean follow-up age of 28.8 months (range 5 to 59), 18 infants (38%) had been hospitalized a total of 30 times for acute respiratory distress. At the time of admission, 18 infants (60%) were less than 12 months, 8 (27%) between 12 and 24 months, and 4 more than 2 years of age. The RSV was identified in seven hospitalized infants, as determined by fluorescent antibody, immunoassay, or culture. Before admission with RSV infection, one of the seven infants had chronic respiratory signs, none had Brasfield chest x-ray scores below 20, and a previous throat culture was positive for Staphylococcus aureus in one infant. Hospitalizations were prolonged (mean duration 22 days), and were characterized by significant morbidity, with three infants (43%) requiring mechanical ventilation and five infants (71%) requiring home oxygen therapy for persistent hypoxemia at discharge. At a mean follow-up age of 26 months, these infants more frequently have chronic respiratory signs (p less than 0.01) and lower chest radiograph scores (p less than 0.05) than other CF infants. These findings demonstrate that RSV is an important cause of early acute respiratory tract morbidity in young infants with CF, and suggest the need for studying new strategies to implement early and aggressive antiviral therapy in young infants with CF.

AIUM practice guideline for the performance of an ultrasound examination of the abdomen and/or retroperitoneum

These guidelines are an educational tool designed to assist practitioners in providing appropriate radiologic care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the American College of Radiology cautions against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question.

Association of Characteristics, Deficits, and Outcomes of Residents Placed on Probation at One Institution, 2002-2012

Purpose To describe the population of residents placed on probation, identify learner characteristics associated with being placed on probation, and describe immediate and long-term career outcomes for those placed on probation as compared with matched controls. Method The authors collected data for residents at the University of Colorado School of Medicine placed on probation from July 2002 to June 2012, including postgraduate year placed on probation, deficits identified, mandated evaluation for physical and mental health, duration of probation, disability accommodations requested, and number of additional training months required. They were retrospectively compared with 102 controls matched for specialty, matriculation, and postgraduate year. Variables assessed included demographics, academic performance, license status, specialty, state board certification, and board citations. Results Of 3,091 residents, 3.3% were placed on probation (88 residents; 14 fellows). Compared with controls, those on probation were more likely to be international medical graduates, married, not Caucasian, older (all P < .001), male (P = .01), to have transferred from another graduate medical education training program, and to have taken time off between medical school and residency (all P < .001). Among those currently in practice, 53 (63.9%) were board certified compared with 93 (100%) of the controls. Placement on probation was associated with failure to graduate and lack of board certification. All 7 graduates cited by state medical boards were in the probation group. Conclusions Further research is needed to understand these associations and to determine whether changes in curricula or remediation programs may alter these outcomes.

The Disruptive Professional: Case Scenarios

This article examines certain critical aspects relating to the clinical competency of professionalism. A discussion is presented which is centered on an analysis of two fictional scenarios explored from the standpoint of a current and a former program director, an associate dean, a department chair, and a lawyer. These cases are followed by a series of questions and a legal discussion which can then be used for either individual study or group discussion.

The role of radiology in the era of compact ultrasound systems: SRU Conference, October 14 and 15, 2003.

PREAMBLE The Society of Radiologists in Ultrasound (SRU) convened its first industry conference in Chicago, Illinois, on October 14 and 15, 2003. Representatives from the SRU and the ultrasound industry met for 2 days to discuss the impact of compact ultrasound on the practice of ultrasound by radiologists. SRU participants were Robert Bree (moderator), Carol Benson, James Bowie Beverly Coleman, Barbara Hertzberg, Alfred Kurtz, Ted Lyons, John Pellerito, Phil Ralls, and Carol Rumack. Industry was represented by Peter Pellerito, Jeff Peiffer, and Nahi Hallman from General Electric; Toni Burkett and Roy Peterson from Philips; Richard Begin and Heike Seck from Siemens; Patrick Martin and Kent Mueller from Sonosite; Robert McClure from Terason; and Anil Singhal and Terry Duesterhoeft from Zonare. Pamela Kassing, Senior Director Economics and Health Policy from the American College of Radiology spoke about the economic impact of compact ultrasound. Formal lectures with active discussion were followed by SRU members adjourning into an executive session to prepare a draft statement. This was presented to the entire group on the second day and the points were discussed until a consensus was reached. Subsequently the revised draft was distributed for further comments. The following document summarizes the final opinion of the group.

