Advertisement

Musculoskeletal radiology training in the UK: a national survey by the British Society of Skeletal Radiologists

  • D. Dalili
    Correspondence
    Guarantor and correspondent: D. Dalili, Epsom & St Helier's University Hospitals NHS Trust, Dorking Road, Epsom, Surrey KT18 7EG, UK. Tel.: +020 8296 2000.
    Affiliations
    Epsom & St Helier's University Hospitals NHS Trust, Dorking Road, Epsom, Surrey KT18 7EG, UK
    Search for articles by this author
  • J. Mackay
    Affiliations
    Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk NR4 7UY, UK

    Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK
    Search for articles by this author
  • P. Robinson
    Affiliations
    Musculoskeletal X-Ray Department, Leeds Teaching Hospitals, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK

    The NIHR Leeds Biomedical Research Centre, Leeds, UK
    Search for articles by this author
  • R. Mansour
    Affiliations
    Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals, NHS Foundation Trust, Windmill Rd, Oxford OX3 7LD, UK
    Search for articles by this author
  • on behalf ofthe British Society of Skeletal Radiologists

      Highlights

      • Core MSK radiology training remains widely variable across the UK.
      • 50% of core and 86% subspecialty trainees are satisfied with current exposure.
      • 20% of core trainees report lack of US sessions or < 4 hours of weekly US in 56%.
      • 95.5% core and all subspecialist trainees believe MSK training could be improved.
      • Other healthcare professionals competing for US experience may impact training.

      AIM

      To identify the standard of core and subspecialist musculoskeletal (MSK) training across deaneries in the UK.

      MATERIALS AND METHODS

      An online survey of 46 questions with responses in Likert scale or dichotomous formats was distributed to members of the Society of Radiologists in training, British Society of Skeletal Radiologists (BSSR), Training Programme Directors and the Royal College of Radiologists (RCR) Junior Radiology Forum representatives for national training schemes across the country. Responses were analysed descriptively with narrative analysis of free-text comments.

      RESULTS

      One hundred and seventy-eight participants completed the survey. Forty-six percent (81/178) were core trainees (ST1–3), 47% (84/178) were subspecialist trainees, and 7% (13/178) were newly qualified consultants (<2 years in post). All (178/178) of the participants had a dedicated MSK rotation, with a duration of ≥3 months in 76% (136/178). Only one-third received a dedicated period in MSK ultrasound and only 60% (107/178) had been actively involved in interventional procedures during their training. Overall, 21% (37/178) and 42% (75/178) of participants rated the quality of their MSK training as excellent and good, respectively. The majority (93%, 168/178) thought that MSK training could be improved, especially for ultrasound (62%, 110/178) and interventional computed tomography (CT) or fluoroscopy (57%, 101/178).

