when do we need to start cutting radiology residency spots?

IRrads10

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    Kuratz

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      Granted I'm trying to do IR but I'm excited to be in radiology. I think the future is bright regardless of what AI may bring. I would be shocked if rads were displaced in the next couple of decades. More efficient? Probably not prudent to expand residency spots and we should cut the poor quality community programs regardless. However people far more intelligent and situated than I are bullish on rads. If you are spooked you can transition to something else after intern year or hell even during residency and beyond. Come what may. Those willing to adapt will land on their feet.
       
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      Dro133

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        Before people get too ahead of themselves, these technologies need to be studied to make sure that their implementation actually improves/does not worsen outcomes. CAD was shown to improve radiologists' detection of microcalcifications in studies dating back as early as 1990. Medicare started reimbursing CAD in 2001; however, clinical trials and retrospective studies performed after the fact showed that CAD actually increased the number of breast biopsies without improving breast cancer detection rates.

        This is a great blog post on the topic: Medical AI Safety: Doing it wrong.
         
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        PCIRISH52

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          When I was an MS4 back in 2015-16, AI was just starting to surface and the hype of replacing radiologists was beginning. I too was worried and thought maybe I had made a bad choice and even started entertaining the idea of a Plan B after intern year (like IR or anesthesia or PM&R). Now I am an R2 and don't lose a wink of sleep over AI. Radiology is much more nuanced and not nearly as prone to AI takeover than I realized as a med student. Dr. Luke Oakden-Rayder's blog posts are by far the most complete and thorough assessment of medical AI I have read on the subject matter and are reassuring. If you have anxiety or fear about AI replacing radiologists read his blog posts which were linked in the previous post. I'd personally be more worried about burning out in EM at 45 than having my radiology job replaced by AI at a similar age. Just my two cents.
           
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          RadsWFA1900

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            I’m noticing a lot of residents now getting their MBAs especially at top tier rads programs. Makes sense. I mean if you go to Harvard or Stanford why not take advantage? I see it more like an exit strategy then adapting to changes in the field. I guess They figure that if clinical Rads goes to hell then next they’ll jump into management. How well that actually pans out though probably has more to do with pedigree and connections than the actual degree which is why someone at a mid or low tier program would be hard pressed for better options even with the extra credentials. But seriously the only real adaptation of Rads to the wave of AI and govt dictat is to stop training them at least until they figure where they fit in with all these new developments.
             

            vm26

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              I’m noticing a lot of residents now getting their MBAs especially at top tier rads programs. Makes sense. I mean if you go to Harvard or Stanford why not take advantage? I see it more like an exit strategy then adapting to changes in the field. I guess They figure that if clinical Rads goes to hell then next they’ll jump into management. How well that actually pans out though probably has more to do with pedigree and connections than the actual degree which is why someone at a mid or low tier program would be hard pressed for better options even with the extra credentials. But seriously the only real adaptation of Rads to the wave of AI and govt dictat is to stop training them at least until they figure where they fit in with all these new developments.


              I have a hard time seeing AI being able to distinguish between a PE versus artifact yet the world of being a MBA being totally unscathed by AI. By the time AI replaces us, they will have replaced pilots, bus/cab drivers, retail workers, pharmacists etc...Corporatization and mid-levels are more of an imminent threat to the field
               
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              Mo991

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                What really worries me is that I am a 27 years old R2, have been studying for 10 years and want to have like 30+ years career in radiology.

                30 years is a long time, and once you really think about it, a LOT will change in this timeframe.
                I agree that it will take 10 years for AI to have a significant impact, but in 15-20 years?

                It could be my OCD talking, but sometimes I think that another speciality choice (was considiring cardiology during my MS4) would have been better for me.
                 
