Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Thilan P. Wijesekera

Abstract

Radiology is essential to the practice of clinical medicine, with ever-increasing volumes of diagnostic imaging studies and image-guided procedures across the U.S. healthcare system. Yet, radiology education has received criticism for its under-representation in formal U.S. medical school curricula, coupled with variable requirements and offerings among institutions. Recent national calls for medical education reform (e.g., the 2010 Carnegie report) and the emergence of new teaching tools (e.g., e-learning, simulation) have led to paradigm shifts in medical education delivery that have been further accelerated by the unprecedented alterations to educational environments catalyzed by the COVID-19 pandemic. In this landscape of profound change, numerous works have reported on curricular restructuring and innovations in radiology, extracurricular radiology educational activities, and trainee and faculty perceptions of radiology education, among other domains, at both institutional and national scales. However, there is a paucity of literature synthesizing these reports into a coherent and comprehensive illustration of the current status of radiology in American undergraduate medical education. This thesis aims to provide a state-of-the-art review of contemporary radiology education for U.S. medical students by contextualizing its historical underpinnings, highlighting key themes and trends in radiology educational practice, and anticipating future directions for continued paradigmatic evolution. This thesis follows the six-stage approach for conducting a state-of-the-art review as described in the literature. A comprehensive search was performed between September and December 2023 using five online databases: OVID Medline, Embase, ERIC, PsycInfo, and PubMed. Search strategies were developed in collaboration with an institutional librarian. Additional literature was obtained through manual exploration of article citations and education-tagged articles on radiology journal websites. 280 relevant articles were identified in the search. Subsequent thematic analysis revealed eight major trends in medical student radiology education: (1) integration of radiology into earlier phases of medical school curricula, with most schools not requiring a distinct preclinical or clinical course experience in radiology; (2) transformation of radiology clerkship and elective activities into more active, self-directed learning experiences; (3) heightened curricular emphasis on non-interpretive imaging skills; (4) incorporation of standardized radiology curricula into institutional educational activities; (5) shift to virtual radiology clerkship and elective activities during the COVID pandemic, with persistence into the post-pandemic era; (6) emergence of digital and microlearning tools supplementing formal education; (7) creation of extracurricular radiology experiential learning opportunities; and (8) discussions of radiology trainee diversity and imaging care disparities. Medical student radiology education has changed significantly in the 21st century. Understanding this shift is crucial for maintaining and reshaping medical student radiology education to meet the needs of an ever-evolving profession and society.

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This is an Open Access Thesis.

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