      CONCLUSIONS

      There are inconsistencies in MSK training offered in the UK. Although the majority of trainees are satisfied, there were gaps and potential threats to the quality of training. MSK training is witnessing substantial demand from trainees and workforce strategists necessitating tactical investments to standardise and enhance its quality.
      To read this article in full you will need to make a payment
      Subscribe to Clinical Radiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rosenkrantz A.B.
        • Hughes D.R.
        • Duszak R.
        Increasing subspecialization of the national radiologist workforce.
        J Am Coll Radiol. 2020; 17: 812-818https://doi.org/10.1016/j.jacr.2019.11.027
        • Verma N.
        • Pacini G.S.
        • Torrada J.P.
        • et al.
        Subspecialized radiology reporting: productivity and impact on the turnaround times for radiology reports in a middle-income country.
        Radiol Bras. 2020; 53: 236-240https://doi.org/10.1590/0100-3984.2019.0089
        • Snoj Ž.
        • Hebar T.
        • Sconfienza L.M.
        • et al.
        Present status of musculoskeletal radiology in Europe: international survey by the European Society of Musculoskeletal Radiology.
        Semin Musculoskelet Radiol. 2020; 24https://doi.org/10.1055/s-0040-1713119
        • Zabel A.O.J.
        • Leschka S.
        • Wildermuth S.
        • et al.
        Subspecialized radiological reporting reduces radiology report turnaround time.
        Insights Imaging. 2020; 11: 114https://doi.org/10.1186/s13244-020-00917-z
        • European Society of Skeletal Radiology
        Diploma - European Society of Musculoskeletal Radiology.
        (Available at:)
        https://www.essr.org/diploma/
        Date accessed: February 5, 2021
        • The Royal College of Radiologists
        Workforce and staffing.
        RCR, 2021 (Available at:)
        • European Society of Radiology (ESR)
        Summary of the proceedings of the International Summit 2015: general and subspecialty radiology.
        Insights Imaging. 2016; 7: 1-5https://doi.org/10.1007/s13244-015-0453-6
        • Walker R.E.A.
        • Hiemstra L.A.
        • Forster B.B.
        Musculoskeletal radiology practice subspecialization in Canada: a subject of substance?.
        Semin Musculoskelet Radiol. 2018; 22: 522-527https://doi.org/10.1055/s-0038-1673384
        • Tagliafico A.S.
        • Wilson D.
        • Sconfienza L.M.
        • European Society of Musculoskeletal Radiology (ESSR) Research Committee
        Encouraging MSK imaging research towards clinical impact is a necessity: opinion paper of the European Society of Musculoskeletal Radiology (ESSR).
        Eur Radiol. 2019; 29: 3410-3413https://doi.org/10.1007/s00330-019-06218-4
        • Rozenberg A.
        • Kenneally B.E.
        • Abraham J.A.
        • et al.
        Second opinions in orthopedic oncology imaging: can fellowship training reduce clinically significant discrepancies?.
        Skeletal Radiol. 2019; 48: 143-147https://doi.org/10.1007/s00256-018-3024-3
        • Jaspan O.
        • Wysocka A.
        • Sanchez C.
        • et al.
        Improving the relationship between confidence and competence: implications for diagnostic radiology training from the psychology and medical literature.
        Acad Radiol. 2021; 3 (S1076-6332(20)30699-1)https://doi.org/10.1016/j.acra.2020.12.006
        • The Royal College of Radiologists
        The RCR Clinical Radiology Specialty Training Curricula 2021.
        RCR, 2021 (Available at:)
        • The Royal College of Radiologists
        Clinical radiology examinations.
        RCR, 2021 (Available at:)
        https://www.rcr.ac.uk/clinical-radiology/exams
        Date accessed: February 1, 2021
        • NIHR
        • MRC
        Is my study research? Decision Tool.
        HRA, 2021 (Available at:)
        http://www.hra-decisiontools.org.uk/research/
        Date accessed: February 9, 2021
        • The Royal College of Radiologists
        Junior Radiologists’ Forum.
        RCR, 2021 (Available at:)
        • The Royal College of Radiologists
        RCR statistics on careers; specialty recruitment.
        RCR, 2021 (Available at:)
        • The Royal College of Radiologists
        The History of the Royal College of Radiologists.
        RCR, 2021 (Available at:)