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                cyberchicken001

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                  I worried a lot about AI in medical school when deciding on radiology. But I’m so miserable in my medicine prelim year, that I’m confident I made the right choice pursuing it regardless of what happens in the future. If radiology doesn’t exist in 15 years (which I highly doubt but hypothetically) I would rather leave medicine then do something more clinical. That’s just me personally
                   
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                  Gurby

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                    Isn't this pretty much what we expect from AI? Just like how it's learned to beat people at Chess and Go and Starcraft, it's going to be better than humans very soon when it comes to discrete problems: Is there a head bleed? How many lung nodules are there?

                    1) Humans are still going to need to over-read the AI for a long time to come purely for liability, even for those more mundane things.

                    2) In the study, AI was still consistently worse than the best radiologists... that will eventually change of course though.

                    3) I hope I don't offend breast radiologists by positing that AI is likely better suited for interpreting DM's than it would be for, say, body CT/MRI's - just my impression as a naive M2.

                    4) As technology eventually gets to the point where AI can do a reasonable job of interpreting complicated cross-sectional studies, radiologists will still be important for interpreting the AI's read. Just imagine an AI spitting out every abnormality seen on a body CT - it would be completely overwhelming and ridiculous. Clinicians will need help figuring out which findings are the most relevant and how to apply that information to patient care.

                    I think the role of radiologists is going to change a lot over the next 30 years... but I think they'll still be relevant and needed - just the role might entail less time spent counting lung nodules and more time spent being an AI shepherd / using critical thinking to work through fringe cases that stump the AI. The amount of data available and in need of interpretation is only going to continue increasing with new frontiers like radiomics opening up. Since radiology as a field is embracing AI and staying on top of it, it is more likely radiologists will be at the forefront of these changes and able to benefit from them.

                    I think the people who should really be shaking in their boots are the non-procedural IM/FM-type fields where AI-assisted midlevels could take over a lot of the bread-and-butter stuff.

                    Those are my musings as an M2 considering radiology... @Mo991 I would love to hear your thoughts on these points, as someone with much better perspective on the field than I have. Am I off the mark?
                     
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                    Radology

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                      October 2018:

                      New Study Finds No Mortality Benefit from Mammography Screening”

                      New Study Finds No Mortality Benefit from Mammography Screening



                      /crickets



                      Today: AI does as well as radiologists at screening mammography.

                      “WERE ALL GOING TO BE HOMELESS!!!”

                      2D mammography has been a worthless, outdated test since the 90s. Even over the course of time it took these guys to do this study, 3D breast tomosynthesis has taken over as standard of care in many centers.

                      What will they come after next?

                      IVP?

                      Nuclear medicine testicular torsion studies?
                       
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                      Cognovi

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                        I’m noticing a lot of residents now getting their MBAs especially at top tier rads programs. Makes sense. I mean if you go to Harvard or Stanford why not take advantage?

                        Can you name some Harvard radiology residents who got an MBA during residency? I have not heard of this.
                         
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                        Tiger100

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                          October 2018:

                          New Study Finds No Mortality Benefit from Mammography Screening”

                          New Study Finds No Mortality Benefit from Mammography Screening



                          /crickets



                          Today: AI does as well as radiologists at screening mammography.

                          “WERE ALL GOING TO BE HOMELESS!!!”

                          2D mammography has been a worthless, outdated test since the 90s. Even over the course of time it took these guys to do this study, 3D breast tomosynthesis has taken over as standard of care in many centers.

                          What will they come after next?

                          IVP?

                          Nuclear medicine testicular torsion studies?


                          Many studies have shown benefit of screening mammography and some studies have shown no benefit. Overall, it seems screening mammography saves lives.

                          I don't know the point of your post but IVP is a true outdated study unlike 3D mammograms that are being done in a large scale and save lives.
                           

                          Radology

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                            Many studies have shown benefit of screening mammography and some studies have shown no benefit. Overall, it seems screening mammography saves lives.

                            I don't know the point of your post but IVP is a true outdated study unlike 3D mammograms that are being done in a large scale and save lives.


                            I said 2d mammo is outdated
                             
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