When USMLE Step 1 went pass/fail, the goal was to lower stress and level the playing field. Instead, it may have just moved the goalposts.

In this week's episode, Ruth Carlos, MD and Megan Worthington, MS join Maddi and Jeff to talk about how the change to pass/fail for the USMLE Step 1 examination has reshaped the residency match - especially for competitive specialties like radiology. Although the move to pass/fail was supposed to fix student stress, it instead shifted the spotlight (and pressure) to Step 2, school prestige, and the alphabet soup of rankings.

Find the JACR article here: https://pubmed.ncbi.nlm.nih.gov/40541763/

Women make up half of the medical school graduates, but only a quarter of radiology residents.

In this episode, Maddi and Jeff are joined by Amy Patel, MD and Shiva Yagobian, BS to go beyond the statistics and explore the social, institutional, and policy-level barriers that shape the "leaky pipeline" from training to leadership. Whether you're a trainee wondering where all the women in leadership are - or a department leader looking to make real, sustainable change - this episode offers both the data and the direction to help close the gap.

Find the JACR article here: https://pubmed.ncbi.nlm.nih.gov/40216284/

As health systems and radiology practices continue to consolidate, education often ends up as collateral damage.

In this episode, Charlotte Taylor, MD joins Jeff and Maddi to discuss how radiology educators can adapt - and even thrive - when clinical demands and financial pressures are rising. From incentive scorecards and creative teaching models to intentional early resource allocation to enable tailored training, this conversation explores practical, scalable ways to preserve excellence in training the next generation of radiologists.

Find the JACR article here: https://pubmed.ncbi.nlm.nih.gov/40543532/

Claim your CME here: https://shorturl.at/LVxwh

What happens when hackers meet PACS? Nothing good for patient care.

Join us this week as Maddi and Jeff get insight from Po-Hao Chen, MD, MBA and Christoph Wald, MD, PhD, MBA on their brand-new ACR-SIIM white paper on radiology cybersecurity. We will explore ransomware, downtime drills, and the unglamorous but essential world of cyberhygiene.

Read the full JACR manuscript: https://www.jacr.org/article/S1546-1440(25)00409-0/fulltext

Want more cybersecurity resources? Visit: https://www.acr.org/Data-Science-and-Informatics/Informatics/cybersecurity-resources

Do labor unions really change the residency experience - or just the perception of it?

This week, Maddi and Jeff explore radiology residents' perspectives on labor union participation with Erica Kinne, MD, Elliot Varney, MD, PhD, and Lars Grimm, MD based on their most recent research. From vacation days and housing stipends to duty hours and wellness, radiology residents weighed in on both the perks and pitfalls of unionization.

Find the original JACR article here: https://www.jacr.org/article/S1546-1440(25)00203-0/fulltext

How can multidisciplinary teams improve lung cancer screening? What are the primary barriers to lung cancer screening and how can they be addressed?

In this week's episode, Maddi and Jeff catch up with Lauren Groner, DO, MS and Rishikesh Dalal, MD, MPH about their research that used behavioral and implementation science to better understand lung cancer screening barriers and develop a strategy to increase screening rates. Their team also developed LungCheck.org to help serve as a hub of information for both providers and patients!

Claim your CME here: https://shorturl.at/6qr97

Find the JACR original article here: https://www.jacr.org/article/S1546-1440(24)00999-2/fulltext

Are radiologists following the playbook on what to do next when there is an incidental adrenal nodule on a lung cancer screening CT?

Maddi and Jeff interview Aparna Singh, MD about her new study that shows radiologists aren't exactly consistent in handling these unexpected findings - sometimes over-reacting, sometimes under-reacting, and often skipping an important lab test entirely. There is also a special guest appearance by Jared Christensen, MD, MBA and his expert insight on the S modifier.

Find the JACR original article here: https://pubmed.ncbi.nlm.nih.gov/40044307/

Inappropriate medical imaging results in low-value, excess imaging - but what about the environmental impact?

Maddi and Jeff sit down with Gregory Cavanagh, MD, Julia Schoen, MD, MS, and Elizabeth Rula, PhD to discuss how their study estimated excess green house gas emissions that are associated with inappropriate medical imaging in the Medicare Part B population from 2017 to 2021.

Find the JACR article here: https://pubmed.ncbi.nlm.nih.gov/40152841/

Get your CME here: https://cortex.acr.org/Presenters/CaseScript/CaseView?Info=RTWVsH3pWR4iYbD5FO37fw305omFBCsKOef8Wr0foV4%253d

The incidental finding of hepatic steatosis on imaging may present an avenue for opportunistic screening, leading to more efficient identification of metabolic dysfunction-associated steatotic liver disease (MASLD) and risk prediction for fibrosis. How can radiologists best facilitate this?

In this episode, Maddi and Jeff sit down with Emily Schonfeld, MD and Andrea Siobhan Kierans, MD to discuss their recent review article about recommendations for when hepatic steatosis is found on imaging and subsequent noninvasive tests to help predict overall fibrosis staging.

Find the JACR article here: https://pubmed.ncbi.nlm.nih.gov/40044315/

Have you ever wondered what additional screening measures could be implemented by utilizing information from routine CT scans?

In this episode, Maddi and Jeff were joined by Soterios Gyftopoulos, MD, MBA, FACR and Casey Pelzl, MPH to discuss their research about how simple, opportunistic CT bone density screening could transform bone health and healthcare spending.

Find the JACR article here: https://www.jacr.org/article/S1546-1440(24)00837-8/fulltext

The Merit-Based Incentive Payment System (MIPS) is the largest pay-for-performance program that links reimbursement to performance of Medicare clinicians. How have radiologists performed under this program and are there certain predictors of success? In this episode, Maddi and Jeff are joined by YoonKyung Chung, PhD and Lauren Nicola, MD to discuss their findings about radiologists' performance under the 2019 MIPS program and they also gain valuable insight from the experts.