        • The Royal College of Radiologists
        FRCR pass rates per module.
        RCR, 2019 (Available at:)
        • European Society of Radiology
        Training Curricula.
        (Available at:)
        • Chalian M.
        • Del Grande F.
        • Thakkar R.S.
        • et al.
        Second-opinion subspecialty consultations in musculoskeletal radiology.
        AJR Am J Roentgenol. 2016; 206: 1217-1221https://doi.org/10.2214/AJR.15.14540
        • Ciarrapico A.M.
        • Ugenti R.
        • Di Minco L.
        • et al.
        Diagnostic imaging and spending review: extreme problems call for extreme measures.
        Radiol Med. 2017; 122: 288-293https://doi.org/10.1007/s11547-016-0721-7
        • Nelson R.E.
        • Ma J.
        • Miller K.
        • et al.
        The impact of a musculoskeletal training program on residents’ recognition and treatment of osteoporosis.
        BMC Med Educ. 2019; 19: 223https://doi.org/10.1186/s12909-019-1653-4
        • Maloney E.
        • Hippe D.S.
        • Paladin A.
        • et al.
        Musculoskeletal ultrasound training for radiology residents: lecture versus interactive learning module.
        Acad Radiol. 2016; 23: 789-796https://doi.org/10.1016/j.acra.2015.11.018
        • The Royal College of Radiologists
        Ultrasound training recommendations for medical and surgical specialties Third edition.
        2017 (Available at:)
        • Berko N.S.
        • Goldberg-Stein S.
        • Thornhill B.A.
        • et al.
        Survey of current trends in postgraduate musculoskeletal ultrasound education in the United States.
        Skeletal Radiol. 2016; 45: 475-482https://doi.org/10.1007/s00256-015-2324-0
        • Silvestri E.
        • Barile A.
        • Albano D.
        • et al.
        Interventional therapeutic procedures in the musculoskeletal system: an Italian Survey by the Italian College of Musculoskeletal Radiology.
        Radiol Med. 2018; 123: 314-321https://doi.org/10.1007/s11547-017-0842-7
        • Sconfienza L.M.
        • Albano D.
        • Messina C.
        • et al.
        How, when, why in magnetic resonance arthrography: an international survey by the European Society of Musculoskeletal Radiology (ESSR).
        Eur Radiol. 2018; 28: 2356-2368https://doi.org/10.1007/s00330-017-5208-y
        • Sconfienza L.M.
        • Albano D.
        • Allen G.
        • et al.
        Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus.
        Eur Radiol. 2018; 28: 5338-5351https://doi.org/10.1007/s00330-018-5474-3
        • Plagou A.
        • Teh J.
        • Grainger A.J.
        • et al.
        Recommendations of the ESSR Arthritis Subcommittee on Ultrasonography in Inflammatory Joint Disease.
        Semin Musculoskelet Radiol. 2016; 20https://doi.org/10.1055/s-0036-1593533
        • Lalam R.
        • Bloem J.L.
        • Noebauer-Huhmann I.M.
        • et al.
        ESSR Consensus document for detection, characterization, and referral pathway for tumors and tumorlike lesions of bone.
        Semin Musculoskelet Radiol. 2017; 21: 630-647https://doi.org/10.1055/s-0037-1606130
        • Sconfienza L.M.
        • Adriaensen M.
        • Albano D.
        • et al.
        Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—Part II, elbow and wrist.
        Eur Radiol. 2020; 30: 2220-2230https://doi.org/10.1007/s00330-019-06545-6
        • Sconfienza L.M.
        • Adriaensen M.
        • Albano D.
        • et al.
        Clinical indications for image guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part III, nerves of the upper limb.
        Eur Radiol. 2020; 30: 1498-1506https://doi.org/10.1007/s00330-019-06479-z
        • Sconfienza L.M.
        • Adriaensen M.
        • Albano D.
        • et al.
        Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part I, shoulder.
        Eur Radiol. 2020; 30: 903-913https://doi.org/10.1007/s00330-019-06419-x
        • Veerasuri S.
        • Vekeria M.
        • Davies S.E.
        • et al.
        Impact of COVID-19 on UK radiology training: a questionnaire study.
        Clin Radiol. 2020; 75 (877.e7-877.e14)https://doi.org/10.1016/j.crad.2020.07.022
        • Porrino J.
        • Mulcahy M.J.
        • Mulcahy H.
        • et al.
        Emotional wellness of current musculoskeletal radiology fellows.
        Acad Radiol. 2017; 24: 682-693https://doi.org/10.1016/j.acra.2016.12.024