Who Is Accountable for the Milestones?

We believe that the recently introduced postgraduate radiology milestones are a sadly accurate example of the old saying, “The road to hell is paved with good intentions.” A joint initiative of the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Radiology (ABR), the milestones are intended to improve educational quality. However, our experiences and those of many of our colleagues lead us to believe that the milestones are producing more harm than good. As such, the milestone experience offers important lessons that should be lost on no educator

Pediatric Program Directors Should have an Active Presence on Twitter

For academic pediatricians, social media has become an important avenue for professional development through continuing education, professional networking, and academic collaboration. Pediatric residency program directors have recognized additional benefits of social media engagement via program promotion and resident recruitment. The novel coronavirus disease 2019 (COVID-19) pandemic and subsequent move to virtual interviews for the 2020–2021 residency interview season have created a new urgency for pediatric program directors to establish an active social media presence, primarily as a means to engage applicants and provide them with information in lieu of cancelled away rotations and in-person interviews. Twitter is a free microblogging and social networking platform that allows real-time engagement among academic pediatricians. Here, we make the case that all pediatric program directors should have an active presence on Twitter

Management of broncholithiasis

Broncholithiasis is a condition in which calcified material has entered the tracheobronchial tree, at times causing airway obstruction and inflammation. Broncholiths generally originate as calcified material in mediastinal lymph nodes that subsequently erode into adjacent airways, often as a result of prior granulomatous infection. Disease manifestations range from asymptomatic stones in the airway to life-threatening complications, including massive hemoptysis and post-obstructive pneumonia. Radiographic imaging, particularly computed tomography scanning of the chest, is integral in the evaluation of suspected broncholithiasis and can be helpful to assess involvement of adjacent structures, including vasculature, prior to any planned intervention. Management strategies largely depend on the severity of disease. Observation is warranted in asymptomatic cases, while therapeutic bronchoscopy and surgical interventions may be necessary for cases involving complications. Bronchoscopic extraction is often feasible in cases in which the broncholith is freely mobile within the airway, whereas partially-embedded broncholiths represent additional challenges. Surgical intervention is indicated for advanced cases deemed not amenable to endoscopic management. Complex cases involving complications such as massive hemoptysis and/or bronchomediastinal fistula formation are best managed with a multidisciplinary approach, utilizing expertise from fields such as pulmonology, radiology, and thoracic surgery

A Resident Perspective on Adding Value as Radiologists

During the annual 46th annual American Alliance of Academic Chief Residents in Radiology (A3CR2) meeting in New Orleans, chief residents discussed the role of residents within American College of Radiology 3.0 campaign. Our discussion was directed toward the evolving role of fourth-year radiology residents and how we might improve their training to better prepare them to add value as both leaders and radiologists. The ideas resulting from our Problem Solving session were divided into three categories: clinical presence in the wards and subspecialty clinics; visibility to clinicians and patients; and the education of medical students, residents, and advanced practice clinicians to aid in realizing the long-term goals of Imaging 3.0