35 Years of Experience From the American Association for Women Radiologists: Increasing the Visibility of Women in Radiology

Women radiologists remain in minority, unchanged for the past several decades. In 1981, the American Association for Women Radiologists (AAWR) was founded to address the problems that women radiologists were experiencing in being subordinate to male radiologists in the workplace and at the national level in organizations with respect to political power and financial compensation, as well as additional issues unique to women in radiology. The AAWR defined goals to meet the needs of women in radiology: improve the visibility of women radiologists, advance the professional and academic standing of women in radiology, and identify and address issues faced by women in radiology. AAWR efforts have included providing opportunities for career development and award recognition, hosting educational programs at national meetings, and publishing numerous manuscripts on issues faced by women in radiology. The AAWR recognizes that although there has been significant progress in the standing of women in radiology over the past 35 years, there is much room for improvement. The AAWR will continue to advocate for the needs of women in radiology.

Radiologic history exhibit: the American Association for Women Radiologists (AAWR): 25 years of promoting women in radiology.

On the 25th anniversary of the American Association for Women Radiologists (AAWR), the associations accomplishments in promoting the careers of women radiologists were reviewed. Programs that feature opportunities for women to balance their careers and their personal lives have contributed greatly to promoting networking opportunities at national meetings. Highlights of womens accomplishments in national radiology organizations underline how far women have advanced in the specialty. Future initiatives for the organization center on increasing womens involvement in recruiting and mentoring other women in radiology.

Academic Remediation: Why Early Identification and Intervention Matters

At our institution, we have developed a remediation team of strong, focused experts who help us with struggling learners in making the diagnosis and then coaching on their milestone deficits. It is key for all program directors to recognize struggling residents because early recognition and intervention gives the resident the best chance of success.

Women Don’t Ask

n What will happen if we encourage women to negotiate? WHY WOMEN DON’T ASK At theACR2015 meeting, I spoke to the members of the American Association forWomen Radiologists (AAWR) about an issue I have heard as a recurrent theme from leaders in academic medicine, specifically in radiology (Table 1). This topic came to my attention when I read about research done by Linda Babcock and Sara Laschever [1], which they summarized in a book calledWomen Don’t Ask. You might wonder why this is an issue. I believe it comes from the historical realitywomenhave experienced. They have been told, “Wedon’t accept women to our all-male colleges,” until by Harvard University in 1977 and Columbia College in 1983, which is relatively recent. Until Title IX legislation passed in 1972 [2], women rarely played on high school varsity sports teams; they were told that they were too weak and might damage their health. Even now, women are expected to wait to be asked to get married. When I finished my fellowship in pediatric radiology and was looking for a job inDenver, I was turned down by three different radiology groups. First, a private practice group refused my request to interview. The head of the search committee said, “We have 20 men in our radiology group, and we don’t want to hire any women. They get pregnant andquit.Therefore we don’t interview women.” At that time, radiology groups were already terminating women who became pregnant when working as technologists. They did not feel any pressure to

Launchpad for Onboarding New Faculty Into Academic Life

We developed a faculty professional development seminar series in order to facilitate the integration of our numerous new faculty into academics. The changing nature of the healthcare system, increasing clinical and administrative responsibility, and lack of access to senior mentors can hinder junior faculty productivity and possibly increase attrition. Given that no ready-made resources existed to address these issues we established a Professional Development Committee, developed a curriculum that covers relevant topics including promotion, mentorship, conflict management and feedback, and effective presentation of scientific data, and instituted changes iteratively based upon feedback. We used surveys from successive years of this seminar series to assess effectiveness, and our data demonstrate that our Professional Development Seminar Series was valued by its participants and that individual lectures improved from year to year. While it is too early to determine whether our efforts will lead to long-term changes in promotion success or faculty retention, our initial data are promising.