You direct the radiology elective, a course offered eight times a year to medical students in their clinical years. It currently has a waiting list that stretches into 2009. What makes it so hot?
Maybe it’s the “hot seat” approach. I call a student up to the front of the room and put her on the spot. I present a film, give her a history and ask her what she sees. Lots just point and say, There’s something over here. I want them to describe what they see in flawless medical English: There’s a 2-by-3-millimeter lobulated, calcified finding between the first and second inter-space on the right side.
But you’re not necessarily teaching future radiologists.
No, I assume I’m teaching future clinicians. I want them to know how to order exams from us, consult with us, and understand us when we give them a written report. When there’s no radiologist available, I want them to know how to handle some basic plain film.
Along with another radiologist, you do most of the plain-film reading in Emergency Medicine and the orthopedic clinic. Now, with CT and MRI, isn’t traditional imaging becoming obsolete?
Many patients move on to some sort of sophisticated cross-sectional imaging, but the gateway to diagnostic imaging is and will remain traditional radiology. It’s still the lowest-dose, cheapest, quickest way to start triaging a patient into a worry/don’t worry category.
You’ve been teaching Hopkins medical students for a decade. How would you characterize them?
Extraordinary. They’re inquisitive, interested, motivated, ethical and compassionate. They go out into the neighborhood as big brothers and sisters, tutors and teachers. They run sports clinics and screening clinics. They are the future leaders of American medicine.
You help them match with residency programs. You even co-authored Apps of Steel, a 28-page guide to the radiology match. Do they really need this much hand holding?
Yes. I am ardently devoted to advising students applying for residencies through the national match. Traditionally, it’s been a hands-off, you’ll-figure-it-out process. I’d love to see more hands-on match help and counseling for students across all the departments and subspecialties.
Why would anyone choose to specialize in radiology?
Radiology is the gateway to clinical care and diagnosis and increasingly, with all the interventional procedures, to noninvasive treatment. These are all Gen-Y kids. They were born plugged in. They’re digitally intuitive. And if you want to play with the best toys, radiology has ’em.
Students say you’re a real Baltimore booster. How so?
I came here as a medical student years ago, and I had the attitude that lots of students do: Hopkins is fabulous; too bad it’s in Baltimore. Then I found out that Baltimore is a fantastic place to live. When I started teaching, I’d come in on Monday and ask, Did you do this? Did you see that? I started e-mailing an informal newsletter to just a few students and then, with the permission of the dean and my chairman, to all students, telling them about all the strange, fun, artsy-craftsy things happening in Baltimore that weekend.
They also enjoy getting together at your house.
When I was a med student, my chief resident, John Tarpley, had us over to the old compound for a barbeque with his family. From then until I finished residency, only two other attendings ever had us over, and I decided that if I were ever in a position to do the same thing for med students, I would. So now, every month, we have a casual “rad grad” party at my house. Anyone who is taking or has taken the radiology elective can come.
But the parties and newsletters, on top of the teaching and serving as assistant director of the radiology residency, must leave time for little else.
Eventually I figured out that one need not do 100 percent of everything personally to do it effectively. In fact, off-loading to more junior people may mean it is done better. So since 2005, I’ve had a “vertical counseling” system in effect. I engage my more senior students to teach my more junior students, my junior residents to teach my senior students, and so on. Now the teaching and mentoring system is not so entirely dependent on me.
The new curriculum, due to roll out in 2009, is expected to bring together faculty from different disciplines. What does this mean for radiology?
I rolled out an embryonic version of the new radiology curriculum last November when I started teaching in the gross anatomy course for first-year students. The reality of radiology and anatomy holding hands was just so obvious that I didn’t want to wait. This way, I’ll be able to get feedback and figure out what works. By 2009, it will be a fairly polished presentation.
In this research institution, will teaching ever take its place in the sun?In his evaluation [of the radiology elective], one student wrote that this was the first time the traditional triangle—research, teaching and patient care—felt like it was equilateral, instead of isosceles. I knew exactly what that student meant, and I was very pleased to think that he perceived the important emphasis on teaching in the Department of Radiology.
—Anne Bennett Swingle