Medical students who choose a radiology elective: Career decisions, motivations, and intentions

Rationale and Objectives.: A national survey of American medical students was conducted to determine the effects of taking a radiology elective. The survey also probed attitudes of students not planning a career in radiology relative to the interpretation of medical images independently of radiologists. Methods.: The names of all students taking an elective in radiology in 1993-1994 were solicited from all American medical schools. Eighty-one of 124 radiology elective programs responded, and 3872 questionnaires were returned to the 81 medical schools for delivery to the students. Approximately 25% of the questionnaires were returned, and data were derived from these. Results.: Rarely did the radiology elective influence a change (2.1%) from another specialty or primary care to radiology. Eighty-nine percent of the students sampled indicated that the elective had no effect on their decision. Of students who were undecided about their careers, 13.2% indicated that the elective changed their career choice, but 63.2% said the elective had no effect. The data revealed that there are multiple, often overlapping, reasons for a medical student not planning a career in radiology to choose a radiology elective. Most of the students (93.5%) expected to interpret radiographs or other medical images themselves and then correlate their impression with a radiologic report. However, 30% of the students planned to interpret some radiographs independently of radiologists, and another 15% expected to interpret medical images other then plain radiographs without a radiologic consultation. Conclusion.: Our data suggest that attitudes regarding interpretation of radiographs or other medical images without involvement of a radiologist are ingrained in medical students and correspond to attitudes among practicing clinicians. There is an expectation among medical students that taking a 4-week elective is useful or even necessary to independently interpret radiographs in future clinical practice. The effect of these attitudes on the cost and quality of future medical care should engender considerable concern. A basic conceptual change in the structure and content of the radiology elective is suggested.