Find the JACR article here: https://www.jacr.org/article/S1546-1440(25)00055-9/fulltext

Join us for the last installment of this three part series about re-imagining the radiology residency! In this episode, Fatima Elahi, DO guest co-hosts with Maddi and Jeff to discuss RadDiscord, which is a free educational digital community that allows equalized access to high-quality education. Available to medical students, radiology residents, as well as attending physicians, the platform allows access to case conferences, crowd-sourced Anki decks, and a supportive community.

Link to RadDiscord: https://www.raddiscord.org/

Claim your CME here: https://cortex.acr.org/Presenters/CaseScript/CaseView?Info=wQDhaBanwKm1w3DGH9WrXdv9Thf1LcnhMqXIoSk5Hqk%253d

Part 2 of Revamping the Radiology Residency! Fatima Elahi, DO joins Maddi and Jeff again to discuss competency-based education and its feasibility for real-world adoption in residencies. Priscilla Slanetz, MD, MPH, FACR gives her insight regarding metrics and standardized radiology residency curricula to enable a competency-based education that is time independent.

Find the JACR articles here: https://pubmed.ncbi.nlm.nih.gov/39612973/

https://pubmed.ncbi.nlm.nih.gov/39612972/

Claim your CME here: https://cortex.acr.org/Presenters/CaseScript/CaseView?Info=bSIRxZHC2JPSCgR0CE01uLu%2fU1lCh%2b%2blG%2fLdV1V0Wj0%253d

If you could build your own radiology residency from theground up, what would be the key ingredients you would include? In this episode, Jeff and Maddi invite Fatima Elahi, DO to join them in a discussion on how they would revamp the radiology residency. They also get insights from MaryScanlon, MD and how she has adapted the radiology residency as the program director at her own institution.  She also discusses navigating challenges such as increasing personalized teaching sessions, tailoring case-based conferences, and establishing specialty residency tracks.

Find the JACR article here: https://pubmed.ncbi.nlm.nih.gov/39612972/

Claim your CME here: https://cortex.acr.org/Presenters/CaseScript/CaseView?Info=bSIRxZHC2JOduKkDvGG1zhX3MuyU7KnFQKj2%2bSwWjZo%253d

Link to the APDR Quarterly Roundtable: Customizing the R4Year https://www.youtube.com/watch?v=WIAOATY9sN4

How do academic radiology chairs view the use of artificial intelligence (AI) in practice and how do they intend on implementing it in their departments? In this episode, Jeff and Maddi catch up with Elizabeth Burnside, MD, MPH, MS and Elizabeth Morris, MD who found in their recent study that radiology chairs have high levels of optimism about implementing AI in clinical practice. Although cost was identified as an obstacle, chairs indicated that they will work to address all manner of problems ranging from "tame" to "wicked."

Find the JACR manuscript here: https://www.jacr.org/article/S1546-1440(25)00041-9/abstract

Claim your CME here: https://cortex.acr.org/Presenters/CaseScript/CaseView?Info=VNwyWkmL0wVebbDKwN8waB7s67dFj%2by%2fEMJQpIw8lDQ%253d

Now that large language models (LLMs) are widely available, how do radiology program directors view their use among residency applicants to craft their personal statements? In this episode, Maddi interviews Lars Grimm, MD, MHS, FSBI about his recent JACR publication and observations regarding the unwelcome but inevitable use of LLMs by applicants.

Find the JACR manuscript here: https://www.jacr.org/article/S1546-1440(24)00768-3/fulltext

Claim your CME credit here: https://cortex.acr.org/Presenters/CaseScript/CaseView?Info=sc0sNS4DGQwkMIf7LIi2gQuYH6a9BSklSNJx7UBsQZA%253d

What are the projections for the radiologist workforce and imaging volumes in the future? Maddi and Jeff interview Eric Christensen, PhD and Jay Parikh, MD about their two most recent JACR manuscripts where they project future imaging utilization and the radiologist workforce through 2055. They also catch up with Matthew Phelps, MD about his accompanying commentary on ways to streamline the training process and optimize the work environment.

Find the JACR manuscripts here:

Projected US Imaging Utilization, 2025 to 2055: https://shorturl.at/GM3DM

Projected US Radiologist Supply, 2025 to 2055: https://shorturl.at/d617U

Planning for the Future: https://shorturl.at/84iRH

Does imaging price transparency impact downstream patient decision making to receive recommended care? In this episode, Jeff and Maddi interview Gelareh Sadigh, MD about her recent work entitled "Unintended Consequences of Price Transparency Initiatives: Examining Patient Decision Making in Imaging Services."

Find the JACR article here: https://www.jacr.org/article/S1546-1440(24)00831-7/fulltext

What are the overall costs to a radiology department to adequately staff multidisciplinary conferences (MDCs)? Jeff and Maddi discuss the challenges associated with MDCs despite their overall added value to patient care and management. Lindsay Stratchko, DO shares her insights based on her recent manuscript entitled "Unreimbursed Costs of Multidisciplinary Conferences to a Radiology Department: A Prospective Analysis at an Academic Medical Center."

Find the article here: https://www.jacr.org/article/S1546-1440(23)00847-5/abstract

In this bonus episode, Maddi and Jeff revisit the use of nonphysician practitioners (NPPs) in interventional radiology. Will Lindquester, MD and Matt Hawkins, MD share their perspectives as interventional radiologists regarding the increasing use of NPPs for procedures as well as the financial advantages of employing NPPs within a physician-led IR team.

Find the article here: https://pubmed.ncbi.nlm.nih.gov/38964445/