Challenger Medical Education Blog

December 18, 2024 Residency Newsletter

Written by Challenger Corporation | Dec 18, 2024 10:21:23 PM

  • Physician Survey
  • CME for Faculty
  • Funding Radiology Residencies
  • Transparency of Residency Programs
  • QUIZ QUESTION - Test Your Knowledge

2024 Survey of America’s Current and Future Physicians

The Physician’s Foundation conducts an annual survey of physicians, residents, and medical students' well-being. The 2024 survey highlights continued and increasing career dissatisfaction. Burnout rates have not declined since 2018. Beyond the changes in the healthcare landscape driven by the practice environment and consolidation, the report examines mental health and feelings about the future of patient care. It also includes some interesting studies on physicians' and residents' reactions to consolidation and the loss of private practice.

2024 Survey of America’s Current and Future Physicians - 2024 PDF Results Report

Hospitals Increasingly Funding Their Own Radiology Residency Positions

While it’s true that the cost of a resident will exceed $400,000 during a three-year residency, there’s an important caveat. Radiology does not require the attending physician to be present during image acquisition. However, the teaching attending must document and review every image—a process known as “over-read supervision.” For interventional radiology, the attending does need to be physically present. In radiology training, costs are somewhat offset by billing, as there is a potential efficiency gain that is unlikely to be found in other primary and acute care residency programs.

Still, the reaction of hospital systems to key specialties being slow-walked (radiology residency slot growth is likely averaging 3% compared to 15% in family medicine) has been to start funding their own programs. For instance, HCA is currently running approximately 60 of the 576 internal medicine residencies.

Hospitals Increasingly Funding Their Own Radiology Residency Positions

Booker Introduces Bill to Increase Transparency of Medical Residency Programs

More reports! Senator Cory Booker is sponsoring a bill in the Senate to require the reporting of demographic data on attrition in residency programs. The noteworthy aspect of this legislation is the proposed shift of residency data reporting requirements from the Accreditation Council for Graduate Medical Education (ACGME) to the federal Department of Health & Human Services (HHS). 

While the ACGME collects most of this data, it is not publicly accessible and does not track probation, withdrawals, dismissals, or transfers in a reportable format. However, since 2017, the ACGME has been collecting and publishing survey data on resident well-being and burnout indicators. If this bill makes it to the docket, it is expected to pass fairly easily.

Booker Introduces Bill to Increase Transparency of Medical Residency Programs

QUIZ QUESTION

20-year-old college student with prolonged productive cough and fatigue

A 52-year-old gravida 3 para 3 woman underwent abdominal hysterectomy for uterine fibroids. Her medical history is significant for 3 spontaneous vaginal deliveries in her 20s, hypertension, obesity, depression, and osteoarthritis. Past surgical history is significant for appendectomy at 20 years of age and tonsillectomy and 9 years of age. Medications include a calcium-channel blocker and selective serotonin reuptake inhibitor, along with acetaminophen as needed for arthritis pain. She does not smoke.

Following an uncomplicated surgery, she was transferred from the postanesthesia unit to the regular floor. On postoperative day 1, it was noted that her urinary output was decreasing. During each of the past 3 hours, she has voided 18 mL/hour.

Vital signs are P: 100; BP: 90/55; RR: 18; T: 99.9°F; and oxygen saturation: 99% on 3 L via nasal cannula.

On physical examination, she is awake, alert, and oriented. Lungs are clear to auscultation, and bowel sounds are hypoactive. S1 and S2 heart sounds are present. No jugular venous distension is noted. Abdomen is soft. Dressings are dry. There is decreased turgor of skin and dry mucous membranes. Laboratory results are pending.

What is the most likely etiology for the decreased urinary output?

  • ureteral obstruction
  • decreased intravascular volume
  • cardiogenic failure
  • acute hemorrhage into the abdominal compartment